bluuebunny/crossref_metadata_2025_split huggingface dataset:
O uso do Doppler intra-operatório na cirurgia para clipagem de aneurisma cerebral
Authors: Silva João Miguel De Almeida , De Aguiar Guilherme Brasileiro , De Souza Rodrigo Becco , Badke Guilherme Lellis , Silva Felipe Gustavo Vilar , Veiga José Carlos Esteves 
Published: April 2019

O resultado do tratamento dos aneurismas cerebrais é influenciado por diversos fatores. O tratamento cirúrgico pode ter sua evolução comprometida pela ocorrência de isquemia cerebral decorrente da clipagem inadvertida de vasos adjacentes, assim como o risco de hemorragia futura aumenta diante de oclusão incompleta do aneurisma. A utilização do Doppler intra-operatório para o estudo da hemodinâmica dos aneurismas e dos vasos adjacentes vem sendo preconizada como ferramenta assistente, com análises recentes a respeito da sua segurança e confiabilidade. O presente caso tem o intuito de expor e discutir a situação em que após a clipagem inicial do aneurisma, considerada adequada sob a óptica do microscópio, o Doppler constatou fluxo intraaneurismático residual, sendo necessárias medidas adicionais para a oclusão do aneurisma.
Percutaneous Vertebroplasty for Tumoral Fractures
Authors: Narata Ana Paula , Brina Olivier , Herbretau Denis , Cottier Jean-Philippe , Dietrich Pierre-Yves , Yilmaz Hasan , Martin Jean-Baptiste , Pereira Vitor Mendes 
Published: April 2019

The pain management in oncologic patients requires a multidisciplinary approach. Considering bone metastases, multiple myeloma and lymphoma, percutaneous procedures like vertebroplasty can provide rapid pain relief. However, percutaneous vertebroplasty must be placed in order to not delay systemic therapy or other modalities of treatment. In this article, we described our 15 years’ experience in collaborating with a multidisciplinary team, reviewing literature and special issues percutaneous vertebroplasty for spinal tumoral fractures.
Chance Fracture in Three Brothers
Authors: Filho Lucidio Duarte De Souza , Bicalho Geraldo Vitor Cardoso , Drummond Bernardo , Rosseto Rafael Stein , Faleiro Rodrigo Moreira , Pimenta Newton José Godoy 
Published: April 2019

Chance fracture, suggestive of a flexion-distraction mechanism, is an uncommon type of injury in the pediatric population. Its occurrence, with associated intra-abdomimal lesions, has increased with the widespread use of seat belts. Since this type of fracture presents subtle variations on common image examinations, its diagnosis may be delayed increasing the probability of subsequent neurologic deficits. In this paper we report the case of three siblings, victims of a motor vehicle head-on collision,either presenting seat belt fracture or Chance fracture. They were treated in the Hospital João XXIII, Belo Horizonte. The case reported reinforces the hypothesis describing the fracture mechanism and associated intra-abdominal injuries.
Stentoplastia no tratamento precoce das fraturas de coluna em idoso
Authors: Aires Rogério , Marinello João 
Published: April 2019

O objetivo deste artigo é fazer o relato de caso de um paciente idoso, submetido a tratamento cirúrgico de fratura osteoporótica de coluna lombar com um método pouco difundido no Brasil. Normalmente o tratamento instituído é a vertebroplastia ou cifoplastia, mas os autores vêm obtendo melhores resultados com a stentoplastia nesta população, método este que envolve a colocação de um stent no corpo vertebral associado a cimento ósseo. Este procedimento fornece mais segurança e estabilidade à vértebra quando comparado aos métodos tradicionais.
Sacral Tuberculosis in the Elderly
Authors: Cavalcante Rodrigo A. C. , Giacomini Leonardo , Joaquim Andrei Fernandes , Yoshinari Halissom , Dal Fabbro Mateus , Tedeschi Hélder 
Published: April 2019

Vertebral Tuberculosis represents about 50% of all osseous compromised in tuberculosis. However, sacral tuberculosis is rare even in developing countries. Objective: Describe the importance of the diagnosis of vertebral tuberculosis in the sacral region. Methods: Case report of a 67 year-old woman who presented with low back pain for one year. Results: Initial radiological evaluation was compatible with a lytic lesion at the first sacral (S1) vertebrae on the computed tomography scan. Open surgical biopsy was performed, but it was inconclusive. A second procedure was performed and Mycobacterium tuberculosis bacilli werevisualized on microbiological purulent fluid analysis. A complete improvement of pain was obtained after introduction of antituberculousdrugs. Conclusion: Although rare, sacral tuberculosis should be considered as a differential diagnosis of low back pain in endemic regions.
Displasia Fibrosa Óssea Extensa em Coluna Cervical de Paciente Jovem e Assintomático
Authors: Zicarelli Carlos Alexandre Martins , Maldaun Marcos Vinícius , Aguiar Paulo Henrique Pires , Georgeto Sérgio Murilo , Pesente Francisco Spessatto , Sampaio Milena Gerke 
Published: April 2019

Introdução: A Displasia Fibrosa Óssea (DFO) é uma lesão benigna, representando 5 a 7% dos tumores ósseos benignos. Tem sua etiologia relacionada a mutações somáticas. Classifica-se em monostótica, quando atinge apenas um osso ou poliostótica no envolvimento de mais de um. O acometimento cervical é raro, sendo mais comum na apresentação poliostótica. Os casos com comprometimento funcional ou estético excessivo constituem-se como principais indicações para o tratamento cirúrgico. Objetivos: Os autores mostram o tratamento da lesão destrutiva do corpo vertebral cervical, quinto segmento, causada por DFO monostótica, por meio de somatectomia associada a artrodese anterior com substituto de corpo vertebral, placa de titânio anterior, laminectomia e fixação posterior com cabos de titânio sublaminares. Métodos e Resultados: Relato de caso, inicialmente de trauma automobilístico, que após estudo por imagem da coluna cervical confirmou diagnóstico de DFO. Devido à instabilidade da região cervical indicou-se cirurgia, sobre a qual foram comentadas suas principais etapas.
An Unusual Case of CV Junction Tuberculosis Revealed as Post-Traumatic Cervical Pain
Authors: Moscote-Salazar Luis Rafael , Alvis-Miranda Hernando Raphael , Lee Angel , Alcala-Cerra Gabriel 
Published: April 2019

Background: Tuberculosis (TB) is a worldwide health problem. Extrapulmonary manifestations of TB are common with skeletal system involvement being the most frequent. Spinal TB accounts for 50% of these cases. Case report: Colombian male patient, 66-years-old, without any medical antecedent of interest, who after traumatic brain injury developed cervical pain, and cervicalmovement limitation. Cervical MRI revealed an osteolytic process in the odontoid process, which was biopsied transorally. Histological analysis showed chronic granulomatous type of inflammation with caseous necrosis in addition to nonspecific lymphoplasm infiltrate, suggestive of tuberculous origin. Patient was conservative managed. Conclusions: It is vital to maintaina high degree of clinical suspicion for diagnosis of spinal TB when the location of spinal TB is cervical, and specifically suboccipital. This can be suspected when patient refers to pain, with the previously mentioned characteristics. Conservative management and closely follow up is recommended, but when not improved with conservative therapy, or when paralysis isevident, surgery is indicated.
Can Natural Disasters Increase the Risk of Stroke?
Authors: Takeshita Bruno Toshio , Rowe Adriel , Nascimento Fábio A. , Machado Joao Natel Pollonio , Siquineli Fabio , Takeshita André Issamu , Kowacs Pedro Andre , Ramina Ricardo 
Published: April 2019

Introduction: Natural disasters occur more and more frequently. In 2008, the cities of Itajaí Valley were hit by flooding of large proportion associated with landslides. Objective: To evaluate the frequency of cases of cerebrovascular disease (CVD) admitted to the Hospital Santa Isabel de Blumenau (HSI) in three periods and its possible relationship with the natural disaster occurred in November 2008. Method: CVD cases were selected among inpatients in the HSI in Period I: 2007 to 2008, Period II: 2008 to 2009 (period of natural disaster) and Period III: 2009 to 2010. Results: There was an increase in the absolute number of CVD cases over the three periods (32, 56 and 77, respectively). In the year of the disaster a significant elevation of the numbers of cases of CVD was seen. Conclusion: Statistically significant increase in the frequency of CVD after the natural disaster of November22nd, 2008 could be considered as implication of correlation.
Aneurisma Pediátrico del Sector A1
Authors: Crosa Roberto , Glumcher Damian , De los Santos Veronica , Rodriguez María Fernanda , Brunet Florencia , Macadam Jose Pedro 
Published: April 2019

Presentamos un paciente de 12 años con una hemorragia meníngea secundaria a ruptura de un aneurisma en una topografía inusual, confirmado por tomografía computada (TC). La angioTC evidencia además una imagen compatible con dilatación sacular de la porción A1 de la arteria cerebral anterior izquierda. Se realiza angiografía que evidencia aneurisma A1 izquierdo de 5 mm, con cuello de 3 mm, en forma de coma, del cual se origina la arteria recurrente de Heuber. Se realiza tratamiento endovascular, logrando la exclusión del fondo y parte del cuerpo del aneurisma, manteniendo la permeabilidad de la Arteria recurrente de Heubner. En el control al mes, el paciente sigue asintomático, GOS 5.
Giant Cell Glioblastoma Associated with Intrinsic Arteriovenous Malformation
Authors: Brock Roger Schmidt , Gomes Marcos De Queiroz Teles , De Oliveira Matheus Fernandes , Lancellotti Carmen Lúcia Penteado 
Published: April 2019

Background: Primary brain tumors associated with cerebral arteriovenous malformations (AVM) although known is a rarely reported finding. There have been approximately 50 cases reported. Only two cases of a single lesion with coexistence of AVM and glioblastoma were described. Case Report. We report a case of a 46-year-old woman with headache and seizures for 2 months who performed a MR which displayed a large right frontal lesion suggesting a glioblastoma. Results. During surgical resection, two large veins could be seen draining tumoral vascularization in the surrounding cortex. After reaching the deepest portion of tumor, veins were coagulated and cut to allow tumor removal. However, unexpected bleeding started to occur with associated lesion growth and edema, resembling an AVM. Material sent to pathology revealed giant glioblastoma in association to an AVM with some thrombosed vessels and ischemic necrosis. Two previous studies discussed similar cases. Conclusion. The need of magnetic resonance in all AVM cases is highlighted in order to analyze brain parenchyma within AVM. We also remark the need of pathological analysis of whole surgical material, in order to characterize whole piece and to avoid not diagnosingan associated lesion.
Improvement of Hydrocephalus in Patients with Chiari Malformation After Posterior Fossa Decompression
Authors: Heringer Lindolfo Carlos , De Oliveira Matheus Fernandes , De Sousa Ulysses Oliveira , De Lima Wanderley Cerqueira , Botelho Ricardo Vieira 
Published: April 2019

Introduction. The association between hydrocephalus and Chiari malformation (CM) has not been described frequently. Ventricular dilation affects 7% to 10% of patients with CM, but the ideal choice of surgical treatment is controversial. Wereport a case of a patient with Chiari malformation and hydrocephalus with improvement in clinical symptoms and ventricular dilatation. Case Description. A 19-year-old male complaining of frontal headache when coughing, laughing and during valsalva maneuvers, associated with dizziness for 2 months. Magnetic resonance (MR) showed hydrocephalus and small posterior fossa with overcrowding of contents, characterizing Chiari malformation type I, with cerebellar tonsils protruding through magnum foramen. Patient underwent surgery with posterior fossa decompression in a semi-sitting position and removal of the arc C1.After 3 months of follow-up, headache disappeared becoming asymptomatic. Control MR showed improvement of hydrocephalus with restoration of the cisterna magna and CSF flow. Discussion. Hydrocephalus has been related to CM for a long time. In our case, we performed treatment with intradural and intra-arachnoidal approach with bilateral tonsillectomy without placing ventricular shunt. The cisterna magna was “recreated”. There was improvement of hydrocephalus with decreased Evans ratio index and symptoms disappearance. Although there is no other studies addressing such matter, in this case, the improvement suggests that the CSF compression at the foramen magnum was the cause of associated hydrocephalus with Chiari malformation.
Anterior Communicating Artery Aneurysms
Authors: Rabelo Nicollas Nunes , Pereira Victor Hugo Honorato , Sant'Anna Marco Aurélio Ferrari , Rabelo Neiffer Nunes , Dias Júnior Luiz Antônio Araújo , Dias Luiz Antônio Araújo , Pereira Carlos Umberto 
Published: April 2019

Introduction: Anterior communicating artery complex (ACoA) is the most frequent intracranial aneurysms (30%) and the most complex of the anterior circulation, due to variation of architecture, flow and many branches involved. This paper aims toestablish anatomical study and clinical manifestations, analyzing a series of cases of AcoA aneurysms. Methods: Articles in PubMed, Scientific Direct were reviewed using as key words, anatomy variations. In addition, AcoA features were analyzedbased on our series cases. Results: Most common anatomical variations found in the literature were: plexiform (30%), curling (33%), fenestration (21%), duplication (18%). Clinical features: Fasciobraquial hemiparesis, headache, personality changes,intellectual deficit, anxiety, fear, emotional disturbances, dizziness, agitation, hypokinesia, decreased level of consciousness. Total of 5-year series of 234 cerebral aneurysms (32 deaths -13.6 %). Analyzing the series, 41 ACoA (18%), with 32 ruptured (78%); 19 deaths (46%); 16 prior hypertension arterial (39%); and a ratio between women and men of 2.25 were found. Conclusion: In our series, we concluded that the ACoA aneurysms are more common in women, the diagnosis is often after rupture and highincidence of death. Probably the anatomical variations, location between bifurcation arteries, A1 characteristics and different direction of the domus, contribute for different outcomes and uncertain clinics. Therefore, to predict the topography of theaneurysm by analyzing only the clinic is difficult.
Tópicos em Neurocirurgia
Authors: Pereira Carlos Umberto , Rabelo Nicollas Nunes , Pereira Francisco De Assis , Oliveira Débora Moura da Paixão , Rabelo Neiffer Nunes 
Published: April 2019

Vítimas de lesões medulares têm sido frequentes emconsequência de acidentes automobilísticos, quedas de altura e outras lesões traumáticas geradas pelo crescimento da violência urbana. A lesão medular leva a um importante impacto tanto ao nível físico quanto psicológico e se associa a vários graus de incapacidade que contribui para o comprometimento da qualidade de vida dos pacientes e familiares. O TRM cervical pode ocasionar uma série de problemas neurológicos, envolvendo a perda da função sensitiva e motora, disfunção esfincteriana e intestinal, espasticidade,dor neuropática e DISREFLEXIA AUTONÔMICA. Asdisfunções autonômicas após o TRM cervical são responsáveis pelo aumento da morbidade e mortalidade, tanto na sua fase aguda como na crônica. Do ponto de vista terapêutico é necessário intervir precocemente, se possível, para evitar maiores danos tissular, medular e complicações, estabelecendo uma terapêutica medicamentosa que promova neuroproteção. O objetivo desta monografia é levar o conhecimento sobre essaafecção a todos os envolvidos no tratamento e na reabilitação dos pacientes vítimas de TRM, principalmente cervical; contribuir para ampliar os conhecimentos dos cuidadores de indivíduos vítimas de TRM cervical e seus familiares, bem como na compreensão e participação da sociedade.
Acidente Vascular Cerebral Hemorrágico em Adultos Jovens
Authors: Guimarães Victor De Oliveira Sousa , Pereira Carlos Umberto 
Published: April 2019

Objetivo: O acidente vascular cerebral hemorrágico (AVCH) é um fardo para os jovens devido às suas altas mortalidade e incapacidade. Apesar de incomum, há uma tendência ao aumento na sua incidência, em especial pela alta prevalência de fatores de risco. Esse estudo procura identificar as características epidemiológicas dos adultos jovens acometidos por AVCH. Métodos: Foram analisados 49 pacientes com idade entre 20 e 45 anos e diagnóstico de AVCH, entre julho de 2012 e abril de 2015. Resultados: Foram 37 (75,5%) do sexo masculino e 12 (24,5%) do sexo feminino, com idade média de 39,5 anos. A hipertensão arterial sistêmica (HAS) foi o fator de risco mais prevalente (55,1%). Não foram encontrados casos associados ao tabagismo. AVCH secundário a malformações arteriovenosas (MAV) e ao uso de drogas simpaticomiméticas foram10,2% e 8,1%,respectivamente. A região lobar (46,9%) foi a mais acometida. A taxa de mortalidade foi de 49%, com 24,5% sobrevivendo sem apresentar sequelas. Conclusões: O subdiagnóstico e o baixo controle da HAS no Brasil devem destacá-lo entre os fatores derisco do AVCH. O aumento no consumo de drogas simpaticomiméticas também eleva sua importância. São necessárias medidas de saúde pública para a prevenção do AVCH entre os jovens.
Multiple Neural Tube Defect
Authors: Cohen Moysés Isaac , Ferreira Wander Da Silva , Dos Anjos Renildo Sérgio Batista , Souza Marcos Robert Da Silva , Do Vale Cleóstenes Farias 
Published: April 2019

Double neural tube defect is a rare congenital problem. We report a case and discuss about current theories of neural tube closure. A 39 weeks term baby with occipital encephalocele and lumbosacral myelomeningocele is reported and her managementis described. A single-staged surgery was performed. The present case is the first described in South America and seems to support a multi-site closure theory.
Effects of rapid maxillary expansion on upper airway volume: A three-dimensional cone-beam computed tomography study
Authors: Abdalla Yousef , Brown Louise , Sonnesen Liselotte 
Published: April 2019

ABSTRACT

Objective:
To compare changes in pharyngeal airway volume and minimal cross-sectional area (MCA) between patients undergoing rapid maxillary expansion (RME) and a matched control group and to identify markers for predicting airway changes using cone-beam computed tomography (CBCT).

Materials and Methods:
Pre- and posttreatment CBCT scans were selected of children who had RME (14 girls and 12 boys; mean age, 12.4 years) along with scans of a control group (matched for chronological age, skeletal age, gender, mandibular inclination) who underwent orthodontic treatment for minor malocclusions without RME. Changes in airway volume and MCA were evaluated using a standardized, previously validated method and analyzed by a mixed-effects linear regression model.

Results:
Upper airway volume and MCA increased significantly over time for both the RME and matched control groups (P &lt; .01 and P = .05, respectively). Although the RME group showed a greater increase when compared with the matched controls, this difference was not statistically significant. A reduced skeletal age before treatment was a significant marker for a positive effect on the upper airway volume and MCA changes (P &lt; .01).

Conclusions:
Tooth-borne RME is not associated with a significant change in upper airway volume or MCA in children when compared with controls. The younger the skeletal age before treatment, the more positive the effect on the upper airway changes. The results may prove valuable, especially in RME of young children.
Tax-Related Burden on SMEs in the European Union: The Case of Slovenia
Authors: Ravšelj Dejan , Kovač Polonca , Aristovnik Aleksander 
Published: April 2019

Abstract
Small and medium enterprises (SMEs) are very important for the European economy. However, SMEs often encounter various barriers, whereby tax-related barriers are perceived as the most burdensome that affects their business operations and entrepreneurial activity in general. The aim of this paper is twofold. First, it attempts to identify SMEs perception on current state and measures to be carried out in order to reduce respective red tape. Second, it tries to establish the relationship between burdens imposed by tax policy and entrepreneurial activity. Using hierarchical cluster analysis and descriptive statistics two different datasets are analyzed for the European Union (EU) and Slovenia separately. The results provide evidence that tax burden is less influential than tax administrative burden among EU countries by considering their impact on new business density and total early-stage entrepreneurial activity. Additionally, the results for Slovenia reveal that the need for a stable tax system, with IT and procedurally related measures are highlighted.
The role of interleukin-6 in pathogenesis of chronic periapical lesions
Authors: Popović Jelena , Cvetković Tatjana , Džopalić Tanja , Nikolić Marija , Mitić Aleksandar , Barac Radomir , Živković Slavoljub 
Published: April 2019

Summary
Introduction Cytokine network plays an important role in pathogenesis of chronic periapical lesions. The aim of this study was to determine the concentration of interleukin-6 (IL-6) in tissue homogenates of human periapical lesions and correlate its levels with symptomatology and size of the lesions.
Materials and Methods 93 samples of chronic periapical lesions were obtained after extraction of teeth. Samples were divided according to the clinical presentation as symptomatic and asymptomatic, and according to the size as large and small. The concentration of IL-6 was analyzed using ELISA.
Results Statistically significant difference in IL-6 concentration was observed in symptomatic lesions compared to asymptomatic (p<0.001). Analysis showed statistically higher concentration in large symptomatic lesions compared to large asymptomatic lesions (p<0.001), and in small symptomatic lesions compared to small asymptomatic (p<0.05). Higher production of IL-6 was observed in large lesions compared to small but this difference was not statistically significant.
Conclusion Higher concentration of IL-6 in lesions with expressed clinical symptoms as well as in large lesions indicates that IL-6 is an important factor responsible for the progression of lesions and bone resorption.