bluuebunny/crossref_metadata_2025 huggingface dataset:
Os desafios constantes de uma psicóloga no abrigo
Authors: Rotondaro Daniela Pacheco
Published: September 2012

Relato sobre a construção contínua de formas de trabalhar com crianças e adolescentes ,em uma Instituição que abriga aqueles que foram abandonados ou perderam os pais. Esses meninos lidam rotineiramente com todos os entraves da institucionalização e tentamos proporcionar-lhes condições para uma estruturação pessoal , visando à independência e autonomia.
Uma contribuição à história do movimento psicanalítico: a trajetória de Wilhelm Reich
Authors: Weinmann Amadeu de Oliveira
Published: September 2012

O artigo propõe-se a reconstituir a trajetória de Wilhelm Reich na história do movimento psicanalítico através da análise de suas contribuições teórico-clínicas e político-institucionais, realizadas no interior desse movimento no período compreendido entre 1920/34.
A lógica do discurso penitenciário e sua repercussão na constituição do sujeito
Authors: Lira Patrícia Oliveira , Carvalho Glória Maria Monteiro de
Published: September 2012

Neste estudo, coloca-se em questão o modo pelo qual se estrutura o sistema penitenciário, buscando uma articulação teórica que permita discutir o sujeito submetido ao discurso norteador de todo o sistema. Nesse sentido, parte-se das questões já abordadas por Foucault, para quem o discurso humanista que fundamenta o sistema penitenciário se constitui como um tipo de controle das condutas e de manutenção de poder. No entanto, procura-se incluir, nessas questões, a problemática da subjetividade implicada na lógica do aprisionamento a partir do referencial de sujeito pressuposto pela psicanálise.
A saída do sujeito sem alta médica: a discussão sobre a autonomia e a postura do profissional psicólogo
Authors: Coelho Adilson Rodrigues
Published: September 2012

Este texto analisa a saída do sujeito do ambiente hospitalar sem autorização do médico. Apresenta ainda uma concepção sobre a Ética, entendida como um processo dialético entre os costumes da sociedade e a afirmação da liberdade do sujeito. Em seguida, o texto aborda a Bioética explicitando a etimologia da palavra Autonomia e sua relação permanente com a Heteronomia, tecendo as principais críticas do século XIX e XX a esse conceito. O texto também destaca maneiras de se controlar a influência dos profissionais de saúde sobre os usuários e finalmente ressalta os aspectos importantes sobre a postura do profissional psicólogo frente à questão inicial.
Da cultura do dentro à etnicidade do fora: o devir como desafio à psicologia brasileira
Authors: Silva Édio Raniere da
Published: September 2012

Por meio dos cruzamentos experienciados entre o XIV Erep-Sul - Encontro Regional dos Estudantes de Psicologia - e o II Fórum Social Mundial, o artigo se propõe a discutir o desafio da pluralidade étnica para a Psicologia brasileira. Demostra haver duas pluralidades possíveis: a do folclore, da essência do dentro, e a da fronteira, da etnicidade do fora, chega, conseqüentemente, a uma Psicologia da homogeneização, cuja intervenção se debruça sobre o indivíduo; e numa outra que, experimentando o devir por desafio, pretende trabalhar com as relações do múltiplo. O texto aponta o devir como desafio à psicologia plural.
Sonhos atrás da porta
Authors: Ramminger Tatiana
Published: September 2012

Este artigo é inspirado nas aulas do mestrado de Psicologia Social e Institucional da UFCRS. A partir da autobiografia de L.F. Barros - "Memórias do Delírio - Confissões de um Esquizofrênico", permito-me uma releitura da psicopatologia, à luz de dois "loucos" pensadores: Foucault e Nietzsche.
O abuso de medicamentos psicotrópicos na contemporaneidade
Authors: Pelegrini Marta Regueira Fonseca
Published: September 2012

O artigo propõe uma análise crítica do fenômeno do abuso de medicamentos psicotrópicos na atualidade. A base teórica é a psicanálise. A argumentação parte da discussão da subjetividade contemporânea, resgatando o conceito de mal-estar na civilização em Freud, para elucidar algumas das causas e dos efeitos desse fato atual.
Repensando a perspectiva institucional e a intervenção em abrigos para crianças e adolescentes
Authors: Arpini Dorian Mônica
Published: September 2012

O trabalho faz uma reflexão sobre a realidade institucional de abrigo para crianças e adolescentes, mostrando, através do discurso de adolescentes, como os mesmos a representam, bem como a importância de repensar, recuperar e investir no universo institucional superando os estigmas que acompanham a realidade das instituições como lugar do “fracasso”, permitindo que a mesma seja vista como um local de possibilidades, de acolhimento, de afeto e proteção, objetivo, aliás, que determinou sua origem. Dentro dessa perspectiva, o texto enfatiza a importância da intervenção da Psicologia nas instituições, auxiliando as mesmas através de um trabalho de assessoria no enfrentamento dos preconceitos, dificuldades e conflitos que caracterizam seu funcionamento.
Percepção de homens e mulheres acerca de quem entrega um filho para adoção
Authors: Mello Ivana Suely Paiva Bezerra de , Dias Cristina Maria de Souza Brito
Published: September 2012

Este trabalho tem como objetivo investigar como os indivíduos percebem a pessoa que entrega um filho para adoção e as circunstâncias que envolvem este ato. Para tal, foram entrevistados 10 adultos e, após a categorização das respostas por temas afins, foi montado um questionário que foi aplicado a 60 pessoas de diferentes idades e profissões, sendo 30 de cada sexo. As variáveis analisadas foram as seguintes: características de quem doa um filho, motivos que levam à doação, pontos positivos na doação de um filho, repercussões da doação na vida de quem doa e na vida da criança, justificativas para a doação de um filho e direito ao reencontro entre doador e o filho. Concluímos por uma maior abertura para com o tema, embora ainda permeado de contradições e ambivalências, tendo as mulheres se mostrado um pouco mais severas na percepção sobre os doadores e sobre a possibilidade do reencontro com o filho. Os homens, por sua vez, destacaram-se ao assinalar que a doação se dá por falta de preocupação com o filho, sendo tal resultado significativo.
Preconceito no Brasil contemporâneo: as pequenas diferenças na constituição das subjetividades
Authors: Silva Sérgio Gomes da
Published: September 2012

Ao compreender o preconceito como um conjunto de crenças, atitudes e comportamentos negativos atribuídos a membros de determinados grupos sociais, o objetivo do presente trabalho é analisar o preconceito contra as minorias negras e homoeróticas, a partir de uma leitura da Psicologia Social e freudiana, verificando qual a saída mais ética para esse mal-estar que ainda se vivencia na contemporaneidade.
Ciberespaço: nova realidade, novos perigos, novas formas de defesa
Authors: Nicolaci-da-Costa Ana Maria
Published: September 2012

A mídia, nacional e internacional, vem divulgando à exaustão vários tipos de perigo que supostamente rondam a utilização da Internet. Por trás dessa divulgação, parece estar um pressuposto que desafia a Psicologia: o de que somos indefesos para lidar com a nova realidade do ciberespaço. Resultados inesperados de uma pesquisa sobre o uso intensivo da Internet, no entanto, mostram o contrário. A partir destes, novas estratégias de auto-proteção online, que visam principalmente à preservação da intimidade, puderam ser identificadas. Essas estratégias envolvem diferentes formas de utilização, por parte dos usuários, dos próprios programas e recursos tecnológicos disponíveis.
Escuta analítica no hospital geral: : implicações com o desejo do analista
Authors: Torezan Zeila C. Facci , Rosa Abílio da Costa
Published: September 2012

Partindo da experiência na enfermaria de um hospital-escola1, do confronto com o status-quo do trabalho dos psicólogos em hospitais e da avaliação da literatura sobre a clínica psicanalítica em hospital, esta pesquisa se propôs a buscar avanços frente a uma questão específica: a escuta psicanalítica no trabalho em enfermarias de hospital geral e as implicações dessa prática com o desejo do psicanalista. Foram entrevistados quinze psicólogos declaradamente de orientação psicanalítica, vinculados a unidades de internação e com experiência mínima de dois anos de trabalho em hospital geral. As entrevistas foram abertas e semi-estruturadas, com o intuito de contemplar de maneira uniforme a coleta de informações de cunho mais objetivo, assim como de facilitar a pertinência ao tema de estudo. A interpretação dos dados foi realizada à luz do referencial clínico psicanalítico (freud-lacaniano), sendo que tal interpretação nos permitiu identificar uma importante interação entre os impasses, presentes na instituição hospitalar, da prática clínica psicanalítica com questões pessoais e de formação do profissional, interação que se vincula à postura de trabalho adotada no hospital. Reafirmamos, através desta pesquisa, a possibilidade de fazer uso de uma escuta analítica no trabalho com pacientes internados, a qual está sempre voltada para as manifestações do inconsciente ao longo da fala, e na qual a direção do tratamento é a emergência do sujeito do inconsciente.
The Role of Lung Metastasis Resection in Improving Outcome of Colorectal Cancer Patients: Results From a Large Retrospective Study
Authors: Tampellini Marco , Ottone Azzurra , Bellini Elisa , Alabiso Irene , Baratelli Chiara , Bitossi Raffaella , Brizzi Maria P. , Ferrero Anna , Sperti Elisa , Leone Francesco , Miraglia Stefania , Forti Laura , Bertona Erica , Ardissone Francesco , Berruti Alfredo , Alabiso Oscar , Aglietta Massimo , Scagliotti Giorgio V.
Published: September 2012

Background.

The role of surgery for lung metastases (LM) secondary to colorectal cancer (CRC) remains controversial. The bulk of evidence is derived from single surgical series, hampering any definitive conclusions. The aim of this study was to compare the outcomes of CRC patients with LM submitted to surgery with those who were not.

Patients and Methods.

Data from 409 patients with LM as the first evidence of advanced disease were extracted from a database of 1,411 patients. Patients were divided into three groups: G1, comprised of 155 patients with pulmonary and extrapulmonary metastases; G2, comprised of 104 patients with LM only and no surgery; G3, comprised of 50 patients with LM only and submitted to surgery.

Results.

No difference in response rates emerged between G1 and G2. Median progression-free survival (PFS) times were: 10.3 months, 10.5 months, and 26.2 months for G1, G2, and G3, respectively. No difference in PFS times was observed between G1 and G2, whereas there was a statistically significant difference between G2 and G3. Median overall survival times were 24.2 months, 31.5 months, and 72.4 months, respectively. Survival times were longer in resected patients: 17 survived >5 years and three survived >10 years. In patients with LM only and no surgery, four survived for 5 years and none survived >10 years.

Conclusions.

Even though patients with resectable LM are more likely to be those with a better outcome, our study provides evidence suggesting an active role of surgery in improving survival outcomes in this patient subset.
Chemotherapy-Induced Ovarian Failure as a Prototype for Acute Vascular Toxicity
Authors: Ben-Aharon Irit , Meizner Israel , Granot Tal , Uri Shiri , Hasky Noa , Rizel Shulamith , Yerushalmi Rinat , Sulkes Aaron , Stemmer Salomon M.
Published: September 2012

Background.

Chemotherapy-related amenorrhea is a frequent side effect observed in young breast cancer patients. Studies in mice revealed that chemotherapy-induced gonadal toxicity may result from vascular damage. We prospectively evaluated ovarian blood flow and function in young breast cancer patients following chemotherapy.

Methods.

Young female patients with localized breast cancer undergoing adjuvant or neoadjuvant anthracycline- or taxane-based chemotherapy were evaluated using transvaginal ultrasound prior to initiation of and immediately after cessation of chemotherapy. Doppler-flow velocity indices of the ovarian vasculature—resistance index (RI), pulsatility index (PI)—and size measurements were visualized. Hormonal profiles, anti-Müllerian hormone (AMH) levels, and menopausal symptoms were assessed at the same time points.

Results.

Twenty breast cancer patients were enrolled in the study. The median age was 34 ± 5.24 years. Ovarian blood flow was significantly reduced shortly following chemotherapy: RI decreased by 52.5% and PI decreased by 24.2%. The mean ovarian size declined by 19.08%. Patients who were treated with sequential chemotherapy experienced further reductions in ovarian blood flow and ovarian size after the second sequence. AMH levels dropped dramatically in all patients following treatment. Hormonal profiles after treatment depicted a postmenopausal profile for most patients, accompanied by related symptoms.

Conclusions.

Our results may imply a mechanism of chemotherapy-induced ovarian toxicity manifested by decreased ovarian blood flow accompanied by a reduction in ovarian size and diminished post-treatment AMH levels. Based upon our former preclinical studies, we assume that this may derive from an acute insult to the ovarian vasculature and may represent an initial event triggering a generalized phenomenon of end-organ toxicity.
Hydrogen isotope variability in prairie wetland systems: implications for studies of migratory connectivity
Authors: Bortolotti Lauren E. , Clark Robert G. , Wassenaar Leonard I.
Published: September 2012

Hydrogen isotopes (δ2H) are often used to infer the origins of migratory animals based on the strong correlation between deuterium content of tissues and long‐term patterns of precipitation. However, the extreme flood and drought dynamics of surface waters in prairie wetland systems could mask these expected correlations. We investigated H isotopic variability in an aquatic food web associated with Tree Swallows (Tachycineta bicolor) that rely heavily on wetland‐derived aerial insects for food. We evaluated isotopic turnover and incorporation of environmental water into tissue, processes that could affect H isotopic composition. Wetland water and aquatic invertebrates showed intra‐ and interannual H isotopic variation mainly related to evaporation and the amount and timing of precipitation. Snails showed rapid turnover of tissue deuterium and a large contribution of environmental water to their tissues. Swallow feather deuterium (δ2Hf) was variable but did not clearly follow changes in any of the food web compartments measured. Instead, isotopic variability may have been driven by shifts in the type or relative amounts of prey consumed and types of wetlands used. Nevertheless, despite relatively high variance in δ2Hf, the majority of birds fell within the predicted range of δ2Hf for the study area, revealing that significant trophic averaging occurred. However, both (presumed) diet shifts and variable hydrological conditions have the potential to greatly increase variance that must be considered when assigning origins of migratory animals based on δ2H.
TEACHING CHILDREN WITH AUTISM TO ENGAGE IN PEER‐DIRECTED MANDS USING A PICTURE EXCHANGE COMMUNICATION SYSTEM
Authors: Paden Amber R. , Kodak Tiffany , Fisher Wayne W. , Gawley‐Bullington Elizabeth M. , Bouxsein Kelly J.
Published: September 2012

We evaluated differential reinforcement of alternative behavior (DRA) plus prompting to increase peer‐directed mands for preferred items using a picture exchange communication system (PECS). Two nonvocal individuals with autism participated. Independent mands with a peer increased with the implementation of DRA plus prompting for both participants. In addition, peers engaged in brief social interactions following the majority of mands for leisure items. These results suggest that teaching children to use PECS with peers may be one way to increase manding and social interactions in individuals with limited or no vocal repertoire.
COMPARING THE EFFECTS OF ECHOIC PROMPTS AND ECHOIC PROMPTS PLUS MODELED PROMPTS ON INTRAVERBAL BEHAVIOR
Authors: Valentino Amber L. , Shillingsburg M. Alice , Call Nathan A.
Published: September 2012

We compared strategies to teach vocal intraverbal responses to an adolescent diagnosed with autism and Down syndrome. One strategy involved echoic prompts only. The second strategy involved an echoic prompt paired with a modeled prompt in the form of sign language. Presenting the modeled prompt with the echoic prompt resulted in faster acquisition of correct responding. Results are discussed in terms of using functional stimulus classes to facilitate vocal intraverbal acquisition with learners who have a history of sign language training.
Familial Factors in the Association between Preeclampsia and Later ESRD
Authors: Vikse Bjørn Egil , Irgens Lorentz M. , Karumanchi S. Ananth , Thadhani Ravi , Reisæter Anna Varberg , Skjærven Rolv
Published: September 2012

Background and objectives

Women with preeclampsia have increased risk of developing ESRD. This study assessed whether this can be explained by preeclampsia itself or by familial aggregation of common risk factors.

Design, setting, participants, & measurements

Since 1967, the Medical Birth Registry of Norway has registered data on all births in the country. By linkage with the Norwegian Population Registry, different, but overlapping, cohorts were defined: the first and second cohorts included women and a sibling (first cohort) or child (second cohort) with a registered first birth between 1967 and 2008. Similar cohorts were defined for men. The Norwegian Renal Registry provided data on ESRD from 1980 to June 2009.

Results

Cohort 1 was used for the main analyses and included 570,675 women, 291 of whom developed ESRD after a median 18.2 years. Compared with women without preeclampsia and no siblings with preeclampsia, women without preeclampsia but a sibling with preeclampsia had a relative risk (RR) of ESRD of 0.96 (95% confidence interval, 0.59–1.6), women with preeclampsia but no siblings with preeclampsia had a RR of 6.0 (4.4–8.1), and women with preeclampsia and a sibling with preeclampsia had a RR of 2.8 (0.88–8.6). Further analyses of women showed no increased risk of ESRD if a child had preeclampsia in first pregnancy.

Conclusions

Familial aggregation of risk factors does not seem to explain increased ESRD risk after preeclampsia. These findings support the hypothesis that preeclampsiaper semay lead to kidney damage.
Peritoneal Dialysis–Associated Peritonitis with Simultaneous Exit-Site Infection
Authors: Mehrotra Rajnish , Singh Harmanjit
Published: September 2012

With the implementation of best demonstrated clinical practices, peritonitis has become an infrequent complication of peritoneal dialysis in many centers around the world. Yet the gains in reduction in risk of peritonitis are not uniform. Most episodes of peritonitis do not require hospitalization and it is possible to achieve cure rates of 70%–80%. Some circumstances, however, necessitate the removal of the peritoneal dialysis catheter. These include patients with inadequate response to antimicrobial therapy, those with fungal peritonitis, or those with Staphylococcus aureus or Pseudomonas peritonitis with coexisting exit-site infection with the same organism. If the peritoneal dialysis catheter is removed in the presence of active intraperitoneal infection, replacement of the peritoneal dialysis catheter should be deferred by 2–4 weeks. However, simultaneous removal and replacement is possible in selected circumstances such as in patients with S. aureus or Pseudomonas peritonitis who also have exit-site infection with the same organism, after the intraperitoneal infection has responded to antibiotic therapy.
A study of cordierite ceramics synthesis from serpentine tailing and kaolin tailing
Authors: Zhu P. , Wang L.Y. , Hong D. , Zhou M.
Published: September 2012

Cordierite ceramics was synthesized using a composition prepared by the
mixture of three different materials: waste serpentine mine tailing (WST),
waste kaolin mine tailing (WKT) and alumina. The formation of cordierite was
achieved with the solid-state sintering reactions at 1350?C for 3 h. The
synthesized cordierite ceramics was characterized by X-ray diffractometer
(XRD), thermal analysis (TG-DTA), and SEM-EDS (Scanning Electron
Microscopy-Energy Dispersive Spectrometer). The XRD analysis results showed
the cordierite with typical rhombic system as a major phase, and its
compositions consisted of O, Al, Si and Mg by means of SEM-EDS.
Defectoscopy of direct laser sintered metals by low transmission ultrasonic frequencies
Authors: Ebersold Zoran , Mitrovic Nebojsa , Djukic Slobodan , Jordovic Branka , Peulic Aleksandar
Published: September 2012

This paper focuses on the improvement of ultrasonic defectoscopy used for
machine elements produced by direct laser metal sintering. The direct laser
metal sintering process introduces the mixed metal powder and performs its
subsequent laser consolidation in a single production step. Mechanical
elements manufactured by laser sintering often contain many hollow cells due
to weight reduction. The popular pulse echo defectoscopy method employing
very high frequencies of several GHz is not successful on these samples. The
aim of this paper is to present quadraphonic transmission ultrasound
defectoscopy which uses low range frequencies of few tens of kHz. Therefore,
the advantage of this method is that it enables defectoscopy for honeycombed
materials manufactured by direct laser sintering. This paper presents the
results of testing performed on AlSi12 sample.
Effect of milling and annealing on microstructural, electrical and magnetic properties of electrodeposited Ni-11.3 Fe-1.4w alloy
Authors: Spasojevic M. , Ribic-Zelenovic L. , Cirovic N. , Spasojevic P. , Maricic A.
Published: September 2012

A nanostructured Ni-11.3Fe-1.4W alloy deposit was obtained from an ammonium
citrate bath at a current density of 600 mAcm-2. XRD analysis shows that the
deposit contains an amorphous matrix having embedded nanocrystals of the FCC
phase of the solid solution of Fe and W in Ni with the average crystal grain
size of 8.8 nm. The deposit has a high internal microstrain value and a high
minimum density of chaotically distributed dislocations. The effect of
milling and annealing of the Ni-11.3Fe-1.4W alloy on electrical and magnetic
properties was studied. Structural changes in the alloy take place during
both annealing and milling. Upon deposition, the alloy was heated to 420?C.
Heating resulted in structural relaxation which induced a decrease in
electrical resistivity and an increase in magnetic permeability of the alloy.
Further heating of the alloy at temperatures higher than 4200C led to
crystallization which caused a reduction in both electrical resistivity and
magnetic permeability. The milling of the alloy for up to 12 hours caused a
certain degree of structural relaxation and crystallization of the alloy. The
increase in crystal grain size up to 11 nm and the partial structural
relaxation induced a decrease in electrical resistivity and an increase in
magnetic permeability of the alloy. Heating the powders obtained by milling
at 4200C led to complete structural relaxation, reduced electrical
resistivity, and increased magnetic permeability. During heating of the
powders obtained by milling at temperatures above 420?C, crystallization and
a significant increase in crystal grain size occurred, leading to a reduction
in both electrical resistivity and magnetic permeability. The best magnetic
properties were exhibited by the alloys milled for 12 hours and annealed
thereafter at 420?C. In these alloys, crystal grains were found to have an
optimum size, and complete relaxation took place, resulting in a maximum
increase in magnetic permeability.
A Genome-Wide Association Study Identifies GRK5 and RASGRP1 as Type 2 Diabetes Loci in Chinese Hans
Authors: Li Huaixing , Gan Wei , Lu Ling , Dong Xiao , Han Xueyao , Hu Cheng , Yang Zhen , Sun Liang , Bao Wei , Li Pengtao , He Meian , Sun Liangdan , Wang Yiqin , Zhu Jingwen , Ning Qianqian , Tang Yong , Zhang Rong , Wen Jie , Wang Di , Zhu Xilin , Guo Kunquan , Zuo Xianbo , Guo Xiaohui , Yang Handong , Zhou Xianghai ,   DIAGRAM Consortium,   AGEN-T2D Consortium, Zhang Xuejun , Qi Lu , Loos Ruth J.F. , Hu Frank B. , Wu Tangchun , Liu Ying , Liu Liegang , Yang Ze , Hu Renming , Jia Weiping , Ji Linong , Li Yixue , Lin Xu
Published: September 2012

Substantial progress has been made in identification of type 2 diabetes (T2D) risk loci in the past few years, but our understanding of the genetic basis of T2D in ethnically diverse populations remains limited. We performed a genome-wide association study and a replication study in Chinese Hans comprising 8,569 T2D case subjects and 8,923 control subjects in total, from which 10 single nucleotide polymorphisms were selected for further follow-up in a de novo replication sample of 3,410 T2D case and 3,412 control subjects and an in silico replication sample of 6,952 T2D case and 11,865 control subjects. Besides confirming seven established T2D loci (CDKAL1, CDKN2A/B, KCNQ1, CDC123, GLIS3, HNF1B, and DUSP9) at genome-wide significance, we identified two novel T2D loci, including G-protein–coupled receptor kinase 5 (GRK5) (rs10886471: P = 7.1 × 10−9) and RASGRP1 (rs7403531: P = 3.9 × 10−9), of which the association signal at GRK5 seems to be specific to East Asians. In nondiabetic individuals, the T2D risk-increasing allele of RASGRP1-rs7403531 was also associated with higher HbA1c and lower homeostasis model assessment of β-cell function (P = 0.03 and 0.0209, respectively), whereas the T2D risk-increasing allele of GRK5-rs10886471 was also associated with higher fasting insulin (P = 0.0169) but not with fasting glucose. Our findings not only provide new insights into the pathophysiology of T2D, but may also shed light on the ethnic differences in T2D susceptibility.
Long-term outcomes for low-grade intracranial ganglioglioma: 30-year experience from the Mayo Clinic
Authors: Compton Julia J. , Issa Laack Nadia N. , Eckel Laurence J. , Schomas David A. , Giannini Caterina , Meyer Fredric B.
Published: September 2012

Object

Gangliogliomas comprise less than 1% of all brain tumors and occur most often in children. Therefore, there are a limited number of patients and data involving the use or role of adjuvant therapy after subtotal resections (STRs) of gangliogliomas. The objective of this study was to examine and review the Mayo Clinic experience of 88 patients with gangliogliomas, their follow-up, risk of recurrence, and the role of radiation therapy after STR or only biopsy.

Methods

Eighty-eight patients with gangliogliomas diagnosed between 1970 and 2007 were reviewed. Data on clinical outcomes and therapy received were analyzed. The Kaplan-Meier method was used to estimate progression-free survival (PFS) and overall survival.

Results

The median age at diagnosis was 19 years. The median potential follow-up as of June 2008 was 142 months (range 9–416 months). Fifteen-year overall survival was 94%, median PFS was 5.6 years, with a 10-year PFS rate of 37%. Progression-free survival was dramatically affected by extent of initial resection (p < 0.0001).

Conclusions

This single-institution retrospective series of patients with gangliogliomas is unique given its large cohort size with a long follow-up duration, and confirms the excellent long-term survival rate in this group. The study also shows the importance of resection extent on likelihood of recurrence. Patients with gangliogliomas who undergo STR or biopsy alone have poor PFS. Radiation therapy may delay time to progression in patients with unresectable disease.
Differences in simple morphological variables in ruptured and unruptured middle cerebral artery aneurysms
Authors: Lin Ning , Ho Allen , Gross Bradley A. , Pieper Steven , Frerichs Kai U. , Day Arthur L. , Du Rose
Published: September 2012

Object

Management of unruptured intracranial aneurysms remains controversial in neurosurgery. The contribution of morphological parameters has not been included in the treatment paradigm in a systematic manner or for any particular aneurysm location. The authors present a large sample of middle cerebral artery (MCA) aneurysms that were assessed using morphological variables to determine the parameters associated with aneurysm rupture.

Methods

Preoperative CT angiography (CTA) studies were evaluated using Slicer software to generate 3D models of the aneurysms and their surrounding vascular architecture. Morphological parameters examined in each model included 5 variables already defined in the literature (aneurysm size, aspect ratio, aneurysm angle, vessel angle, and size ratio) and 3 novel variables (flow angle, distance to the genu, and parent-daughter angle). Univariate and multivariate statistical analyses were performed to determine statistical significance.

Results

Between 2005 and 2008, 132 MCA aneurysms were treated at a single institution, and CTA studies of 79 aneurysms (40 ruptured and 39 unruptured) were analyzed. Fifty-three aneurysms were excluded because of reoperation (4), associated AVM (2), or lack of preoperative CTA studies (47). Ruptured aneurysms were associated with larger size, greater aspect ratio, larger aneurysm and flow angles, and smaller parent-daughter angle. Multivariate logistic regression revealed that aspect ratio, flow angle, and parent-daughter angle were the strongest factors associated with ruptured aneurysms.

Conclusions

Aspect ratio, flow angle, and parent-daughter angle are more strongly associated with ruptured MCA aneurysms than size. The association of parameters independent of aneurysm morphology with ruptured aneurysms suggests that these parameters may be associated with an increased risk of aneurysm rupture. These factors are readily applied in clinical practice and should be considered in addition to aneurysm size when assessing the risk of aneurysm rupture specific to the MCA location.
Diaphragmatic height index: new diagnostic test for phrenic nerve dysfunction
Authors: Pornrattanamaneewong Chaturong , Limthongthang Roongsak , Vathana Torpon , Kaewpornsawan Kamolporn , Songcharoen Panupan , Wongtrakul Saichol
Published: September 2012

Object

The diaphragmatic height index (DHI) was developed to measure the difference in diaphragm levels. The purpose of this study was to set definite DHI values and test the accuracy of these values for use as a new diagnostic test for phrenic nerve dysfunction.

Methods

All data for this study were obtained from medical charts and retrospectively reviewed.

Results

One hundred sixty-five patients with brachial plexus injury who had undergone nerve transfers between 2005 and 2008 were divided into Groups A and B. Group A consisted of 40 patients (mean age 28.0 years) who had sustained concomitant injury of the brachial plexus and phrenic nerves. Patients in Group A1 had right phrenic nerve injury and those in Group A2 had left phrenic nerve injury. Intraoperative direct electrical stimulation of the phrenic nerve was considered the gold standard in assessing nerve function in all patients with brachial plexus injury. Group B consisted of 125 patients (mean age 28.7 years) with brachial plexus injury and normal phrenic nerve function. Group C, the control group, consisted of 80 patients with nonbrachial plexus injury (mean age 34.0 years) who had undergone other kinds of orthopedic operations between April and June 2009.

Standard posteroanterior chest radiographs were blindly interpreted using the Siriraj inhouse picture archiving and communication system in all 245 patients in the study. First, a reference line (R line) was drawn along the inferior endplate of T-10. Then, 2 lines (lines A and B) were drawn through the highest point of each diaphragm and parallel to the R line. The difference between these 2 lines divided by the height of T-10 was defined as the DHI. The cutoff points of the DHI for diagnosing right and left phrenic nerve dysfunction were analyzed with a receiver operating characteristic curve. The accuracy of these DHI values was then evaluated. The DHI in Group C was 0.64 ± 0.44, slightly higher than the DHI in Group B, with no significant difference. Diaphragmatic height indexes in Groups A1 and A2 were 2.0 ± 0.99 and −1.04 ± 0.83, respectively, which were significantly different from those in Groups B and C (p < 0.05). The cutoff point of the DHI for diagnosing right phrenic nerve dysfunction was > 1.1, and that for left phrenic nerve dysfunction was < 0.2. The sensitivity and specificity of right and left DHI values were 90.5% and 86.3%, and 94.7 and 88.3%, respectively.

Conclusions

Data in this study show that diaphragm paralysis can be simply and reliably predicted by the DHI. Diaphragmatic height index values > 1.1 and < 0.2 are proposed as the new diagnostic test for right and left phrenic nerve dysfunction with a high degree of accuracy. This index is applicable in diagnosing phrenic nerve dysfunction that occurs concomitantly with brachial plexus injury or from other etiologies.
Short circuit in deep brain stimulation
Authors: Samura Kazuhiro , Miyagi Yasushi , Okamoto Tsuyoshi , Hayami Takehito , Kishimoto Junji , Katano Mitsuo , Kamikaseda Kazufumi
Published: September 2012

Object

The authors undertook this study to investigate the incidence, cause, and clinical influence of short circuits in patients treated with deep brain stimulation (DBS).

Methods

After the incidental identification of a short circuit during routine follow-up, the authors initiated a policy at their institution of routinely evaluating both therapeutic impedance and system impendence at every outpatient DBS follow-up visit, irrespective of the presence of symptoms suggesting possible system malfunction. This study represents a report of their findings after 1 year of this policy.

Results

Implanted DBS leads exhibiting short circuits were identified in 7 patients (8.9% of the patients seen for outpatient follow-up examinations during the 12-month study period). The mean duration from DBS lead implantation to the discovery of the short circuit was 64.7 months. The symptoms revealing short circuits included the wearing off of therapeutic effect, apraxia of eyelid opening, or dysarthria in 6 patients with Parkinson disease (PD), and dystonia deterioration in 1 patient with generalized dystonia. All DBS leads with short circuits had been anchored to the cranium using titanium miniplates. Altering electrode settings resulted in clinical improvement in the 2 PD cases in which patients had specific symptoms of short circuits (2.5%) but not in the other 4 cases. The patient with dystonia underwent repositioning and replacement of a lead because the previous lead was located too anteriorly, but did not experience symptom improvement.

Conclusions

In contrast to the sudden loss of clinical efficacy of DBS caused by an open circuit, short circuits may arise due to a gradual decrease in impedance, causing the insidious development of neurological symptoms via limited or extended potential fields as well as shortened battery longevity. The incidence of short circuits in DBS may be higher than previously thought, especially in cases in which DBS leads are anchored with miniplates. The circuit impedance of DBS should be routinely checked, even after a long history of DBS therapy, especially in cases of miniplate anchoring.
Reliability of postoperative photographs in assessment of facial nerve function after vestibular schwannoma resection
Authors: Gordon Amber S. , Westrick Ashly C. , Falola Michael I. , Shannon Chevis N. , Walters Beverly C. , Fisher Winfield S.
Published: September 2012

Object

This study was undertaken to assess the reliability of observations of postoperative photographs in assigning House-Brackmann scores as outcome measures for patients following resection of vestibular schwannomas.

Methods

Forty pictures of differing facial expressions typically elicited from patients for assigning House-Brackmann scores were individually evaluated by neurosurgery residents and faculty members at the University of Alabama at Birmingham; a score was assigned to each picture by the individual raters. The interrater reliability was measured using the Spearman correlation coefficient, Kendall coefficient of concordance, and kappa statistic; internal consistency was calculated using the Cronbach alpha reliability estimate.

Results

The Spearman correlation coefficients showed strong positive association among raters, with a range of values of 0.66 to 0.90. Internal consistency measured by the Cronbach alpha coefficient was excellent (α = 0.97). The Kendall coefficient of concordance for the ordinal grades suggested a substantial degree of agreement among the raters (w = 0.76, p < 0.001).

Conclusions

Static postoperative photographs are a reliable outcome measure for determining facial nerve function after vestibular schwannoma resection and may serve as a surrogate for the dynamic patient interview.
Influence of the combination of patient age and deep venous drainage on brain arteriovenous malformation recurrence after surgery
Authors: Morgan Michael Kerin , Patel Nirav J. , Simons Mary , Ritson Elizabeth Anne , Heller Gillian Z.
Published: September 2012

Object

Case reports suggest that young age is a critical factor in determining recurrence of brain arteriovenous malformations (AVMs) after surgery. However, other factors that may contribute to the increased risk of recurrence have not been considered. In this study, the authors' goal was to ascertain the risk and risk factors of recurrence after resection of AVMs of the brain.

Methods

A consecutive case series (prospectively collected data) of 600 cases of resection of brain AVMs was retrospectively analyzed. Radiological evidence of recurrence or nonrecurrence, as well as clinical evidence of recurrence, could be established in 427 of these cases that underwent follow-up for more than 350 days after initial surgery. These cases were analyzed using Kaplan-Meier curves and Cox regression with respect to age and the presence of deep venous drainage.

Results

Nine recurrent AVMs were found in 8 patients. By analysis of the Kaplan-Meier curves, the 10-year recurrence rate was 14% for those with deep venous drainage, compared with 4% for those without deep venous drainage. Stratifying by age, in the 0- to 20-year age group, the 10-year recurrence rates were 63% and 13% for those with and without deep venous drainage, respectively. In the 20- to 39-year age group, the rates were 5% and 0% respectively, and in the 40-year and older age group they were 0% and 3%, respectively. The hazard ratio for deep venous drainage, adjusted for age, was 5.97 (95% CI 1.20–29.69, p = 0.029).

Conclusions

The risk of recurrence after AVM resection is significant for young patients with deep venous drainage.
Feasibility of repeat surgery for pediatric brain tumors: an objective assessment of perioperative outcomes
Authors: Moiyadi Aliasgar V. , Shetty Prakash
Published: September 2012

Object

Repeat surgery for pediatric brain tumors is gaining acceptance, with extent of resection an important predictor of outcome. However, repeat surgeries may be associated with increased morbidity. Few studies in the literature provide such outcomes objectively. The authors report on their experience with repeat surgery at a tertiary care neurooncology referral center in India.

Methods

A prospectively maintained database documented epidemiological, clinical, radiological, operative, and perioperative events. The authors analyzed 117 children (younger than 18 years of age) who had undergone various resective surgeries for brain tumors over a period of 5 years. Assessed end points included immediate postoperative neurological status, neurological outcome at discharge, regional complications, systemic complications, overall morbidity, and mortality.

Results

The majority of children (48%) were between 3 and 10 years of age. Elevated intracranial pressure (70% of patients) and neurological deficits (60% of patients) were the commonest presenting symptoms. A significant proportion of patients (35%) had a poor Karnofsky Performance Scale score (≤ 70). Supratentorial procedures were performed in 58% of the patients. Most patients (72%) had large (> 4 cm) tumors. Fifty-eight patients (50%) had received prior treatment, surgery in 55. Neurological morbidity (worsening), regional complications, and systemic complications occurred in 27%, 32%, and 25% of patients overall, respectively. Overall morbidity was 44.4% (26.5% major), and perioperative mortality was 7.7%. Neurological worsening occurred more frequently in patients undergoing a first surgery (p = 0.038), whereas wound-related complications were more common in those undergoing reoperations (p = 0.00).

Conclusions

Pediatric patients had larger tumors and were more likely to present with a poor performance status, often after prior treatment, than their adult counterparts. Wound-related complications were higher in the previously treated subgroup; however, neurological complications were fewer, probably because of a favorable selection of patients. Despite the unavailability of advanced intraoperative aids, acceptable levels of overall morbidity and mortality could be achieved in repeat surgeries for pediatric brain tumors.
MENS, an Info-Computational Model for (Neuro-)cognitive Systems Capable of Creativity
Authors: Ehresmann Andrée C.
Published: September 2012

MENS is a bio-inspired model for higher level cognitive systems; it is an application of the Memory Evolutive Systems developed with Vanbremeersch to model complex multi-scale, multi-agent self-organized systems, such as biological or social systems. Its development resorts to an info-computationalism: first we characterize the properties of the human brain/mind at the origin of higher order cognitive processes up to consciousness and creativity, then we ‘abstract’ them in a MENS mathematical model for natural or artificial cognitive systems. The model, based on a ‘dynamic’ Category Theory incorporating Time, emphasizes the computability problems which are raised.
Comments on: Cardoso, C.F.; Drummond, A.F.; Lages, E.M.B.; Pretti, H.; Ferreira, E.F.; Abreu, M.H.N.G. The Dental Aesthetic Index and Dental Health Component of the Index of Orthodontic Treatment Need as Tools in Epidemiological Studies. Int. J. Environ. Res. Public Health 2011, 8, 3277–3286
Authors: Arora Varun , Gupta Narendra Kumar , Nath Dilip K. , Tandan Amrit , Chandra Pratik
Published: September 2012

In regard to the article entitled “The Dental Aesthetic Index and Dental Health Component of the Index of Orthodontic Treatment Need as Tools in Epidemiological Studies” by Cardoso et al. [1] which checks the validity and agreement of two scales for orthodontic treatment need, we would like to draw your attention to a number of discrepancies in the design and methodology which have affected the results. [...]
Novel Lipophilic Lanthanide Bis-Phthalocyanines Functionalized by Pentadecylphenoxy Groups: Synthesis, Characterization and UV-Photostability
Authors: Słota Rudolf , Dyrda Gabriela , Hofer Maria , Mele Giuseppe , Bloise Ermelinda , Sole Roberta del
Published: September 2012

Novel sandwich-type phthalocyanines containing a rare earth metal core (Pr, Nd, Eu–Lu) and macrocycles peripherally substituted by pentadecylphenoxy groups were synthesized using a cardanol-based phthalonitrile precursor and the respective lanthanide acetate. Additionally, the metal free-base analog compound was studied for comparison. The purified reaction products were all found to be thick and viscous substances at room temperature, showing liquid crystalline behavior with a distinct increase in fluidity at ca. 40 °C. The complexes are readily soluble in chloroalkyl solvents and dissolve fairly well in DMF with some tendency to form aggregates. Besides they are strongly hydrophobic and reveal a peculiar affinity for lipophilic media. The compounds have been characterized by UV-Vis (absorption and emission), FTIR, MS and DSC methods. Photochemical activity in the liquid phase (dimethylformamide, dichloromethane, mineral oil) and the degree of photodegradation demonstrated under constant UV-irradiation (λ = 352 nm) have been analyzed and discussed in terms of photostability.
Estimation of Supraglacial Dust and Debris Geochemical Composition via Satellite Reflectance and Emissivity
Authors: Casey Kimberly , Kääb Andreas
Published: September 2012

We demonstrate spectral estimation of supraglacial dust, debris, ash and tephra geochemical composition from glaciers and ice fields in Iceland, Nepal, New Zealand and Switzerland. Surface glacier material was collected and analyzed via X-ray fluorescence spectroscopy (XRF) and X-ray diffraction (XRD) for geochemical composition and mineralogy. In situ data was used as ground truth for comparison with satellite derived geochemical results. Supraglacial debris spectral response patterns and emissivity-derived silica weight percent are presented. Qualitative spectral response patterns agreed well with XRF elemental abundances. Quantitative emissivity estimates of supraglacial SiO2 in continental areas were 67% (Switzerland) and 68% (Nepal), while volcanic supraglacial SiO2 averages were 58% (Iceland) and 56% (New Zealand), yielding general agreement. Ablation season supraglacial temperature variation due to differing dust and debris type and coverage was also investigated, with surface debris temperatures ranging from 5.9 to 26.6 °C in the study regions. Applications of the supraglacial geochemical reflective and emissive characterization methods include glacier areal extent mapping, debris source identification, glacier kinematics and glacier energy balance considerations.
Telaprevir: Pharmacokinetics and Drug Interactions
Authors: Garg Varun , Kauffman Robert S , Beaumont Maria , van Heeswijk Rolf PG
Published: September 2012

Telaprevir is an inhibitor of the HCV NS3/4A protease. When used in combination with pegylated interferon and ribavirin, telaprevir has demonstrated a substantial increase in sustained virological response compared with pegylated interferon and ribavirin used alone. Telaprevir has good oral bioavailability, which is enhanced when administered with food. Telaprevir is extensively metabolized and primarily eliminated via faeces. No dose adjustment of telaprevir is needed in patients with mild to severe renal impairment or mild liver impairment. Telaprevir is a substrate and inhibitor of cytochrome P450 3A and P-glycoprotein and, thus, might interact with coadministered drugs that affect or are affected by these metabolic/transport pathways. This article reviews the pharmacokinetic and drug interaction profile of telaprevir.
Creating a Void or Sublimation in Lacan
Authors: Saint-Cyr Viviana M.
Published: September 2012

Nous étudions la théorie lacanienne de la sublimation dont la formule principale est celle du séminaire sur l’éthique de la psychanalyse : la sublimation « élève un objet à la dignité de la Chose ». Nous nous efforçons de démontrer la logique de cette définition, qui va de l’objet imaginaire désiré au vide de l’Autre entouré, et approfondissons les paradoxes qu’elle implique en ce qu’elle a affaire au rapport des trois registres de la réalité humaine : Symbolique, Imaginaire, Réel. Ce parcours nous permet de tirer l’enseignement de l’architecture, art paradigmatique de la sublimation pour autant qu’elle est créatrice de vide. Comme la sublimation, l’art de bâtir parvient à nous mettre en rapport avec notre propre vide en tant que sujets du désir. L’une et l’autre organisent le vide tout en créant un vide. Ainsi, elles pallient à l’horreur du vide réel de la Chose sans pour autant refermer la possibilité de s’en rapprocher.