bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of different household food security assessment methods in the rural area of a Brazilian city
Authors: Dutra Luiza Veloso , Morais Dayane de Castro , Santos Ricardo Henrique Silva , Franceschini Sylvia do Carmo Castro , Priore Silvia Eloiza
Published: April 2019

Aim: To evaluate and compare household food security situations in the rural area of a Brazilian city by three different methods: Availability of food energy at home, nutritional status and Perceptionof food insecurity. Methods: Cross-sectional study of 79 families living in 19 rural communities in a small city in Minas Gerais, Brazil, including a total of 272 residents. Families were selected by drawing lots, respecting the proportionality of families per community. The inclusion criteria included living in rural areas, inhabiting a selected household, and using food products available for consumption, by purchase and production. During family visits, nutritional status was analyzed by anthropometry, the perception of food insecurity by Food Insecurity Scale (EBIA) and availability of food energy at household for 30 days. Results: Of the 79 families of family farmers, 12.7% were considered to be unsafe for availability of food energy at household, 24.0% due to the presence of low weight at the household and 49.5% by EBIA. There was a low correlation among the methods, with differences between them (Kendall W 0.162 p <0.001). Food insecurity was associated to the presence of at least one individual aged less than 18 years old in the household. Food security classified according to EBIA was associated with an increase in the number of people living in the household, the production of vegetables and fruits. Conclusions: No single indicator can coverseveral dimensions of food security. Food Security involves a broad and multifaceted approach; therefore, its thorough evaluation requires different classification methods.
Application of an Innovative Drilling Simulator Set Up to Test Inhibitive Mud Systems for Drilling Shales
Authors: Konate Nabe , Ezeakacha Chinedum Peter , Salehi Saeed , Mokhtari Mehdi
Published: April 2019

Wellbore instability is caused by the radical change in the mechanical strength as well as chemical and physical alterations when exposed to drilling fluids. A set of unexpected events associated with wellbore instability in shales account for more than 10% of drilling cost, which is estimated to one billion dollars per annum. Understanding shale-drilling fluid interaction plays a key role in minimizing drilling problems in unconventional resources. The need for efficient inhibitive drilling fluid system for drilling operations in unconventional resources is growing. This study analyzes different drilling fluid systems and their compatibility in unconventional drilling to improve wellbore stability.

A set of inhibitive drilling muds including cesium formate, potassium formate, and diesel-based mud were tested on shale samples with drilling concerns due to high-clay content. An innovative high-pressure high temperature (HPHT) drilling simulator set-up was used to test the mud systems. The results from the test provides reliable data that will be used to capture more effective drilling fluid systems for treating reactive shales and optimizing unconventional drilling.

This paper describes the use of an innovative drilling simulator for testing inhibitive mud systems for reactive shale. The effectiveness of inhibitive muds in high-clay shale was investigated. Their impact on a combination of problems, such high torque and drag, high friction factor, and lubricity was also assessed. Finally, the paper evaluates the sealing ability of some designed lost circulation material (LCM) muds in a high pressure high temperature environment.
Transient Multiphase Analysis of Well Trajectory Effects in Production of Horizontal Unconventional Wells
Authors: Tran Ngoc , Karami Hamidreza
Published: April 2019

The effects of horizontal well geometry remain debatable in most production modeling works. Most of recent reports fail to mention the effects of well geometries, especially in severe slugging cases. This study presents a qualitative comparison between different well geometries and their impacts in production performance of horizontal wells.

The study utilizes a transient multiphase simulator to mimic the production from a horizontal well over a 12-hour period. The well has a 2-7/8″ ID tubing with TVD of approximately 5000 ft and MD of 10000 ft and maximum inclination angle of 10º within the horizontal section. The trajectories of horizontal section in the well include 5 cases, 5 undulations, hump (one undulation upward), sump (one undulation downward), toe-up and toe-down. These configurations are the representative examples of horizontal wells. A reservoir with a given deliverability equation and several perforation stages is used to provide well inflow. The impacts of reservoir deliverability, GOR, pressure and temperature are studied for all well geometries.

The simulation results offer some valuable insights into the effects of well trajectory on production performance, including borehole pressure profile, liquid holdup, gas and liquid rate variations with time, and cumulative gas and liquid production. At high production rates, severe slugging is not observed, and thus, the well geometry effects are minimized with a consistent production at the surface. However, toe-up configuration exhibits a slightly better performance than the others.

As the productivity and pressure reduces throughout the life of a well, the impacts of well trajectories become clearer. The presence of severe slugs and blockage of perforations near the toes causes a noticeable drop in production. During severe slugging, the pressure profile reveals longer fluctuation cycles, resulting in extreme separator flooding issues. The slugging frequencies are compared among different well geometries. Toe-down case exhibits lower slugging severity. As a result, toe-down well produces the highest cumulative liquid and gas rates. The presence of liquid blockage is observed in lateral and curvature sections. The toe-up and hump configurations exhibit the most severe slugs with minimum cumulative gas and liquid productions. The differences in productions among well trajectories exceed 30% under different well configurations.

With the augmented growth of production from unconventional reservoirs, horizontal well technology has grown in oil and gas industry, yet study of well geometry in production system remains to be limited. This study is a unique effort to optimize well configuration and perforation placement in order to alleviate multiphase flow problems in the wellbore. Providing the practical potential on simulation works, this study provides a predictive guidline to connect well geometry selection and production optimization.
Detecting influenza and emerging avian influenza virus by influenza and pneumonia surveillance systems in a large city in China, 2005 to 2016
Authors: Guo Xiaorong , Yang Dong , Liu Ruchun , Li Yaman , Hu Qingqing , Ma Xinrui , Li Yelan , Zhang Heng , Zhang Xixing , Zhao Benhua , Chen Tianmu
Published: April 2019

Background: Detecting avian influenza virus has become an important public health strategy for controlling the emerging infectious disease. This study aimed to analyze the efficiency of two surveillance systems in detecting the emerging avian influenza viruses.
Methods: A modified influenza surveillance system (ISS) and a new built pneumonia surveillance system (PSS) have been used to monitor the viruses in Changsha City, China. The ISS is based on monitoring outpatients in two sentinel hospitals to detect mild influenza and avian influenza cases, and PSS is based on monitoring inpatients in all 49 hospitals to detect severe and death influenza cases.
Results: During the study period, 3551917 outpatients were monitored by the ISS system, among which 126076 were influenza-like illness (ILI) cases, with the ILI% of 3.55%. Totally, 14913 throat swabs were collected by the ISS system, among which 2016 were tested positive of influenza or avian influenza virus. Among the positive results, 621 were H3N2, 135 were seasonal H1N1, 610 were influenza A/H1N1 (pandemic in 2009), 106 were untyped influenza A, 540 were B, 1 was H5N6, 1 was H7N9, and 2 were H9N2 virus. 5491560 inpatient people were monitored by the PSS system, among which 6.61% (362743/5491560) were pneumonia cases. 10.55% (38260/362743) of reported pneumonia was severe or death cases. 3401 throat swab or lower respiratory tract samples were collected, among which 2094 were tested positive of influenza or avian influenza virus. Among the positive results, 78 were H3N2, 17 were seasonal H1N1, 1871 were influenza A/H1N1, 103 were untyped influenza A, 16 were B, 1 was H5N6, and 8 were H7N9 virus. Of 15 avian influenza cases reported from January, 2005 to September, 2016, 26.7% (4/15) were mild cases detected by the ISS system, while 60.0% (9/15) were severe or death cases detected by the PSS system. Two H5N1 severe cases were missed by the ISS system in January, 2009 when the PSS system was not available.
Conclusion: The two systems seem to be of high efficiency in detecting the emerging avian influenza viruses but need to be verified in other cities or countries.
The effect of implementing an aseptic practice bundle for anaesthetists to reduce postoperative infections. Protocol for a stepped wedge, cluster randomised, multi-site trial. The Anaesthetists Be Cleaner (ABC) Study.
Authors: Merry Alan F , Gargiulo Derryn , Bissett Ian , Cumin David , English Kerry , Frampton Christopher , Hamblin Richard , Hannam Jacqueline , Moore Matthew , Reid Papaarangi , Roberts Sally , Taylor Elsa , Mitchell Simon J
Published: April 2019

Background

Postoperative infection is a serious problem in New Zealand, and internationally with considerable human and financial costs. Also, in New Zealand, certain factors that contribute to postoperative infection are more common in Māori and Pacific populations. To date, most efforts to reduce postoperative infection have focused on surgical aspects of care and on antibiotic prophylaxis, but recent research shows that anaesthesia providers may also have an impact on infection transmission. These providers sometimes exhibit imperfect hand hygiene and frequently transfer the blood or saliva of their patients to their work environment. In addition, intravenous medications may become contaminated while being drawn up and administered to patients. Working with relevant practitioners and other experts, we have developed an evidence-informed bundle to improve key aseptic practices by anaesthetists with the aim of reducing postoperative infection. The key elements of the bundle are the filtering of compatible drugs, context-relevant hand hygiene practices, and enhanced maintenance of clean work surfaces.

Methods

We will seek support for implementation of the bundle from senior anaesthesia and hospital leadership and departmental “champions”. Anaesthetic teams and recovery room staff will be educated about the bundle and its potential benefits through presentations, written material, and exemplar videos. We will implement the bundle in operating rooms where hip or knee arthroplasty or cardiac surgery procedures are undertaken in a five-site, stepped wedge, cluster randomised, quality improvement design. We will compare outcomes between approximately 5,000 cases before and 5,000 cases after implementation of our bundle. Outcome data will be collected from existing national and hospital databases. Our primary outcome will be days alive and out of hospital to 90 days, which is expected to reflect all serious postoperative infections. Our secondary outcome will be the rate of surgical site infection. Aseptic practice will be observed in sampled cases in each cluster before and after implementation of the bundle.

Discussion

If effective, our bundle may offer a practical clinical intervention to reduce postoperative infection and its associated substantial human and financial costs.

Trial registration

Australian New Zealand Clinical Trials Network Registry: ACTRN12618000407291
ETIOLOGICAL VERIFICATION OF TUBERCULOSIS IN CASE OF SYSTEM INFLAMMATORY SYNDROME IN HIV PATIENTS
Authors: Vladimirov K. B. , Marfina G. Yu. , Karaseva E. V. , Damadanov B. D. , Zhuravlev V. Yu.
Published: April 2019

The objective: to study the efficacy of etiological verification of tuberculosis in case of systemic inflammation syndrome in HIV patients. Subjects and methods. 116 HIV patients were examined; all of them were admitted to hospital due to systemic inflammatory syndrome (SIS). In order to diagnose tuberculosis, clinical, bacteriological, and instrumental examinations were performed. Specimens of venous blood were used for the detection of tuberculous mycobacteria by RT-PCR and culture. Results. More than half (64.6%) of cases of systemic inflammatory syndrome in the examined HIV patients was due to tuberculosis onset. The degree of immunity suppression (considering CD4 count) in SIS patients with tuberculosis onset and various HIV-associated pathologies was not statistically significantly different. The frequency of MTB DNA detection by RT-PCR in venous blood in case of verified tuberculous sepsis (non-academic term) in TB/HIV patients made 29.3%, and taking into account positive results of blood culture in 5 patients with no MTB DNA found in the blood, the efficiency of diagnosis of tuberculosis in blood specimens reached 33.3%, while efficiency of blood cultures for MTB made 36.0%, with 100% specificity. Repeated PCR tests and blood cultures performed in some patients allowed increasing the total efficiency of blood tests.
THE SURGICAL STAGE OF PULMONARY TUBERCULOSIS TREATMENT USING MOLECULAR-GENETIC METHODS TO TEST SUSCEPTIBILITY TO RIFAMPICIN
Authors: Golovnin A. V. , Khanin A. L. , Golovnin V. I.
Published: April 2019

The objective of the study: to analyze the frequency and patterns of drug resistance of Mycobacterium tuberculosis (MTB) according to the results of microbiological tests of surgical specimens of the patients who underwent surgery due to tuberculosis, and to compare them with the results of sputum tests done in the pre-operative period. Subjects and methods. The data of surgical specimens from 170 patients operated due to tuberculosis were analyzed. The surgical specimens were sent for histological and microbiological tests (detection of MTB DNA and rifampicin resistance by GeneXpert, culture on solid media with drug sensitivity testing). Results. The molecular genetic testing of surgical specimens by GeneXpert was highly effective for detection of rifampicin resistance; in 97.8% of cases, there was a match with the results of sputum culture with consecutive DST performed before the surgery. Molecular genetic tests of surgical specimens allowed detecting MTB DNA in 66.1% of patients in whom no MTB or MTB DNA was detected in sputum and bronchial washings prior to the surgery, and of them in 28.2% of cases, rifampicin resistance was detected, which was unknown before the surgery. These data allowed prescribing adequate chemotherapy immediately after surgery.
THE SAFETY OF TREATMENT OF MULTIPLE DRUG RESISTANT TUBERCULOSIS IN HIV POSITIVE PATIENTS RECEIVING ANTIRETROVIRAL THERAPY
Authors: Degtyareva S. Yu. , Beloborodova E. N. , Pokrovskaya A. V. , Klimova Yu. A. , Viktorova I. B. , Zimina V. N.
Published: April 2019

The review analyzed the studies and meta-analyses devoted the treatment of multiple drug resistant tuberculosis in combination with antiretroviral therapy as a possible risk factor of adverse events and the worst outcomes of therapy. In total, the analysis included 18 sources from the Russian and English databases. Most of the studies did not reveal a confident relation between the simultaneous use of antiretroviral and anti-tuberculosis therapy with second line drugs and increased frequency of adverse events. At the same time, in the largest studies, as well as studies devoted to certain adverse events, the authors managed to prove the existence of such a connection. Data on the structure of adverse events also significantly differed in the results obtained by various authors. Most trials were conducted in African countries with a high prevalence of HIV infection.
Application of polymeric membranes for the purification of solutions containing cationic surfactants
Authors: Klimonda A. , Kowalska I.
Published: April 2019

The aim of the study was to examine physicochemical properties of three cationic surfactants and to evaluate the effectiveness of their removal with the use of polymeric membranes. The experiments were performed in a laboratory scale set-up with the use of Microdyn-Nadir® nanofiltration and ultrafiltration membranes. Cetrimonium bromide (CTAB), benzalkonium chloride (BAC) and Tequat LC90i (TEAQ) were chosen for the test. In the experiments, surfactant solutions in a wide range of concentration were treated (50–3,000 mg L−1). The experimental research included evaluation of the effect of membrane type and solution parameters (surfactant type and concentration, presence of inorganic compounds) on the process efficiency (retention coefficient and permeate flux). It was shown that surfactant removal by means of the pressure-driven membrane processes is an extensive issue and its efficiency depends on many factors. Ultrafiltration and nanofiltration membranes proved to be usable in CTAB removal (separation exceeded 90%); however, the process effectiveness was affected by surfactant concentration, membrane polymer type and membrane pore size. Separation obtained for BAC was on the lower level – the use of nanofiltration membranes brought maximum retention of 70%. TEAQ separation was very high and reached 100% with the use of ultrafiltration membranes. Mineral salt addition led to significant drop in surfactant retention.
Determination of the velocity potential of liquid with weakly nonspherical bubbles located in line
Authors: Aganin A.A. , Davletshin A.I.
Published: April 2019

The efficiency of the method of reflections and the method of expansion in terms of spherical functions is investigated in determining the potential of the velocity of liquid with two or more weakly-nonspherical bubbles. The bubble centers are on a straight line, which is the axis of symmetry of the problem.
Hydrodynamics and heat transfer of a two-phase gas-liquid flow in fuel assemblies
Authors: Kashinsky O.N. , Pribaturin N.A. , Lobanov P.D. , Kurdyumov A.S. , Randin V.V.
Published: April 2019

A study was carried out of the hydrodynamics and heat transfer of two-phase flow in the main elements of the heat-exchange circuits of a nuclear power plant: axisymmetric annular channel and an assembly of vertical rods. The features of the distribution of the gas phase in the section of the working sections of the setup were studied. The dependences of the frictional stress and the heat transfer coefficient are obtained for various flow rates of liquid and gas. The interaction of one- and two-phase flows with barriers that overlap a portion of the cross-section of the channels by a spacer grid in the rod assembly and a partition covering 25% of the cross section of the annular channel is considered. The obtained data can be used for verification of modern computational codes.
Features of the dynamics of the heavy bubble magma state in explosive volcanic eruptions
Authors: Kedrinskii V.K.
Published: April 2019

The explosive eruption of a volcano that occurs when a volcanic canal is suddenly depressurized is one of the mysterious phenomena of nature, the mechanism of which is associated with the sudden decompression of a high-pressure magma containing dissolved gas and microcrystallites and with its transition to a multiphase state. With the obvious lack of the possibility to directly investigate these processes, the problem of experimental and numerical modeling, and creation of mathematical models that would allow describing the state of magma during various stages of eruption with a certain degree of adequacy are becoming topical. A model combining systems of equations of the mechanics of multiphase media is proposed. The model is formulated on the basis of the modified Iordansky–Kogarko–van Wijngaarden model with the Navier-Stokes equation for the variable viscosity, and the full range of kinetic relationships, including spontaneous nucleation and saturation dynamics of magma with cavitation nuclei. An analysis of a pre-explosive state of a number of volcanoes was carried out, which showed that the structural features of explosive volcanoes are analogous to the schemes of hydrodynamic shock tubes (UT), such as Glass-Heuckroth. Experimental modeling of the flow structure demonstrates the probability of the formation of the projectile regime as a consequence of coalescence of bubbles in the flow. A physical model of combined explosive volcanic eruptions is proposed; the process of formation in the magma flux of an independent flow of crystalline clusters (magmatic ”bombs“) moving with respect to the flow of cavitating magma at a much higher rate is experimentally studied.
Nonlinear oscillations of aerosol in shock-wave flow in open tube
Authors: Tkachenko L.A.
Published: April 2019

Nonlinear oscillations of aerosol in open tube in shock-free wave mode at resonance at various amplitudes of excitation are experimentally investigated. Pressure diagrams are continuous. With an increase in the excitation amplitude, the amplitude of the pressure oscillations of the medium increases. At large amplitudes, the oscillation form is close to harmonic. The numerical concentration of aerosol droplets decreases monotonically with time. This is due to the coagulation of the aerosol, which consists in the coalescence of droplets and their sedimentation on the walls of the tube, as well as the emission of the aerosol into the surrounding space. With an increase in the excitation amplitude, the dependences acquire greater curvature and the aerosol clearing time decreases. At the same time, the aerosol clearing time is 5-10 times lower than in the case of natural sedimentation.
Thin structure of heterogeneous and multiphase fluid flows
Authors: Chashechkin Yu.D.
Published: April 2019

According to the results of visualization of streams, the existence of structures in a wide range of scales is noted: from galactic to micron. The use of a fundamental system of equations is substantiated based on the results of comparing symmetries of various flow models with the usage of theoretical group methods. Complete solutions of the system are found by the methods of the singular perturbations theory with a condition of compatibility, which determines the characteristic equation. A comparison of complete solutions with experimental data shows that regular solutions characterize large-scale components of the flow, a rich family of singular solutions describes formation of the thin media structure. Examples of calculations and observations of stratified, rotating and multiphase media are given. The requirements for the technique of an adequate experiment are discussed.
Specific approach for synthesis method an information system of a multilink manipulator taking into account the specific environment
Authors: Bogdanov D.R.
Published: April 2019

The article consist specific methods of building a manipulator link on the basis of kinematically connected disks with a spherical surface, the requirements for its control system. The implementation of the information-measuring system of the manipulator is described. Preliminary results obtained during the experiments are presented.
Acceleration of molecular dynamics simulation of multiphase systems on GPU
Authors: Marin D.F.
Published: April 2019

The paper presents results on acceleration of molecular dynamics simulations with the usage of GPUs. A system of water molecules is considered as an example of polar liquid. The intermolecular interaction is modeled with the usage of Coulomb and truncated Lennard-Jones potentials. Results of computational experiments on acceleration and performance of the developed code are presented.
The relationship between organizational justice with job satisfaction and organizational citizenship behavior
Authors: Indahyati Nurul , Sintaasih Desak Ketut
Published: April 2019

This study aims to explain the effect of organizational justice on job satisfaction and organizational citizenship behavior. The technique used to test the research hypothesis used Structural Equation Modeling (SEM) analysis techniques using SMARTPLS assistance, using IBM SPSS Statistics 22, and 65 respondents in this study, taken using Purposive Sampling techniques. The results of the study show that (1) distribution justice has a positive and significant effect on job satisfaction. (2) procedural justice has a positive and not significant effect on job satisfaction. (3) interactional justice has a positive and not significant effect on job satisfaction. (4) justice distribution has a positive and insignificant effect on organizational citizenship behavior. (5) procedural justice has a positive and insignificant effect on organizational citizenship behavior. (6) interactional justice has a positive and insignificant effect on organizational citizenship behavior. (7) job satisfaction has a positive and significant effect on organizational citizenship behavior.
Successful Balloon Mitral Valvuloplasty in 21-week Pregnant Patient with Severe Mitral Stenosis: A Case Report and Literature Review
Authors: Silitonga Cynthia Yosephine , Taufiq Nahar , Setianto Budi Yuli
Published: April 2019

Mitral stenosis is the most common manifestation of rheumatic heart disease. Hemodynamic changes during pregnancy increase the burden of the heart in pregnant women with cardiac abnormalities. A 33 years old woman, G3P1A1 is 21 weeks pregnant came to our hospital with a shortness of breath during daily activity, which was worsened since 3 months of pregnancy. The patient has been diagnosed with severe mitral stenosis. The results of echocardiography examination was left atrial dilatation, normal global function and left ventricular with ejection fraction 51%, severe mitral stenosis Wilkin Score 8 with Mitral Valve area 0.53 cm2 and Mitral Valve Gradient 33 mmHg. Subsequently, Balloon Mitral Valvuloplasty was successfully performed. During and after the procedure there was no complication. The fetus was considered in stable condition.
Peningkatan Pengetahuan Faktor-Faktor yang Memengaruhi Perilaku Seks dalam Upaya Cegah Seks Pranikah pada Siswa-Siswi SMP N 77 dan SMA N 77 Jakarta Pusat
Authors: Susmiarsih Tri Panjiasih , Marsiati Himmi , Endrini Susi
Published: April 2019

ABSTRACT The premarital sex behavior is a problem and social phenomenon that is  increasingly prevalent in society. At a young age, the premarital sex should be a major concern to reduce pregnancy rates unintended, sexually transmitted diseases, school drop out, abortion and even a death. One effort to prevent the premarital sex behavior for students in schools with methods of providing knowledge about sexual behavior, reproductive health, an understanding of religious and the early marriage law. Evaluation of  indicators usingpre test and post test data that are  analyzed with paired t and regression test. The results show that after counseling, the knowledge of junior high school students about sexual behavior, reproductive health and religious knowledge increased significantly (p <0.05), while high school students of religious knowledge and early marriage law increased significantly.  Keywords: premarital sex; reproductive health; sexual behavior
Pemberdayaan Masyarakat Desa Menggunakan Badan Usaha Milik Desa: Desa Ponggok dan Kritik Terhadap Prestasi “Terbaik Nasional”
Authors: Sidik Fajar , Nasution Fatih Gama Abisono , Herawati Herawati
Published: April 2019

Penelitian ini bertujuan untuk mengeksplorasi pada salah satu Badan Usaha Milik Desa (BUM Desa)“terbaik nasional” kategori pemberdayaan masyarakat menurut pemerintah pusat, yaitu BUM Desadi Desa Ponggok, Kabupaten Klaten. Penelitian ini dilatarbelakangi masalah meningkatnya jumlahBUM Desa secara signifikan setelah kebijakan UU Nomor 6/2014 tentang Desa ditetapkan, namunbanyak BUM Desa yang belum mampu mereduksi kemiskinan desa. Pemasalahan ini dipahamimenggunakan konseptual teori hybrid institutions. Penelitian kualitatif dengan pendekatan metodestudi kasus digunakan untuk mengeksplorasi BUM Desa di Desa Ponggok. Teknik wawancara,observasi dan dokumentasi digunakan untuk mengumpulkan data primer dan sekunder. Datasekunder dan primer dianalisis menggunakan tahapan analisis data kualitatif menurut Miles danHuberman. Berdasarkan hasil ekplorasi, tim peneliti menemukan bahwa Pemerintah Desa Ponggokberhasil mentransformasikan pemberdayaan masyarakat dari berbasis komunitas menjadi BUMDesa dalam mengelola dan memanfaatkan hasil sumber daya milik bersama (desa wisata alam).Meskipun berhasil bertransformasi, fakta di akar rumput menunjukkan bahwa pemberdayaanmasyarakat yang dilakukan oleh BUM Desa sebagai hybrid institutions gagal menyentuh danmemberdayakan warga miskin.
Montemayor: Entre la ensoñación, la muerte y el gnosticismo en algunos relatos de Las llaves de Urgell y cuentos gnósticos
Authors: Montemayor Galicia Victoria María
Published: April 2019

Este ensayo realiza un análisis literario de temas como la muerte, la ensoñación y el enfrentamiento con el destino presentes en los cuentos de “De Caelo et Inferno”, “El regreso” y “La muerte de Tsin Pau” del libro Las llaves de Urgell. Así como un análisis de las alegorías de la caída y redención, aspectos de religiosidad, espiritualidad y revelación presentes en los relatos de “Persecución de demonios”, “Canto”, “Monodia” y “Danza” que se encuentran en Cuentos gnósticos. El análisis literario y retórico se realiza a partir del estudio de imágenes, metáforas, símbolos, temas y mitos presentes en los textos de acuerdo con las teorías que proponen René Wellek y Austin Warren en su libro Teoría literaria; así como una aproximación a los principales postulados del pensamiento gnóstico de acuerdo con Serge Hutin en su libro Los gnósticos
Aproximaciones a Carlos Montemayor y su quehacer narrativo
Authors: Navarro Trujillo Alejandra
Published: April 2019

Este ensayo se suma a la búsqueda de enfoques cuya inclinación es cada vez más puntual en su interés por la voz y los testimonios de los sujetos y, a su vez, se deslinda de aquellas voluntades, influidas notoriamente por lo que desde la academia señalan displicentemente como “literatura”, que esquivan la exaltación de lo vivencial y diluyen la experiencia como valor privilegiado en la construcción del sujeto social. En este sentido, por tratarse de un punto de encuentro de reflexión y análisis entre el relato, la identidad, la experiencia, el contexto y el sujeto, este ensayo está dedicado a la comprensión del quehacer narrativo de Carlos Montemayor al ser la narrativa, para él, una especie de necesidad de apropiarnos del mundo. Para lograr este cometido, el trabajo se respalda en la entrevista que Silvia Lemus le realizó a Montemayor, ensayos suyos y textos de un par de personas allegadas que escribieron sobre él y su obra. Infiero que estas vías mepermiten abordar a Montemayor en su individualidad y posibiliten rastrear el contexto, intenciones, necesidades, esperanzas, que rodearon al autor en la hechura de sus novelas, haciendo visible la vivencia, el sentido, la interpretación y la complejidad de los fenómenos que él percibió.
Hérnia de disco torácica operada por toracoscopia videoassistida
Authors: Pimenta L. H. Mattos , Zanetti O. Tella, R. , Gehter M.
Published: April 2019

Os augures apresentam seus cinco primeiros casos de hérnia de disco torácica submetidos à cirurgia pela técnica de toracoscopia videoendoscópica. Descrevemos detalhadamente os passos dessa nova técnica que permite a abordagem do disco intervertebral torácico por via ânteroo-lateral e de forma minimamente invasiva. Através de pequenos orifícios de 1 5-2 em na parede torácica são introduzidos aparelhos de visão, seccão, coagulação e aspiração que possibilitam todas as manobras antes realizadas somente a céu aberto. O resultado mais importante desse trabalho foi a recuperação mais rápida do paciente (internação de 3 a 4 dias) sem necessidade de internação em terapia intensiva com retorno precoce ao trabalho. Como complicações observamos a dor torácica pós-operatória que durou 24 a 48 h em 3 pacientes não tendo ocorrido óbito nem infecção. Por se tratar de técnica minimamente invasiva e portanto com menor morbidade relacionada ao procedimento esta cirurgia pode ser indicada mais precocemente antes de instalado déficit neurológico severo.
Comunicação de trabalho científico por meio de pôster
Authors: Gusmão Sebastião Silva , Silveira Roberto Leal
Published: April 2019

Descrevem-se as orientações básicas para a comunicação científica por meio de pôster.
Presença de radicais livres na lesão medular traumática
Authors: De Araújo Ivan Soares , Prandini Mirto Nelso
Published: April 2019

Foram estudados 24 ratos Wistar, submetidos a um modelo de compressão medular que permitisse o estudo da liberação de oxirradicais por meio de reativo óptico. Os animais foram divididos em três grupos de 8. No primeiro grupo, apenas a laminectomia foi efetuada; no segundo e terceiro, a compressão medular foi efetuada, sendo que, neste último, foi administrado um reativo óptico, o nitro azul de tetrazólio, que sofre redução na presença de radicais livres, com mudança de cor. Associadamente, procedeu-se ao estudo com microscópio óptico e eletrônico. Concluiu-se que o ânion superóxido é o mais encontrado na lesão medular; o binômio anoxia–reoxigenação é mais relevante que a chamada síndrome de reperfusão; os restos membranosos elétronluminescentes vistos à microscopia eletrônica poderiam ser o resultado sofrido pela ação dos oxirradicais nas estruturas fosfolipídicas das biomembranas.
Tratamento da siringomielia associada à malformação de Chiari
Authors: De Arruda José Arnaldo Motta , Jr. Oswaldo Inácio Tella , Evangelista Flávio Belmino Barbosa , Jr. Edson Lopes
Published: April 2019

Os autores apresentam detalhes da técnica cirúrgica empregada em 60 pacientes com siringomielia (SM) associada à malformação de Chiari (MC), operados no período de 1982 a 2000. Foi utilizada, em todos os casos, a técnica de descompressão craniovertebral com laminectomia de C1 e eventualmente de C2, tonsilectomia cerebelar e plástica de dura-máter. Nove pacientes foram submetidos à fixação occipitocervical, e em três pacientes desse grupo foi realizada a ressecção transoral do processo odontóide do áxis. A complicação cirúrgica mais freqüente foi a pseudomeningocele, que ocorreu em 23,3% dos casos. Não houve óbitos nesse grupo de pacientes operados de SM associada à MC.
Conduta terapêutica nos meningiomas em idosos
Authors: Aguiar Paulo Henrique , Jr. Oswaldo Inácio Tella , Mandel Maurício , Fontes Ricardo B. V. , Herculano Marco Antônio , Teixeira Manoel Jacobsen
Published: April 2019

Os autores avaliam as dificuldades clínicas pré-operatórias, as complicações e as condutas para o manuseio de riscos nas cirurgias de meningiomas em pacientes idosos. Foram estudados 34 pacientes de 1994 a 2002 com 65 a 86 anos de idade. Todos os casos apresentavam algum tipo de comorbidade, estando entre as mais freqüentes: insuficiência coronariana, insuficiência cardíaca congestiva, enfisema pulmonar, osteoartrose cervical, diabetes melito e artrite reumatóide do idoso. A localização mais comum foi parassagital posterior e convexidade frontal (6 casos cada). Quanto à morbidade cirúrgica, 2 casos apresentaram déficit motor permanente e 3 casos foram reabordados para descompressão devido a infarto venoso extenso por trombose de seio. Três pacientes morreram no período pós-operatório por associação entre edema cerebral por infarto venoso e complicações de ordem pulmonar. Conclui-se que a cirurgia dos meningiomas em idosos deve ser meticulosamente programada devido às co-morbidades inerentes, mas não deve ser negligenciada simplesmente em virtude da idade do paciente.
Uma avaliação sobre a problemática dos clipes de aneurismas no Brasil
Authors: Maset Angelo L. , Veiga José Carlos , Saade Nelson
Published: April 2019

Este estudo utiliza a sistemática da utilização dos clipes de aneurisma para tecer considerações sobre a metodologia de fabricação, utilização e controle de próteses no Brasil. Inicialmente, abordamos alguns aspectos das normas internacionais que regem a fabricação de clipes de aneurisma, analisando algumas características físicas e mecânicas de 600 clipes nacionais, comparando a metodologia nacional de fabricação e fornecimento com as normas internacionais. Este trabalho leva às seguintes conclusões: 1) Não existe diferença significativa entre a qualidade dos dois fabricantes de clipes nacionais testados. 2) Embora os clipes importados tenham apresentado desempenho superior, alguns detalhes de fabricação podem tornar os nacionais tão bons quanto os importados. 3) Alguns aspectos da norma ISO 9713 podem ser revistos e aplicados nas normas nacionais de produção e fornecimento de clipes e implantes em geral. 4) Para benefício de todos, quais sejam, a comunidade neurocirúrgica, a indústria nacional, a ANVISA (Agência Nacional de Vigilância Sanitária) e os agentes normatizadores (ABNT – Agência Brasileira de Normas Técnicas), recomenda-se que as sociedades brasileiras da especialidade tomem assento e participe da formulação das normas de fabricação dos materiais utilizados em neurocirurgia.
Paracoccidioidomicose de medula espinhal
Authors: Cavalcanti Carlos Eduardo , Filho Raimundo Nonato , Costa Luis César da Silva
Published: April 2019

A paracoccidioidomicose (blastomicose sul-americana) é uma micose sistêmica da América Latina. De caráter endêmico entre as populações de zona rural, a paracoccidioidomicose (PCM) acomete principalmente indivíduos do sexo masculino, entre 30 e 50 anos de idade, sendo rara a incidência abaixo de 14 anos. Sua importância em saúde coletiva está ligada aos custos sociais e econômicos derivados, não apenas da doença em atividade, que ocorre em indivíduos na fase mais produtiva de vida, como também das freqüentes seqüelas secundárias a esta micose, motivo comum de incapacitação para o trabalho. Quando não tratada, geralmente evolui para o óbito. Esta enfermidade se traduz clinicamente pelo comprometimento primário do aparelho respiratório, havendo freqüentemente lesões do fígado, baço, gânglios e orofaringe e possibilidades de envolvimento cutâneo ósseo e neurológico, sendo extremamente raro o acometimento medular.
Enfermedad Moyamoya
Authors: Marín Leonidas Quintana
Published: April 2019

En la presente revisión sobre la enfermedad Moyamoya se detallan aspectos generales relacionados con el orígen de su nombre, su epidemiología a nivel de las distintas regiones del mundo, siendo notoria su mayor frecuencia en Japón. Se mencionan aspectos asociados con su etiología, y posible base genética, y presentación de su anatomía patológica, esencialmente una endarteritis de las grandes arterias que configuran en polígono de Willis. Se tocan aspectos diagnósticos tanto clínicos, con sus 2 conocidas presentaciones isquémica en niños, y hemorrágica en adultos jóvenes, y de exámenes complementarios, que permiten su clasifi cación en distintas etapas de evolución, lo cual hace posible mencionar algunas guías para su diagnóstico. Se hace referencia a todas las posibilidades de revascularización quirúrgica intentadas en ésta patología.
Meningioma da região do forame magno
Authors: Borba Luis A. B. , Guimarães Ricardo M. R. , Moro Marlus S. , Correia Alceu , Filho Miguel Giudicissi , Holanda Carlos Vanderley
Published: April 2019

Meningiomas do forame magno estão entre os tumores mais difíceis de serem removidos. A abordagem cirúrgica, assim como a extensão da remoção óssea, são pontos de controvérsia. Neste trabalho os autores apresentam sua experiência com o tratamento cirúrgico destes tumores, a forma de abordá-los, baseada na expansão tumoral e no local de origem são os pontos fundamentais que norteiam o planejamento cirúrgico. As manifestações clínicas, assim como a morbidade mais comum relacionada com estes tumores serão apresentadas.
Experimental evaluation of 2-octyl-cyanoacrylate on dura mater healing
Authors: Holanda Maurus Marques de Almeida , De Almeida Wagner Leite , Diniz Margareth de Fátima F. M. , Marinho Segundo Luiz Márcio De Brito , De Medeiros Isac Almeida
Published: April 2019

Objective: The aim of the present study was to evaluate the effect of this synthetic glue tissue on the healing of dura mater closure in rabbits. The study was undertaken to investigate the histological and toxicological behavior of dural repair using standard suture techniques and suture supplemented with tissue adhesive. Methods: A total of 54 rabbits was divided into 9 groups of 6 animals, and then were divided equivalently into 3 groups (A, B and C), each one containing 3 sub-groups of 6 rabbits, sacrificed on days 7, 30 and 60 respectively. After 1cm parasagital craniectomy and 0.5cm dural opening, three different procedures were carried out: in group A dura mater was reinforced by using 2-octyl-cyanoacrylate, in group B biological glue (fibrin glue) was applied and in group C only the dura mater suturing was performed. The rabbits were sacrificed on specific days following the operation. Integrity of the sutures, existence of abscess, wound infection and adhesion formation were recorded. The heads were sent for histological examination. Results: The synthetic glue didn’t interfere with the metabolism of the animals. The mean weight of rabbits in groups A and B increased. Temperature did not increase and was not statistically different between the three groups (p=0.210). Dura mater healing process, as assessed by fibroblast activity and inflammatory cell infiltration, did not differ statistically between the three groups (p>0.05). Only neovascularization increased in the control group. Conclusion: Histological sections obtained from the dura mater treated with 2-octyl-cyanoacrylate polymer demonstrated minimal inflammatory response, similar to that treated with fibrin adhesive sealant. Results indicate that this new substance seems to have applications as an adjunctive means of effecting dural closure.
Alterações cognitivas associadas à síndrome de Kojewnikoff
Authors: Miotto Eliane Correa , Azevedo Cleide Lopes , Benute Gláucia R. G. , Lucia Mara C. S. , Scaff Milberto
Published: April 2019

Introdução: A síndrome de Kojewnikoff, associada ao estado de mal epiléptico (EME), também denominada de Epilepsia Parcial Contínua (EPC), é caracterizada por crises somatomotoras, com marcha jacksoniana e mioclonias que afetam a extremidade contralateral sendo o giro pré-central a principal região cerebral afetada. São raros os estudos na literatura que descrevem as alterações cognitivas destes pacientes. Objetivo: descrever o funcionamento cognitivo de uma paciente com EPC através de um protocolo de testes neuropsicológicos. Método: Foram realizadas duas sessões com duas horas de duração cada, utilizando-se para tanto, uma bateria de testes neuropsicológicos. Resultados: Os resultados da avaliação indicaram comprometimento de velocidade de processamento de informações, atenção, fluência verbal e memória episódica. Conclusão: Os resultados da avaliação neuropsicológica são compatíveis com os déficits cognitivos esperados em lesões corticais na área motora primária e com os resultados da avaliação clínica pré-existente.
The use of the cyberknife stereotactic radiosurgery system for the treatment of intracranial and extracranial residual or recurrent chordoma
Authors: Lee Marco , Lieberson Robert E. , Soltys Scott G. , Gibbs Iris C. , Adler Jr John R. , Chang Steven D.
Published: April 2019

Objectives: Chordomas are relatively rare primary malignant bone tumors that arise from remnants of the notochord along the craniospinal axis. They tend to be locally invasive around the clival or sacro-coccygeal regions and critical neurological structures are often involved. Complete surgical excision is rarely possible and post-resection radiation enhances local control of the disease. The CyberKnife is a frameless imageguided LINAC radiosurgical system that allows treatment of both intracranial and extracranial lesion. We review here the methodology of the system and present our experience of treating skull base and spinal chordomas. Methods: Between 1994 and 2008, 22 patients with a histological diagnosis of a chordoma underwent stereotactic radiosurgery (SRS) at Stanford University Hospitals. 17 patients underwent frameless SRS at the Stanford CyberKnife Center. A retrospective and prospective review of these patients was undertaken by obtaining clinical and radiological information from an institutional review board-approved prospective database. Results: There were 11 males and 6 females with an average age of 42 years (range 10-73). 12 lesions were in the clivus, 3 in the cervical spine below C2, 1 lumbar and 1 sacral region. All but one patient had prior surgery. 9 had undergone one resection, 5 had two and 2 had three resections. Three patients had prior radiation or proton beam therapy. The average tumor volume treated was 10.9 cm3 (range 1.9-31.6 cm3), with a mean radiation dose of 29.3 Gy (range 18-50 Gy), and a mean maximum intratumoral dose of 41.0 Gy (range 24.1-67.6 Gy). Patients were followed up for an average of 4 years. Tumor control was achieved in 12 out of the 17 cases (70.6%). 5 of the 12 patients showed tumor size reduction. However, 5 out of the 17 cases showed progression with one developing a new lesion at a lower cervical vertebra despite good local control. None of the patients with tumor control developed new neurological deficits, but 4 of the 5 cases with tumor progression showed worsening neurological deficits. There was no radiation associated complications. Conclusions: Good tumor control rates can be achieved with no significant morbidity with CyberKnife based stereotactic radiosurgery. Cases with poor control tended to have complexmultiple surgical resections. Longer follow-up in larger series is required to adequately compare this technique with other forms of radiation therapy.
Perfil do paciente vítima de traumatismo de crânio no sub-médio do Vale do São Francisco
Authors: De Moura José Carlos , Rocha Filho Marco Augusto Sobreira , Neto Aldo Leite Moreira , Júnior Raimundo Honorato da Silva , Câmara Fhilipe Xavier Do Sacramento , De Moura Samuel Miranda
Published: April 2019

Introdução: O traumatismo crânio-encefálico (TCE) constitui a principal causa de óbitos e seqüelas em pacientes politraumatizados. Entre as principais causas estão: quedas, acidentes motociclísticos, acidentes automobilísticos e agressões. Objetivos: Quantificação dos casos de TCE na região do sub-médio do Vale do São Francisco, qualificação dos seus fatores, além de avaliação das influências interfatoriais. Os resultados foram analisados visando uma orientação para prevenção dos TCEs na região do sub-médio do Vale do São Francisco centrada em Petrolina-PE e Juazeiro-BA. Casuística e métodos: Estudo prospectivo, transversal, descritivo, feito através da coleta de dados sobre os principais aspectos do TCE no Hospital Dom Malan, centro de referência no sub-médio São Francisco, localizado no município de Petrolina-PE, no período de 12 de agosto de 2007 a 12 de novembro de 2007. A pesquisa foi aprovada pelo comitê de ética da Universidade Federal de Pernambuco sob o protocolo número 195/07. Resultados: Dos 158 casos analisados, tem-se que 70,89% sofreram TCE leve; 18,35%, moderado; e 10,76%, grave. A faixa etária predominante foi de 21 a 30 anos, que apresentou um percentil de 29,11%. Dentre as principais causas de TCE, queda e acidente motociclístico foram as mais prevalentes apresentando, respectivamente, 32,91% e 31,01% dos casos. Conclusão: Os acidentes por queda e por motocicleta são as causas mais freqüentes de TCE no submédio do Vale do São Francisco. O consumo de álcool, o uso do capacete e do cinto de segurança figuram entre os maiores determinantes da extensão da gravidade do trauma.