bluuebunny/crossref_metadata_2025_split huggingface dataset:
A rare case of pituitary macroadenoma with synchronous suprasellar meningioma.
Authors: David Bogdan Ionut , Tataranu Ligia Gabriela , Ciubotaru Vasile Gheorghe , Sandu Aurelia Mihaela , Gorgan Radu Mircea 
Published: April 2020

Synchronous tumours can be found all along the entire neuraxis, however, some lesions are far less likely to coexist. One of these extremely rare associations is between GH-pituitary adenomas and suprasellar meningiomas. A wide spectrum of transcranial and transsphenoidal approaches were described in the literature for either sellar, suprasellar and parasellar lesions, but no agreement has been reached for the cases of simultaneous occurring lesions.
We present a rare case of a woman with GH-secreting pituitary adenoma and concomitant suprasellar meningioma. The strategy chosen was sequential transsphenoidal surgeries. However, after the first surgery, the remaining tumour mass did not mobilize as expected due to gravity, hence we decided to perform a transcranial subfrontal unilateral approach. Surprisingly, the second surgery revealed a different histopathological result.
Association of a GH-pituitary adenoma and suprasellar meningioma is very rare, only 17 cases being reported in the relevant literature so far. Different authors prefer different strategies, ranging from only transsphenoidal to simultaneous transsphenoidal and transcranial approaches, but no general consensus was established.
In conclusion, the existence of synchronous tumours of the sellar region should be taken into account when imaging studies reveal an intracranial mass developing both sellar and suprasellar. The surgical strategy should be tailored to every specific patient and experience of the neurosurgeon.
Risk factors and clinical and neurological consequences of intraoperative rupture of brain aneurysms in microsurgical operations
Authors: A. V. Bindu , Yu. Orlov M. , O. Litvak S. , Yeleynik M. V. 
Published: April 2020

Objective. to assess the frequency, risk factors and clinical and neurological consequences of intraoperative rupture of arterial aneurysm (AA) of the brain (B) in clipping operations of the B AA .
Materials and approaches. A retrospective analysis of microsurgical operations clipping of cerebral aneurysms in 1449 (100%) patients for the period from 2011 to 2018 was performed, of which 141 (9.73%) cases had intraoperative rupture of the aneurysm (IORA). Preoperative examination: clinical and neurological examination, CT of the brain, cerebral angiography( CAG), duplex scanning of the main vessels of the head and neck. The analyzed criteria are risk factors of IORA: AA size, localization, shape, duration of surgery after the primary rupture of AA, the presence of hypertension and the patient's condition before surgery.
Results. The frequency of IORA in clipping operations of B AA was 9.73% (141 patients) in a series of observations 1441 (100%). Most often IORA-141 (100%) was registered in clipping operations of AA of complex ACA-AcomA (86 (61%) cases out of 141 (100%)). IORA is possible at all stages of the operation with the maximum frequency of contact breaks – 135 (95.74%); the rarest-6 ( 4.26%) - non - contact IORA (at the stage of craniotomy) was recorded. At the preoperative stage, the vast majority of patients with subsequent IORA were diagnosed with cerebral edema, AA of large size, atherosclerotic changes in the aneurysm-affected segment of the artery and cervical areas of the aneurysm, high blood pressure during surgery, adhesive arachnoid changes. At the time of discharge from the hospital, according to the Glasgow results scale: 69 (48.94%) full or partial restoration of labor activity, 18 (12.77%) had limited daily activities without the need for outside assistance, 37 (26 24%) deep disability ) Deaths were in the group of "contact" IORA - 17 (12.06%). At 6 ( 4.26%) of "non-contact" IORA, a deepening of initial neurological symptoms was recorded with a suppression of the level of consciousness, the addition of pyramidal insufficiency, speech impairment and psycho-organic syndrome, and a deepening of the phenomena of initial cerebral arterial vasospasm.
Conclusions. IORA is predominantly in contact with a frequency of occurrence-9.73 %. The most common risk factors for IORA were: cerebral edema, large AA, atherosclerotic changes in the aneurysm-affected artery segment and cervical aneurysm sites, high blood pressure during surgery, adhesions arachnoid changes. IORA leads to deepening of initial neurological symptoms, phenomena of initial vasospasm of cerebral arteries with the level of total mortality-17 (12.06%).
Surgical challenges and outcome of endoscopic endonasal approaches in the management of recurrent pituitary adenomas
Authors: Taha Ahmed Nageeb Mohamed , Mohamed Hosam Shata , Mohamed Mahmoud Saad 
Published: April 2020

Background: Various surgical approaches for the management of midline anterior skull base meningiomas exist in the literature. The main surgeon target is proper selection the appropriate approach that achieves total removal of the lesion without causing morbidity or mortality and facilitates safe effective removal of the tumor.
Objectives: To evaluate the role of the extended pterional approach for excision of midline anterior skull base meningiomas as regard the effectiveness, extent of resection and surgical outcome.
Patients and methods: This retrospective study involved 23 cases with midline anterior skull base meningiomas resected through the extended pterional approach. Patients' clinical data, operative notes, imaging studies and clinical follow-up data were analyzed and evaluated.
Results: Tumors studied were 9 olfactory groove meningiomas, 8 tuberculum Sellae meningiomas, 4 planum sphenoidale meningiomas and 2 diaphragma sellae meningiomas. Gross total resection tumor excision in 15 cases (64.5%), subtotal excision in 5 cases (21.5%) and partial excision in 3 cases (14%). Complications were diabetes insipidus (2 cases 8.6%), CSF rhinorrhea (3 cases 12.9%) and visual deterioration (3 cases 12.9%). We had two cases of mortality.
Conclusion: The extended pterional approach allows safe and effective removal of midline anterior skull base meningiomas. It expands the exposure offered by the classic pterional approach and minimizing the necessity for applying fixed brain retraction with good cosmetic outcome and less approach related morbidities in comparison with the extensive skull base approaches.
The extended pterional approach for midline anterior skull base meningiomas
Authors: Taha Ahmed Nageeb Mohamed , Mohamed Hosam Shata , Mohamed Mahmoud Saad 
Published: April 2020

Background: Various surgical approaches for the management of midline anterior skull base meningiomas exist in the literature. The main surgeon target is proper selection the appropriate approach that achieves total removal of the lesion without causing morbidity or mortality and facilitates safe effective removal of the tumour.
Objectives: To evaluate the role of the extended pterional approach for excision of midline anterior skull base meningiomas as regarding the effectiveness, extent of resection and surgical outcome.
Patients and methods: This retrospective study involved 23 cases with midline anterior skull base meningiomas resected through the extended pterional approach. Patients' clinical data, operative notes, imaging studies and clinical follow-up data were analyzed and evaluated.
Results: Tumors studied were 9 olfactory groove meningiomas, 8 tuberculum Sellae meningiomas, 4 planum sphenoidale meningiomas and 2 diaphragma sellae meningiomas. Gross total resection tumour excision in 15 cases (64.5%), subtotal excision in 5 cases (21.5%) and partial excision in 3 cases (14%). Complications were diabetes insipidus (2 cases 8.6%), CSF rhinorrhea (3 cases 12.9%) and visual deterioration (3 cases 12.9%). We had two cases of mortality.
Conclusion: The extended pterional approach allows safe and effective removal of midline anterior skull base meningiomas. It expands the exposure offered by the classic pterional approach and minimizing the necessity for applying fixed brain retraction with good cosmetic outcome and less approach-related morbidities in comparison with the extensive skull base approaches.
Intraneural synovial sarcoma of median nerve
Authors: Bhardwaj Sandeep , Kansal Anil , Bansal Rohit , Sharma Rakesh , Sharma Akangsha 
Published: April 2020

Synovial sarcomas are highly aggressive soft tissue tumour with a poor and dismal prognosis. These tumours have a high propensity for distant metastasis and local recurrence. Although originally believed to arise from synovium, these tumours have been found to occur anywhere in body1,2. We report here, a case of median nerve sarcoma in a 15-year female. This is a rare tumour, which is diagnosed only after histopathological examination with only a few cases reported in the literature (Table 1). Although preoperatively tumour was thought to be a nerve sheath tumour, on histopathology analysis was found to be synovial sarcoma. Despite aggressive behaviour, wide local excision is recommended even in smaller lesions. So, the diagnosis should always be kept in differentials of nerve sheath tumour, as what may be a synovial sarcoma.
Association of platelet count and platelet indices with cranial meningioma
Authors: Karatas Yasar , Keskin Fatih , Erdi Mehmet Fatih , Kaya Bulent , Arac Densel , Izci Emir Kaan , Kalkan Erdal 
Published: April 2020

Introduction and Objectives: In this study, we aimed to investigate whether platelet count (PLT) and platelet indices included mean platelet volume (MPV), platecrit (PCT), platelet distribution width (PDW) values can be used as diagnostic markers in cranial meningiomas.
Materials and Methods: The study included results of 29 patient and 47 healthy contributors. Based on pathologies, the patients were divided into two groups. The first group included meningioma patients and the second one included healthy individuals. Healthy contributors named control group. Platelet count and platelet indices were determined using Sysmex XN 550 haematology analyzer. The preoperative platelet count (PLT) and platelet indices included mean platelet volume (MPV), platecrit (PCT), platelet distribution width (PDW) values were recorded from the routine laboratory tests.
Results: There was no statistically significant difference in PLT between the meningioma and healthy groups (p = 0.217). There was a statistically significant difference in PCT between the meningioma group and the healthy group (p = 0.002). There was a statistically significant difference in PDW between meningioma group and healthy group (p = 0.001). In terms of MPV, there was a statistically significant difference between meningioma group and the healthy group (p = 0.001)
Conclusion: Platelet count and indices are easily available in the routine blood tests. Despite the retrospective design and small sample size, our findings suggest that altered MPV, PDW and PCT levels might serve as potential biomarkers for the diagnosis of meningiomas.
Fast growing recurrent grade I meningioma
Authors: Goel Prashank , Singh Daljit 
Published: April 2020

Meningiomas are mostly regarded as benign tumours, accounting for 13% to 26% of all primary intracranial tumors1. According to 2016 World Health Organization (WHO) classification, meningiomas are classified into grade I (benign), II (atypical), and III (anaplastic).2 Meningioma are neoplasms derived from arachnoidal (meningothelial) cells. These lesions can occur in people of any age but commonly present in middle age. Women are more likely to develop a meningioma, with a female/male ratio of approximately 2:1 intracranially and 10:1 in the spine.3 Even after complete removal, meningiomas have been estimated to recur in 10 to 32% of the cases within 10 years. However, recurrences in grade 1 meningiomas are rare and occur after long duration.4 We herein report a case of grade 1 meningioma that recurs very fast, within the duration of 1 yr and the recurrent size of the tumor was approx three times the size of the primary one. To our knowledge, very few cases in the literature have been reported with such a fast-growing grade 1 meningioma.
Efficacy of c-arm scopy-guided erector spinae plane block (ESPB) in postoperative pain control and reduction of opioid side effects in spinal instrumentation surgery
Authors: Karatas Yasar , Keskin Fatih , Erdi Mehmet Fatih , Kaya Bulent , Kosemen Ibrahim , Kenan Mehmet , Kalkan1 Erdal 
Published: April 2020

Background: Spinal instrumentation surgery causes significant pain in patients. As a result, patients are exposed to excessive opioid use and the associated side effects, as well as prolonged hospital stay, resulting in economic burden. Local anaesthetics can help both reduce postoperative pain and minimize the side effects associated with systemically administered opioid analgesics.
Objective: The aim of this retrospective study was to investigate the effect of erector spinae plane block on analgesia in spinal instrumentation surgery and to reduce the side effects of excessive opioid use.
Materials and Methods: We reported a retrospective study. Thirty patients, who underwent spinal instrumentation surgery from 2017 to 2018, were chosen from the hospital records. We performed spinal instrumentation and decompression by laminectomy to all patients under general anaesthesia. While 15 of these patients underwent erector spinae plane block, these patients received patient-controlled analgesia postoperative period. The other 15 patients received only patient-controlled analgesia postoperative period. We analyzed patients' data for differences in preoperative and postoperative visual analogue scores, nausea vomiting scores, constipation life quality scale, patient-controlled analgesia shot count and mean opioid consumption of patients.
Results: The data of 30 patients undergoing lumbar spinal instrumentation surgery were retrospectively analyzed. There was no significant difference in the age, preoperative VAS, preoperative ODI and sex between the two groups (p?0,05). In addition, there were statistically significant differences in postoperative VAS, postoperative ODI, Nausea Vomiting Score, Constipation Life Quality Score (CLQS), petidin consumption and PCA shot count (p <0.05). In all variables with significant differences, the values ??in the block group were lower than the non-block group.
Conclusion: ESPB provides effective analgesia and reduces side effects due to excessive opioid usage.
Clinical spectrum of paediatric head injury. A prospective study from tribal region
Authors: Lodha Krishna Govind , Gupta Tarun Kumar , Jaiswal Gaurav , Singh Yogendra 
Published: April 2020

Introduction: Traumatic brain injury is considered as a major health problem which causes frequent deaths and disabilities in the paediatric population with special concern to tribal regions of developing countries like India where aetiology of traumatic brain injury in the paediatric population fall from height dominant over the road traffic accident as a major.
Aim & Objective: The aim is to analyse the epidemiology, mechanism, clinical presentation, severity and outcome of paediatric head injury in the tribal region of northern India that could help to make preventive policies to improve their care.
Material Methods: It is a prospective observational study of 345 children of up to 18 years of age admitted under Department of Neurosurgery from October 2017 to April 2019.
Results: The study population comprised of 345 paediatric patients. Mean age was 9.25 years.36.81% patients were in 1-6-year age group and male to female ratio was 2.45. The most common cause for trauma was fall from height in 179(52%) cases followed by RTA in 141(41%) cases. The most common radiological finding was depressed skull fractures in 97(50%) cases. There was 35% mortality in severe head injury patients.
Conclusion: This study through some light on the different scenario of head injury in Tribal regions of Developing country and will help to formulate effective strategies for prevention and better care of the patients.
The tumour volume influence on tumour recurrence and progression-free survival in the case of atypical meningiomas
Authors: Cucu A. I. , Costea Claudia Florida , Turliuc Mihaela Dana , Dascalu Cristina Gena , Jitaru Ioana , Dinu R. , Dumitrescu Gabriela , Sava Anca , Dobrovat B. , Bogdanici Camelia , Andrei T. , Stirban I. , Poeata I. 
Published: April 2020

Objective: The objective of our study was to evaluate a possible relation between the volume of atypical meningiomas (AMs) and the risk of tumour recurrence, as well as progression-free survival (PFS).
Material and methods: We evaluated 81 patients diagnosed with AMs (WHO grade II meningioma) who have undergone surgery at the "Prof. Dr. N. Oblu" Emergency Clinical Hospital Iasi between January 1, 2010, and December 31, 2019. The recorded data were demographic and imagistic (MRI, contrast-enhanced T1WI). We calculated the tumour volume prior to the surgery and evaluated the tumour recurrence using MRI at 12, 24, 36, 48 and 60 months after the surgery.
Results: 50.6% of patients had meningioma volume < 26.4 cm3. Women had larger tumour volumes than men (52.6%). Patients of age ? 60 years old, had tumour volumes ? 26.4 cm3 in 58.5% of cases and meningiomas with volumes ? 26.4 cm3 recurred earlier (p=0.010). Also, patients who had tumour volumes ? 26.4 cm3, had a shorter PFS (40.976 months), compared to patients with tumour volumes < 26.4 cm3, who had better PFS (53.4 months).
Conclusions: the tumour volume of AMs ? 26.4 cm3 represents a negative prognostic factor for both early tumour recurrence and reduced PFS.
Long-term functioning of kidney grafts
Authors: Nikonenko T. N. , Trailin A. V. , Nepomnyashchy V. N. , Fen S. V. , Vildanov S. R. , Rusanov I. R. , Nikonenko A. S. 
Published: April 2020

Purpose of the study. to study the morphological changes of long-functioning kidney transplants and determine the main causes of transplant dysfunction.
Materials and methods. A total of 52 recipients aged 20 to 70 years were analyzed retrospectively at different times after transplant surgery (5 to 22 years).Morphological changes in the kidney transplant are comparable according to light microscopy. The morphological changes in the graft were studied in the initial and long-term period. Morphological studies were conducted in monitoring mode.
Results. In the early period after transplantation, ischemic injuries, primary graft function, and episodes of acute rejection were taken into account. In the distant period, morphological changes were evaluated in accordance with the recommendations of the Banff-classification.
When analyzing long-term results, antigendependent (immune) and antigen-independent (visible) factors that affect the renal transplant are distinguished. The main clinical and laboratory indicators of allografts dysfunction are increased creatinine and proteinuria.
In antigen-dependent forms (cellular, humoral and mixed rejection), humoral rejection is the most common (25%) allografts dysfunction.
Antigen-independent forms of dysfunction (streptococcal infection 25%, inflammatory diseases 19,2%, recurrent pathology 3,8%, signs of cyclosporine nephrotoxicity in combination with other forms was found in 59,2%, nephrosclerosis 65,4%).
Conclusions. The data obtained suggest that antigen-dependent (immune) factors, and in particular humoral rejection, are the most common cause of allografts dysfunction, and antigenindependent factors contribute to the progression of chronic rejection and the development of nephrosclerosis.
The effect of nanoscale biodegradable polymer film on the healing of cut wounds of the skin of complicated Psevdomonas auregenosa (Experimental research)
Authors: Popadyuk O. Y. , Genyk S. M. , Kuzyk R. V. , Kostyuk V. V. 
Published: April 2020

Introduction. Effect of the biodegradable polymer film saturated with zinc nanoxide and hydrated C60 fullerene on the healing of skin cut wounds complicated Pseudomonas aeruginosa are study.
Materials and methods. The studies were performed on 35 Guinea pigs in vivarium of IvanoFrankivsk National Medical University.
The animals were divided into three groups: group I (10 animals) the wounds were treated without the use of films; group II (10 animals) – the covering material for Curasorb Zn wounds was used; group III (10 animals) –the biodegradable polymer film with C60 fullerene and zinc nanoxide (nZnO – particle size of 30 nm) was used.
The simulated skin cut wounds were infected with Pseudomonas aeruginosa and investigated wound healed at 3, 7, 14 and 21 days using a Curasorb Zn film and a biodegradable polymer film with C60 fullerene and zinc nanoxide. The area of the wounds was measured, the microbiological examination of the wound content and pathomorphological evaluation of the wound tissues.
Results. Wounds area in animals of group II to the 3-rd day increased slightly by 8,9 mm2, and wounds area animals of group III decreased by 44,8 mm2, indicating the therapeutic effect and sorption capacity of the film from the first days of treatment.
Curasorb Zn films reduced the bacterial pathogen by two orders and the nanooxide film reduced the bacterial level to non-pathogenic levels of magnitude by 3 orders of magnitude by day 3. The bacterial level remained high in the film-free group (group I).
Conclusion. The polymer film saturated with zinc nanooxide and hydrated C60 fullerene has a high local wound healing effect, antimicrobial activity, which improves the effectiveness of local treatment of purulent wounds and reduce the healing time.
Dynamics analysis of the reasons for disability among population of Zaporizhzhia region at 2013–2018
Authors: Lashkul Z. V. , Chemirisov V. V. , Kurochka V. L. , Mashikhina I. V. , Poliakov G. L. 
Published: April 2020

Purpose of the study. To study the dynamics of the main causes of disability among the population of Zaporizhzhia region for 2013– 2018.
Materials and methods. The materials of the study were statistical reports of medical and social expert commissions of Zaporizhzhia Region Center for Medical and Social Expertise for 2013–2018.
Statistical data processing was performed with calculations of intensive indicators for 10 thousand of the total population and for 10 thousand of adult population of Zaporizhzhya region. Statistical processing of the study materials was using computer programs of the STATISTICA package (StatSoft Statistica v. 6.0).
Results. The disability indicator can be considered as a reflection of the success of society, social protection and the level and quality of public health.
The article analyzes the dynamics of causes of disability among the population of Zaporizhzhia region for 2013–2018 according to the annual reports of medical and social expert commissions. We conducted an analysis of the causes of disability among the population of Zaporizhzhia region for 2013–2018.
The main causes of disability are: general illness; disability since childhood; industrial accident (occupational injury or other damage to health); occupational disease; diseases associated with exposure to radioactive radiation due to the Chornobyl disaster; injuries, injuries, injuries, illnesses in the military.
Conclusions. The most common cause of disability is «common disease», which is established in the absence of grounds (evidence) for recognizing the presence of any other cause.
In recent years, the population of Zaporizhzhia region has seen a gradual increase in primary disability due to general illness, work injury and among military personnel. At the same time, there is a tendency to decrease primary childhood disability and occupational diseases.
During the indicated period (2013–2018), there has been a slight fluctuation in the disability indicators due to the Chornobyl disaster, both downward and upward, with an overall trend towards stability.