bluuebunny/crossref_metadata_2025 huggingface dataset:
Khảo sát một số đặc điểm trên chẩn đoán hình ảnh và mối tương quan với tình trạng lâm sàng của hẹp ống sống cổ đa tầng: Phân tích 34 bệnh nhân
Authors: Yên Nguyễn Trọng , Bắc Nguyễn Thành , Anh Phạm Quang
Published: December 2021

Mục tiêu: Khảo sát một số đặc điểm trên X-quang, cộng hưởng từ của bệnh hẹp ống sống cổ đa tầng và xác định mối tương quan với tình trạng lâm sàng. Đối tượng và phương pháp: Hồi cứu 34 bệnh nhân hẹp ống sống cổ đa tầng có tổn thương tủy, được đánh giá tình trạng lúc nhập viện theo thang điểm JOA. Khảo sát các tham số: Góc ưỡn C2C7, tình trạng mất vững cột sống (trên X-quang quy ước), sự thay đổi tín hiệu của tủy sống trên T2W và T1W, chỉ số chèn ép (CR), tỷ lệ thay đổi ống sống tối đa (MCC), tỷ lệ chèn ép tủy tối đa (MSCC), tỷ lệ chiếm chỗ của tủy sống (SCOR) trên cộng hưởng từ. Đánh giá mối tương quan của các tham số này với điểm JOA lúc nhập viện. Kết quả: Góc ưỡn C2C7 trung bình 11,95º ± 12,30º với 32,4% có gù và 55,9% mất vững cột sống. Trên cộng hưởng từ: 91,2% tăng tín hiệu tủy trên T2W, 14,7% giảm trên T1W. Giá trị trung bình của các tham số CR, MCC, MSCC tương ứng là: 0,31 ± 0,11, 53,27 ± 13,83% và 37,67 ± 17,79%. SCOR: 54,58 ± 8,49%, với 2/34 (5,9%) có SCOR ≥ 70%. Không có sự tương quan giữa điểm JOA với sự thay đổi tín hiệu tủy trên T1W, hình thái cột sống cổ và tình trạng mất vững cột sống (p>0,05). Tuy nhiên có sự khác biệt với thay đổi tín hiệu tủy trên T2W (p=0,007). Không có sự tương quan giữa điểm JOA lúc nhập viện với CR, MCC, MSCC (r ~ 0, p>0,05). Có sự tương quan nghịch giữa CR với MCC (r: -0,39, p=0,022), MSCC (r: -0,482, p=0,004). Kết luận: Không có sự liên quan giữa điểm JOA trước mổ với hình thái, sự mất vững của cột sống và các chỉ số CR, MCC và MSCC, trên cộng hưởng từ (p>0,05). Tuy nhiên, có liên quan chặt chẽ giữa tình trạng thần kinh và sự thay đổi tín hiệu tủy trên T2W (p=0,007).
Tác dụng ức chế cảm giác-vận động theo vùng thần kinh chi phối khi gây tê ống cơ khép giảm đau sau phẫu thuật nội soi khớp gối
Authors: Trường Nguyễn Quang , Hùng Tống Xuân , Lý Nguyễn Minh , Hà Quách Nguyên , Hảo Phan Thị , Thực Nguyễn Văn
Published: December 2021

Mục tiêu: Đánh giá tác dụng ức chế cảm giác, vận động của thần kinh hiển, thần kinh chày và thần kinh mác chung khi gây tê ống cơ khép bằng dung dịch bupivacain nồng độ 0,25% liều 1mg/kg giảm đau sau phẫu thuật nội soi khớp gối. Đối tượng và phương pháp: 36 bệnh nhân phẫu thuật nội soi tái tạo dây chằng chéo trước khớp gối, vô cảm bằng gây tê tủy sống, ASA I-II, BMI < 30, khi hết tác dụng của thuốc tê tủy sống, gây tê ống cơ khép giảm đau sau phẫu thuật bằng dung dịch bupivacain 0,25% liều 1mg/kg. Đánh giá mức độ ức chế cảm giác, vận động của thần kinh hiển, thần kinh chày và thần kinh mác chung tại các thời điểm sau gây tê 30 phút, 60 phút, thời gian khởi phát tác dụng ức chế cảm giác của thần kinh hiển, thần kinh chày và thần kinh mác chung, điểm VAS khi nghỉ và khi vận động tại các thời điểm sau gây tê 30 phút, 60 phút, 3 giờ, 6 giờ, 12 giờ. Kết quả: 100% bệnh nhân có ức chế cảm giác thần kinh hiển, 58,3% bệnh nhân có ức chế cảm giác thần kinh chày, 52,7% bệnh nhân có ức chế cảm giác thần kinh mác chung, 2,8% bệnh nhân có ức chế vận động cơ tứ đầu đùi, 0% ức chế vận động nhóm cơ chi phối bởi thần kinh chày và thần kinh mác chung. Thời gian khởi phát tác dụng ức chế cảm giác của thần kinh chày (n = 21) là 10,4 ± 10,2 phút, thần kinh mác chung (n = 19) là 12 ± 8,9 phút dài hơn thời gian khởi phát ức chế cảm giác của thần kinh hiển (n = 36) là 6,6 ± 2,7 phút, p<0,05. Điểm VAS khi nghỉ và khi vận động khớp gối < 4 tại tất cả các thời điểm nghiên cứu, p<0,05. Kết luận: Qua nghiên cứu thử nghiêm lâm sàng ở 36 bệnh nhân gây tê ống cơ khép bằng dung dịch bupivacain 0,25% giảm đau sau phẫu thuật nội soi khớp gối, 100% bệnh nhân ức chế cảm giác thần kinh hiển, 58,3% bệnh nhân ức chế cảm giác thần kinh chày, 52,7% bệnh nhân ức chế cảm giác thần kinh mác chung, 2,8% bệnh nhân có ức chế vận động cơ tứ đầu đùi. Thời gian khởi phát tác dụng ức chế cảm giác của thần kinh hiển, thần kinh chày và thần kinh mác chung lần lượt là: 6,6 ± 2,7, 10,4 ± 10,2, 12 ± 8,9 phút. Điểm VAS cả khi nghỉ và khi vận động đều < 4 tại các thời điểm sau gây tê ống cơ khép 30 phút, 60 phút, 3 giờ, 6 giờ, 12 giờ.
Đặc điểm và cách sử dụng vít neo chặn ngoài xương ổ răng trong chỉnh hình răng mặt
Authors: Thành Ngô Việt , Phương Nguyễn Thị Thu , Hải Lê Thị Thu
Published: December 2021

Vít neo chặn ngày càng được sử dụng rộng rãi trong chuyên ngành chỉnh hình răng mặt như một khí cụ neo chặn tuyệt đối, đơn giản và hiệu quả. Từ khi ra đời, vít neo chặn đã góp phần rất lớn vào sự phát triển của các kỹ thuật dịch chuyển răng cũng như thay đổi các quan điểm điều trị. Ngoài phương pháp đặt vít neo chặn vào trong xương ổ răng, giữa các chân răng, chỉ định đặt vít neo chặn ngoài xương ổ răng (extra-alveolar bone mini screw) ngày càng trở nên rộng rãi. Hai vị trí phổ biến được lựa chọn đặt vít là trụ gò má xương hàm trên và gờ chéo ngoài xương hàm dưới. Tuy nhiên, đặc điểm và cách sử dụng của vít neo chặn ngoài xương ổ răng vẫn còn đang là mối quan tâm lớn của các bác sĩ chỉnh nha. Mục tiêu của bài báo này là tổng hợp các bằng chứng từ y văn về khái niệm, đặc điểm, chỉ định, cách sử dụng của vít neo chặn ngoài xương ổ răng, giúp các bác sĩ chỉnh nha hiểu rõ và điều trị hiệu quả.
Validación de escala de predicción del riesgo de feminicidio con base en la identificación de violencia grave en la pareja
Authors: Carrillo Mamani Hermógenes David , Hidalgo Maynaza Virginia
Published: December 2021

La violencia en los hogares bolivianos refleja cifras que preocupan, este panorama se agrava por las denuncias y la prevalencia del feminicidio íntimo. La presente investigación tiene el propósito de facilitar a los equipos interdisciplinarios de las instituciones públicas y privadas que realizan la atención e intervención en casos de violencia en pareja (enamoramiento, convivencia libre y relaciones de matrimonio) un instrumento idóneo con soporte científico, teórico y práctico que contribuya a la prevención del feminicidio, identificando anticipadamente la violencia extrema.
Asimismo, el documento es el resultado inicial de una decisión del Gobierno Autónomo Municipal de La Paz respecto a la necesidad de abordar la problemática del feminicidio, también desde una perspectiva académica y científica; y materializada a través del Observatorio Municipal de Seguridad Ciudadana y profesionales investigadores con amplia experiencia en la intervención de casos en violencia y feminicidio íntimo, integrantes del Comité Académico Municipal de Seguridad Ciudadana.
El estudio tiene un enfoque mixto, es de tipo descriptivo y no experimental, se aplicó como técnica de recolección de datos entrevistas y test psicológicos, que permitieron caracterizar los indicadores de violencia a la cual estuvieron expuestas las víctimas de feminicidio, evidenciados en los casos con sentencia y contacto directo con víctimas y agresores; es decir, de fuentes de información primaria y secundaria.
Liver Transplantation – A Case Report
Authors: Mabel Annarani. I Arockiaseeli , Lucas Amalorpavamari , Gnanadeepam Gnanadeepam , Ann. C Shirley , Gunaseeli. S Christy
Published: December 2021

Liver transplantation is a treatment option for patients with End-stage Liver disease for whom all possible modes of surgical and medical treatment have been exhausted. The indications for Liver transplantation can be either acute or chronic liver disease. The absolute contra indications are active alcohol or substance abuse, severe cardiopulmonary or other co morbid conditions that would preclude meaningful recovery after transplant. Patients are listed on the waiting list according to their blood type and Model of End- Stage Liver Disease (MELD) score. The surgical procedure entails the excision of both donor and recipient livers and transplantation of the donor liver into the recipient (Orthotopic Liver Transplantation). This article gives an overview about liver transplantation and its management. A case report is presented and the nursing care has been discussed in detail.
Effectiveness of Breast crawl in initiation and maintenance of effective breast feeding among new borns in selected hospital at Kollam
Authors: Shan Shahana
Published: December 2021

A quantitative research study to assess the effectiveness of breast crawl in initiation and maintenance of effective breast feeding among newborns in selected hospital at Kollam. The objectives of the study were to assess the effectiveness of breast crawl in initiation of breast feeding among newborns, to assess the effectiveness of breast crawl in maintenance of effective breast feeding among newborns and to find the association between the breast crawl of new born with the socio demographic variables. A quasi experimental non-equivalent control group design was used for the study. Purposive sampling technique was used to select 60 newborns born by normal vaginal delivery who were alternatively posted as experimental group and control group. The tools were demographic proforma, observation checklist for breast crawl, observation checklist for initiation of breast feeding and observation checklist for maintenance of effective breast feeding. Breast crawl given to the experimental group and assessed the initiation of breast feeding. Routine initiation of breastfeeding given to control group. Continuation of breast feeding was assessed equally in both groups, for six feeds in a day for 3days. The unpaired ‘t’ value was used to assess the effectiveness of breast crawl in initiation of breast feeding. The calculated ‘t’ value, (14.47) was greater than table value, (2.660). Effectiveness of breast crawl in maintenance of effective breast feeding was assessed by using unpaired ‘t’ value. The calculated t value in Day I (8.6551), Day II (18.55) and Day III (19.24) were greater than table value (2.660) at 0.05 level of significance. It concludes that there was effectiveness of breast crawl in initiation and maintenance of effective breast feeding among newborns. There was also progressive increase in the second and third day.
Sickle Cell Disease- A Case Report in a theoretical approach
Authors: Pramanik Samarpita
Published: December 2021

Sickle cell disease (SCD) is a major healthcare and societal problem affecting millions of people worldwide. In United States of America (USA), it is the most common genetic disorder affecting more than 80,000 people per year; majority of which are the African Americans Arabian and Indian (6,10). It is a genetic blood disorder affecting the red blood cells. Sickle cell pain is the hallmark of sickle cell disease and is associated with a very high mortality and morbidity rates (12). Being a genetic abnormality, the complete eradication of the disease from the affected seems to be difficult. Genetic counselling during pregnancy being the prime preventive step, Hematopoietic stem cell transplantation becomes the mainstay of treatment for complete eradication of the disease. But it is not done very often because of the significant risks involved.
An evaluation of Mucormycosis, Outburst
Authors: CK Sholly.
Published: December 2021

Black fungus is also known as Mucormycosis, and it is occasional but threatening infection. Black fungus is caused by getting into exposure with fungus spores in the surroundings. It can also form in the skin after the fungus enters through a cut, scrape, burn, or another type of skin trauma. Fungi live in the environment, particularly in soil and decaying organic matter such as leaves, compost piles, rotten wood, particularly in soil, compost, and animal dung. This fungal infection is caused by a type of mould known as 'mucromycetes’. It should be noted that this rare fungal infection affects persons who have health issues or who use drugs that weaken the body's ability to fight the infections. There are different types of mucormycosis Trusted Source, including rhino cerebral (sinus and brain), pulmonary (lung), gastrointestinal, and cutaneous (skin) mucormycosis. The COVID-19 generates a sudden change in the interior environment of the host for the fungus, and the medical treatment administered unknowingly promotes fungal development. COVID-19 causes harm to the airway mucosa and blood vessels. It also causes a rise in serum iron, which is required for the fungus to grow. Broad-spectrum antibiotics not only kill potentially harmful bacteria but also beneficial commensals. Although antifungals such as Voriconazole prevent Aspergillosis, Mucor survives and grows due to a lack of resistance. Long-term ventilation decreases immunity, and there is conjecture that the humidifier water that is delivered along with the oxygen transfers the fungus. It is ubiquitous and found in soil and air and even in the nose and mucus of healthy people. It affects the sinuses, the brain and the lungs and can be life-threatening in diabetic or severely immunocompromised individuals, such as cancer patients or people with HIV/AIDS. Doctors believe mucormycosis, which has an overall mortality rate of 50%, may be being triggered by the use of steroids, a life-saving treatment for severe and critically ill Covid-19 patients. Steroids reduce inflammation in the lungs for Covid-19 and appear to help stop some of the damage that can happen when the body's immune system goes into overdrive to fight off coronavirus. But they also reduce immunity and push up blood sugar levels in both diabetics and non-diabetic Covid-19 patients. It’s thought that this drop in immunity could be triggering these cases of mucormycosis.
Mucormycosis: Why Incidence Rate is more in Covid -19 patients
Authors: Sharma Neha Abhishek
Published: December 2021

This article aims to review existing evidence and evaluate the documented reasons of high association of Mucormycosis with Covis-19 patients. A literature search was conducted using CDC, MedlinePlus, PubMed, Medscape and Researchgate databases.
Meta-analisi del ruolo dell'attività fisica nel trattamento della stitichezza
Authors: Weiser Thomas , Landes Sabine
Published: December 2021

Le attuali linee guida raccomandano l'introduzione di cambiamenti nello stile di vita (tra cui più attività fisica) come prima opzione per il trattamento della stitichezza. Questa meta-analisi ha esaminato gli effetti dell'attività fisica sui sintomi dei pazienti con stitichezza cronica. Circa la metà di coloro che hanno seguito un programma di allenamento della durata di diverse settimane ha sperimentato un effetto positivo sui sintomi. Negli studi clinici condotti con i lassativi bisacodile e sodio picosolfato, generalmente questi farmaci si sono dimostrati in grado di alleviare i sintomi già il primo giorno di trattamento.
Content Analysis of the Studies Examining the Opinions of Teachers and Teacher Candidates on STEM Education
Authors: ÜLTAY Eser , BALABAN Sinem , ÜLTAY Neslihan
Published: December 2021

The aim of this study is to analyze the content of the studies examining the opinions of teachers and teacher candidates on STEM education, which will shed light on the future. This study is a qualitative study and theses and articles were analyzed with content analysis, one of the qualitative research methods. For this purpose, content analysis was performed on the studies examined according to the purpose, method, study group, data collection tools, data analysis, results, and suggestions. For this study, a research has been conducted using the keywords "opinion on STEM education", "STEM", "teacher candidates", "attitude", "awareness". Identified 23 studies were examined and seven questions were determined and the data tried to be answered to these questions were presented in tables and their frequency distributions were determined. The result with the highest frequency was the positive attitudes of teachers and teacher candidates and opinions towards STEM. Based on the results obtained from the research, the following suggestions can be made: STEM activities can be carried out in teacher education programs to increase the tendency towards STEM education. STEM education can be included in teacher education programs as an applied lesson.
Một số yếu tố ảnh hưởng tới kiến thức và thực hành về dự phòng bệnh tăng huyết áp của người dân tại huyện Hạ Hoà, Phú Thọ năm 2018
Authors: Toàn Ngô Văn , Hương Lê Vũ Thuý , Anh Trần Quỳnh , Hải Trần Minh , Thọ Lê Quang
Published: December 2021

Bệnh tăng huyết áp là một trong những bệnh không lây nhiễm phổ biến trên thế giới cũng như ở Việt Nam. Bệnh tăng huyết áp hoàn toàn có thể dự phòng được nếu người dân có kiến thức và thực hành về việc dự phòng bệnh. Nghiên cứu mô tả cắt ngang được thực hiện trên 515 đối tượng là người dân không mắc bệnh tăng huyết áp tại huyện Hạ Hoà, tỉnh Phú Thọ vào năm 2018. Nghiên cứu chỉ ra mối liên quan giữa giới tính, nhóm tuổi, nghề nghiệp và tình trạng kinh tế đều có liên quan tới kiến thức hoặc thực hành việc dự phòng bệnh tăng huyết áp. Trong đó nữ giới có kiến thức tốt hơn nam giới (OR=1,5; 95%CI: 1,04-2,08). Có sự liên quan giữa kiến thức và thực hành dự phòng bệnh tăng huyết áp. Người có kiến thức đạt thì có tỷ lệ thực hành đúng cao gấp 2,2 lần những người không có kiến thức đạt (95%CI: 1,53-3,25). Nghiên cứu cung cấp bằng chứng về quan trọng của việc dự phòng bệnh tăng huyết áp cho người dân, với mục đích nâng cao chất lượng cuộc sống cho người dân đặc biệt là người dân tại huyện Hạ Hoà, tỉnh Phú Thọ.
Ung thư biểu mô tuyến đại trực tràng trên bệnh nhân có hội chứng Peutz - Jegher: Báo cáo ca bệnh và hồi cứu y văn
Authors: Hoa Trần Thị , Luận Đào Thị , Dũng Trần Ngọc , Quỳnh Nguyễn Thị
Published: December 2021

Hội chứng Peutz-Jeghers là một hội chứng hiếm, được đặc trưng bởi sự xuất hiện của các polyp dạng harmartoma ở đường tiêu hoá và các đốm tàn nhang mọc rất đặc trưng quanh môi, trong miệng, ở tay, chân và mi mắt. Mục tiêu của nghiên cứu nhằm mô tả ca bệnh ung thư biểu mô tuyến đại trực tràng có hội chứng Peutz-Jeghers. Thiết kế nghiên cứu mô tả ca bệnh. Bệnh nhân nam, 36 tuổi, có tiền sử mắc hội chứng Peutz-Jeghers, nôn nhiều, đau quặn bụng từng cơn. Chẩn đoán hình ảnh cho thấy khối lồng ruột non vùng tiểu khung, đa polyp đại trực tràng, đặc biệt đoạn trực tràng cao có polyp lớn kích thước 38 x 37 mm, dạng nụ sùi, thuỳ múi. Kết quả mô bệnh học cho thấy: polyp lớn ở trực tràng là ung thư biểu mô tuyến xâm nhập lớp cơ trơn; các polyp khác là polyp Peutz - Jeghers điển hình, có kèm loạn sản độ thấp. Bệnh nhân được chẩn đoán là ung thư biểu mô tuyến biệt hóa vừa xâm lấn cơ trực tràng trên bệnh nhân có hội chứng Peutz - Jeghers.
Hiệu quả của bài tập Tiếng Việt cho bệnh nhân liệt dây thần kinh quặt ngược một bên sau cắt tuyến giáp toàn bộ
Authors: Phạm Thị Bích Đào , Lê Minh Đạt , Tâm Trần Văn , Phạm Anh Dũng , Thuỷ Phạm Thị Bích , Mai Thị Mai Phương , Bùi Thị Mai
Published: December 2021

Tỷ lệ phẫu thuật cắt tuyến giáp toàn bộ do ung thư tuyến giáp có xu hướng tăng dần, đi kèm với phẫu thuật này là những thay đổi về giọng sau phẫu thuật, đặc biệt là tổn thương dây thần kinh hồi quy sau phẫu thuật. Mục tiêu của nghiên cứu nhằm đánh giá hiệu quả của bài tập tiếng Việt trên những bệnh nhân liệt thần kinh thanh quản quặt ngược sau phẫu thuật cắt toàn bộ tuyến giáp. Nghiên cứu được tiến hành trên 60 bệnh nhân bị tổn thương dây thần kinh hồi quy sau phẫu thuật cắt toàn bộ tuyến giáp tại Bệnh viện Đại học Y Hà Nội, Bệnh viện Tai Mũi Họng Trung Ương, Bệnh viện K từ tháng 1/2015 đến tháng 1/2020. Đối tượng nghiên cứu được chia làm 2 nhóm: 30 người được can thiệp bằng bài tập và đánh giá chất lượng giọng của bài tập sau 03 tháng, 06 tháng và 12 tháng (nhóm 1) và 30 người khác theo dõi chất lượng giọng mà không có can thiệp gì thêm sau 03 tháng, 06 tháng và 12 tháng (nhóm 2). Chất lượng giọng được đánh giá bằng phần mềm phân tích âm PRAAT. Kết quả cho thấy ở nhóm 1: vận động của sụn phễu và dây thanh bên liệt cải thiện, không thấy hiện tượng teo cơ dây thanh, hai dây thanh khép kín hơn, các chỉ số: jitter, shimmer, noise-to-harmonic ratio (HNR) các nguyên âm (trầm, trung tính, cao), phụ âm, thanh điệu và tần số âm cơ bản (F0, F1, F2) đều cải thiện so với nhóm 2 (p < 0,005), khả năng kéo dài phát âm. Kết luận: Nhóm đối tượng liệt hồi quy sau cắt tuyến giáp toàn bộ nên được thực hiện bài tập phát âm.
How Did the Cultural Revolution Affect Your Culture?
Authors: Eisenberg Amy , Amato Photography by John
Published: December 2021

As an international expert at the Research Institute of Anthropology and Ethnology, Jishou University, Xiangxi Autonomous Prefecture, China, on UNESCO Local Indigenous Knowledge Systems/UN Permanent Forum on Indigenous Issues/UN Department of Economic and Social Affairs projects with Kam people and ministries responsible for ethnic development, I asked my colleagues this question: How did the Cultural Revolution affect your culture? This article details their answers.
Autoimmune diseases associated with inflammatory demyelinating diseases of the central nervous system – a cross sectional study
Authors: Seixas Luiza Kohler , Paz Marcio da Silva , Kay Claudia Suemi Kamoi , Werneck Lineu Cesar , Lorenzoni Paulo José , Prá Ducc Renata Dal- , Scola Rosana Herminia
Published: December 2021

Background: The most prevalent autoimmune diseases (AID) of the Central Nervous System (CNS) are Multiple Sclerosis (MS) and Neuromyelitis Optica Spectrum Disorder (NMOSD), both being demyelinating diseases. Recent studies show that patients with CNS demyelinating diseases have a higher risk of presenting associated diagnosis of another AIDs. Objectives: The present study aimed to evaluate the frequency of autoimmune comorbidities and autoantibodies in patients with MS and NMOSD. Design and setting: Were analyzed the medical records of 126 patients with MS or NMOSD, from the Demyelinating Diseases Outpatient Clinic in the Neurological and Psychiatric Unit in the Complexo Hospital de Clinicas da Universidade Federal do Parana (CHC-UFPR), taking in consideration the presence of AIDs and autoantibodies. Methods: The variables were organized in a Microsoft® Office Excel spreadsheet for statistical analysis. Results: Of the 126 analyzed cases, 111 (88%) corresponded to MS and 15 (12%) to NMOSD. From the total, at least one AID was associated in 11 patients (8.7%), six of which were diagnosed with MS and five with NMOSD (p<0.05). Regarding autoantibodies, there were 21 cases (16.7%) in which antinuclear antibodies (ANA) were present, and 12 cases (9.5%) in which autoantibodies other than ANA were present (p<0.05). Conclusions: The results of the study showed a higher frequency of AIDs in patients with CNS demyelinating diseases compared to the normal population. The results found in this study may contribute to improve the treatment and follow-up of patients with CNS demyelinating diseases, so that the concomitance of other AIDs is considered by the clinician.
Case Report: Reversible Cerebral Vasoconstriction Syndrome in a cancer patient using ZoladexTM
Authors: Magalhães Paolla Giovanna Rossito de , Seraidarian Marina Buldrini Filogonio , Caetano Bernardo Tardin , Paixão Barbara Oliveira , Freitas Tassila Oliveira Nery de , Tavares Daniel Vasconcelos de Pinho , Silva Gabriella Braga da Cunha , Gomez Rodrigo Santiago , Aspahan Maira Cardoso , Fernandes Breno Franco Silveira , Trivelato Felipe Padovani
Published: December 2021

Context: The Reversible Cerebral Vasoconstriction Syndrome (SVCR) is characterized by rapid and reversible vasoconstriction and segmental dilation of cerebral arteries, usually preceded by thunderclap headache. The involvement of second and third-order branches of the cerebral arteries is the most commom finding in a cerebral angiography. This report is about a SVCR case with atypical involvement, significantly compromising extracranial vessels and raising the hypothesis of association between the use of hormonal blocker gosserelin acetate (ZoladexTM) with SVCR. Case report: Female, 39 years old, with breast cancer and bone metastasis using ZoladexTM that presented with a sudden headache and vomiting, progressing to global afasia and paresis in the right upper limb. Magnetic resonance identified hyperacute intraparenchymal hematoma in left frontoparietal convexity and subarachnoid haemorrhage. Cerebral angiography showed irregularities in the distal branches (M3 and M4) of the middle cerebral arteries, as well as in the superficial temporal artery, characterized by focal strictures. Conclusion: Studies show that hormonal fluctuations in the postpartum period can trigger SVCR due to the drop in estrogen and progesterone (gonadotropins). During postpartum, the stimulus of breastfeeding increases prolactin levels leading to GnRH suppression, which decreases the level of gonadotropins. ZoladexTM is a GnRH analogue and its chronic administration results in suppression of these hormones - similar to the postpartum period. Therefore, there may be an association of hormonal blockers with SVCR.
Taxa de morbidade por transtornos mentais e comportamentais devido ao abuso de álcool no Brasil nos anos de 2010 a 2020
Authors: Pinto João Pedro Miguez , Silva Laís Cristina Pereira da , Lago Katarina Pereira do , Seixas Neto Orlando Rocha , Alvarez Luiz Augusto Ferreira , Ferreira Luciana Lins Palmeira , Oliveira Bianca Gabriella de
Published: December 2021

Introduction: Alcohol consumption in Brazil portrays a major economic, social, and health challenge. There is no single solution to this complex problem. However, over the years, the morbidity rate for mental and behavioral disorders due to alcohol abuse has been reducing, in absolute values, throughout Brazil. Objective: To compare morbidity rates for mental and behavioral disorders due to alcohol abuse in Brazil from 2010 to 2020, in view of the implementation of public policies aimed at reducing alcohol consumption in contrast to the pandemic resulting from the COVID-19 declared by the World Health Organization (WHO) in 2020. Methodology: This was a cross-sectional observational study of aggregate data collected from the SUS Hospital Information System (SIH-SUS) by the SUS Department of Informatics (DATASUS), where the morbidity rate for mental and behavioral disorders due to alcohol abuse in Brazil from 2010 to 2020 was observed. The Kolmogorov-Smirnov test was performed for further adjustment as to parametric or nonparametric group comparison tests. A linear regression in the 11 years surveyed was also performed to assess the reduction of the morbidity rate in the Brazilian territory in this period. Results: In the linear regression from 2010 to 2020, across Brazil, there was evidence of a reduction in the morbidity rate for mental and behavioral disorders due to alcohol abuse, with the following Results: β=-2767.706; R2=0.964; p <0.001. Conclusion: Therefore, it can be seen that, according to the study, there was a decrease in the mortality rate for mental and behavioral disorders due to alcohol abuse. It is hypothesized that the political implementations that defined guidelines and goals for attention to this disease possibly influenced the final result of the study.
Spondylodiscitis and early diagnosis: a case report
Authors: Sa Mariana Moreira Soares de , Barreto Emanuelle Ferreira , Vilela Marina Soares , Guimarães Roberta Kelly Netto Vinte , Lobato Vanessa Alves , Costa Junior Renato Pereira da , Gomes Neto Antonio Pereira , Christo Paulo Pereira
Published: December 2021

Context: Spondylodiscitis is a term that includes vertebral osteomyelitis, spondylitis and discitis. Among the vertebrae, the most affected are the lumbar (45%), followed by the thoracic (35%). Adults present themselves progressively, with a predominant complaint of low back pain and pain on palpation of the affected site, with significant limitation of movement due to muscle spasms. Report a clinical case with an emphasis on the possibility of early diagnosis and correct treatment aimed at the recovery of patients with neurological sequelae. Analysis of medical records in a patient admitted to the neurology ward of Santa Casa de Belo Horizonte. Clinical Case report: A.I.S. patient, 45 years old, with chronic low back pain due to asymmetry of the left lower limb. History of wear of the femoral head diagnosed in adolescence. Evolving for 2 months with progressive weakness in the lower limbs, associated with paresis and paresis in the left lower limb. He performed abdominal USG which showed hepatosplenomegaly with collateral circulation, increased caliber of the portal, splenic and superior mesenteric veins. Tomography of the lumbosacral spine with osteolytic lesions in the joints of L2-L3, L3-L4 and L4-L5., With almost total osteolysis of the L4 vertebral body, retropulsion of much later at this level, suggesting spondylodiscitis. The resonance of the lumbar spine performed with acute spondylodiscitis L2-L3 and L3-L4, compressing the roots of the equine tail with a comprehensive potential, remains as the emerging emerging roots. Liquid filling of the L3- L4 intervebral disc compatible with acute spondylodiscitis. Staphylococcus aureus and enterobacteria are responsible for more than half of the cases of non-tuberculosis. Conclusion: The diagnosis of discitis can be quite difficult, due to the rarity of the disease, the insidious symptoms and the high prevalence of low back pain in the general population. It is considered an important morbidity factor, as it causes an important neurological sequel. In addition, it points to the importance of differential diagnosis of low back pain in the population.
Association between HIV infection and neurocognitive disorders: a review
Authors: Rodrigues Rafael Felipe Silva , Almeida Ana Luiza Soares Henriques de , Rosa Amanda Mansur , Vieira Suelen Darlane , Silva Luciana Maria Campos e , Baltazar Ana Catarini Lopes , Guedes Isabela , Pinto Melina Efraim Vieira
Published: December 2021

Background: HIV-associated neurocognitive disorders (HAND) are characterized by impairment in at least two cognitive domains with a prevalence of up to 50% in people living with HIV (PLHIV). HAND is subdivided into asymptomatic neurocognitive impairment (ANI), mild neurocognitive disorder (MND) and HIV-associated dementia (HAD). Objectives: Demonstrate the impact of HAND and possible pathogenic mechanisms by relating them to the prevalence of subtypes Design and Setting: Review of the literature. Methods: Review made from PubMed with the descriptors “neurocognitive disorder”, “HIV”, “review”. Twelve articles were selected, among systematic reviews and meta-analysis published since 2017. Results: Before Highly Active Antiretroviral Therapy (HAART) HAD cases had a higher prevalence, probably due to the high viral load causing intense brain inflammation. Today the percentage of HAD has decreased, but the cases of ANI and MND continue to increase. HAART increases life expectancy and reduces viral load, but it may be related to the increase in ANI / MND associated with early brain aging and mild inflammatory processes resulting from primary infection. Conclusions: HAND is a concern for its impact on the quality of life and life expectancy of PLHIV. Therefore, neuropsychological assessment is an important tool for early diagnosis and disease management. The change in prevalence of different HAND subtypes raises doubts about the pathogenesis of these conditions and further studies are needed to elucidate this issue and develop therapeutic solutions.
Sneddon’s Syndrome: a case report
Authors: Sousa Letícia Alves de , Ferreira Junior Luís Marcos , Lima Lolrrayna Pedroso de , Silva Priscilla Rezende Pereira , Vieira Marcus Vinícius de Araújo
Published: December 2021

Context: Sneddon’s Syndrome is a small and medium caliber arteries vasculopathy, characterized by concomitant occurrence of cerebrovascular disease and livedo reticularis. It’s a rare disorder, more prevalent in women. In up to 80% of cases, positive antiphospholipid’s antibodies are found. Case report: A 28-year-old woman was admitted to Hospital das ClínicasUFTM on May 21th, 2020, referred under suspicion of stroke with ictus on May 19th, 2020. The exam revealed left hemiparesis, anomic afasia and livedo reticularis on her thighs and thorax. She denied having comorbidities or previous episodes of thromboembolism. She had taken combined oral contraceptive for eleven years, having changed medication a year ago. In the cranial angioresonance exam, acute ischemia was confirmed in addition to moderate microangiopathy and an area of encephalomalacia. In the etiological investigation, HEP-2 positive antibody (antinuclear factor in a fine dotted nuclear pattern) was detected. She was discharged with a prescription of 100 mg of acetylsalicylic acid daily, maintained as a form of secondary prophylaxis. Conclusions: The case illustrates the importance of a thorough physical examination and anamnesis in cerebrovascular disease patients, in order to get a accurate aetiological diagnosis of these diseases, enabling a more effective prognostic evaluation and secondary prophylaxis.
Cerebral Aspergillosis: Literature Review
Authors: Freijanes Loise Maria de Souza , Ueda Elisa Yuki Kurosawa , Lemaitre Paola Restum Antonio , Prado Isabela Pierotti
Published: December 2021

Background: Cerebral Aspergillosis is an opportunistic fungal infection. It reaches by a hematogenous pathway or by paranasal sinuses. Furthermore, the diagnosis is delayed due to the nonspecific clinical signs. Objectives: This study aims to highlight cerebral invasive aspergillosis as a diagnostic hypothesis in a difficult-to-diagnose and nonspecific neurological clinical scenario. Design and setting: This is a literature review from the Escola de Medicina Souza Marques‘s students, Brazil. Methods: The used articles were published between 2016 to 2021, from UpToDate, Journal of Oncology Pharmacy Practice, Elsevier, and Google Academic databases. Results: In immunosuppressed individuals, it manifests as single or multiple brain abscesses with vascular invasion, posing as a life-threatening factor. Immunocompetent patients may respond differently, presenting with meningitis or granulomatous mass, associated with seizures, headache, and visual acuity impairment. MRI or PCR in cerebrospinal fluid is the most used for diagnosis. T2 hypodensity, irregular margins with intracavitary projections on MRI, and absence of the choline peak suggest a fungal etiology. The histopathological study is not common in clinical practice. The recommended treatment is voriconazole in association with echinocandins, for 6 to 12 weeks. Notably, the mortality rate of cerebral aspergillosis in patients who are taking Ibrutinib for other conditions is close to 90%. Conclusion: Therefore it is essential to recognize the complication to avoid morbidity and mortality in immunosuppressed and immunocompetent individuals.
Surgical procedures for the treatment of extradural hematoma in the state of São Paulo, Brazil: an analysis
Authors: Hernandes Júnior Paulo Roberto , Brandão Bruno Carvalho , Rosa Juliana de Souza , Silva Heloá Santos Faria da , Lopes Patrick de Abreu Cunha , Gomes Tiago Veiga , Feitosa Jhoney Francieis , Côrtes Paula Pitta de Resende
Published: December 2021

Background: extradural hematoma (EDM) is one the most lethal traumatic brain injury, being due to the rupture of middle meningeal artery and resulting in intracranial hypertension and brain damage. Objectives: to describe the overview of surgical procedures for the treatment of EDM in the state of São Paulo, correlating it with current epidemiology. Methods: observational, descriptive, and transversal data collect on surgical procedures for the treatment of EDM, available on DATASUS website, from January 2008 up to December 2020, taking in account: number of hospitalizations, public health expenditures, complexity, mortality rate, deaths, hospital stay, and service character. Results: there were 10,210 hospitalizations for such procedures in this period, accounting for R$39,342,868.41, with 2010 the year with the greatest number of hospitalizations (1,074) and 2011 with the greatest expenditure (R$3,772,361.55). 849 of them were elective, while 7,279 were urgent. 4,459 were carried out in public care and 2,671 in private one. All of them were considered medium complexity. Mortality rate was 11.29%, corresponding to 1,153 deaths, with 2015 the year with the greatest mortality (14.20%) and 2020 the lowest (9.93%). Mortality rate was lower in elective procedures (10.60 versus 11.46 in urgent ones) and when carried out in public sector (10.88 versus 11.49 in private care). Average stay was 10.9 days and average cost per hospital stay was R$3,853.37. Conclusion: surgical procedures for the treatment of EDM are considered medium complexity, most of which being carried out in public care. Higher mortality rate was observed in urgent cases and private care.
Neurological manifestations caused by COVID-19 in Alagoas, Brasil
Authors: Melo Mônica Thalia Brito de , Melo Kirsten Araujo , Almeida Juliana Oliveira de , Lima Luana Thayse Barros de , Alves Filho Arnon Castro , Baggio Jussara Oliveira , Rocha Letícia Januzi de Almeida
Published: December 2021

Introduction: COVID-19 affects several vital organs, including the brain, and can cause neurological manifestations. Objective: To characterize the neurological manifestations of hospitalized patients with laboratory confirmation of COVID-19, between May and August, 2020. Design and setting: Observational study at Veredas Hospital and University Hospital Professor Alberto Antunes in Alagoas, Brazil. Methods: Socio-demographic data, infectious and neurological symptoms, risk factors for neurological and infectious diseases, clinical history, treatment instituted and outcome of patients were collected. Results: We included 30 patients with a mean age of 61.05 ± 18.65 years, 70% were female. The average between the onset of COVID-19 symptoms and hospital admission was 10 ± 9.7 days. Systemic arterial hypertension (66.7%) and diabetes mellitus (63.3%) were the main comorbidities. Cough, fever (60%) and dyspnea (56.7%) stood out in general symptoms. The most frequent neurological symptoms were changes in the level of consciousness (56.7%), epileptic seizures (33.3%) and motor deficits (23.3%). Ischemic stroke (40%) was the main neurological diagnosis, followed by epileptic seizures (33.3%), delirium (13.3%), encephalitis (10%), SAH (6.6%), vasculitis (6, 6%), hemorrhagic stroke, TIA, cranial neuropathy, meningitis and peripheral neuropathy (3.3% each). Regarding treatment, 100% used antibiotic therapy, 96.7% prophylactic heparin, 50% mechanical ventilation, 46.7% antiparasitic, 20% vasoactive drugs and 6.7% hydroxychloroquine. The death rate was 40%. Conclusions: Neurological manifestations by patients with COVID-19 are not uncommon, presenting in different ways, and can be potentially fatal. The main neurological symptom was changes in the level of consciousness and diagnosis, ischemic stroke.
Epidemiological profile of Dementia in the state of São Paulo in the last 5 years
Authors: Innocencio Giovanna de Camargo , Hernandes Júnior Paulo Roberto , Rosa Juliana de Souza , Lopes Patrick de Abreu Cunha , Feitosa Jhoney Francieis
Published: December 2021

Background: dementia is a syndrome characterized by the presence of a progressive deficit in cognitive function, with interference in social and occupational activities, with risk factors varying with genetic and environmental stressors. The differential diagnosis must identify potentially reversible conditions, of different etiologies, such as metabolic changes, intoxications, and nutritional deficiencies. In primary degenerative dementias and sequelae forms, the etiological diagnosis carries therapeutic and prognostic implications. Objectives: to analyse the current epidemiological profile of dementia in the state of São Paulo in the last 5 years. Methods: a literature review was carried out based on articles available in the Scielo and PubMed database and an observational, descriptive and cross- sectional collection of epidemiological data on dementias available in DATASUS – SUS Hospital Information System (SIH/SUS) – in the last 5 years – January 2016 to December 2020 – assessing the number of hospitalizations, the amount of public spending, mortality rate and permanence. Results: in the analyzed period, 3.105 hospitalizations were observed due to occurrences related to dementia, representing a total expenditure of R$37.847.961,13, with 2017 being the year with the highest number of hospitalizations and responsible for the highest amount spent. The total mortality rate in the 5 years studied was 5,57, corresponding to 173 deaths, with 2020 being the year with the highest rate while 2017 had the lowest rate. The average of the permanence in the hospital was 180 days. Conclusion: patients with dementia need early diagnosis and procedures to reduce the rate of hospitalizations and mortality, as well as public costs. For this, technological innovations, using structural and functional neuroimaging methods, as well as biology and molecular genetics techniques, have presented perspectives for the early diagnosis of dementia.
Epilepsy in patients with COVID-19
Authors: Batista Suzana Bastos , Coelho Deborah Calado , Amorim Gabriela Coutinho
Published: December 2021

Introduction: Coronavirus disease 2019 (COVID-19), caused by SARSCoV-2, appeared in a Chinese city in late 2019. Four months after its emergence it was declared by the World Health Organization as a pandemic. Although the virus has tropism for respiratory tract cells, there is evidence of involvement of systems such as vascular, digestive, hematological, urinary and nervous. Some neurological complications were observed in patients with COVID-19, such as stroke, myopathies and polyneuropathies. Encephalitis may cause seizures, suggesting that the inflammatory process by COVID-19 may be associated with seizures. Objectives: To address the possible association between seizures and SARS-CoV-2 infection. Methodology: The research is na integrative review carried out in a virtual environment, based on articles published between 2020 and 2021, with the theme “COVID-19, epilepsy and seizures”, on the academic Google platforms, SciELO portal and PubMed. Results: It is known that encephalitis and viral infections can trigger epileptic seizures by the pathophysiological mechanisms of activation of the inflammatory cascade. This process involves the release of inflammatory cytokines, tumor necrosis factor (TNF-α), interleukins 2, 6, 7 and 10, and complement, this neuronal hyper excitability activates Glutamate receptors, triggering seizures. Based on this, epileptic seizures can be explained in patients with neurological impairment by COVID-19. Conclusion: It was observed that inflammatory processes lead to excitation of receptors that trigger seizures. Therefore, the disruption of the blood brain barrier can play a fundamental role in the initiation of this process. However, the pathophysiological mechanism is not yet well elucidated, and further studies are needed on this.
Association of sleep and wake bruxism in patients with migraine
Authors: Godk Keryn Sporh , Santos Maria Luiza dos , Piovesan Elcio Juliato , Utiumi Marco Antônio Takashi , Küster João Guilherme Bochnia , Canalli Filho Luiz Carlos , Kotsifas Nikolai José Eustátios , Tan Bin Cheng , Mioto Eldislei , Colombani Gabriel Eduardo Faria
Published: December 2021

Introduction: When migraine evolves from episodic to chronic form, it becomes more disabling, due to refractory treatment and the arising of comorbidities. Bruxism has already been associated with migraine in adults, with a bidirectional relationship between sleep bruxism and chronic migraine. This study aimed to assess whether sleep and wake bruxism are more prevalent in chronic migraine when compared to episodic migraine and also to establish possible clinical correlations with chronification. Methods: 210 patients were allocated to the study, 97 with episodic migraine (EM) and 113 with chronic migraine (CM). The patients were submitted to face-to-face interviews with a neurologist to confirm the diagnosis and fill in the scales: specific questionnaire for the diagnosis of sleep and wake bruxism, PHQ-9 (depression), GAD-7 (anxiety), Epworth Scale (sleepness), MIDAS and HIT-6 scales to assess the migraine disability and the headache impact on patients. Results: The prevalence of sleep and wake bruxism was similar in patients with EM versus CM (p=0.300 and p=0.238). The correlation of patients with both bruxism forms at the same time with the high scores on the migraine disability and the headache impact, was higher among patients with chronic migraine than in patients with chronic migraine. episodic migraine (p <0.001). Conclusion: Sleep and wake bruxism alone aren’t more prevalent in chronic migraine when compared to episodic migraine. In patients affected with both bruxism forms, bruxism only causes a greater impact and disability on individuals with chronic migraine.
Familial ALS Type 25 – A Brazillian Case Serie
Authors: Albuquerque Filho José Marcos Vieira de , Athayde Natália Merten , Carvalho Alzira Alves de Siqueira , Farias Igor Braga , Machado Roberta Ismael Lacerda , Chieia Marco Antônio Troccoli
Published: December 2021

Introduction: Familial Amyotrophic Lateral Sclerosis (fALS) represent 5-10% of ALS patients. Different mutations in the N-terminal motor or coiled-coil domains of the kinesin family member 5A (KIF5A) cause Hereditary Spastic Paraplegia Type 10 (HSP10), Charcot-Marie-Tooth 2 (CMT2), Neonatal Intractable Myoclonus and more recently described fALS Type 25. Previous described phenotypes are very similar to the sporadic type, except from the long course of disease. Methods: We describe four Brazillian patients, under clinical follow-up on two Neuromuscular services with genetic diagnosis of fALS25. Results: Four diferent fALS25 are described. Two brothers and two unrelated patients, with distinct features, three males and one female, age range from 72 to 24; age of onset ranged from 62 to 22. The genetic mutations were the following: simple heterozygous pathogenic variant c.1651C>G (p. Leu551Val), simple heterozygous pathogenic variant c.2953G>A (p. Gly985Ser) and pathogenic variant c.484C>T (p.Arg162Trp); all of KIF5A gene (fALS25). Only one patient presented with similar phenoptype and age of onset as sporadic ALS (sALS), the two brothers presented the symptoms at the ages of 28 and 30, the female patient at 22. All patients still walk without assistence after the diagnosis. All patients showed classic superior and inferior motor neuron involvement signs, but one brother had a mild limb ataxia. The three younger patients had MRI with no specific findings, except from subtle cortical atrophy in one brother, and mild vermis and corpus callosum atrophy on the other brother. Only the female patient had negative familiar history. Conclusions: fALS25 should be suspected in patient with fALS and longer course disease. Mutations KIF5A gene must be remembered either in juvenile form of ALS.