bluuebunny/crossref_metadata_2025 huggingface dataset:
Situación de Enfermería en tiempos de COVID-19: Una mirada panorámica
Authors: López Vega María Jesús , Majo Marrufo Helga Ruth
Published: October 2020

El presente artículo tiene por objetivo analizar la situación de enfermería en tiempos de covid-19: una mirada panorámica, a nivel nacional y mundial, a través del método de revisión de artículos científicos y documentos, enfoque cualitativo, estudio de tipo básico, descriptivo. Resultados: Impacto del comportamiento social ante el rol del profesional de enfermería en medio de un sistema de salud en crisis y débil, fuerza laboral del profesional de enfermería insuficiente ante una brecha o déficit de profesionales de enfermería en primera línea de acción, déficit de formación de profesionales de enfermería ante la demanda en los sistemas de salud, mortalidad con consecuencias en los profesionales de enfermería y colectividad, adquisición y disponibilidad insuficiente de equipos de protección personal al profesional de enfermería, despliegue de la teoría de la enfermería moderna y teoría del autocuidado. Conclusiones: el análisis y sistematización de la información permitió reconocer el impacto del comportamiento social ante el rol del profesional de enfermería en medio de un sistema de salud en crisis y débil, la fuerza laboral del profesional de enfermería fue insuficiente ante una brecha o déficit de profesionales de enfermería en primera línea de acción, existe déficit de formación de profesionales de enfermería ante la demanda en los sistemas de salud, la adquisición y disponibilidad es insuficiente de equipos de protección personal al profesional de enfermería, ante la contextualización ocurrió la mortalidad con consecuencias en los profesionales de enfermería y colectividad. Por lo tanto, hubo despliegue de la teoría de la enfermería moderna y teoría del autocuidado.
Eficacia de los tipos de aislamiento utilizados en clínicas de Odontopediatría UCSG, semestre B-2019
Authors: Sánchez Romero María de Lourdes , Amado Scheneider Adriana Rocio
Published: October 2020

Introducción: El aislamiento dental es un procedimiento clínico que previene y controla fluidos salivales, generando un ambiente óptimo para su rehabilitación. Existen dos tipos de aislamiento dental: aislamiento absoluto y aislamiento relativo. Objetivo: Establecer la eficacia del tipo de aislamiento utilizado en las Clínicas de Odontopediatría UCSG, durante el semestre B-2019 por medio de una valoración observacional. Materiales y Métodos: En el presente trabajo de investigación científica se aplicó un enfoque tipo transversal, analítica y descriptiva. La muestra estuvo conformada por 103 pacientes, en edades de 5 a 11 años de género femenino y masculino, pasando por un análisis estadístico descriptivo. Resultados: Tras la evaluación clínica y estadística de las muestras alcanzadas, se consideró un porcentaje de 58% en la frecuencia del aislamiento absoluto, y en cuanto a su efectividad se obtuvo “muy buena” 55%, mientras que el aislamiento relativo demostró una frecuencia de 42% y 2% de efectividad según el operador de ser “muy buena” la calidad de su tratamiento dental. Conclusión: Se concluye, que el tipo de aislamiento de mayor eficacia en las clínicas de odontopediatría UCSG es el aislamiento absoluto, ya que demostró confirmar sus criterios de diagnóstico para conseguir calidad en el tratamiento.
Malaria Por Plasmodium Falciparum, evolución de un caso
Authors: Armijos Gía Lissettte Gabriela , Del Rosario Peralta Ingrid Lucely , Moyón Gusqui Gustavo Adolfo , Cevallos Hernández Lisbeth Katherine , Dominguez Vera Anny Nicole
Published: October 2020

La malaria es una enfermedad parasitaria con una amplia distribución en zonas tropicales y subtropicales, endémica en más de 100 países, producida por cuatro especies de plasmodios. Es una patología presente en zonas con abundantes mosquitos Anopheles, por lo que su prevalencia está directamente relacionada con las condiciones socioeconómicas y ambientales de los pacientes. Al tratarse de una enfermedad capaz de producir la muerte rápidamente, es necesario considerarla como una urgencia médica. En este contexto se presenta paciente masculino que acude al servicio de emergencias con un cuadro clínico cuyos síntomas hacen sospechar de un brote de malaria. El diagnóstico oportuno de malaria por Plasmodium falciparum permitió un abordaje óptimo del paciente al cabo de pocos días de realizada la prueba confirmatoria, el examen de gota gruesa y extensión
Checklist of the grasses of India
Authors: Kellogg Elizabeth , Abbott J. Richard , Bawa Kamaljit , Gandhi Kanchi , Kailash B. R. , Ganeshaiah K. N. , Babu Shrestha Uttam , Raven Peter
Published: October 2020

A checklist of the grasses of India is presented, as compiled from survey of all available literature. Of the twelve subfamilies of grasses, ten are represented in India. Most subfamilies have been examined by taxonomic experts for up-to-date nomenclature. The list includes 1506 species plus infraspecific taxa and presents information on types, synonyms, distribution within India, and habit. Twelve new combinations are made, viz.Arctopoa tibetica(Munro ex Stapf) Prob. var.aristulata(Stapf) E.A. Kellogg,comb. nov.;Chimonocalamus nagalandianus(H.B. Naithani) L.G. Clark,comb. nov.;Chionachne digitata(L.f.) E.A. Kellogg,comb. nov.;Chionachne wallichiana(Nees) E.A. Kellogg,comb. nov.;Dinebra polystachyos (R. Br.) E.A. Kellogg,comb. nov.;Moorochloa eruciformis(Sm.) Veldkamp var.divaricata(Basappa & Muniv.) E.A. Kellogg,comb. nov.;Phyllostachys nigra(Lodd. ex Lindl.) Munro var.puberula(Miq.) Kailash,comb. & stat. nov.;Tzveleviochloa schmidii(Hook. f.) E.A. Kellogg,comb. nov.;Urochloa lata(Schumach.) C.E. Hubb. var.pubescens(C.E. Hubb.) E.A. Kellogg,comb. nov.;Urochloa ramosa(L.) T.Q. Nguyen var.pubescens(Basappa & Muniy.) E.A. Kellogg,comb. nov.;Urochloa semiundulata(Hochst. ex A. Rich.) Ashalatha & V.J. Nair var.intermedia(Basappa & Muniy.) E.A. Kellogg,comb. nov.
Women in Neurosurgery (WIN): Barriers to progress, world WIN directory and the way forward
Authors: Balasubramanian Sneha , Palanisamy Dhivya , Bakhti Souad , El Abbadi Najia , Collange Nelci , Karekezi Claire , Liew Boon , Kato Yoko
Published: October 2020

Women in Neurosurgery (WIN) have come a long way and are making inroads in every neurosurgical subspecialty. There has been a worldwide increase in the number of female neurosurgeons both in the training and practice. Although this is a welcome trend, gender equality at work in terms of opportunities, promotions, and pay scales are yet to be attained. This is more apparent in the developing and underdeveloped nations. Barriers for a female neurosurgeon exist in every phase before entering residency, during training, and at workplace. In the neurosurgical specialty, only a few women are in chief academic and leadership positions, and this situation needs to improve. WIN should be motivated to pursue fellowships, sub-specialty training, research, and academic activities. Furthermore, men should come forward to mentor women, only then the gender debates will disappear and true excellence in neurosurgery can be attained. This article reviews the issues that are relevant in the present era focusing on the barriers faced by female neurosurgeons in the developing and underdeveloped countries and the possible solutions to achieve gender equality in neurosurgery. The authors also present the data from the World WIN Directory collected as a part of Asian Congress of Neurological Surgeons-WINS project 2019. These numbers are expected to grow as the WIN progress and add value to the neurosurgical community at large.
Endoscopic third ventriculostomy in failed ventriculoperitoneal shunt in pediatric population
Authors: Choudhary Ajay , Sobti Shivender , Zambre Sourabh , Bhaskar Suryanarayanan
Published: October 2020

Introduction: Ventriculoperitoneal (VP) shunt malfunction is common in pediatric age group patients. There is a high complication rate and revision rate of VP shunt. Endoscopic third ventriculostomy (ETV) can alleviate these complications and can act as an effective alternative for the treatment of hydrocephalus in this age group of patients. Materials and Methods: The authors retrospectively reviewed the management and outcome of 36 failed VP shunts in pediatric patients for the treatment of hydrocephalus. The surgeries were performed between November 2010 and January 2016 in a tertiary care hospital. The minimal follow-up period was 3 months. We divided the patients into the following age groups: <1 year (eight infants), 1–10 years (18 children), and 10–18 years (10 children). The success of the procedure was determined by age, sex, type of hydrocephalus, and the number of shunt revisions and malfunction before ETV. Children with different age (P = 0.839) and sex group did not show any significant data (P = 0.798). Children with communicating hydrocephalus had a success rate of 52.9% (17 patients), and children with noncommunicating hydrocephalus had a success rate of 84.2% (19 patients). The success rate in children with only one shunt malfunction was 57.1% (21 patients), whereas in 15 children with two or more shunt malfunctions, the success rate of ETV was 86.7%. Conclusions: The authors conclude that ETV is an effective alternative for the treatment of hydrocephalus in children. Age does not present a contraindication for ETV in failed VP shunt.
Primary spinal epidural extraosseous Ewing's Sarcoma with brachial plexus infiltration
Authors: Tiwari Sarbesh , Yadav Taruna , Pamnani Jaya , Shukla Kartikeya , Rao Meenakshi , Gosal Jaskaran , Garg Pawan , Khera Pushpinder
Published: October 2020

The Ewing's sarcoma family of tumors are aggressive malignant small round blue cell tumors of undifferentiated mesenchymal origin. Skeletal Ewing's sarcoma is a common entity that classically involves the diaphysis of the long bones, pelvis, ribs, and sacrum. Extraosseous Ewing's sarcoma (EES) is rare, most commonly presenting as a paravertebral mass lesion. Its manifestation as an anterior epidural mass lesion with extension along brachial plexus is an even rarer phenomenon. A 25-year-old male presented with neck stiffness and progressive weakness of the bilateral upper and lower limbs. Magnetic resonance imaging of the cervical spine revealed an anterior epidural mass lesion compressing the cervical cord and extending along the right brachial plexus, suggesting imaging differentials of EES and lymphoma. The patient underwent laminectomy with gross tumor resection, and histopathology confirmed a diagnosis of EES. EES should be kept in the differential diagnosis of anterior epidural mass lesions in young adults, specifically when the lesion shows extension along multiple neural foramina and nerve plexus.
Endoscopic microvascular decompression for hemifacial spasm
Authors: Matmusaev Maruf , Kumar R , Yamada Yasuhiro , Nagatani Tetsuya , Kawase Tsukasa , Tanaka Riki , Kyosuke Miyatani , Kato Yoko
Published: October 2020

Introduction and Objective: Hemifacial spasm (HFS) is a condition, characterized by painless, involuntary unilateral tonic or clonic contractions of the facial muscles innervated by the ipsilateral facial nerve. HFS starts with contractions in the orbicularis oculi muscle with subsequent eyelid closure and/or eyebrow elevation, but may spread to involve muscles of the frontalis, platysma, and orbicularis oris muscles. Microvascular decompression (MVD) is reliable and accepted surgical treatment for HFS. MVD is the standard surgical technique now for HFS treatment with long-term success rates. Materials and Methods: We performed fully endoscopic MVD technique for 1 patient with HFS (a 83-year-old female) at our institution. HFS was diagnosed based on the clinical history and presentation, a neurologic examination, and additional imaging findings. Respectively, the durations of HFS were 3 years, respectively. The patient had been previously treated with repeated botulinum toxin injections. Preoperative evaluation was done with magnetic resonance imaging; three-dimensional computed tomography fusion images examinations had identified the anterior inferior cerebellar artery (AICA) as the offending vessel in this patient. Results: The patient with HFS was treated by fully endoscopic MVD technique. The AICA, which had been identified as the offending vessel by preoperative magnetic resonance imaging, was successfully decompressed. No surgery-related complications occurred and had excellent outcomes with the complete resolution of HFS immediately after the operation. Conclusions: Endoscopic surgery can provide a more panoramic surgical view than conventional microscopic surgery. Fully endoscopic MVD is both safe and effective in the treatment of HFS. This method minimizes the risks of brain retraction and extensive dissection often required for microscopic exposure. Endoscopic MVD is safe and has advantage over microscope in terms of visualization of structure, identification of neurovascular conflict, but it has a learning curve and technically challenging.
Endoscopic third ventriculostomy: Role of image guidance in reducing the complications
Authors: Wasi Muhammad , Sharif Salman , Shaikh Yousuf
Published: October 2020

Introduction: Endoscopic third ventriculostomy (ETV) is performed by neurosurgeons around the world for the management of hydrocephalus. ETV has been associated with multiple complications, the most significant being iatrogenic injury to the fornix. We aim to establish the fact that the use of image guidance while planning a trajectory can reduce the incidence of complications as it significantly alters the usual approach for ETV, i.e., the coronal burr hole can be useful for young neurosurgeons to overcome the learning curve associated with the procedure. Materials and Methods: This is a prospective, observational study conducted at Liaquat National Hospital. In this study, 43 patients were included who underwent ETV for hydrocephalus. Complications were divided into three major groups: arterial hemorrhage, venous hemorrhage, and injury to neural structures (fornix, hypothalamus, and oculomotor nerve). The data were compared with studies showing the complications of ETV with and without usage of image guidance. Results: Among the 43 patients who underwent ETV with image guidance, only two patients (4.65%) had iatrogenic fornix contusions. Neither of them developed memory impairment. None of the patients (0%) encountered other major iatrogenic complications, including injury to the mammillary body, basilar artery, or oculomotor nerve. Conclusion: The use of image guidance can reduce trajectory-related complications, including hemorrhage and iatrogenic injuries to the fornix. This study showed that the altered trajectory was beneficial in avoiding major neurological structures while introducing an endoscope through the cortex into the ventricular system.
Modification of periosteal flap as management of cerebrospinal fluid leakage after frontal sinus fracture surgery in moderate traumatic brain injury patients
Authors: Destiansyah Rifqi , Rahmadhan Mustaqim , Niantiarno Fajar , Yusuf Yusuf , Dustur Shafhan , Permana Galih , Balafif Fachriy , Ranuh IGM Aswin , Apriawan Tedy , Bajamal Abdul
Published: October 2020

Main management for the frontal sinus fracture is using the pericranial flap. Pericranial flaps based on the supraorbital and supratrochlear vasculature have previously been used with significant success for the separation of intracranial and extracranial spaces after major trauma. Defect closure was modified due to lack of the frontal periosteum; the graft was made from the temporal side of periosteum to make primary periosteal flap longer. Defect closure could be optimum. Evaluation for 6 months showed a significant improvement without major complications. In this article, we propose a new modification technique as one of promising alternatives.
Comparison of preoperative hypertonic saline versus mannitol for intraoperative brain relaxation and early postoperative outcome among patients with cerebral low-grade glioma: A prospective study
Authors: Etezadi Farhad , Babaie Mahsa , Larijani Amirhossein , Ketabchi Mehdi , Mojtahedzadeh Mojtaba , Jalali Ali , Alimohamadi Maysam
Published: October 2020

Introduction: Hypertonic saline (HS) has an important role in the treatment of raised intracranial pressure after traumatic brain injury. This study evaluates the efficacy and safety of HS and its impact on the postoperative course of patients undergoing craniotomy for low-grade gliomas. Materials and Methods: Sixty patients with supratentorial low-grade glioma were enrolled. All patients were anesthetized and operated with the same team and protocol. They successively received either HS or mannitol just before surgery. The amount of brain edema was classified according to the dural tension score (I–III) just after craniotomy and before dural opening. Other intraoperative measurements (such as urine output, need, and dosage of other diuretic agents) and postoperative findings (intensive care unit [ICU] and hospital stay, corticosteroid demand, and confusion period) were also assessed. Pre- and postoperative serum S100B levels were documented in both groups. Results: The dural tension score was not significantly different among the two groups: severe tension in six and five patients in the mannitol and HS groups, respectively. HS group had a significantly lower amount of diuresis (609 vs. 725 ml) during surgery. Patients in the HS group had shorter ICU stay (16.3 vs. 27.9 h) and shorter duration of corticosteroid therapy after surgery (3.4 vs. 5.2 days). Conclusion: HS infusion just before the onset of craniotomy is at least as effective as mannitol in controlling intraoperative brain edema in patients with supratentorial glioma. Improved early postoperative course and lower degrees of S100B rise after craniotomy seen in the HS group needs to be explained in more detailed studies.
Osteoid osteoma of the body of the vertebrae causing painful scoliosis
Authors: Jain Mantu , Doki Sunil , Gantaguru Amrit , Mohakud Sudipta , Jha Shilpy
Published: October 2020

Osteoid osteoma (OO) affecting the spine is one of the common causes of painful scoliosis in the growing age group. The involvement is usually in the posterior elements involving the lumbar and cervical spine. We report a case of OO affecting the body of the thoracic vertebral body. A 15-year-old male presented with painful left thoracolumbar scoliosis. Computed tomography (CT) and magnetic resonance imaging (MRI) and MRI showed a lucent area with central dense focus (nidus) suggesting OO. Surgical excision was done under image intensifier and void filled with a mesh cage having bone graft reinforced posteriorly with pedicle screws. Postoperatively, the patient was relieved of his diffuse pain and CT scan revealed complete excision of the lesion. At the follow-up, the patient has an active, unconstrained life. OO in the spine presents as scoliosis which can be painful or painless. The diagnosis can be missed on a plain radiograph and complete radiographic evaluation includes a CT scan and MRI. Spinal management includes curettage or radiofrequency ablation. Recurrence is a known but rare complication.
The wakayama-immediate stroke life support course: Achieving successful training on the stroke emergency system without using mechanical medical training simulators
Authors: Fujita Koji , Yoshimura Ryo , Tanaka Yoshiyuki , Kawabata Masayuki , Masumitsu Akane , Kawasaki Sadao , Kato Yoko , Kato Seiya , Nakao Naoyuki
Published: October 2020

Background: The Immediate Stroke Life Support (ISLS) course run in Wakayama (Wakayama-ISLS course) is an off-the-job training course for understanding the initial treatment of acute stroke. A total of 22 Wakayama-ISLS courses have been held in Wakayama Prefecture since 2008. To begin with, the case presentation was performed using human-like, mechanical manikins for simulation training. However, as the course progressed, we found the students paying great attention to the display monitor, and less to the patients' neurological status. Methods: From the fourth Wakayama-ISLS course onward, we conducted the group work with the facilitators pretending to be patients, i.e., without medical training manikins. Results: When the facilitators acted as patients, the students gained a more realistic and expressive perception of neurological symptoms. As a result, they expressed a high level of satisfaction with the course in the questionnaire sent immediately afterwards, regardless of their profession or prior experience. Moreover, as we did not need to transfer medical training simulators, we were able to carry out three ISLS courses at locations some distance from Wakayama city on a low-cost basis. This also enabled the regional medical staff in rural hospitals to participate in the courses easily. Conclusion: The Wakayama-ISLS course without medical training manikins is an entirely feasible off-the-job training course, which provides training on fast and excellent treatment of acute stroke problems based on clinical practice. The course has the potential to spread not only across Japan but throughout the world, including to developing countries, given the cost perspective.
Spontaneous disappearance of an intracranial small unruptured aneurysm on magnetic resonance angiography: Report of two cases
Authors: Akimoto Yu , Yanaka Kiyoyuki , Onuma Kuniyuki , Nakamura Kazuhiro , Takahashi Nobuyuki , Ishikawa Eiichi
Published: October 2020

Spontaneous radiographic disappearance of cerebral aneurysms is often observed under special conditions such as giant aneurysms. However, spontaneous disappearance of an unruptured and nongiant intracranial saccular aneurysms is rare. We describe two cases of this rare vascular phenomenon. The first patient is a 64-year-old female diagnosed with a small unruptured aneurysm arising from the distal anterior cerebral artery. Spontaneous disappearance of the aneurysm on magnetic resonance angiography (MRA) was observed 5 years after the initial diagnosis. Continuous imaging surveillance also revealed spontaneous reappearance of the aneurysm 2 years later. The second patient is a 57-year-old female harboring a small unruptured saccular aneurysm arising from the M1–M2 bifurcation of the middle cerebral artery. The aneurysm showed spontaneous disappearance on MRA 13 years after the initial diagnosis. These cases provide a new insight into this natural dynamic process even in cases of a small unruptured intracranial saccular aneurysm.
Ruptured mycotic cerebral aneurysm secondary to disseminated nocardiosis
Authors: Goto Masayuki , Marushima Aiki , Tsuda Kyoji , Takigawa Tomoji , Tsuruta Wataro , Ishikawa Eiichi , Matsumaru Yuji , Matsumura Akira
Published: October 2020

We report a case of a ruptured mycotic cerebral aneurysm caused by Nocardia infection. A 22-year-old immunocompromised woman with adult-onset Still's disease developed a subarachnoid hemorrhage (SAH). Digital subtraction angiography revealed a small aneurysm at the M2-3 bifurcation of the right middle cerebral artery. Cardiac ultrasonography showed vegetation at the posterior cardiac wall, suspecting infective endocarditis (IE). Gram-positive filamentous bacteria were observed in the necrotic tissue surrounding the aneurysm obtained during trapping surgery. Long-term blood culture showed that the cause of her cerebral mycotic aneurysm was nocardiosis. A mycotic ruptured cerebral aneurysm is an important cause of SAH in immunocompromised patients. Early diagnosis of IE, detection of gram-positive rods by Gram staining, and long-term culture to identify the bacteria is crucial in diagnosing nocardiosis.
Preoperative localization of the carotid bifurcation for cervical carotid exposure using the mastoid-hyoid line
Authors: Wongsuriyanan Somkiat , Sriamornrattanakul Kitiporn
Published: October 2020

Background and Importance: The location of the carotid bifurcation (CB) is highly variable, which makes precise exposure of the cervical carotid artery difficult, especially in transverse incisions. The method for preoperative localization of the CB is not well established. We used the distance from the mastoid-hyoid (M-H) line to the CB, measured preoperatively with computed tomography angiography, to localize the location of the transverse skin incision. We describe and evaluate the accuracy of a method for preoperative localization of the CB for cervical carotid exposure. Methods: The researchers retrospectively evaluated 16 patients with aneurysms arising from the internal carotid artery (ICA) who had received cervical carotid exposure using the localization method of incision and were retrospectively evaluated from February 2018 to November 2019. The method of measurement and localization of the skin incision are described, and two illustrative cases are demonstrated. Results: Saccular aneurysms of the ophthalmic (C2) segment and communicating (C1) segment of the ICA were found in 8 and 8 patients, respectively. Nine patients had left-sided exposure, and 7 patients had right-sided exposure. The mean distance from the M-H line to the CB was 2.1 cm (range 0.5–3.5 cm). The accuracy of this method was 93.8%. No paralysis of the depressor anguli oris or the depressor labii inferioris was found postoperatively. Conclusion: The distance from the M-H line to the CB can be used to estimate transverse skin incisions for cervical carotid exposure.
Role of combined vertebroplasty and spinal decompression in the management of aggressive vertebral hemangiomas
Authors: Shamhoot Ebrahim , Balaha Ahmed , Ganna Ahmed
Published: October 2020

Background: There are different surgical modalities designed to manage aggressive vertebral hemangioma (VH) that causes neurological symptoms. The selection of the best approach is still controversial. It is crucial to safely achieve neurological recovery with the elimination of the risk of recurrence. The combined use of surgical decompression and vertebroplasty is one of the surgical modalities that are used to manage these cases. Patients and Methods: From January 2012 to January 2019, nine patients with aggressive VH were retrospectively included in the study. All of them were operated upon using combined surgical decompression and vertebroplasty. We evaluated all the patients preoperatively, immediate postoperative, 1 month, and 12 months later. Clinical and radiological outcomes were assessed. Results: Affected spinal levels were dorsal in six cases and lumbar in three cases. There was no postoperative worsening of the preoperative neurological status. For the cases presented with sciatica, the mean VAS score has dropped from 8.33 preoperatively to 2.67 postoperatively. One month later, all of them are free from the radicular pain. For the cases presented with myelopathy, they regain their motor power in both lower limbs over a period of 4 weeks with a mean Nurick grade of 1.17. The postoperative radiological studies revealed near total occlusion of the VH with the maintenance of the vertebral body height. No clinical or radiological signs of spinal instability or recurrence are observed over the period of follow-up. Conclusions: The combined use of surgical decompression and vertebroplasty is considered a safe and effective modality in the management of aggressive VHs.
Acquired lumbosacral spinal dural arteriovenous fistula in association with degenerative lumbosacral disc herniation and spinal canal stenosis: Report of two cases and review of the literature
Authors: Iampreechakul Prasert , Polpong Pongwat , Wangtanaphat Korrapakc , Lertbutsayanukul Punjama , Wattanasen Yodkhwan , Siriwimonmas Somkiet
Published: October 2020

The authors describe two cases harboring lumbosacral spinal dural arteriovenous fistulas (SDAVFs) manifested with nonspecific initial symptoms, leading to misdiagnosis and unnecessary procedures. A curvilinear flow void in the lumbar region and thoracic cord congestion with subtle perimedullary flow voids were detected on magnetic resonance imaging (MRI) in both patients. Contrast-enhanced magnetic resonance angiography and spinal angiography confirmed the SDAVFs in the lower lumbar and sacral region. Both fistulas were located at the same level of disc herniation and spinal canal stenosis and supplied by branches of the internal iliac arteries (i.e., iliolumbar and lateral sacral arteries) with cranial drainage from the dilated vein of the filum terminale, corresponding to a curvilinear flow void, to the perimedullary veins. The first case was successfully treated with embolization. Another case had recanalization of the fistula 4 months after endovascular treatment and was successfully treated with surgical interruption of the fistula. Our two case reports may provide additional evidence supporting an acquired etiology of SDAVFs, probably secondary to lumbosacral disc herniation and spinal canal stenosis. The authors also reviewed literature about preexistent lumbosacral SDAVFs associated with disc herniation and spinal canal stenosis. From our review, the level of SDAVFs in most patients is correlated with the level of disc herniation, spondylolisthesis, and/or spinal stenosis.
Free mucosal graft for reconstruction after nonfunctional pituitary adenoma surgery
Authors: Perez-Lopez Carlos , Palpan Alexis , Zamarrón Álvaro , Alfonso Carolina , De Arriba Álvaro , Giner Javier , Isla Alberto
Published: October 2020

Background: In the search for an effective closure without nasosinusal morbidity, we have studied the efficacy of free mucosal graft as a reconstructive technique of the sellar floor after the resection of nonfunctioning pituitary adenomas (NFPA). Methods: In 100 endonasal endoscopic surgeries, we analyzed the personal history, radiological and intraoperative aspects that could have an impact on the risk of postoperative cerebrospinal fluid (CSF) leak. They were divided into three groups: no mucosa flap/graft, mucosal free graft, and nasoseptal pedicled flap. Results: The characteristics of the patients and adenomas were the same in all three groups. Intraoperative CSF leak was observed in 1/13 cases of the group without graft/flap (7%), in 16/50 of the free mucosal graft (32%) and 12/37 (32%) of pedicle flap. The proportion of cases in which other means of reconstruction were used in addition (fat, collagen matrix, and sealant) was similar in the different groups. No CSF leaks were observed, except for a doubtful one in the free mucosal graft group, which resolved spontaneously within 24 h, without receiving any type of treatment. Conclusions: The middle turbinate free mucosal graft can be of great value in endonasal surgery: It achieves a hermetic closure in cases of low-flow CSF leaks, it can be useful as a rescue for cases where nasoseptal mucosa is not available to perform a pedicled nasoseptal flap, minimizes the nasosinusal complications of the pedicled flap by leaving a smaller surface area of the nasal cavity devoid of the mucosa, and achieves greater nasosinusal functionality because proper reepithelialization occurs in the area.
Surgical management of complex middle cerebral artery aneurysms: An institutional review
Authors: Bhide Anuj , Yamada Yashuhiro , Kato Yoko , Kawase Tsukasa , Tanaka Riki , Miyatani Kyosuke , Kojima Daijiro , Sayah Ahmed
Published: October 2020

Background: Complex middle cerebral artery (MCA) aneurysms are defined as large (≥10 mm) or giant (≥25 mm) aneurysms with M2 branches arising from the aneurysm rather than M1 segments and usually require some form of reconstruction of the bifurcation. Their management is difficult and surgery is preferred over endovascular modalities because of their peculiar angioarchitecture and association with critical branch points or perforators. Objectives: The study was aimed at analyzing surgically managed complex MCA aneurysms and discussing characteristics not favorable for endovascular management, surgical nuances and clipping strategies, patient outcomes, and newer diagnostic modalities which help improve management. Methods: Nine cases of surgically operated complex MCA aneurysms were identified from January 2017 to July 2019. The aneurysm characteristics, surgical nuances, clipping strategies, patient outcomes and points not favoring endovascular management were tabulated and analyzed. Results: The mean maximum aneurysm diameter was 13.4 mm and the mean fundus/neck ratio was 1.6. The average microscope time was 124 min, and the most common method was clip reconstruction. The average number of clips used was 2.7 and the mean follow-up was 13 months. All patients have good postoperative outcome (Modified Rankin Score 0-2). The complete occlusion rate was 88.9% with one intraoperative voluntary residual sac which was coated. Computational fluid dynamic study results done preoperatively correlated with intraoperative findings. Conclusions: MCA aneurysms pose a significant challenge for endovascular treatment because of various factors such as luminal thrombi, complex angio-architecture, precarious branch/perforator locations, broad necks, and fusiform characteristics. Surgical management in experienced hands can tackle all these problems with an armamentarium of clipping techniques and bypass procedures.
Transcranial stab injury with knife: A rare case with excellent outcome
Authors: Garg Rajveer , Wadhwa Chetan , Kaushal Rakesh , Singh Jagminder
Published: October 2020

Traumatic stab injury/wounds to the brain are rare type of injuries having fatal outcomes. In the present case report, we report a case of a 17-year-old male who presented to the accident and emergency department of our hospital with an alleged history of assault due to a vegetable cutting knife with the knife lying in the right temporal region. In these types of injuries, no attempt should be made to remove the weapon without adequate investigations and facilities as it can be fatal. While removing the weapon, care should be taken that there is no rocking or zigzag movement and the weapon should be retrieved back from the same trajectory. The underlying principles in these types of cases include thorough debridement of the wound with removal of dead tissue with no rocking movement while retrieving the weapon. The wound should be thoroughly closed to prevent postoperative cerebrospinal fluid leak.
The State of the Kilis Quilt Art Today
Authors: KILIÇ KARATAY Semra
Published: October 2020

Quilt is an art that has existed in the culture of every nation in the world and continues to exist today. The artists, craftsmen and apprentices engaged in this art are also trying to adapt the quilt art to today's modern life. The quilt is a large cover for covering, and the inside is a material that was previously filled with wool and now cotton or fiber and used to protect from the cold.

There are handicrafts performed today in Kilis. Our handicrafts such as quilting, yemenism, embroidery, wickerwork, copper making, wire breaking and wood carving are among our arts.

Time-varying patterns, composition and materials used are seen as a means of communication used to express people's ideas and thoughts to the environment. The motifs used in Kilis quilts originated from the stylization of objects around people and are today still mentioned by the people of Kilis with these names.

With this field research, information about Kilis quilt art, tools and equipment used, patterns and meanings and their current status are collected and it is aimed to share this information as written literature.
Tópicos nas Ciências da Saúde Volume III
Authors:   Facultad de Medicina #2., Santiago de Cuba, Peña Aris Verdecia
Published: October 2020

A Editora Pantanal em seu 3º Volume do E-book “Tópicos nas ciências da saúde”, com seis capítulos traz novos temas no atuar da medicina. A obra, vem a materializar o anseio da Editora Pantanal na divulgação de resultados, que contribuem de modo direto no desenvolvimento e saúde humana. No primeiro capitulo o trabalho nos apresenta uma patologia que, embora muitos pensem que não é comum, tem grande impacto em nossa população mundial. A frequência desta patologia na década de 80 - 90 foi de 2 - 4 x 10.000 habitantes, porém com estudos atuais e levando em consideração não apenas o transtorno autista, mas todos os transtornos generalizados do desenvolvimento ou TEA (sigla em inglês), nesse novo cenário as estimativas aumentam de 21 para 35 x 10.000 habitantes. Com uma intervenção comportamental intensiva precoce, terapia cognitivo-confuctual e treinamento em habilidades sociais, obteve-se que em alguns casos leves os sintomas desaparecem, razão pela qual o diagnóstico precoce e o apoio incondicional da família são necessários; tudo isso refletido em nosso primeiro tópico. Em seguida, nosso pequeno volume faz uma incursão no campo das vitaminas que, como muitos estudiosos sabem, há um total de 13 vitaminas classificadas em dois grupos, solúveis em água (8 do complexo B e vitamina C) e quatro solúveis em gordura; A; D; E e K, que desempenham um papel fundamental no nosso organismo porque participam nos processos e reações que nele ocorrem e é importante não só tomá-los na forma de comprimidos, mas também incorporá-los através de uma alimentação equilibrada, saudável e saudável, para mim sobretudo a fonte da juventude porque atrasa o envelhecimento devido à sua ação antioxidante, aqui mostramos vários deles nas suas diferentes funções. Por fim, encerramos nosso livro com a apresentação de um caso onde mostramos que não é importante apenas tratar o somático, mas fazer um diagnóstico psicossocial do indivíduo se quisermos obter bons resultados em nossa prática profissional. Agradecemos aos autores pela dedicação e os encorajamos a continuar colaborando em nosso projeto. Aos autores dos capítulos, pela dedicação e esforços sem limites, que viabilizaram esta obra que retrata os recentes avanços científicos e tecnológicos na área de Ciências da Saúde, os agradecimentos da Organizadora e da Pantanal Editora. Por fim, esperamos que este e-book possa colaborar e instigar mais estudantes e pesquisadores na constante busca de novas tecnologias e avanços para a medicina. Assim, garantir uma difusão de conhecimento fácil, rápido para a sociedade. Aris Verdecia Peña
Notes on Penthesilea: The marks of a past of female heroism
Authors: Diefenthaeler Samantha Da Silva
Published: October 2020

The goal of this paper is to construct an image map that will allow us to understand archetypes characteristics that accompany heroic representations of women in cinema. We will begin with the myth of Penthesilea, an Amazon queen whose tragic loss of feminine power will then guide us in the search for new archetypal deflections. We believe the archetype of Penthesilea signifies new leak points in representation of power as connected to the feminine. To prove that will be one of the main goals of this paper. We insist on highlighting that the images associated with the description of this character are allied to a structure linked with a kind of force and power commonly related to the male. Penthesilea bears the mark of an essentially solar/diurnal heroism, in which love will configure as an additional item that makes the characters confront each other violently. The result of this analysis will be a visual trajectory from a moment in the past that connects to contemporary representations of feminine heroism.
Изобрести, деконструировать и снова изобрести Супергероя: злоключения национального героя в модерновых культурах национализма (от националистического политического плаката к комиксу массовой культуры)
Authors: Kyrchanoff Maksym W.
Published: October 2020

Автор рассматривает проблемы развития образов героев и супергероев в западной культуре. Целью статьи является анализ основных векторов и траекторий трансформаций героических образов как форм актуализации национальных и частично политических идентичностей. Теоретические подходы, вдохновленные конструктивистским поворотом, определяют методологические принципы, используемые автором в этой статье. Предполагается, что современные образы супергероев в массовой культуре общества потребления возникли как результат процессов постепенной эрозии и кризиса нации-государства и стандартизированных политических идентичностей эпохи модерна. Автор полагает, что массовая культура существенно изменила основные векторы и траектории развития героических образов в идентичностях. Автор анализирует роль национализма в трансформации образов героев. В статье рассматривается роль национального воображения и изобретения традиций в формировании и трансформации героических нарративов в современных политических и этнических идентичностях. Автор выявляет основные этапы в трансформации героических образов, предполагая, что 1) «национализмы» 19 века предложили классические образы национальных героев; 2) во второй половине 20 века классический герой в национальном воображении стал жертвой массовизации; 3) к началу 21 века сосуществовали множественные образы национального героя классической культуры и супергероя массовой культуры; 4) в начале 21 века супергерой воображался и изобретался в процессах деконструкции классических образов национального героя. В целом предполагается, что комикс в частности и культура комикса в целом актуализирует основные формы трансформации образов супергероя.
Why Superman Will Not Save the World: Theorizing the Relationship Between Suffering and DC Comics Superman
Authors: Tembo Kwasu
Published: October 2020

The hypothesis that there is an inextricable link between comic book superheroes and suffering would, to anyone with a cursory knowledge of superhero characters found in DC, Marvel, Image, Wildstorm and other houses, and their histories, ostensibly seem valid. This validity depends on which character one is applying said hypothesis to; the psychological and physical suffering of a Batman being more acceptable as such than that of a Plastic Man, for example. However, using DC Comics character Superman as a case study, this paper explores the inextricable link between Otherness, power, and suffering within the remit of the character's mythos. In order to do so, this paper refers to psychoanalytic concepts elaborated by Sigmund Freud in his text Beyond the Pleasure Principle (1922) as a way of demonstrating that despite the character's conventional appraisal as a positivist humanistic symbol of pure altruism, an insuperable, unimpeachable symbol of selflessness and good morality, there is in fact a fundamental link between Superman's 'tridentity' of selves (Clark Kent/Kal-El/Superman), the character's own suffering, and human suffering on a terrestrial scale, as represented within the numerous realities of the DC Comics Multiverse.
The Myth of Batman: Intra- and Interdiscursive Transformations
Authors: Kutovaia Arina A. , Mikhailovskaya Ekaterina V.
Published: October 2020

The study focuses on the multimodal discourse of the superhero Batman which is viewed as both a corpus of texts about Batman and a process of their development in various media, such as comics, animation, film, video games. Since the launch of the 1930s’ comics, the discourse has been incessantly developing, getting more and more intertwined with technology and new technology-based arts and industries. The evolution of the discourse can also be accounted for by the changing needs of the audience, as well as the shifts in the audience itself. At present, Batman discourse is comprised of a vast number of media texts, which intersect and influence each other. Each of these presents a new interpretation of the myth, based on the reesthetisization of basic constituent codes. The research aims to cover some aspects that define Batman as a cultural phenomenon of today, such as Batman as part of contemporary mythology and its relatability to the contemporary historical context, authorship in both the multimodal discourse and its media subdiscourses, intertextual and interdiscursive transformations.
Роль супергероя в формировании отечественного социокультурного пространства
Authors: Kuzina Natalia V.
Published: October 2020

Данная статья посвящена анализу репрезентации образа супергероя в культуре и политике 1990-х - 2010-х гг., а также выявлению причин интереса к образу у современной российской молодёжи. Цель исследования: определение зон востребованности модели супергероя в современной отечественной культуре и политике, а также в формировании личной идентичности у молодежи и подростков в повседневной жизни. Выявлено, что при почти полном отсутствии образов супергероев в оригинальных литературных и отечественных кинематографических произведениях для подростков в Российской Федерации в последнее десятилетие, данная модель востребована и активно воплощается в образах их самодеятельного литературного творчества (например, в фанфиках), в интернациональной индустрии компьютерных игр, а также реализуется молодежью в реальной жизни. Сфера функционирования образов, реализующих модернистскую (и романтическую) модель супергероя наиболее полно, – мир современной российской политики, российские кинофильмы о спорте высоких достижений, мюзиклы с участием представителей спорта высоких достижений в роли персонажа-супергероя, самодеятельное литературное творчество молодежи, повседневная жизнь молодежи и подростков. В данном исследовании используются термины литературоведения, педагогики, социологии, психологии, в том числе кросс-культурной, а также термины, возникшие внутри молодежной среды для обозначения новых жанров субкультуры, уже общепринятые как в сообществах, так и в исследованиях (фанфик, стрим).
Stepping out of Divinity: Tom King's “All-too-human” Batman
Authors: Barbosa Taynah Ibanez , Passos Mateus Yuri Ribeiro da Silva
Published: October 2020

This paper focuses on American superhero comics – i.e. superadventures and their likeness to mythology. Our goal is to understand how subtle changes in the characterization of a superhero may make them more congruent with the present day morality and ideals of the society, even if a given character is willing to directly challenge that morality. Through a close reading of Batman #53, in which Bruce Wayne states that Batman is like a god and that he does not believe in him anymore – nor should the people of Gotham – we discuss the symbolic meaning of Bruce Wayne's phrase and the implications for the readers' understanding of who the Batman is and what he stands for. One of the main impacts of this characterization is that Batman ceases to be the “interventionist god” as he was portrayed in many stories in the last decades, and learns to embrace the frailty and limitations of the human condition.
«Тьма страшится меня»: вопросы философской антропологии в трилогии Риддика
Authors: Pesyakov Sergey A.
Published: October 2020

Философско-антропологический анализ кинообразов является популярной формой философского исследования пространства современной массовой культуры. В контексте подобных исследований важным инструментом культурологического и философского осмысления героических кинообразов становится концепция мономифа и его методология, позволяющая анализировать и синтезировать внутренние и внешние основания различных киноперсонажей. Автор приложил концепты и методы мономифа к трилогии Риддика – одного из популярнейших персонажей, созданных в рамках фантастического кинематографа начала XXI века. Исследование позволило выявить три основания, являющихся определяющими лейтмотивами сюжета, которые помогают ответить на поставленные философско-антропологические вопросы. Эти основания обозначены следующим образом: 1. Борьба со Зверем; 2. Преодоление Смерти; 3. Поиск Дома. Указанная триада оснований концептуально и методологически укладывается в рамки концепции мономифа и соответствуют структуре Исход, Инициация, Возвращение. В ходе исследования мы рассмотрим эти стадии и попытаемся использовать их в философско-антропологической расшифровке кинотрилогии Риддика.