bluuebunny/crossref_metadata_2025 huggingface dataset:
Predictors of neoangiogenesis after indirect revascularization in moyamoya disease: a multicenter retrospective study
Authors: Zhao Yahui , Li Jiaxi , Lu Junlin , Zhang Qian , Zhang Dong , Wang Rong , Zhao Yuanli , Chen Xiaolin
Published: February 2019

OBJECTIVE

The effect of indirect revascularization to improve cerebral perfusion for moyamoya disease (MMD) is based on ingrowth of new vessels into the cortical brain. Preoperative indicators for neoangiogenesis would be helpful to the selection of appropriate procedures for MMD patients but have not yet been investigated. Our study aimed to identify potential predictors for neovascularization after indirect bypass surgery.

METHODS

The authors reviewed consecutive cases with complete clinical and radiological documentation of patients who had undergone surgery between December 2010 and January 2018. Patients who were treated with indirect bypass surgery were included. Cerebrovascular characteristics were evaluated by catheter angiography. Neoangiogenesis after indirect bypass was determined as “good” or “poor” based on the Matsushima standard. Univariate and multivariate analyses were performed to identify predictors for neoangiogenesis after indirect bypass. Subgroup analyses by onset type and surgical type were carried out to identify specific predictors for different populations.

RESULTS

In total, 231 hemispheres of 209 patients (mean ± SD age 23.06 ± 15.09 years, range 3–61 years) were retrospectively included. In 146 (63.2%) hemispheres, good neoangiogenesis was observed after indirect revascularization. Multivariate analysis showed that the status of ICA moyamoya vessels (p < 0.001, OR [95% CI] 3.242 [2.007–5.236]) is a predictor of favorable neoangiogenesis after indirect bypass surgery, whereas hemorrhagic onset (p < 0.001, OR [95% CI] 0.138 [0.054–0.353]) is a risk factor for poor neoangiogenesis. In addition, younger age was significantly associated with good neovascularization in patients with hemorrhagic onset (p = 0.027, OR [95% CI] 0.893 [0.808–0.987]), whereas age was not a significant predictor for neovascularization in non–hemorrhagic-onset patients (p = 0.955). Hemispheres with good revascularization had lower incidence of rebleeding, lower modified Rankin Scale scores, and more improvement of symptoms during long-term follow-up (p = 0.026, 0.006, and 0.013, respectively).

CONCLUSIONS

Hemorrhagic onset predicts poor neovascularization after indirect bypass surgery for MMD patients. Abundant ICA moyamoya vessels indicate good neoangiogenesis after indirect bypass and vice versa, whereas absent ICA moyamoya vessels predict poor revascularization. Good neovascularization was associated with better long-term outcome. Future studies are needed to further address this issue and clarify the underlying pathophysiological mechanisms.
Sex-dependent posterior fossa anatomical differences in trigeminal neuralgia patients with and without neurovascular compression: a volumetric MRI age- and sex-matched case-control study
Authors: Hardaway Fran A. , Holste Katherine , Ozturk Gulsah , Pettersson David , Pollock Jeffrey M. , Burchiel Kim J. , Raslan Ahmed M.
Published: February 2019

OBJECTIVE

The pathophysiology of trigeminal neuralgia (TN) in patients without neurovascular compression (NVC) is not completely understood. The objective of this retrospective study was to evaluate the hypothesis that TN patients without NVC differ from TN patient with NVC with respect to brain anatomy and demographic characteristics.

METHODS

Six anatomical brain measurements from high-resolution brain MR images were tabulated; anterior-posterior (AP) prepontine cistern length, cerebellopontine angle (CPA) cistern volume, nerve-to-nerve distance, symptomatic nerve length, pons volume, and posterior fossa volume were assessed on OsiriX. Brain MRI anatomical measurements from 232 patients with either TN type 1 or TN type 2 (TN group) were compared with measurements obtained in 100 age- and sex-matched healthy controls (control group). Two-way ANOVA tests were conducted on the 6 measurements relative to group and NVC status. Bonferroni adjustments were used to correct for multiple comparisons. A nonhierarchical k-means cluster analysis was performed on the TN group using age and posterior fossa volume as independent variables.

RESULTS

Within the TN group, females were found to be younger than males and less likely to have NVC. The odds ratio (OR) of females not having NVC compared to males was 2.7 (95% CI 1.3–5.5, p = 0.017). Patients younger than 30 years were much less likely to have NVC compared to older patients (OR 4.9, 95% CI 1.3–18.4, p = 0.017). The mean AP prepontine cistern length and symptomatic nerve length were smaller in the TN group than in the control group (5.3 vs 6.5 mm and 8.7 vs 9.7 mm, respectively; p < 0.001). The posterior fossa volume was significantly smaller in TN patients without NVC compared to those with NVC. A TN group cluster analysis suggested a sex-dependent difference that was not observed in those without NVC. Factorial ANOVA and post hoc testing found that findings in males without NVC were significantly different from those in controls or male TN patients with NVC and similar to those in females (female controls as well as female TN patients with or without NVC).

CONCLUSIONS

Posterior fossa volume in males was larger than posterior fossa volume in females. This finding, along with the higher incidence of TN in females, suggests that smaller posterior fossa volume might be an independent factor in the pathophysiology of TN, which warrants further study.
Secondary hemorrhagic complications in aneurysmal subarachnoid hemorrhage: when the impact hits hard
Authors: Darkwah Oppong Marvin , Buffen Kathrin , Pierscianek Daniela , Herten Annika , Ahmadipour Yahya , Dammann Philipp , Rauschenbach Laurèl , Forsting Michael , Sure Ulrich , Jabbarli Ramazan
Published: February 2019

OBJECTIVE

Clinical data on secondary hemorrhagic complications (SHCs) in patients with aneurysmal subarachnoid hemorrhage (SAH) are sparse and mostly limited to ventriculostomy-associated SHCs. This study aimed to elucidate the incidence, risk factors, and impact on outcome of SHCs in a large cohort of SAH patients.

METHODS

All consecutive patients with ruptured aneurysms treated between January 2003 and June 2016 were eligible for this study. Patients’ charts were reviewed for clinical data, and imaging studies were reviewed for radiographic data. SHCs were divided into those associated with ventriculostomy and those not associated with ventriculostomy, as well as into major and minor bleeding forms, depending on clinical impact.

RESULTS

Sixty-two (6.6%) of the 939 patients included in the final analysis developed SHCs. Ventriculostomy-associated bleedings (n = 16) were independently predicted by mono- or dual-antiplatelet therapy after aneurysm treatment (p = 0.028, adjusted odds ratio [aOR] = 10.28; and p = 0.026, aOR = 14.25, respectively) but showed no impact on functional outcome after SAH. Periinterventional use of thrombolytic agents for early effective anticoagulation was the only independent predictor (p = 0.010, aOR = 4.27) of major SHCs (n = 38, 61.3%) in endovascularly treated patients. In turn, a major SHC was independently associated with poor outcome at the 6-month follow-up (modified Rankin Scale score > 3). Blood thinning drug therapy prior to SAH was not associated with SHC risk.

CONCLUSIONS

SHCs present a rare sequela of SAH. Antiplatelet therapy during (but not before) SAH increases the risk of ventriculostomy-associated bleedings, but without further impact on the course and outcome of SAH. The use of thrombolytic agents for early effective anticoagulation carries relevant risk for major SHCs and poor outcome.
Pediatric silent corticotroph pituitary adenoma and role for proton therapy: case report
Authors: Prendergast Nicole , Aldana Philipp R. , Rotondo Ronny L. , Torres-Santiago Lournaris , Beier Alexandra D.
Published: February 2019

Tumors involving the sella are commonly craniopharyngiomas, optic pathway gliomas, or pituitary adenomas. Functioning adenomas are expected, with prolactinomas topping the differential. The authors present the case of a silent corticotroph adenoma, which has not been described in the pediatric population, and they detail the use of proton therapy, which is also novel.
The caroticoclinoid foramen in fetal and infantile orbitosphenoid, presphenoid, and sphenoid bones: developmental and neurosurgical considerations
Authors: Zdilla Matthew J.
Published: February 2019

OBJECTIVE

The presence of a caroticoclinoid foramen may increase the likelihood of adverse neurosurgical events. Despite the clinical importance of the caroticoclinoid foramen, its study has been mostly limited to adult populations. Therefore, the object of this study was to describe the prevalence, morphology, and development of the caroticoclinoid foramen among varied sexes and races in early life.

METHODS

The study analyzed caroticoclinoid foramina in dry orbitosphenoid, presphenoid, and sphenoid bones from a population of 101 fetal and infantile crania of varied sex and race.

RESULTS

A caroticoclinoid foramen, whether complete, near complete, or partial, was found in 36 of 199 sides (18.1%). Of the 98 crania with bilaterally intact sides, 21 (21.4%) had the presence of at least one caroticoclinoid foramen. Caroticoclinoid foramina were found unilaterally and bilaterally, in both female and male crania (9/41, 22.0%; 12/57, 21.1%, respectively) and, likewise, in crania of both black and white races (9/54, 16.7%; 12/44, 27.3%, respectively). Caroticoclinoid foramina were formed from cornuate bony projections from the anterior clinoid process, middle clinoid process, or both anterior and middle clinoid processes. Caroticoclinoid foramina were also found in isolated orbitosphenoid bones from individuals as young as 4 months’ fetal age.

CONCLUSIONS

The caroticoclinoid foramen occurs in approximately one of every 5 sides and in one in every 5 individuals of perinatal age and should, therefore, be considered a common finding in both fetuses and infants. It is common in both females and males as well as in both black and white races, alike. Furthermore, the caroticoclinoid foramen can be found in individuals as young as 4 months of fetal age. Failure to anticipate the presence of a caroticoclinoid foramen will place important neurovascular structures, including the internal carotid artery, at risk of injury. Neurosurgeons should, therefore, anticipate the caroticoclinoid foramen even in their youngest patients.
Spinal Instability Neoplastic Score component validation using patient-reported outcomes
Authors: Hussain Ibrahim , Barzilai Ori , Reiner Anne S. , McLaughlin Lily , DiStefano Natalie M. , Ogilvie Shahiba , Versteeg Anne L. , Fisher Charles G. , Bilsky Mark H. , Laufer Ilya
Published: February 2019

OBJECTIVE

The Spinal Instability Neoplastic Score (SINS) correlates with preoperative disability and response to stabilization, with patients with higher scores experiencing greater relief after surgery. However, there is a paucity of data demonstrating the extent to which each component contributes to preoperative clinical status and response to stabilization surgery. The objectives of this study were 2-fold. First, to determine how SINS components correlate with pre- and postoperative patient-reported outcomes (PROs). Second, to determine whether patients with higher SINS (10–12) in the “indeterminate” group respond differently to surgery compared to patients with lower SINS (7–9).

METHODS

SINS and PROs were prospectively collected in 131 patients undergoing stabilization surgery for metastatic spinal disease. Association of SINS components and their individual scores with preoperative symptom burden and PRO symptom change after surgery was analyzed using the Spearman rank correlation coefficient (rho) and the Kruskal-Wallis test. SINS and association with preoperative PRO scores and mean differences in post- and preoperative PRO scores were compared for 2 SINS categories within the indeterminate group (7–9 vs 10–12) using the Wilcoxon 2-sample test and Wilcoxon signed-rank test.

RESULTS

The presence of mechanical pain, followed by metastatic location, correlated most strongly with preoperative functional disability measures and lower disability PRO scores following surgical stabilization. Blastic rather than lytic bone lesions demonstrated stronger association with pain reduction following stabilization. Following surgery, patients with SINS 10–12 demonstrated markedly greater improvement in pain and disability PRO scores nearly across the board compared to patients with SINS 7–9.

CONCLUSIONS

The presence of mechanical pain has the strongest correlation with preoperative disability and improvement in pain and disability PRO scores after surgery. Radiographic components of SINS also correlate with preoperative symptom severity and postoperative PRO, supporting their utilization in evaluation of spinal instability. Among patients with indeterminate SINS, patients with higher scores experience greater reduction in pain and disability PRO scores following surgical stabilization, suggesting that the indeterminate-SINS group includes distinct populations.
Utility of topical tranexamic acid for adult patients with spinal deformity and contraindications to systemic tranexamic acid: initial experience and report of 2 cases
Authors: Desai Bhargav D. , Taylor Davis G. , Chen Ching-Jen , Buell Thomas J. , Mullin Jeffrey P. , Naik Bhiken I. , Smith Justin S. , Shaffrey Christopher I.
Published: February 2019

Tranexamic acid (TXA) is an antifibrinolytic agent with demonstrated efficacy in reducing blood loss when administered systemically. However, in patients with contraindications to systemic or intravenous TXA, topical TXA (tTXA) has been shown to reduce perioperative blood loss, with some studies suggesting equivalence compared to systemic TXA. However, these studies have been conducted in healthy cohorts without contraindications to systemic TXA. In the surgical management of adult spinal deformity (ASD), comorbid disease is commonly encountered and may preclude use of systemic TXA. In this subset of patients with ASD who have contraindications for systemic TXA, use of tTXA has not been reported.

The primary objective of this study was to conduct a systematic review on the use of tTXA in spine surgery and to present the authors’ initial experience with tTXA as a novel hemostatic technique for 2 patients with medically complex ASD. Both patients had contraindications to systemic TXA use and underwent high-risk, long-segment fusion operations for correction of ASD. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used to obtain studies related to spine surgery and tTXA from the National Institutes of Health PubMed (www.pubmed.gov) database. Criteria for final selection included a demonstration of quantitative data regarding operative or postoperative blood loss with the use of tTXA, and selection criteria were met by 6 articles.

Topical TXA may offer a potential therapeutic role in reducing intra- and postoperative blood loss following long-segment spinal fusion surgeries, particularly for medically complex patients with contraindications to systemic TXA. It is reasonable to consider the use of tTXA as a salvage technique in complex high-risk patients with contraindications to systemic TXA, although further research is needed to delineate safety, magnitude of benefit, and optimization of dosing.
Artificial disc replacement versus fusion in patients with cervical degenerative disc disease and radiculopathy: a randomized controlled trial with 5-year outcomes
Authors: MacDowall Anna , Canto Moreira Nuno , Marques Catarina , Skeppholm Martin , Lindhagen Lars , Robinson Yohan , Löfgren Håkan , Michaëlsson Karl , Olerud Claes
Published: February 2019

OBJECTIVE

The method of artificial disc replacement (ADR) has been developed as an alternative treatment to fusion surgery after decompression for cervical degenerative disc disease (DDD) with radiculopathy. Preserving the motion of ADR devices aims to prevent immobilization side effects such as adjacent-segment pathology (ASP). However, long-term follow-up evaluations using MRI are needed to investigate if this intent is achieved.

METHODS

The authors performed a randomized controlled trial with 153 patients (mean age 47 years) undergoing surgery for cervical radiculopathy. Eighty-three patients received an ADR and 70 patients underwent fusion surgery. Outcomes after 5 years were assessed using patient-reported outcome measures using the Neck Disability Index (NDI) score as the primary outcome; motion preservation and heterotopic ossification by radiography; ASP by MRI; and secondary surgical procedures.

RESULTS

Scores on the NDI were approximately halved in both groups: the mean score after 5 years was 36 (95% confidence interval [CI] 31–41) in the ADR group and 32 (95% CI 27–38) in the fusion group (p = 0.48). There were no other significant differences between the groups in six other patient-related outcome measures. Fifty-four percent of the patients in the ADR group preserved motion at the operated cervical level and 25% of the ADRs were spontaneously fused. Seventeen ADR patients (21%) and 7 fusion patients (10%) underwent secondary surgery (p = 0.11), with 5 patients in each group due to clinical ASP.

CONCLUSIONS

In patients with cervical DDD and radiculopathy decompression as well as ADR, surgery did not result in better clinical or radiological outcomes after 5 years compared with decompression and fusion surgery.

Clinical trial registration no.: 44347115 (ISRCTN).
Comparison of clinical outcomes following minimally invasive or lumbar endoscopic unilateral laminotomy for bilateral decompression
Authors: McGrath Lynn B. , White-Dzuro Gabrielle A. , Hofstetter Christoph P.
Published: February 2019

OBJECTIVE

Minimally invasive lumbar unilateral tubular laminotomy for bilateral decompression has gradually gained acceptance as a less destabilizing but efficacious and safe alternative to traditional open decompression techniques. The authors have further advanced the principles of minimally invasive surgery (MIS) by utilizing working-channel endoscope–based techniques. Full-endoscopic technique allows for high-resolution off-axis visualization of neural structures within the lateral recess, thereby minimizing the need for facet joint resection. The relative efficacy and safety of MIS and full-endoscopic techniques have not been directly compared.

METHODS

A retrospective analysis of 95 consecutive patients undergoing either MIS (n = 45) or endoscopic (n = 50) unilateral laminotomies for bilateral decompression in cases of lumbar spinal stenosis was performed. Patient demographics, operative details, clinical outcomes, and complications were reviewed.

RESULTS

The patient cohort consisted of 41 female and 54 male patients whose average age was 62 years. Half of the patients had single-level, one-third had 2-level, and the remaining patients had 3- or 4-level procedures. The surgical time for endoscopic technique was significantly longer per level compared to MIS (161.8 ± 6.8 minutes vs 99.3 ± 4.6 minutes; p < 0.001). Hospital stay for MIS patients was on average 2.4 ± 0.5 days compared to 0.7 ± 0.1 days for endoscopic patients (p = 0.001). At the 1-year follow-up, endoscopic patients had a significantly lower visual analog scale score for leg pain than MIS patients (1.3 ± 0.3 vs 3.0 ± 0.5; p < 0.01). Moreover, the back pain disability index score was significantly lower in the endoscopic cohort than in the MIS cohort (20.7 ± 3.4 vs 35.9 ± 4.1; p < 0.01). Two patients in the MIS group (epidural hematoma) and one patient in the endoscopic group (disc herniation) required a return to the operating room acutely after surgery (< 14 days).

CONCLUSIONS

Lumbar endoscopic unilateral laminotomy for bilateral decompression is a safe and effective surgical procedure with favorable complication profile and patient outcomes.
Study and Analysis of Capillary Tube and Thermostatic Expansion valve in Domestic Refrigerator using Eco friendly Refrigerant : A Review
Authors: Kumar Verma Yudhveer , Singh Ajay , Verma Ashish
Published: February 2019

The current review is concerned with the study of the effect of different expansion devices (capillary tube and Thermostatic expansion valve) on the alternative refrigerants used in the domestic refrigerators to have better performance with minimum losses. This paper give the summary and range of various refrigerants used in the refrigeration cycle of global warming which affect the environment by the use of refrigerant, and our aim is to reduce the effect of global warming as well as optimize the performance of domestic refrigerators by using the latest refrigerants and appropriate expansion devices like capillary tube and Thermostatic expansion valve. R134a is used in vapor compression refrigeration system having zero ozone depletion potential (ODP) and almost good thermodynamic properties, but it has a high Global Warming Potential (GWP) of 1300.So many researchers identifying new refrigerants and their blend which are environmental friendly and having low GWP and low ODP. Hydrocarbon refrigerants mainly propane, butane and isobutene are proposed as an environment friendly refrigerants. After reviewing the various literatures on the various expansion devices and hydrocarbons refrigerants and their mixture gives good performance in small capacity domestic refrigerator.
Perfil Sociodemográfico e Nutricional de Pacientes Oncológicos em Terapia Nutricional Enteral
Authors: Bortoletto Michelle Martins , Souza Iury Antônio de , Dias Anna Marcella Neves , Almeida Nilva Maria de , Mendonça Elisa Grossi
Published: February 2019

Introdução: Os pacientes oncológicos apresentam alto risco nutricional, sendo a desnutrição e a caquexia comumente observadas nesses indivíduos. A terapia nutricional enteral (TNE) é uma terapêutica que pode oferecer inúmeros benefícios. Objetivo: Identificar o perfil sociodemográfico e nutricional de pacientes oncológicos relacionando-os aos efeitos da TNE com estado nutricional e à evolução clínica desses pacientes. Método: Estudo clínico retrospectivo com revisão de prontuários eletrônicos de pacientes admitidos, no período de setembro de 2016 a abril de 2017, em um hospital oncológico público e privado, no município de Juiz de Fora - MG. As análises estatísticas foram por meio de frequências e proporções  e média e desvio-padrão a depender das variáveis, sendo p<0,05. Resultados: Entre os 96 prontuários analisados, 68,75% eram do gênero masculino, 54,16% idosos, 52,1% ex-tabagistas, 39,6% ex-etilistas e 46,9% apresentavam câncer de cabeça e pescoço. Destes, 44,8% apresentavam suspeita de desnutrição e 39,6% estavam desnutridos. A média do índice de massa corporal (IMC) foi de 19,44±4,83 kg/m² e o peso 52,91±12,97 kg antes da TNE, e 18,76±4,47 kg/m² e 51,01±12,69 kg após sete dias em TNE, não apresentando diferença significativa entre os valores obtidos antes e após a TNE. A classificação do percentual da perda de peso no início da TNE evidenciou 88,5% com perda de peso grave e, após sete dias de terapia, houve uma redução nesse percentual para 46,9%. Conclusões: A maioria dos pacientes oncológicos apresenta um comprometimento progressivo do estado nutricional. A TNE contribuiu de modo positivo para o retardo da perda de peso desses pacientes.
Trabalho e Adoecimento: as Repercussões Sociais do Tratamento da Leucemia Linfoblástica Aguda
Authors: Torres Joana Polycarpo , Assis Eliane Santos de
Published: February 2019

Introdução: Trata-se de uma abordagem sobre os impactos do processo de tratamento da leucemia linfoblástica aguda (LLA ) na vida social dos indivíduos a partir de sua inserção no mundo do trabalho. Objetivo: Problematizar as repercussões sociais do tratamento da LLA , identificando de que maneira a inserção no mercado de trabalho (formal ou informal) impacta no processo de tratamento no âmbito do Sistema Único de Saúde (SUS). Método: Estudo qualitativo com análise crítico-reflexiva à luz do referencial teórico do materialismo histórico-dialético. A pesquisa se deu por meio de um roteiro de entrevista semiestruturado aplicado a nove pacientes adultos em tratamento, considerados ativos para o mercado de trabalho. Resultados: Foi identificado o perfil dos participantes do estudo com base em dados sociodemográficos que refletem uma predominância de jovens em situação de restrição financeira e dependência de familiares em diversos âmbitos da vida. A partir da análise das entrevistas, foram elucidados tanto a condição de trabalhador dos indivíduos durante o processo de tratamento oncológico como os impactos oriundos da precária inserção no mercado de trabalho na atual conjuntura política, econômica e social que vem conformando a fragmentação das políticas públicas. Conclusão: Foi possível compreender como as crescentes e, ainda, as mais recentes mudanças na divisão sociotécnica do trabalho têm contribuído para o aumento das disparidades sociais existentes e, principalmente, o quanto tal contexto toma uma dimensão singular e alarmante no âmbito do tratamento oncológico.
Filgrastim Biossimilar para Mobilização de Células Progenitoras antes do Transplante Autólogo: Análise Retrospectiva de Pacientes com Mieloma Múltiplo e Linfomas
Authors: Pinto Simões Belinda , Fogliatto Laura Maria , Arcuri Leonardo Javier , Zanella Capra Marcelo Eduardo
Published: February 2019

Introdução: O filgrastim, que desempenha um papel fundamental na coleta de células progenitoras de sangue periférico (CPSP), está disponível há quase 25 anos, e existem vários biossimilares de filgrastim sendo  comercializados. Objetivo: Avaliar se um filgrastim biossimilar (Filgrastine®) foi associado com mobilização efetiva em pacientes submetidos à coleta de CPSP para transplante autólogo de medula óssea. Método: Foram revisados os prontuários de pacientes com mieloma múltiplo e linfomas tratados em três instituições no Brasil. O desfecho primário (taxa de sucesso de mobilização) foi a proporção de pacientes na população intenção de tratar (ITT), em que pelo menos 2 x 106 células CD34+/kg foram coletadas por leucaférese nos dias 5 e/ou 6. A população per protocolo (PP) foi composta por pacientes que receberam pelo menos quatro dias de Filgrastine e tiveram pelo menos uma contagem de CD34+ nos dias 5 ou 6. Resultados: A dose diária de Filgrastine (no D1, com pequenas alterações subsequentes) variou de 8,5 a 28,9 mcg/Kg nos 52pacientes na população ITT, com uma mediana de 13,8 mcg/Kg; 51 pacientes receberam pelo menos quatro doses. Uma média de 2,84±1,97 x 106 células CD34+/kg foram coletadas. A taxa de sucesso de mobilização foi de 53,9% (IC 95%, 39,5% a 67,8%) na população ITT e 62,2% (IC 95%, 46,5% a 76,2%) nos 45 pacientes da população PP. A mobilização foi considerada efetiva pelos pesquisadores em 80,8% dos pacientes da população ITT e 88,9% daqueles na população PP. Conclusão: Apesar de sua natureza observacional, este estudo sugere que Filgrastine esteja associado com as taxas de sucesso esperadas na coleta de CPSP para transplante autólogo de medula óssea.
A Atenção Oncológica e os 30 Anos do Sistema Único de Saúde
Authors: Migowski Arn , Atty Adriana Tavares de Moraes , Tomazelli Jeane Glaucia , Dias Maria Beatriz Kneipp , Jardim Beatriz Cordeiro
Published: February 2019

O objetivo do presente artigo é apresentar um panorama geral da evolução da organização da atenção oncológica ao longo da história do SUS.
Rastreamento como Estratégia de Controle do Câncer
Authors: Szklo Moysés , Almeida Liz Maria de
Published: February 2019

Além da prevenção primária, o rastreamento (detecção precoce) é uma estratégia importante para o controle do câncer. Neste artigo, resumimos os principais princípios da triagem em geral e usamos o câncer de próstata e colorretal como exemplos da aplicação desses princípios.
Melatonin and oral squamous cell carcinoma: current knowledge and future perspectives
Authors: Tamtaji Omid Reza , Mobini Moein , Atlasi Amir Abbas , Dadgostar Ehsan , Asemi Zatollah
Published: February 2019

On the basis of worldwide ranking, oral cancer is the eighth most prevalent cancer. Oral squamous cell carcinoma is a cancer that occurs following dysplasia of the mucosa of the oral cavity and oropharynx. There are different inflammatory pathways involved in the pathophysiology of oral squamous cell carcinoma. Melatonin (N-acetyl-5-methoxytryptamine), a well documented anticancer agent, exhibits numerous functions including induction of apoptotic pathways and controlling of oxidative stress. In the in vivo and in vitro studies the results have demonstrated that melatonin supplementation is an appropriate therapeutic approach for oral squamous cell carcinoma. Melatonin might inhibit cancer cells through the regulation of molecular pathways including AKT/mTOR pathway, ERK/AKT signaling, LSD1 expression and tumor-associated neutrophils releasing. Limited clinical studies; however, have evaluated the role of melatonin in oral squamous cell carcinoma. This review summarizes current knowledge and evidence regarding the effects of melatonin on oral squamous cell carcinoma and the mechanisms involved.
Plan China de la Secretaría de Estado de Comercio
Authors: Káiser Moreiras José Luis
Published: February 2019

El Plan China es el primer plan PASE (País con Actuación Sectorial Estratégica) que se está elaborando para consolidar, incrementar y diversificar la exportación española, todo ello en el marco de la Estrategia de Internacionalización de la Economía Española 2017-2027 (EIEE), que fue aprobada en el Consejo de Ministros del 8 de septiembre. La EIEE surge bajo el nuevo modelo de desarrollo sostenible de la economía española, que requiere asegurar la contribución positiva estructural del sector exterior con un impacto positivo sobre la creación de empleo. De ahí la necesidad de una estrategia de internacionalización a medio plazo para cohesionar todas las acciones en materia de internacionalización de los diferentes ministerios y comunidades autónomas.  La Secretaria de Estado de Comercio ha querido empezar por el plan PASE para China por la importancia del continente asiático en la economía mundial y estar considerado como un país prioritario en sus políticas de internacionalización.  Con China tenemos una cuota muy inferior a nuestra cuota en el comercio mundial y estamos proporcionalmente más lejos que nuestros competidores.  Podemos afirmar que sin un crecimiento sostenido de nuestras exportaciones al mercado chino va a ser difícil incrementar nuestra cuota en los mercados mundiales en los próximos años.  Actualmente, el saldo negativo de nuestro comercio con China es prácticamente igual la totalidad del déficit comercial español.
La Ruta de la Seda y la cooperación en terceros mercados desde la perspectiva empresarial. El caso de las Técnicas Reunidas
Authors: Sebastián de Erice José Pedro , Rovetta Dubinsky Pablo V.
Published: February 2019

El presente artículo hace una breve presentación de Técnicas Reunidas SA, su experiencia en China, y con empresas chinas en terceros países. El trabajo hace una mención especial a la iniciativa de la Franja y la Ruta planteada por el Presidente Xi Jinping, más conocida por sus siglas en inglés OBOR. Según los autores, España y su Administración no sólo están en el OBOR –cosa que en algunos sectores se duda- sino que llevan realizando importantes esfuerzos con el fin de que las empresas españolas puedan beneficiarse de esta iniciativa.
El nuevo siglo y la entrada en la OMC. Visión desde la Oficina en Shanghai
Authors: González-Izquierdo Revilla Coriseo
Published: February 2019

Shanghai es considerada con frecuencia como la capital económica y comercial de China. Rodeada por las provincias de Jiangsu al norte y noroeste y Zhejiang al sur y suroeste, se ubica en la próspera zona del Delta Yangtzé. Aunque gracias a los 6.300 kms de longitud de este río, ha tenido tradicionalmente un acceso privilegiado al comercio, Shanghai fue un simple pueblo pesquero hasta 1842.
Instituciones financieras de desarrollo bilaterales y bancos multilaterales de desarrollo: complementariedad y experiencia/actividad de COFIDES en este ámbito
Authors: Marín-Hernández Salvador
Published: February 2019

En el contexto actual se constata un crecimiento a nivel mundial de la actividad de las instituciones financieras de desarrollo (IFD) bilaterales, coincidiendo con cambios estructurales en la arquitectura tradicional de financiación del desarrollo. Así, en este artículo se analiza el contexto citado y se describe cómo la actividad de COFIDES se ha ido adaptando al mismo a través de diferentes fórmulas innovadoras, entre las que destacan la puesta en valor de sus treinta años de liderazgo en este ámbito, la captación de nuevos recursos financieros, un mayor apoyo a los instrumentos de financiación combinada o blended finance de la UE y, complementariamente, una mayor integración a los estándares internacionales compartidos por las IFD europeas en cuestiones sociales y ambientales. Todo ello para seguir apoyando al sector privado en su crecimiento vía inversión directa en el exterior (IDE) en países en desarrollo.
Diez años del G20: avances y retos futuros en el ámbito económico y financiero
Authors: Y Sistema Financiero Internacional Subdirección General de Análisis Estratégico
Published: February 2019

Ahora que el G20 cumple sus primeros diez años de vida desde que se elevó el rango de sus reuniones a presidentes de Gobierno en 2008, cabe valorar positivamente su contribución a la salida definitiva de la crisis financiera mundial mediante la coordinación de medidas de impulso económico, el fortalecimiento de la supervisión y regulación del sistema financiero internacional y el aumento de los recursos de la red de seguridad financiera global. Todos estos factores han contribuido a fijar las bases para evitar una nueva crisis similar en el futuro. Asimismo, el G20 ha propiciado importantes avances en cuestiones tan relevantes como la lucha contra la evasión fiscal, la prevención del blanqueo de capitales o el refuerzo de la arquitectura financiera internacional. En el presente artículo se analiza cuáles han sido estos avances a lo largo de los últimos diez años en las principales áreas de trabajo del circuito de finanzas del G20, en particular en los ámbitos de la macroeconomía, la regulación financiera, la fiscalidad internacional, la arquitectura financiera internacional, las finanzas verdes o la prevención del blanqueo de capitales y de la financiación del terrorismo. Adicionalmente, se exponen cuáles son los principales retos de cara al futuro para cada una de estas áreas y, finalmente, se ofrece una breve valoración sobre el posible futuro del G20.
Big Data en China
Authors: En Cantón Oficina Económica y Comercial De España
Published: February 2019

El sector del Big Data en China está creciendo a gran velocidad impulsado por los agentes públicos y privados que lo consideran esencial para la transformación del país en una potencia tecnológica mundial. China cuenta con un entorno privilegiado para el desarrollo del Big Data debido a su volumen de datos, aceptación social y flexibilidad legal, siendo los sectores de mayor aplicación el sanitario, transporte, seguridad, retail, turismo, smart cities, fintech, e incluso un sistema de crédito social para la población. Las empresas españolas pueden encontrar oportunidades de colaboración en materia de formación, desarrollo tecnológico o aplicación de sus productos a un mercado con más de 730 millones de usuarios digitales. Un ejemplo de éxito es el proyecto conjunto de geolocalización entre Telefónica (tecnología) y China Unicom (datos).
La economía de Qatar: situación y perspectivas ante el bloqueo
Authors: Embajada de España en Qatar Agregaduría Comercial Oficina Económica y Comercial de la
Published: February 2019

El artículo pretende dar a conocer la estructura económica de Qatar, conocido por ser el país más rico del mundo en términos per cápita gracias a sus reservas de gas y petróleo. Se describen a continuación los antecedentes e implicaciones del conflicto diplomático con Arabia Saudita, Emiratos Árabes Unidos, Bahréin y Egipto. A su vez, se analiza el impacto del bloqueo sobre sus variables monetarias y financieras así como sobre la economía real, incidiendo en las implicaciones comerciales y empresariales. Se explican también los retos a los que se enfrenta su economía, como el autoabastecimiento o la organización del Mundial de Fútbol FIFA 2022. Por último, se abordan la reacción de Qatar al bloqueo, las perspectivas económicas a largo plazo y las posibles estrategias de las partes implicadas para poder alcanzar una solución al conflicto actual.
Estadísticas de exportaciones de material de defensa, de otro material y de productos y tecnologías de doble uso, año 2017
Authors: Internacional de Material de Defensa Subdirección General de Comercio
Published: February 2019

Las estadísticas que se publican en este número del Boletín Económico de ICE son enviadas a las Comisiones de Asuntos Exteriores y de Defensa del Congreso de los Diputados. De esta manera, se da cumplimiento a lo dispuesto en el artículo 16 de la Ley 53/2007, de 28 de diciembre, sobre el control del comercio exterior de material de defensa y de doble uso, al mismo tiempo que se ofrece una detallada información tanto de las operaciones de exportación de este tipo de productos como de las acciones acometidas en los foros internacionales de control y no proliferación en el año 2017.
Estructura del consumo de pescado en España
Authors: González-Laxe Fernando
Published: February 2019

España es uno de los principales países pesqueros europeos. Destaca no solo por la relevancia de su flota, empleo, producción e industrias, sino también por el consumo de productos pesqueros y de la acuicultura. Sin embargo, en los últimos años, los hábitos de consumo de dichos productos se han modificado y reducido de manera significativa.El trabajo explica las variaciones en el comportamiento de la demanda y las oscilaciones en lo tocante a las preferencias del patrón alimentario español, en lo que atañe a los consumos de pescado fresco y congelado; a los de los mariscos, moluscos y crustáceos frescos y congelados; y a los productos procedentes de la industria de la conserva. Analiza los canales de distribución de dichas ventas y significa las preferencias de la demanda atendiendo a dichas formas de distribución.Profundiza en las diferencias existentes entre los niveles de consumo y los niveles de gasto, y se reflejan las variaciones de los precios de las especies y los cambios más notables en lo que respecta a la organización logística de la distribución de los productos pesqueros en los mercados nacionales.
Clima comercial y barreras a la internacionlización
Authors: Política Comercial de la Unión Europea Subdirección General de
Published: February 2019

Durante el último año, hemos asistido a un incremento en las tensiones comerciales internacionales, lideradas por el enfrentamiento comercial entre algunos de los principales actores. Estas tensiones suponen un notable riesgo, tanto para el crecimiento económico mundial como para el sistema multilateral de comercio. Sin embargo, desde la crisis financiera y económica internacional de 2008, ya se venía registrando una gran proliferación de las barreras a la internacionalización con un fuerte impacto en los intereses españoles y de la Unión Europea. Así, es necesaria la actuación decisiva de la Unión Europea, España y el resto de sus Estados Miembros, para liderar la modernización del sistema multilateral de comercio y exigir el cumplimiento de sus normas.
¿A qué barreras se enfrentan hoy las pymes en el mercado de las licitaciones públicas internacionacionales?
Authors: Fayos Gardó Teresa , Calderón García Haydeé , García García Juan Manuel
Published: February 2019

El objetivo de este trabajo es contribuir a la escasa investigación existente sobre el acceso de las empresas españolas al mercado de las licitaciones públicas internacionales analizando, en particular, los problemas que encuentran las pymes. Se identifican y analizan las 21 barreras a las que estas se enfrentan en el mercado de las licitaciones públicas internacionales clasificadas en función de su origen: unas determinadas por la propia Administración y por el país de la licitación, denominadas barreras externas y otras debidas a las capacidades, recursos y habilidades de las pymes, denominadas internas. El análisis teórico se complementa con un estudio cualitativo de empresas españolas.
La empresa española ante el brexit
Authors: Política Comercial de la Unión Europea Subdirección General de
Published: February 2019

El 23 de junio de 2016 se celebró en Reino Unido un referéndum en el que se decidió la salida de este Estado de la Unión Europea. Reino Unido es uno de los principales socios comerciales y de inversión de España, y continuará siéndolo tras el brexit. Sin embargo, la incertidumbre sobre la situación final hace necesario que los agentes que se vayan a ver afectados elaboren planes de contingencia frente a los posibles escenarios.
PIB per cápita y formación de capital humano. Importantes detonantes de la IED en México: 1994-2016
Authors: Pérez Martínez José Emmanuel , Reyes Guzmán Gerardo , Moslares García Carlos
Published: February 2019

La inversión extranjera directa (IED) ha sido un destacado factor detonante del desarrollo en países emergentes. Para México, uno de los principales propósitos al impulsar el Tratado de Libre Comercio de América del Norte en 1994 fue detonar la IED. El objetivo de este escrito es probar la hipótesis de que durante el periodo 1994 – 2016 existió una correlación positiva entre el bienestar económico y la formación de capital humano vs la IED. Para ello se toman datos anuales publicados por el INEGI (Instituto Nacional de Estadística, Geografía e Informática) que se utilizan en un modelo panel que permite llevar a cabo un análisis transversal-longitudinal. El modelo prueba exitosamente la hipótesis de investigación.
La seguridad de las inversiones en Iberoamérica y el proyecto Iberfides
Authors: Cavallé Cruz Alfonso , Casilda Béjar Ramón
Published: February 2019

América Latina constituye, desde los primeros años de la década de los noventa del pasado siglo, la región donde las principales empresas y bancos españoles iniciaron su expansión internacional. Posteriormente, se le unieron una creciente cantidad de pequeñas y medianas empresas. España se sitúa como el primer inversor europeo y segundo mundial por detrás de Estados Unidos. En un mundo cada vez más globalizado e interconectado se hace ineludible buscar soluciones prácticas que, sin merma de las garantías y seguridad, faciliten las relaciones comerciales, empresariales, interpersonales y familiares, que son especialmente intensas en el ámbito iberoamericano. 

Hoy juega a favor de la creación un sistema de colaboración interinstitucional iberoamericano para la interconexión documental y negocial utilizando las nuevas herramientas tecnológicas. La alianza de la seguridad jurídica con la tecnológica se convierte en vehículo y puente de unión facilitador de las relaciones jurídicas transnacionales y de las inversiones. Iberoamérica cuenta con sistemas comunes de seguridad jurídica preventiva, enmarcados en la Unión Internacional del Notariado (UINL), lo que puede potenciar la contratación y la circulación internacional ágil, eficiente y segura de la documentación mediante el proyecto Iberfides.
The Crime of Migrant Smuggling in Turkish Legal System in The Light of Recent Developments
Authors: BAŞLAR Yusuf
Published: February 2019

As a result of the quality differences of living standards amongst countries, economic problems, repressive policies, civil wars or geographical discrepancies people wish to leave their own countries and to live in the ones having better social and economic standards. In cases where the legal ways of people to leave their own countries and enter the desired ones were not possible illegal ways come into question. The countries, based on various grounds such as to provide border or public security or human dignity, provide the crime of ‘migrant smuggling’ in their criminal laws to impede uncontrolled migrant flow. In particular, Syrian migrants are trying to go to the different countries due to the Syrian civil war continuing for more than seven years for various reasons being to save their own and family lives and to live in higher economic standards. This struggle on the one hand gives way to fatal wounds in the lives and dignities of the migrants on the other hand causes the countries face insurmountable migration problems. Despite this problem primarily arise in countries sharing border with Syria. –to start with Turkey-it is also becoming a growing problem for the such European countries sharing no border with this country,The crime of migrant smuggling, is prepared in the guidance of the definitions taking place in the additional protocols to The United Nations Convention against Transnational Organized Crime. Therefore, the crime of migrant smuggling is prepared (such as the crime of human trade) in the chapter of international crimes in the Turkish Penal Code system. The commission of that crime mostly reveals itself, through criminal organizations, to provide means to have people enter, stay or leave a country in illegal ways for financial profit, the migrants who fall in the hands of such criminal organizations which taking primary roles in the commission of the crime are suffered fatal losses in terms of money and physical integrity.
Fransız Hukukunda Fiili Yolun Yeni Hukuki Rejimi ve Fiili Yolun Türkiye Uygulaması
Authors: YILDIZ Hayrettin
Published: February 2019

Fiili yolun hukuki rejimi son yıllarda bir dönüşümden geçmektedir.
Fransız Uyuşmazlık Mahkemesi’nin Bergoend kararıyla fiili yolun tanımı yeniden yapılarak
teorinin kapsamı daraltılmıştır. Fiili yolun daha önceki tanımında idarenin
temel hak ve özgürlüklere veya mülkiyet hakkına herhangi bir hukuki temelden
yoksun olarak müdahalesi fiili yolun meydana gelmesi için yeterliyken, yeni tanımda
fiili yolun söz konusu olabilmesi için bireyin bireysel hak ve özgürlüklerinden
birinin ihlal edilmesi veya mülkiyet hakkını ortadan kaldıracak şekilde ağır
bir müdahalenin söz konusu olması gerekir. Türkiye’de de fiili yolun hukuki
rejimini etkileyecek yasal düzenlemelere gidilmiştir. Çalışmamızda hem Fransız
hem Türk hukukunda fiili yol rejiminin son yıllarda uğradığı dönüşüm ele
alınmaktadır.
İntifa Hakkının Denkleştirilmesi ve Tenkisi
Authors: POLATER Salih
Published: February 2019

Mirasbırakan,
bir kimseye ölüme bağlı tasarruf ile terekedeki bir malın mülkiyetini
bırakabileceği gibi terekenin tamamı ya da bir kısmı üzerinde intifa hakkının
kazandırılmasını da sağlayabilir (Türk Medeni Kanunu – TMK m. 517/II). Sınırlı
ayni haklardan biri olan intifa kazandırmasının denkleştirilmesi ve tenkisi,
bir malın mülkiyetinin kazandırılması şeklinde gerçekleşen sağlararası ve ölüme
bağlı tasarrufların denkleştirilmesi ve tenkisinden farklı olarak kendine özgü
belli başlı problemleri içinde barındırmaktadır. Sağlararası bir işlemle ve
herhangi bir süre belirlemeksizin yapılan intifa hakkının denkleştirilmesinin
nasıl yapılacağı; saklı paylı mirasçı, lehine yapılan intifa kazandırmasını
reddederek saklı payını mülkiyet şeklinde talep edip edemeyeceği; saklı paylı
mirasçıların TMK m. 568’in intifa hakkının tenkisi bakımından tanıdığı seçimlik
haklar hususunda anlaşmazlığa düşmeleri durumunda mahkemenin hangi yönde karar
vereceği, bu kapsamda tartışılan hususlardan öne çıkanlarıdır.