bluuebunny/crossref_metadata_2025_split huggingface dataset:
Infecções Hospitalares em pacientes submetidos à Clipagem de Aneurisma internados na Unidade de Terapia Intensiva do Hospital Universitário Getúlio Vargas na Cidade de Manaus-AM
Authors: Lins Amanda Cardelis , Pontes Grafe Oliveira , Damian Márcia Melo 
Published: April 2019

Objetivo: Analisar a ocorrência e distribuição de infecções hospitalares (IH) decorrentes e desenvolvidas na Unidade de Terapia Intensiva (UTI) em 57 pacientes submetidos à clipagem de aneurisma cerebral em um Hospital Universitário, na cidade de Manaus entre os anos de 2005 e 2010. Metodologia: Estudo descritivo, retrospectivo com dados coletados das fichas decontrole de Infecção Hospitalar; análise descritiva mediante distribuição de freqüência, e emprego do teste qui-quadrado para verificar presença de associações. Resultados: Foram registrados 22 episódios de IH neste grupo de pacientes (21,8%). Houve predomínio da infecção do trato urinário, seguida da pneumonia e em menor proporção as infecções do sistema nervoso central. Dentre os microrganismos isolados os mais prevalentes foram Staphylococcus epidermidis eEscherichia coli. Conclusão: O estudo traça um perfil dasinfecções no paciente neurocirúrgico, e pode contribuirpara elaborações de protocolos de prevenção de IH nesta população.
Microvascular doppler associated with neuronavigation to intraoperative identification and location of internal carotid artery in transsphenoidal endoscopic pituitary macroadenomas surgery
Authors: Leal André Giacomelli , Vanhazebrouck Pedro , Aurich Lucas Alves , De Oliveira Gustavo Nogueira , Rizelio Vanessa , Ramina Ricardo , Cocorullo Silvia 
Published: April 2019

Context: Enhancements in pulsed doppler techniques have made easier to apply those techniques not only to diagnose brain vascular diseases but also in brain surgery, especially to disclose arteries close to tumors and avoid their manipulation. The aim of this paper is to describe the technique of microvascular doppler associated with neuronavigation in transsphenoidal endoscopic surgery to remove pituitary macroadenomas in three patients. Material And Methods: A sterile 2mm 16-MHz probe was used inside a long curved canula of 17 cm length, attached with a neuronavigation reference. The neuronavigation mapping was done with MRI and angiotomography, which took place 24 hours before the procedure. Results: Intraoperatively, the doppler identified arterial flow compatible with the anatomical localization of the cavernous portion of internal carotid artery, as shown by the neuronavigation system, and this place was avoided during surgery, allowing manipulation of the tumor without risk of damage to the internal carotid artery. The results after surgery were total removal of the tumor in all three cases. No postoperative vascular complications were present. Conclusion: The method with microvascular doppler associated with neuronavigation was essential to the intraoperative vascular diagnosis allowing radical tumoral resections while preventing damage to the internal carotid artery.
Management of Basilar Invagination
Authors: Joaquim Andrei Fernandes 
Published: April 2019

Basilar invagination (BI) is a development anomaly of the craniocervical junction that results in a prolapsed of the upper cervical spine into the skull base, commonly associated to other bone and neural axis abnormalities, like Chiari I malformation and syringomyelia. In this paper, we review the concepts necessary to understand and treat BI. The most comprehensive and accepted classification system is the proposed by Goel, which divides patients with BI into two groups, as it follows: group A) patients with clear elements of instability; and group B) BI secondary to clivus hypoplasia. Treatment in group A includes craniocervical realignment and stabilization, most of the times using an isolated posterior approach, obviating an unnecessaryand morbidity of the anterior decompression. In group B, foramen magnum decompression is the treatment of choice. Surgical techniques should be adequate according to patient’s anatomy and surgeon’s experience. Good surgical results can be obtained with the understanding of the main concepts and treatment options of BI.
Intracranial meningioma manifesting as transient ischemic attack
Authors: Cohen Moyses Isaac , Júnior Sérgio Robinson Martucci , Chaves Renato Andrade , Teixeira Marco Aurélio Fernandes , Adry Rodrigo Antônio Rocha da Cruz , Meguins Lucas Crociati , Spotti Antônio Ronaldo 
Published: April 2019

Meningiomas are the most common intracranial primary neoplasm in adults. They present a wide variety of clinical manifestation and interpreting the symptomatology of meningiomas according to their location is one of the most fascinating topics that explore the full potential of the clinical neurologic examination. Epileptic seizures are reported as the very first symptom in most patients. However, cerebrovascular events, particularly transient ischemic attacks (TIA), are uncommon presentation of meningiomas. We describe the case of a patient with an intracranial meningioma manifesting initially as TIA and make a brief review upon the possible explanations of the event.
Glioblastoma Multiforme
Authors: Welling Leonardo , Lynch José Carlos , Pereira Celestino , Andrade Ricardo , Hidalgo Fabiana Polycarpo , Pereira Alessandra G. L. , Escoteguy Cláudia 
Published: April 2019

Objectives: Glioblastoma multiforme (GBM) has the highest malignancy grade in the astrocitic tumor group besides being the most common central nervous system tumor in adults. This paper aims to evaluate if the following factors: age, Karnofski Performance Status (KPS), extension of surgical removal, radiotherapy (RT), tumor volume and symptoms duration influenced the survival. Methods: We performed a retrospective analysis of GBM operated on at Hospital dos Servidores do Estado between 1986 and 2008. Results: We could observe that age, KPS and radiotherapy influenced the survival of patients. The other variables studied didnot have any prognostic implications. Conclusions: Despite many researches and several improvements regarding diagnosis and surgical techniques, the survivalof patients presenting with GBM could not be changed in the last 30 years. Surgical resection followed by RT is the standard treatment for patients with GBM. The importance of each prognostic factor is still to be established in a multivariate analysis.
Diffuse brain swelling following falcine meningioma surgery
Authors: De Araújo Ricardo Marques Lopes , Nery Breno , Barbosa Bruna Nayana Ribeiro , Barbosa Bernardo Alves , Carvalho Pablo Rodrigues , De Oliveira Eduardo Monteiro , Sousa Antônio Carlos Barbosa , Rodrigues José Carlos , Silva Marcelo Nery 
Published: April 2019

Initially described by Harvey Cushing at the beginning of the last century, meningioma is used for tumors that originate from meningothelial cells of the arachnoid, are usually well-circumscribed, slow growing and amenable to complete resection. The presence of peritumoral edema in meningiomas is known for a long time and has been studied regarding its etiology. The peritumoral edema can lead to technical difficulties during treatment as a limitation of the surgical field when the swelling is extensive. The present study describes a case of a patient who developed severe and persistent neurological impairment due to diffuse cerebral swelling after resection of parasagittal meningioma without complications perioperatively.
Management of Hemangioblastomas
Authors: Viano Juan Carlos , Suárez Julio César , Caussa Lucas , Herrera Enrique José , Surur Alberto , Theaux Ricardo , Zunino Silvia , Pueyrredon Francisco José , Ryan Ruan Manuel 
Published: April 2019

Objective: The aim of this paper is to present our experience in the management of hemangioblastomas. Material and Method: ten patients with sporadic hemangioblastomas (6 male and 4 female; range 4-75 years) were analyzed. Central ventriculography, cerebral arteriogram, cranial CT scan and head MRI (MR spectroscopy and diffusion MRI) were performed. Location was at cerebellum in 8 patients, left occipital lobe in 1 and brain stem in 1. Nine patients were surgically treated and 1 patient underwent stereotactic radiosurgery due to tumour location in the brainstem and surgery was clinically contraindicated. Results: Only onerecurrence occurred in a 4-year-old patient who had undergone subtotal resection and had to be operated 10 years later due to tumor growth. Two patients died; one subject during the immediate post-operative period due to massive gastrointestinal bleeding and cardiac arrest and the other due to myocardial infarction 25 years after surgery. The 8 surviving patients currently present with normal neurological status and have perfectly normal lives, including the subject who underwent stereotactic radiosurgery of brainstem. The survival rate of these patients is 1-16 years.
Vasoespasmo Cerebral Após Hemorragia Subaracnóidea Aneurismática
Authors: Pereira Benedito Jamilson A. , Nakasone Fábio Jundy , De Oliveira Jean G. 
Published: April 2019

A ruptura de aneurisma intracraniano é a principal causa de hemorragia subaracnóidea (HSA) espontânea. O curso clínico da HSA aneurismática pode resultar em complicações como ressangramento, hematomas intraventriculares e intracerebrais, hidrocefalia, convulsão e vasoespasmo cerebral. O vasoespasmo cerebral é a complicação médica mais devastadora após a HSA aneurismática e está associada à alta taxa de morbi-mortalidade, mesmo após o tratamento dos aneurismas que originaram a mesma por sua ruptura. O presente estudo compreende uma revisão bibliográfica sobre a fisiopatologia do vasoespasmo, aspectos diagnósticos e as formas de prevenção e tratamento.
Neurovascular Decompression for Trigeminal Neuralgia in 17-year-old Girl
Authors: Jung Gustavo Simiano , Ruschell Leonardo Gilmone , Da Silva Junior Luis Fernando Moura , Da Silva Jr. Erasmo Barros , Milano Jerônimo Buzetti , Ramina Ricardo 
Published: April 2019

Trigeminal neuralgia in general is a disease of the elderly. Rarely, the disease presents during childhood. Therefore we sought to explore the role of vascular compression in pediatric patients with medically refractory trigeminal neuralgia. A case of venous compression related to trigeminal neuralgia is presented in a 17-year-old girl. Upper petrous vein was found to be related to aneurovascular conflict with unusual response to neurovascular decompression with complete resolution of symptoms in postoperativeperiod.
AAM Psychological Syndrome
Authors: Gatto Luana Maranha , Nascimento Fábio A. , Ottobeli Caterine , Simm Renata , De Aguiar Paulo Henrique Pires 
Published: April 2019

We report three cases of patients with cavernous angioma in a series of 32 cases presenting as initial symptoms of aggressive behavior, anxiety and loss of memory. During the investigation they were diagnosed with cavernomas in limbic system. One man and two women with 58, 56 and 60 year-old, who presented the cavernomas respectively in callosum / cingulum area, gyrus rectus area, and cingulate gyrus. They were treated clinically with Carbamazepine 200mg 8/8 hours, Clonazepam 2mg daily, and Sodium Valproate 500 mg 6/6 hours orally. They showed no results for the ictal behavior disorder. However, after surgery with total removal of the cavernomas through a microsurgery the symptoms immediately finished. The authors discuss the possibility of such symptoms to be part of epileptic manifestation or simple compression of limbic pathways. Also is discussed if there is any possibility to those syndromes with cavernomas in different portions of frontal lobe to be caused by disturbance in the input fibers to nucleus accubens and to nucleus of the solitary tract based on literature review. The proximity and inner connections in frontal lobe structures may be analyzed in the light of neurophysiology and neuroanatomy.
Invasão Intracraniana por Carcinoma Triquilemal
Authors: Gonçalves Simão Luniére , Santacruz Mário José Lopes , Azevedo Eurico Manoel Franco , Da Costa e Silva Ivan Tramujas 
Published: April 2019

Carcinoma triquilemal é uma rara neoplasia descrita pela primeira vez em 1968, que afeta indivíduos de ambos os sexos com idade média de 50 anos. Existe uma forte associação com a exposição solar e à radiação. O diagnóstico é feito através de análisehistológica e imuno-histoquímica. O tratamento cirúrgico é a norma; no entanto, o tratamento adjuvante é recomendado para os raros casos com metástase e recidiva. Este relato de caso é de um paciente com evolução atípica dessa neoplasia que culminou com a invasão intracraniana.
Heart Rate, Autonomic Function, and Future Changes in Glucose Metabolism in Individuals Without Diabetes: The Whitehall II Cohort Study
Authors: Hansen Christian Stevns , Færch Kristine , Jørgensen Marit Eika , Malik Marek , Witte Daniel R. , Brunner Eric J. , Tabák Adam G. , Kivimäki Mika , Vistisen Dorte 
Published: April 2019

OBJECTIVE
Autonomic nervous system dysfunction is associated with impaired glucose metabolism, but the temporality of this association remains unclear in individuals without diabetes. We investigated the association of autonomic function with 5-year changes in glucose metabolism in individuals without diabetes.

RESEARCH DESIGN AND METHODS
Analyses were based on 9,000 person-examinations for 3,631 participants without diabetes in the Whitehall II cohort. Measures of autonomic function included 5-min resting heart rate and six heart rate variability (HRV) indices. Associations between baseline autonomic function measures and 5-year changes in fasting and 2-h plasma glucose, serum insulin concentrations, insulin sensitivity (insulin sensitivity index [ISI0–120] and HOMA of insulin sensitivity), and β-cell function (HOMA of β-cell function) were estimated in models adjusting for age, sex, ethnicity, metabolic factors, and medication.

RESULTS
A 10-bpm higher resting heart rate was associated with 5-year changes in fasting and 2-h insulin and ISI0–120 of 3.3% change (95% CI 1.8; 4.8), P &lt; 0.001; 3.3% change (1.3; 5.3), P = 0.001; and −1.4% change (−2.4; −0.3), P = 0.009, respectively. In models adjusted for age, sex, and ethnicity, higher baseline values of several HRV indices were associated with a 5-year decrease in fasting and 2-h insulin and ISI0–120. However, significance was lost by full adjustment. A majority of HRV indices exhibited a trend toward higher values being associated with lower insulin levels and higher insulin sensitivity.

CONCLUSIONS
Higher resting heart rate in individuals without diabetes is associated with future unfavorable changes in insulin levels and insulin sensitivity. Associations may be mediated via autonomic function; however, results are inconclusive. Resting heart rate may be a risk marker for future pathophysiological changes in glucose metabolism.
RANCANG BANGUN CETAKAN LOGAM UNTUK PRODUK BILAH GAMELAN PADA MESIN HIGH PRESSURE DIE CASTING
Authors: Slamet Sugeng , Harmoko Setiawan 
Published: April 2019

High Pressure Die Casting/HPDC bertujuan untuk mendapatkan produk cor dengan kepadatan dan kepresisian yang tinggi. Salah satu bagian terpenting dari pengecoran adalah cetakan. Besarnya tekanan HPDC yang besar membutuhkan cetakan permanen yang terbuat dari logam dan mampu menerima tegangan tanpa mengalami deformasi. Bilah gamelan selama ini dikerjakan dengan pengecoran konvensional dilanjutkan dengan tempa tangan. Besarnya energi tempa serta lamanya waktu pengerjaan menjadi penyebab produktifitas rendah. Inovasi teknik produksi menggunakan teknik high pressure die casting diharapkan mampu mengatasi permasalahan tersebut. Metode yang dilakukan adalah merancang dan membuat cetakan bilah gamelan dari bahan logam. Tahapan perancangan dimulai dari membuat desain, menentukan bahan logam, menghitung dimensi cetakan, kecepatan alir logam cair, tekanan pada rongga cetakan dan laju perpindahan panas pada dinding cetakan. Cetakan logam berbahan AISI H13 untuk produk bilah gamelan yang dipasang pada mesin HPDC. Hasil perhitungan volume rongga cetakan 180630,786 mm3, kecepatan alir 0,5638 m/s, tekanan rongga cetakan 8385610,98 Pa dan temperatur dinding cetakan rata-rata 150°C.
STUDI KEKUATAN IMPAK DAN KADAR AIR PADA KOMPOSIT SERAT ALAM DENGAN MATRIK POLIESTER TERHADAP ORIENTASI PENYUSUNAN SUDUT SERAT
Authors: Slamet Sugeng , Qomaruddin Qomaruddin 
Published: April 2019

Material komposit banyak digunakan untuk menggantikan material logam. Sebagai negara dengan iklim tropis, Indonesia banyak tumbuh tanaman tropis yang berpotensi sebagai bahan serat untuk material komposit. Selain dari harga yang relatif murah, serat alam merupakan limbah material organik yang dapat diurai oleh lingkungan dibanding dengan serat sintetis. Kebutuhan material komposit terus meningkat setiap tahunnya. Hal ini akan mendorong kebutuhan dan permintaan serat alam semakin meningkat. Sebagian dari serat alam dihasilkan dari tanaman yang dikategorikan sebagai limbah bagi lingkungan.Bahan yang digunakan dalam penelitian ini adalah tanaman enceng gondok dan (Eichhornia Crassipes) serta sabut buah kelapa (Cocos Nucifera). Kedua jenis bahan tersebut merupakan sampah. Fabrikasi dilakukan dengan cara memisahkan sellulose dan senyawa lain untuk mendapatkan bahan serat. Matrik komposit menggunakan resin polyester Yukalac BQTN 157 dan hardner MEKPO. Komposisi antara matrik dan serat 70% : 30% dan 75% : 25%. Orientasi continous fiber dengan variasi 0°, 45°, 90° dan acak. Tujuan dari penelitian ini adalah mengetahui besarnya kadar air setelah fabrikasi dan yang kekuatan impak dari materal komposit serat alam.Hasil penelitian menunjukkan komposit dengan penguat sabut kelapa mempunyai ketangguhan impak yang lebih tinggit pada orientasi sudut serat 0° dan acak pada komposisi 70% : 30%. Penambahan jumlah serat terhadap matrik sangat signifikan meningkatkan ketangguhan impak sebesar 43,2% dan 61,5% pada orientasi penyusunan serat secara acak. Komposisi 75% : 25% terjadi peningkatan sebesar 37,5% dan 47,2% tersusun secara acak. Serat alam tersebut menunjukkan kenaikan energi impak sebesar 68,8% - 139% dengan melakukan orientasi penyusunan sudut serat.
Evaluation of Adhesive Remnant Index after metal brackets removal using AutoCAD software
Authors: Arbutina Adriana , Arapović-Savić Marijana , Umićević-Davidović Mirjana , Radman Irena Kuzmanović , Marin Saša 
Published: April 2019

Summary
Introduction After the completion of treatment with fixed orthodontic appliances, it is necessary to remove the brackets and bands from teeth using an appropriate method. The aim of this study was to determine the most common way of bond failure between teeth and metal brackets, as well as to compare bond failure between the brackets and upper and lower premolars. Material and Method Metal brackets were bonded with Aspire composite material on 154 human premolars, extracted for orthodontic purposes. After debonding, the surface of remaining adhesive on the teeth and brackets was measured. Adhesive Remnant Index (ARI) was used to estimate bond failure between teeth and metal brackets. Results The average size of remaining adhesive surface after removing brackets from the upper premolars was 12.06 mm2, while it was 9.32 mm2 on the lower premolars. The average size of the remaining adhesive surface area on the brackets removed from the upper premolars was 0.37 mm2, while it was 2.08 mm2 on the brackets removed from lower premolars. A statistically significant difference was found between these values. The most common score of ARIteeth was 3 (85.71%) and the most frequent score of ARIbrackets was 0 (85.71%). Conclusion The most common way of bond failure between teeth and metal brackets was between the bracket base and adhesive surface. A statistically significant difference was found between the values of the size of residual adhesive surface on the upper and lower premolars as well as on the brackets debonded from them.
Emergency appointments in orthodontics
Authors: Gyawali Rajesh , Ranjan Pokharel Prabhat , Giri Jamal 
Published: April 2019

Introduction
Patients undergoing fixed orthodontic treatment are usually recalled electively for the adjustments of the appliances, but sometimes they appear suddenly for emergency visit which must be addressed immediately. The primary objective of this study was to assess the nature and frequency of emergency visits made by patients under labial fixed orthodontic therapy. The secondary objective was to compare these visits between genders and age groups.

Materials and Methods
The study was conducted at orthodontic clinic, B. P. Koirala Institute of Health Sciences, Dharan, Nepal. All the patients undergoing fixed labial orthodontic treatment were included and followed up for a period of 6 months. The reason for emergency appointment was recorded along with the demographic and clinical details. Chi-square test was used to find out the possible association between gender and age group with emergency appointment.

Results
Of 327 patients undergoing active fixed orthodontic therapy, 199 were female and 128 were male. A total of 176 emergency appointments were encountered during the study period of 6 months. The most common reason was the loosening of brackets or bondable buccal tubes (118) followed by loosening of bands (45). Other reasons were trauma to the buccal mucosa by the overextended wire (5), detachment of buccal tubes from the band (5), tearing of bands (3), breakage of acrylic plate (2), loosening of ligature tie (1), and dislodgement of elastomeric chain (1). Emergency appointments were not found to have statistically significant association with age group (χ2 = 0.073, P = 0.787) or the gender (χ2 = 3.196, P = 0.074).

Conclusions
Loosening of the brackets or bondable buccal tubes was the most common cause for emergency visit. No significant association was found between the gender and age group with such visits.
Telefitting Between Kajetany and Odessa, Ukraine for Cochlear Implants
Authors: Skarżyński Piotr Henryk , Świerniak Weronika , Ludwikowski Maciej , Bruski Łukasz 
Published: April 2019

Hearing implant fitting is a key component of postoperative patients’ healthcare, by providing the optimum auditory nerve electrical stimulation parameters. It often entails time consuming and long travel to a medical centre, with associated costs. In 2009, the Word Hearing Centre introduced the National Network of Teleaudiology to reduce the burden to patients, and it now consists of 21 co-operating centres in Poland and four abroad in the Ukraine (Odessa and Lutsk), Kyrgyzstan (Bishkek), and Belarus (Brest). The centre in Odessa is sufficiently equipped but programming of cochlear implants cannot be conducted by their team there due to a lack of trained specialists and limited experience. This study reports the use of the teleﬁtting service between Kajetany in Poland and Odessa in the Ukraine. Methods: Specialists in Poland connect by videoconference with patients and support specialists via the Internet, and use remote desktop software to access a remote computer and perform fitting. On completion of telefitting, patients completed a questionnaire in which they compared the telefitting experience with face to face conventional fitting. Results: Supported by a local specialist, 316 patients in Odessa underwent remote telefitting by specialists in Kajetany. Over 95% of respondents were; satisfied with telefitting, found it a suitable alternative to standard fitting, felt that they had good contact by videoconference with the audiologist in Poland, and that it saved them time and money. Conclusion: The development of the telefitting model has increased accessibility to hearing care services in Odessa and opens new possibilities for patients.