bluuebunny/crossref_metadata_2025 huggingface dataset:
Study of Cardiac Manifestation in Patients with Seropositive Dengue Fever and to Find Correlation with Subclinical Cardiac Involvement
Authors: Ahmed Rishad
Published: December 2021

Objective: The main objective of the present study was to observe the electrocardiogram (ECG) changes in dengue fever and to find correlation with subclinical cardiac involvement.
Methods: This was an observational, prospective, non-randomized study. High grade fever for one to five days diagnosed as dengue infection later confirmed by dengue tests (NS1, IgG and IgM ELISA) were included in this study. Prior to the commencement of the study informed consent was taken from all the participants. With 12 lead ECG taken during the febrile phase of dengue fever randomly selected serologically confirmed cases of dengue fever were evaluated at an interval of 24 hrs. for a total of five days. On the day of admission when the patient was afebrile, echocardiography was done. Plasma leakage was diagnosed by presence of any one of four: subcutaneous oedema (pedal oedema, facial puffiness) or pleural effusion or pericardial effusion or ascites.
Result: A total 80 patients who were admitted to hospital during study periods due to symptoms of dengue fever and IgM dengue positive status were included in this study. Among this total population of 80 patients (N=80) 48 were male and 32 were female. Out of these, majority were diagnosed as DF 52 (65%), 23 (29%) were diagnosed as DHF and rest only 5 (6%) were diagnosed as DSS. Total 54 patients were found to have normal ECG among which 35 were having dengue fever, 16 were having DHF and 3 were having DSS. Total 2 patients were diagnosed to have left ventricular hypertrophy among which one had dengue fever and rest two had DHF. ST depression was observed in total 7 patients in which 5 were had dengue fever and 2 were had DHF. Relative bradycardia was found in 14, tall t waves in 2 and ventricular ectopics in 1 patient (table 2). Abnormal ECG findings were compared using Chi-square test and were found to be statistically significant (P < 0.05) in dengue fever and DHF. There was statistically significant correlation between ECG abnormalities and abdominal pain and mucosal bleed. The presence of plasma leakage were observed among 77 (96.3%) patients. Proportion of echocardiography abnormalities were higher among patients with plasma leak 6 (30%) as compared to without plasma leak 9 (15%), this difference was not found to be statistically significant
Conclusion: In all type of Dengue infections incidence of cardiac involvement was quite high. Due to the overlapping clinical manifestations such as capillary leak associated with DENV infection, tachycardia, pulmonary edema, and hypotension as well as due to the low index of clinical suspicion cardiac involvement in dengue fever is often underdiagnosed.

Keywords: Cardiac manifestation, dengue infection, echocardiography, electrocardiography.
National Bank for Agriculture and Rural Development (NABARD)
Authors: Das Mamoni
Published: December 2021

Indian economy is agricultural economy and real India lies in villages. Without the development of the rural economy, the objectives of economic planning cannot be achieved. Hence, banks and other financial institutions are considered to be a vital role for the development of the rural economy in India. NABARD are playing a pivotal role in the economy development of the rural India. In the Indian context rural development assumes greater significance as nearly 70% of its population lives in rural areas. Most of the people living in rural area draw their livelihood from agriculture and allied sectors. Such areas are distinct from more intensively settled urban and suburban areas. Life styles in rural area are different than those in urban areas, mainly because limited services are available. Governmental services like law enforcement, schools, fire departments may be distant, limited in scope, or unavailable. Rural development is a national necessity and has considerable importance in India. The main objective of the rural development programme is to raise the economic and social level of the rural people. National Bank for Agriculture and Rural Development (NABARD) is set up as an apex institution by the Government of India with the main objective of providing and regulating credit and other facilities for the promotion of rural development. It is a single integrated organisation which looks after the credit requirements of all types of agricultural and rural development activities. The present study is a modest attempt to the credit potential for agriculture during the year 2021-22. The study covered aspects such as functions, objectives, management and organizational structure, sources of funds, activities achieved, loan assistance to various institutions, Methodology for preparation of potential linked credit plans (PLPs) and Development Projects in Andaman and Nicobar Islands.

Keywords: NABARD, Rural Development, RBI and SHGs..
Fekalna transplantacija
Authors: Krkić Drobić Aida
Published: December 2021

Transplantacija mikrobiota
iz fecesa (eng. fecal microbiota transplant, fmt) proces je transplantacije infuzije bakterija iz stolice
zdravog donora do primatelja s bolešću za koju se vjeruje da je povezana s
nezdravim crijevnim mikrobiomom. unos kapsuliranih bakterija zdrave osobe
provodi se endoskopom, nazogastričnom sondom ili oralno pomoću kapsule. taj je
pristup prilično uspješan za liječenje infekcija uzrokovanih bakterijom clostridium
difficile, koja uzrokuje po život opasne proljeve. u literature je nađeno da
je kompatibilnost između donora i primatelja znatno važnija nego što se zasada
smatra, pa bi takvim pristupom primjena fmt-a vjerojatno bila uspješna i u
liječenju drugih crijevnih oboljenja. pokazalo se da je
„bakterijska kompatibilnost“ donora i primatelja izuzetno važna – transplantat
jednog donora imao je različite učinke kod triju različitih bolesnika. da bi se
minimalizirao rizik od infekcije ili prijenosa drugih bolesti, potencijalni
donori podvrgavaju se rigoroznom pregledu, uključujući temeljito uzimanje
anamneze, serološke testove i fekalne testove na parazitske, virološke i
bakterijske patogene. iako postoje neke razlike među institucijama, doneseni su
prihvaćeni protokoli za skrining donora. uz banke fecesa, koje
pružaju univerzalni fekalni materijal za korištenje, koji je visoko pregledan i
katalogiziran, mogu se prevladati prepreke poput troškova i dostupnosti, što
omogućuje pojednostavljivanje istraživanja i liječenja. Uz to, uporaba kapsule FMT-a povezuje se s
poboljšanom pogodnošću, smanjenom nevoljkošću bolesnika i pojednostavljenom
proceduralnom pripremom. Kako bi se održala sigurnost bolesnika i prikladna
uporaba fmt-a, očekuje se pojavljivanje standardiziranih protokola za probir
davatelja, pripremu stolice, načina isporuke i indikacija primatelja za
liječenje.
THE INTERMEDIATION ROLE OF CENTRAL CYCLOOXYGENASE PRODUCTS TXA2, PGF2Α, PGE, AND PGD IN OREXIN-EVOKED CARDIOVASCULAR EFFECTS
Authors: ALTINBAŞ Burçin
Published: December 2021

Centrally injected some prostaglandins (PG) and orexin (OX) produce similar cardiovascular responses. We have recently reported that both central cyclooxygenase (COX) and central lipoxygenase (LOX) enzymes mediate the cardiovascular effects of OX. In the current study, we aimed to investigate the mediating effects of thromboxane (TX) A2, PGD, PGE, and PGF2, as COX pathway subproducts known to be active in cardiovascular control, on cardiovascular responses elicited by OX. Intracerebroventricular (i.c.v.) injection of OX increased cardiovascular levels in normotensive male Sprague Dawley rats. Moreover, central pretreatment with the TXA2 synthesis inhibitor furegrelate, PGF2α receptor antagonist, PGF2α-dimethylamine, PGE, and PGD receptor antagonist AH6809 partially attenuated the centrally administered OX -induced pressor and tachycardic cardiovascular responses in rats. In conclusion, our results show that i.c.v. injection of OX increases blood pressure and heart rate. Moreover, TXA2, PGF2α, PGE, and PGD mediate, at least in part, the centrally applied OX -evoked pressor and tachycardic responses. The results suggest that centrally injected OX -evoked pressor and tachycardia responses may also be mediated by arachidonic acid metabolites other than TXA2, PGF2α, PGE, and PGD.
Đọc nội dung “Hồ Chí Minh - Nhà giáo dục đi trước thời đại” của Trần Văn Nhung: những cộng hưởng và liên tưởng
Authors: Đặng Quốc Bảo , Nguyễn Văn Đệ , Phạm Minh Giản
Published: December 2021

Hồ Chí Minh được Tổ chức Giáo dục, Khoa học và Văn hóa Liên hiệp quốc (UNESCO) tôn vinh là “Anh hùng giải phóng dân tộc và Nhà văn hóa kiệt xuất”. Những di sản mà Người để lại luôn có giá trị lý luận và thực tiễn, đặc biệt trong lĩnh vực giáo dục. Hồ Chí Minh được xem là nhà giáo dục đi trước thời đại. Những tư tưởng, triết lý giáo dục của Người được chứng minh có sự tương đồng với những tư tưởng của các danh nhân, tổ chức trên thế giới. Giáo sư Trần Văn Nhung đã thể hiện những cảm xúc, ghi nhận những điều trên trong chuyên khảo“Về giáo dục và đào tạo - Đôi điều ghi lại”. Bài viết tổng thuật và công hưởng của nhóm tác giả góp phần khẳng định Hồ Chí Minh là một nhà giáo dục vĩ đại với tầm nhìn xa trông rộng.
Biện pháp bồi dưỡng kỹ năng mềm cho sinh viên ngành Giáo dục Tiểu học, thông qua dạy học bộ môn Tiếng việt - Văn học và Phương pháp dạy học
Authors: Nguyễn Văn Bản
Published: December 2021

Bài viết xác định những kỹ năng mềm cần thiết và phân tích thực trạng kỹ năng mềm của sinh viên ngành Giáo dục Tiểu học, Trường Đại học Đồng Tháp. Trên cơ sở đó, đề xuất các biện pháp bồi dưỡng kỹ năng mềm cho sinh viên ngành Giáo dục tiểu học thông qua dạy học các môn học Tiếng Việt - Văn học và Phương pháp dạy học.
Phát triển nguồn lực đảm bảo thực hiện truyền thông giáo dục giá trị sống cho thế hệ trẻ
Authors: Nguyễn Diệu Ngọc
Published: December 2021

Công tác truyền thông giáo dục giá trị sống cho học sinh, sinh viên nếu được đầu tư thỏa đáng về mặt nhân lực, vật lực sẽ mang lại những hiệu quả thực tế, góp phần giải quyết những thách thức của giáo dục giá trị sống, đáp ứng yêu cầu phát triển con người toàn diện mang giá trị văn hóa truyền thống Việt Nam trong bối cảnh hội nhập quốc tế. Bài báo đề cập đến các yêu cầu truyền thông giáo dục giá trị sống, từ đó đưa ra một số giải pháp phát triển nguồn nhân lực và cơ sở vật chất đảm bảo thực hiện hiệu quả công tác truyền thông giáo dục giá trị sống cho thế hệ trẻ trong bối cảnh hiện nay.
Biểu tượng "chim" trong ca dao dân ca Nam Bộ
Authors: Đào Duy Tùng
Published: December 2021

Biểu tượng “chim” là kết quả của sự biểu trưng hóa nghệ thuật mang đậm dấu ấn văn hóa của vùng đất Nam Bộ. Nghiên cứu biểu tượng “chim” có ý nghĩa khoa học và thực tiễn vì một mặt có thể góp thêm tư liệu cho việc nghiên cứu các biểu tượng ngôn ngữ, mặt khác góp phần khẳng định giá trị tư liệu văn hóa của ca dao, dân ca Nam Bộ. Bài viết nghiên cứu ngôn ngữ biểu tượng “chim” trong ca dao, dân ca Nam Bộ trong mối quan hệ ngôn ngữ - tư duy và văn hóa, qua đó cung cấp cho người đọc những thông tin hữu ích về đời sống sinh hoạt, đời sống tình cảm, cách tư duy của người Việt Nam Bộ qua biểu tượng “chim”.
Một số biện pháp đánh giá kết quả học tập của sinh viên theo hướng tiếp cận năng lực thông qua dạy học môn Phương pháp dạy học toán tại Trường Đại học Đồng Tháp
Authors: Lê Xuân Trường
Published: December 2021

Đánh giá với tư cách là một bộ phận của quá trình dạy học cần đóng góp một cách có ý nghĩa vào việc học tập của sinh viên, đánh giá không đơn thuần chỉ là việc thu thập các thông tin về chất lượng học tập của sinh viên mà còn tạo cơ hội và thúc đẩy quá trình học tập của họ. Chính vì vậy, đề ra được các biện pháp thích hợp để đánh giá năng lực học tập của sinh viên sẽ là một trong những động lực quan trọng nâng cao chất lượng đào tạo. Bài báo này đề xuất, phân tích được một số thành tố của năng lực học tập môn phương pháp dạy học toán và đề ra được các biện pháp khả thi về đánh giá năng lực của sinh viên trong khi học tập môn học này.
Bước đầu hình thành năng lực giảng dạy thực hành cho sinh viên ngành Sư phạm Hóa học
Authors: Đặng Thị Thu Liễu
Published: December 2021

Hóa học là một khoa học thực nghiệm, vì vậy người giáo viên không chỉ có kiến thức lý thuyết tốt mà kỹ năng thực hành thí nghiệm cũng rất quan trọng. Thí nghiệm Hóa học là công cụ góp phần đổi mới phương pháp dạy học theo hướng tích cực hóa hoạt động học tập của người học. Do đó, trong quá trình đào tạo giáo viên sư phạm Hóa học, bằng nhiều cách thức khác nhau, sinh viên cần được hình thành, bồi dưỡng từng bước những năng lực chuyên môn, trong đó cần đặc biệt chú ý đến năng lực giảng dạy thực hành Hóa học nhằm phục vụ tốt hơn cho công tác giảng dạy trong tương lai.
Sử dụng phương pháp trò chơi trong dạy học tiếng Việt ở tiểu học nhằm phát triển năng lực nghe, nói, đọc, viết cho học sinh
Authors: Lê Sao Mai
Published: December 2021

Vui chơi là hoạt động không thể thiếu được của con người ở mọi lứa tuổi, đặc biệt là ở lứa tuổi tiểu học. Hoạt động vui chơi có chủ đích sẽ mang lại những hiệu quả thiết thực hỗ trợ cho việc học nói chung và cụ thể ở đây là môn Tiếng Việt nói riêng. Bài viết trình bày những khái niệm cơ bản về năng lực ngôn ngữ và năng lực tiếng Việt; đưa ra các nguyên tắc và quy trình sử dụng trò chơi dạy học môn Tiếng Việt nhằm phát triển năng lực ngôn ngữ cho học sinh. Việc sử dụng trò chơi dạy học môn Tiếng Việt đã tạo điều kiện dạy tiếng Việt theo quan điểm giao tiếp, giúp thực hiện dạy học tích hợp và phát huy tính tích cực trong học tập của học sinh.
Nghiên cứu vấn đề đầu tư từ ngân sách nhà nước đối với phát triển Dạy nghề ở nước ta hiện nay
Authors: Phạm Anh Tuân , Ngô Việt Cường , Phạm Duy Phương
Published: December 2021

Bài báo phân tích mối quan hệ giữa gia tăng mở rộng quy mô đào tạo nghề và thực trạng đầu tư từ ngân sách nhà nước đối với phát triển Dạy nghề. Qua đó đề xuất một số giải pháp nhằm nâng cao kinh phí đầu tư và hiệu quả đầu tư ngân sách nhà nước đối với phát triển dạy nghề ở nước ta hiện nay.
Phân tích phổ quang electron của cluster MnS- bằng hóa học lượng tử tính toán
Authors: Trần Văn Trận , Trần Quốc Trị , Nguyễn Minh Thảo , Phan Trung Cang , Trần Văn Tân
Published: December 2021

Các trạng thái electron cơ bản và kích thích của cluster MnS−/0 được nghiên cứu bằng các phương pháp CASSCF và NEVPT2. Kết quả chỉ ra rằng, trạng thái electron cơ bản của cluster MnS− là 7Σ+ với 6 electron độc thân phân bố trên các orbital phân tử có lượng đóng góp chủ yếu của orbital 3d và 4s của Mn. Trạng thái electron cơ bản của cluster MnS là 6Σ+. Các kết quả tính đã được sử dụng để giải thích phổ quang electron của cluster MnS−.
Sự biến động các yếu tố môi trường nước trong hệ thống ương nuôi cá tra (Pangasianodon hypophthalmus) tuần hoàn
Authors: Nguyễn Thị Hồng Nho
Published: December 2021

Cá tra 15 ngày tuổi được ương trong hệ thống tuần hoàn cho đến khi cá đạt chiều cao thân 1,5 cm. Mật độ cá thả là 2 con/l. Mẫu nước được thu hàng tuần tại bể nuôi, bể lắng và bể lọc. Cá được cân, đo 3 lần vào đầu, giữa và cuối thí nghiệm. Kết quả thí nghiệm cho thấy các yếu tố TSS, NO3-, TN và PO43- tăng về cuối thí nghiệm. Hàm lượng TAN, NO2- được duy trì ở mức thấp; pH, độ kiềm có xu hướng giảm. Tốc độ tăng trưởng tương đối trung bình của cá là 4,32%/ngày và tốc độ tăng trưởng tuyệt đối trung bình là 0,30 g/ngày. Tỉ lệ sống của cá đạt 100% sau 56 ngày thí nghiệm.
Translanguaging, Diglossia and Bidialectalism in the Video Gamer Argot
Authors: Arnold-Stein Róbert , Hortobágyi Ildikó
Published: December 2021

Video games have undergone an extensive technological advancement which has triggered a rapid shift in the role and potency the different media have gained in meeting infotainment needs. The widespread use of the internet has increased the frequency of video gaming among the youth thus promoting the emergence of linguistic material which could be instrumental in second language acquisition. The present paper aims to reveal the linguistic gains from virtual multicultural environments for video gamers in relation to their communication needs, a situation which rightfully characterizes them as bilinguals. Despite the continuing linguistic experimentation activities initiated by researchers, the video gamers’ language utilization has not been paid much attention to as potential research domain in bi/multilingualism. The research has capitalized on the germane information of a cross sectional survey conducted on secondary school video gamer students in Hungary by investigating their language use habits derived from video game usage. The ample research scope results contribute to filling the linguistic gap of word formation methods, translanguaging, diglossia and bidialectalism by comparing the international and Hungarian instances of the video gamer argot. We also journey through the description, modelling, explanation of several processes which could happen within and outside the digital world as an illustration of language use in contact.
Fotogrametrik nirengiyle üretilen ortofoto haritalar ile koordinat altyapısındaki değişimlerin analizi: İzmit Körfezi örneği
Authors: ARSLAN Ozan , YAĞCIOĞLU Kubilay
Published: December 2021

Digital fotogrametrik nirengi yöntemiyle üretilen ortofoto haritaların doğruluk değerlendirmesi, üretim sürecini etkileyen çok sayıda parametre olması nedeniyle karmaşık bir konudur. Bu çalışmada Kocaeli ilinde kinematik GPS/IMU destekli fotogrametrik nirengi yöntemiyle üretilen 1:5000 ölçekli sayısal fotogrametrik harita ve ortofotoların geometrik doğruluğunun değerlendirilmesi amaçlanmıştır. Proje sahasında blok içinde yer alan yer kontrol ağının geometrik doğruluk kalitesi, üretilen haritaların doğruluğuna yansıyacağından göz önünde bulundurulması gereken bir husustur. Kocaeli kenti Kuzey Anadolu Fay Sistemi üzerinde bulunduğundan, bölgede zeminin jeoteknik özellikleri nedeniyle mevcut yer kontrol ağı noktalarında ve özellikle İzmit Körfezi kıyı boyunca zeminde kararsızlık problemi oluştuğu da bilinmektedir. Bu nedenle belirtilen problemin, projede fotogrametrik nirengi blok doğruluğuna ve 15 cm yer örnekleme aralığı ile üretilen ortofoto haritaların doğruluk değerlerine hangi düzeyde yansıdığını araştırmak önem kazanmıştır. Bu amaçla zemin kararsızlığı tespit edilmiş olan körfez kıyı alanlarında GPS ile arazi kontrol ölçmeleri yapılarak doğruluk değerlendirmesi yapılması planlanmış ve belirtilen sahalarda digital ortofoto üzerinde seçilen detaylar, arazide kontrol amaçlı olarak GPS ile ölçülmüş ve elde edilen nokta konum koordinatları karşılaştırılmıştır. Arazi ve ortofoto üzerinden üretilen noktaların planimetrik doğruluklarının ortalaması 31.5 cm olarak elde edilmiş olup; harita ölçeği dikkate alındığında elde edilen sonuç bulguların BÖHYY’de öngörülen hata sınırları içerisinde ve uluslararası standartlara da uygun olduğu görülmüştür.
Management challenge of basilar artery occlusion in SUS: Case report
Authors: Ferreira Isadora Santos , Silva Mauricio Elias Nunes da , Rebouças Liz Barros , Carra Rafael Bernhart , Gleizer Rene de Araújo , Alquéres Rafaela Almeida
Published: December 2021

Context: Stroke caused by basilar artery occlusion is rare, corresponding to 1% of strokes. There is no consensus in the literature on the ideal management of this disease at acute phase. However, mechanical thrombectomy may be a viable treatment option. Case report: 68-year-old female, with no comorbidities, admitted to a secondary hospital 14h after headache, dizziness, vomiting and difficulty walking. She was disoriented, with severe dysarthria and dysphonia, horizontal and vertical ophthalmoparesis and pronation of the right upper limb (NIHSS: 4). Cranial tomography was normal and cranial angiotomography showed a basilar artery thrombosis. Patient was out of the window for intravenous thrombolysis and our hospital did not have another possibility of treatment. Due to high morbidity and mortality, also the possibility of neurological deterioration, medical contact was made with a tertiary hospital with hemodynamic service. During patient transference, she evolved with decreased level of consciousness, aphasia and tetraparesis (NIHSS: 18). Upon arrival at the hospital, a thrombectomy was performed due to an important clinical-radiological mismatch, 19 hours within symptoms onset and 3 hours after neurological worsening. After discharge, patient walked with assistance and physical examination showed a significant improvement in neurological deficits (NIHSS: 6). Conclusions: This case demonstrates the importance of engaging Brazil’s public health system in the management of acute ischemic stroke, especially in challenging cases such as basilar artery occlusion. This patient was the first admitted to our hospital to perform a thrombectomy after effective transference for a tertiary hospital and staff engagement of both hospitals.
Morphometric analysis of the orbit in dry human skulls in Northeast Brazil
Authors: Borba Sarah Dias de França , Melo Tássia Santos de , Ferreira Larissa Vilar , Lucena Jalles Dantas de , Oliveira André de Sá Braga , Alexandre Lucas de Andrade
Published: December 2021

Introduction: The orbit is a bone cavity in the skull. Its morphological and anthropological knowledge is essential, as it is a region subjected to several surgical procedures. Objective: To analyze the morphology of orbits in the skulls of two populations in Northeastern Brazil Methods: 115 skulls belonging to Federal University of Paraíba (UFPB) and Federal University of Ceará (UFC) were analyzed. The skulls were categorized into three types: Megaseme, Mesoseme and Microseme. Quantitative analysis included these measurements: orbital height (OH), Orbital Breadth (OB) and index orbital (OI). Data were prepared for statistical analysis using IBM SPSS 23 software, with a significance level of 5%. Results: 58 skulls (50.4%) were female and 57 (49.6%) were male. The sample consisted of 91 (79.1%) skulls from UFPB and 24 (20.9%) from UFC. At UFPB, 85.16% of the orbits were Microseme, 12.64%, Mesoseme and 2.2%, Megaseme. In the UFC, 58.3% were Microseme, 25%, Mesoseme and 16.7%, Megaseme. Considering both populations, 79.6% of the orbits were microseme, 15.2%, mesoseme and 5.2%, megaseme. There were no differences in morphometric parameters between the orbits (p> 0.05). When comparing the two populations studied, there were significant differences in the variables OI and OB (p <0.05). Conclusions: Orbits were of the Microseme type. No difference between the height of the UFC and UFPB orbits was found, however, there was a difference in OI and OB. These regional differences corroborate the clinical and surgical importance of the morphological study of the orbit, as it undergoes changes depending on the population.
Psychomotor consequences in children with Tourette’s Syndrome
Authors: Vasconcellos Barbara Cunha , Arbex Tamie Mota , Ziehe Aline Silva , Senna-Fernandes Lara Cruz de , Barbosa Samantha Golçalves , Cordeiro Tatiana Virgínia Fidélis , Rodrigues Caio Andrade Prins
Published: December 2021

Background: Tourette’s Syndrome (TS) has a neuropsychiatric aspect and a chronic repertoire of motor-phonic tics. The common onset is in infants and remission in adults. Objective: investigate psychomotor consequences in children with TS. Design and settings: literature review. Methods: eleven studies were selected from a group of 20 after searching the MEDLINE database for “psychomotor performance OR psychomotor development” and “Tourette’s Syndrome”. Only articles with full texts available and published from 2011-2021 were included. Results: the response time (RT) of children with TS was longer. Throughout Do/Don’t tasks, with/without false alarms, the RT was lower while the accuracy of movement (AM) was greater. A study on RT and AM with different levels of complexity showed greater difficulty in ST group (p<0.001) with RT increasing according to complexity. Many children with TS also had ADHD, and when comparing them to the ones only with TS, the ADHD+TS group made more mistakes while having the same RT. The ADHD+TS group also had a response blockage in non-sequential tests and lower TS in sequential tests (p=0.006). Studies showed an association between motor tics and forgetfulness rate (FR), with these being inversely proportional. Conclusion: children with TS have greater RT and the response to uni and bimodal stimuli differ, with greater AM and lower RT to single stimulus. More severe tics were associated with better content retention. Other psychiatric disorders are common, especially ADHD, requiring further studies to link the consequences of each pathology accordingly.
Cognitive function and risk factors in the older population: differences between the sexes
Authors: Barros Vinícius Lúcio de , Bomfim Larissa Gomes Peres , Souza Melyssa Alves , Ginsicke Danielle , Colovati Mileny Esbravatti Stephano , Zanesco Angelina
Published: December 2021

Background: Studies have shown a sex difference in the cognitive dysfunction in the elderly where women are more susceptible to Alzheimer’s disease than men. Physical activity (PA) is an important strategy for brain health, but the exact mechanism is unclear. Santos has the largest proportion of the elderly population in São Paulo State (22%), but no studies have whether there are differences between the sexes in cognitive function. Objective: To evaluate the differences between the sexes in the cognitive function of the elderly and which factors are associated with this difference. Methods: Ninety-seven women and sixty-nine men were eligible for the study. Inclusion criteria were >65 years old, no severe cognitive impairment, preserved activities of daily living. Cognitive function and PA were assessed by the mini-mental state examination (MMSE) and Baecke questionnaire. Results: The mean age was 75±7 and 73±7, for women and men, respectively. Both sexes showed a similar MMSE score (26, varying between 14 and 30) that was inversely associated with age. The influence of the schooling status on MMSE was greater in women (r=0.49, p=0.0001) compared to men (r= 0.30, p9. Conclusions: The MMSE score is affected by the aging process similarly between the sexes. The years of schooling have an influence on cognitive function in women that is attenuated by higher PA. Ethical Committee: CAAE 20938619.4.0000.5509. Financial Support: São Paulo Research Foundation.
Elsberg Syndrome
Authors: Nunes Lília Tereza Diniz , Aota Flávia S. Silva, Karyme G. , Assis Maria Beatriz Miranda S. B. de , Bento João Fellipe B. , Alves Oscar Nunes , Silva Pedro Henrique C. V.
Published: December 2021

Context: Elsberg Syndrome (ES) is a rare syndrome associated with acute or subacute infections, often accompanied by myelitis confined to the lower spinal cord, in addition to paresthesia, weakness in the lower limbs, urinary retention, constipation, among others. It is a self-limiting disease, manifested through primary HSV type 2 infection, especially in immunocompetent patients. Case report: Male patient J.F.C., 58 years old, reports a sudden paresthesia in the lower limbs without other associated clinical conditions for approximately 2 months that progressed to paresis, cramps and loss of sphincter control. Admitted to the General Hospital of Palmas, Tocantins on 02/18/2020 with suspicion of Peripheral Polyneuropathy that was discarded after electroneuromyography. Imaging exams without relevant findings. After a week of hospitalization, multiple lesions appeared in the region of the lower third of the dorsum and buttocks, compatible with lesions by HSV (herpes simplex virus) and the diagnosis of ES was concluded. At the moment, he was undergoing treatment with acyclovir and awaiting the evolution of the condition. Conclusion: ES is an often unrecognized cause of lumbosacral radiculitis, which is why it is important to establish as a diagnosis differential. The analysis of CSF, PCR and MRI confirm the diagnosis in cases of HSV-2 lumbosacral radiculomyelitis. CSF usually reveals a lymphocytic pleocytosis and a slight elevation of proteins.
Morphological study of foramen venosum in dry human skulls in Northeast Brazil
Authors: Rodrigues Ivon Marcos Inácio , Magalhães Desiré Dominique Diniz de , Oliveira André de Sá Braga , Oliveira Pablo Mariz de , Carneiro Amanda do Nascimento Oliveira e
Published: December 2021

Introduction: The foramen venosum (FV) is located in the larger wing of the sphenoid bone and allows the passage of emissary veins that help to balance the intra and extracranial pressure. Knowledge of its morphology and associated structures has an important surgical value. Objective: Analyze the morphology of FV and its relation to adjacent foramina in Northeast Brazil. Methods: 117 human adult skulls of Federal University of Paraíba were classified by gender, FV type and laterality, being evaluated the diameter of FV, foramen ovale (FO) and foramen spinosum (FS), as well as the distance of FO and FS to FV (DFVFO and DFVFS). Values of p≤0.05 were considered significant. Results: 52 (44.4%) skulls (65 sides, 29 on the right and 36 on the left) presented FV, being 63.46% females and 36.53% males. 33.3% of FV were unilateral and 11.1% were bilateral. The FV were mostly oval (50.7%) and round (49.3%) types. Mean diameter of FV was 3.56±0.7mm, FO 7.88±1.16mm, FS 4.01±0.39mm, DFVFO 8.18±1.09mm and DFVFS was 14.54±1.68mm. Only FO (p=0.009) and FS (p=0.001) had significant differences between genres, and DFVFO had among sides (p=0.021). Conclusions: FV has a high incidence in Northeast Brazil, predominantly in females on the left side with oval and round types. Its relation with other foramina showed differences among genres and sides. This shows the relevance of the FV study to minimize the risk of iatrogenic injury during surgical interventions in this region.
An epidemiological overview of spina bifida in Brazil in the years 2010 to 2019
Authors: Silva Bianca Brinques da , Paglioli Victoria Bento Alves , Bernich Natali Rocha , Soares Bruna Martins de , Redmann Lucas Henrique Skalei , Guglielmi Vanessa Saling , Falcetta Julia Estrazulas , Fassina Vitória , Ferrari Gabriela Kreutz , Affonso Ana Laura Terra , Toffoli Laura , Busin Isabella Montemaggiore , Oliveira René Ochagavia Chagas de , Ribeiro Ana Luiza Savioli , Roehrig Júlia Bortolini
Published: December 2021

Background: Spina bifida is a birth defect not fully understood, which suggests the association of genetic factors with environmental factors as possible causes. Objectives: To analyze the epidemiological data of Spina Bifida in the period from 2010 to 2019 in Brazil. Design and setting: Descriptive cross-sectional epidemiological study with patients with Spina Bifida in Brazil between 2010 and 2019. Methods: Study realized using data from the Department of Information of the Brazilian Health System (DATASUS). The data used were classification, sex, ethnicity, Regions of Brazil, mother’s age and adequacy to prenatal care. Results: In this period, there were 10,309 cases of spina bifida and a record of 229 deaths. In classification criteria, a non-specific spina bifida predominated, corresponding to 74.3%. The greatest number of hospitalizations occurs in children under 1 year of age. At maternal age, cases of spina bifida prevailed in mothers aged 15 to 29 years. Regarding prenatal, 36.91% were considered more than adequate. The Northeast is the region with the most reports of spina bifida cases in the country. In relation to sex, girls are followed up similarly to boys. The black race and the white count the majority of cases. Conclusion: The profile of anomalous patients is brown skin and less than 1 year old of both sexes and children of mothers aged between 15 and 29 years. Spina Bifida unspecified is the most frequent.
Neurological conditions caused by microgravity
Authors: Pereira Luiza de Lima , Sousa Ana Flávia Silva e , Mota Júnior Anderson Pedrosa , Rezende Giovanna Martins Romão , Ribeiro Marcella Ferreira , Colaço Carolina Ferreira
Published: December 2021

Background: Since Space Tourism is closer to reality, a review of the most prevalent neurological pathologies in microgravity is needed. Objective: Review major neurological afflictions in astronauts. Methods: Research into bibliographic reviews at PubMed, using the descriptors “astronauts” and “neurological disorders” Results: Several neurological alterations, such as ataxy, intracranial hypertension (ICH), neuromuscular disorders, ocular disturbances and changes in cognitive functions were assigned to a microgravity environment. Astronauts returning from space presented ICH; being the main pathophysiology hypothesis referred to a change in the liquor dynamics as a result of venous drainage obstruction and hematoencephalic barrier. Also, gravity doesn’t act on the neurovestibular system during space flights. This phenomenon can lead to Space Motion Sickness, situation in which astronauts report balance, coordination and sight disturbances, as well as movement illusions. A subset of this syndrome, called Space Movement Disorder, may occur; which includes symptoms, such as flushing, anorexia, nausea, vomiting, dizziness and malaise. Based on electromagnetic resonance, the occurrence of problems with movement time, balance, spatial working memory and motor coordination after the return of the space crew suggests alterations in cerebellum’s function and structure, which is responsible for the coordination and the fine motor control. Conclusion: Most studies presented disruptions of the neurofunctional homeostasis, for instance, changes in functional connectivity while in rest and alterations of the white and grey matter in sensor motor, somatosensory and cognitive regions of the brain.
Use of Mannitol and Saline Solution in the management of ICP in patients with Traumatic Brain Injury: Evidence of superiority?
Authors: Purificação Isaac Rêgo , Meira Rodrigo Defensor , Costa Vitor Gabriel Dantas
Published: December 2021

Background: Mannitol (MT) and Hypertonic Saline Solution (HSS) exert an osmotic effect by lowering Intracranial Pressure (ICP) in patients with Traumatic Brain Injury (TBI), but there are doubts as to which is more efficient. Objective: Analyze the use of MT and HSS in the management of ICP in patients suffering from TBI. Design and Settings: This is a literature review, produced by medical students from Bahia, Brazil. Methods: The evaluated studies were obtained in PubMed, with MeSH terms, published since 1988. The studies that did not correspond with the purpose of this review were excluded. Results: 34 of the 114 articles found, were selected. Observational and laboratory studies have shown an advantage in the use of SSH to reduce ICP and a longer duration of the effect in relation to MT. However, clinical trials and meta-analyzes do not show significant differences in relation to MT and SSH for reducing ICP, however they describe a slight preference for the use of SSH. As for side effects, MT mainly causes hemodynamic changes such as hypotension and SSH causes a significant increase in serum sodium concentration. Conclusion: Although there are benefits to both the use of TM and SSH, there is a preference to use SSH for the management of ICP in patients with TBI. The studies were not enough to show superiority in relation to these solutions and new Clinical Trials must be carried out.
Meningitis: etiological and outcome panorama in Brazil in the 2019-2020 biennium
Authors: Azeredo Saulo , Escher Emanuel Kerber, Yasmynni , Martio Artur , Angeliero Victor
Published: December 2021

Background: Meningitis is the inflammation of the meninges. The outcome varies between etiologies. It is endemic in Brazil with mandatory notification. Objectives: To analyze the number of diagnoses and outcomes of meningitis in Brazil in the 2019-2020 biennium. Design and setting: Cross-sectional epidemiological study using DATASUS database realized by Neurology department of the University of Passo Fundo. Methods: Data from patients diagnosed with meningitis in the period from 2019 to 2020 were included, correlating them to the etiologies and their outcomes. Results: There was a 70.8% reduction in the absolute number of diagnosed meningitis in 2020 (4,713) compared to 2019 (16,155). The most prevalent specified cause was “viral meningitis”, corresponding to 49,1% in 2019 and 42% in 2020. There was no great variation in the percentage of etiologies. “Hospital discharge”, corresponding to 76.8% in 2019 and 68% in 2020. “Death” was the outcome of 14.8% of patients in 2020 and 12.9% in 2019. The most related option to “Death from meningitis” was “Bacterial meningitis”, responsible for 24% in 2020 and 21.3% in 2019. Conclusions: The number of diagnoses of meningitis fell in the 2019-2020 comparison. The context of under-diagnosis worries because it means late diagnoses and worse outcomes.
The role of Transcranial Doppler in the detection of vasospasm after subarachnoid hemorrhage: updates and new parameters
Authors: Purificação Isaac Rêgo , Oliveira João Gustavo dos Anjos Morais , Brandão Gabriela Sarno , Assis Ana Flávia Paiva Bandeira , Santos Leonardo Mattos , Cruz Mariana Portella Lopes , Cunha Matheus Almeida Ribeiro da , Alves Isabella Trindade Lopes , Fernandes Raimundo Nonato Ribeiro
Published: December 2021

Introduction: Transcranial Doppler (DTC) is useful in the evaluation of vasospasm after subarachnoid hemorrhage (SAH). Thus, it is important to know the accuracy and impact of this tool in the management of patients. Objective: Analyze the use of DTC in the detection of vasospasm after subarachnoid hemorrhage and its clinical relevance. Design and Setting: This is a literature review, produced in Bahiana School of Medicine and Public Health, Bahia, Brazil. Methods: The evaluated studies were obtained in PubMed, published since 2010. The studies did not correspond with the purpose of this review were excluded. Results: 26 of the 515 articles found, were select. Clinical studies that sought to demonstrate the accuracy of TCD in the detection of vasospasm and prediction of Delayed Cerebral Ischemia show high sensitivity and negative predictive value.There are studies that measure the accuracy of DTC in detecting angiographic vasospasm with high specificity. New parameters are emerging for the detection of vasospasm, even early. However, there are studies that demonstrate that the use of TCD does not favor the clinical outcomes of patients after SAH. Conclusion: TCD has moderate-high accuracy and can help in the detection and management of patients with vasospasm. Nonetheless, there are studies that refute the relevance of TCD in HSA. Furthermore, there is a lack of concrete evidence, with larger studies, for the widespread use of this tool with greater reliability and precision.
Economic impact of hospitalizations for migraine and other cephalic pain syndromes to the Brazilian Unified Health System
Authors: Andrade Isabela Mascarenhas de , Silveira Beatriz Silva , Orleans Beatriz Checcucci de , Silva Fernanda Souza Gracílio da , Magalhães Lara Cordeiro
Published: December 2021

Background: Headache disorders are the third most frequent complaint in ambulatory care facilities, leading to an important loss of healthy years of life. Thus, it is important to study the factors related to hospitalizations due to these syndromes in Brazil. Objective: To describe the profile of hospitalizations due to migraine and other cephalic pain syndromes. Design and methods: This is an ecological study, based on secondary data with a descriptive approach. Data were collected from DATASUS regarding the number of hospitalizations, days spent in hospital, average cost per hospital stay, total amount of expenses, besides sex and age of hospitalized pacients due to migraine and other cephalic pain syndromes from 2011-2020. Results:78.058 hospitalizations were registered, with Southeast region’s prevalence (35.7%). The female and the economically active population (15-64 years) stand out in these results (65.8% and 79.9% respectively). The average permanence was of 3.84 days in SUS and the average value per hospital stay was R$ 407.77. The total amount spent on hospital services was R$ 28,153,255.86. Conclusion: The present study indicates a female and economically active population prevalence in hospitalizations. And also point out a Southeast region’s predominance in total amount of hospitalizations and second place regarding the costs on hospital services.
Meningitis: etiological and outcome panorama in Brazil in the 2019-2020 biennium
Authors: Azeredo Saulo , Kerber Emanuel , Escher Yasmynni , Martio Artur , Angeliero Victor
Published: December 2021

Background: Meningitis is the inflammation of the meninges. The outcome varies between etiologies. It is endemic in Brazil with mandatory notification. Objectives: To analyze the number of diagnoses and outcomes of meningitis in Brazil in the 2019-2020 biennium. Design and setting: Cross-sectional epidemiological study using DATASUS database. Methods: Data from patients diagnosed with meningitis in the period from 2019 to 2020 were included, correlating them to the etiologies and their outcomes. Results: There was a 70.8% reduction in the absolute number of diagnosed meningitis in 2020 (4,713) compared to 2019 (16,155). The most prevalent specified cause was “viral meningitis”, corresponding to 49,1% in 2019 and 42% in 2020. There was no great variation in the percentage of etiologies. “Hospital discharge”, corresponding to 76.8% in 2019 and 68% in 2020. “Death” was the outcome of 14.8% of patients in 2020 and 12.9% in 2019. The most related option to “Death from meningitis” was “Bacterial meningitis”, responsible for 24% in 2020 and 21.3% in 2019. Conclusions: The number of diagnoses of meningitis fell in the 2019-2020 comparison. The context of under-diagnosis worries because it means late diagnoses and worse outcomes.
Study of the prevalence of Frank’s sign in a general population
Authors: Zuniga Rubén David dos Reis , Soares Izadora Fonseca Zaiden , Corazzini Roseli , Carvalho Alzira Alves de Siqueira
Published: December 2021

Background: Frank’s sign is a diagonal crease in the earlobe that extends from the tragus to the inferior-posterior auricle’s edge. Described as a predictor of cardiovascular diseases (CVDs), it was considered an independent cardiovascular risk factor (CRF) and associated with cerebrovascular events and cognitive impairment (CI). Objectives: To assess the prevalence of Frank’s sign in a general population aged 60 years or older regardless of the presence of CRFs and to relate the presence of this sign with epidemiological and clinical aspects. Design and setting: This is an analytical, observational and cross- sectional study accomplished in ABC Region and in Itapecerica da Serra (Greater São Paulo). Methods: 500 individuals aged 60 years or older randomly recruited had their ears photographed, responded to either Mini Mental State Examination or Montreal Cognitive Assessment depending on education achievement. Results: 57% were women; 57% were white, 39% black and 4% asian; 64% had the sign; Frank’s sign was associated with dyslipidemia and almost with hypertension, but not with cardiovascular events or CI. Conclusions: 1. Frank’s sign was more prevalent in older people, in the white population and, for the first time, in women. 2. There is a pattern in the sign prevalence in Greater São Paulo, which differs from the international one. 3. Frank’s sign seems to be a marker for CV risk, but not for previous CV events. 4. There was no association between Frank’s sign and CI. 5. Prospective studies could assure whether this sign is a marker for CVDs in this population.
Chronic inflammatory demyelinating polyradiculoneuropathy induced by paclitaxel
Authors: Borges Isabella Sabião , Moreira João Victor Aguiar , Damasceno Junior Eustaquio Costa , Santos Alencar Pereira dos , Alves Gabriela Tomás , Garcia Leonardo Peixoto , Rosa Maria Fernanda Prado , Assunção Gabriel Nunes Melo , Aguiar Pedro Otávio Rego de , Ferreira Thaciany Soares , Pacheco Glauber Mota , Oliveira Clarice Pereira Sales , Maciel Pedro Henrique Pereira , Fernandes João Paulo Moreira , Bueno Mateus Barros , Souza Rafael Lopes de , Silvestre Leonardo Rivelli , Santos Diogo Fernandes dos
Published: December 2021

Background: Peripheral neuropathies in cancer are most often due to neurotoxic chemotherapeutic agents. Approximately 30% of patients receiving neurotoxic chemotherapy (CTX) will suffer from chemotherapy-induced peripheral neuropathy (CIPN). Paclitaxel is an extremely effective chemotherapeutic agent for the treatment of breast, ovarian, and lung cancer. However, paclitaxel-induced peripheral neuropathy occurs in 59-87% of patients who receive this drug. Paclitaxel is an anti-tubulin drug that causes microtubule stabilization, resulting in distal axonal degeneration, secondary demyelination and nerve fiber loss. Case: We present a case of a 68-year-old female patient with history of breast cancer who presented sensorial ataxia and progressive muscle weakness two months after starting CTX with paclitaxel. The physical examination showed tetraparesis with proximal predominance, areflexia, severe hypopalesthesia and postural instability. Electroneuromyography showed the existence of asymmetric demyelinating polyradiculoneuropathy, with conduction block and temporal dispersion in practically all evaluated nerves. The cerebrospinal fluid confirmed the albumin-cytological dissociation. Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) was confirmed and patient underwent monthly treatment with methylprednisolone with good response. Discussion: Evidences has implicated neuroinflammation in the development of PIPN. While most CTX drugs do not cross the blood-brain-barrier, they readily penetrate the blood-nerve-barrier and bind to and accumulate in dorsal root ganglia and peripheral axons. CTX can induce neuroinflammation through activation of immune and immune- like glial cells. In fact, immune cells (e.g., macrophages, lymphocytes) and glial cells (e.g., Schwann cells) in the peripheral nervous system play important role in the induction and maintenance of neuropathy. Conclusion: CIDP should be included in the spectrum of CIPN.
Cerebrovascular diseases mortality in young adults in the state of São Paulo
Authors: Purificação Isaac Rêgo , Nogueira Allêh Kauãn Santos , Souza Matheus Araújo de , Lima João Vitor Lopes , Jorge Douglas Mateus Pereira , Oliveira João Gustavo dos Anjos Morais , Amancio Bianca Colacioppo Oliveira , Castanheira Luiza Lemos Pinto
Published: December 2021

Background: The incidence of Cerebrovascular Diseases (CVD) increases significantly with age, being more frequent in the elderly. For this reason, there are still few studies that describe the epidemiological profile of these pathologies in youn g adults. Methods and Objective: From the data collected prospectively and allocated on the TabNet platform (DataSUS, MS), an observational, descriptive and cross-sectional study was carried out. As a primary objective, we seek to describe the demographic information most associated with CVD mortality in individuals between 20 and 49 years old, in São Paulo. Results: The year 2011 emerged in relation to mortality, with 1,432 deaths; in the 2010- 2019 period, the average number of deaths (± standard deviation [SD]) was 1,318 (± 61), per year. In this period, the number of deaths was higher in the capital (4,605; 34.9% of the total in the state). The mean deaths (± SD), per year, in the capital and in the interior cities were, respectively: 442 (± 58) and 2.4 (± 6.2). People with schooling from 4 to 7 years old and from 8 to 11 years old were the most affected. The ratio of male deaths to female deaths was 1.05. Conclusion: There is relative stability in relation to mortality per year among young adults in the state of SP, the capital being the city with the highest number of deaths. Male individuals, with a medium level of education were responsible for most of the deaths.