bluuebunny/crossref_metadata_2025_split huggingface dataset:
Avaliação de fatores prognósticos da deambulação em crianças com mielomeningocele
Authors: Collange Luanda André , Martins Roberto S. , Zanon-Collange Nelci , dos Santos Marco T. S. , Moraes Osmar J. S. , Franco Renata C. 
Published: January 2018

Resumo
Objetivo: Caracterizar o grau de acometimento neurológico, estabelecendo uma correlação entre o nível funcional da lesão e a aquisição da marcha, além de identificar os fatores que interferem nessa capacidade. Método: Foram avaliadas prospectivamente vinte e oito crianças portadoras de mielomeningocele operadas com idade igual ou superior a três anos. Foram determinados o nível funcional da lesão, a aquisição ou não da marcha e os fatores associados por meio das medidas do grau de força muscular nos membros inferiores, presença de deformidades articulares, ocorrência de contratura da musculatura flexora e trato iliotibial, eficácia da reação de equilíbrio e presença de hidrocefalia tratada. Resultados: Todos os fatores avaliados, exceto a hidrocefalia, foram relacionados de forma significativa à aquisição da marcha. Conclusão: A aquisição da marcha em crianças portadoras de mielomeningocele sofre influência de vários fatores, além do nível de acometimento neurológico, o que deve ser considerado no prognóstico e na programação terapêutica.
Das trepanações pré-históricas à neuronavegação: evolução histórica das contribuições da neuroanatomia e das técnicas de neuroimagem à prática neurocirúrgica
Authors: Ribas Guilherme Carvalhal 
Published: January 2018

ResumoEm forma de revisão, o presente artigo trata do histórico das contribuições da neuroanatomia e dos métodos de neuroimagem à prática neurocirúrgica. Destaca, em particular, a evolução histórica do conhecimento neuroanatômico a respeito da superfície cerebral e das correlações topográficas cranioencefálicas, o advento da microneurocirurgia e as recentes contribuições da ressonância magnética.
Fratura traumática da coluna torácica limitada entre T1 e T10
Authors: Antunes Filho Gibrail Dib , Alliez Jean Roch , Kaya Jean Marc , Reynier Yves , Alliez Bernard 
Published: January 2018

Resumo
Objetivo: Estudo retrospectivo de uma série de 79 pacientes com fratura traumática da coluna torácica, limitada entre T1 e T10, hospitalizados entre 1995 e 2004 no Serviço de Neurocirurgia do Centro Hospitalar Universitário (CHU), Norte de Marseille, França. Métodos: As fraturas foram classificadas de acordo com a classificação da AO (Arbeitsgemeinschaft für Osteosynthesefragen) e o quadro neurológico por meio da classificação de Frankel na hospitalização, aos seis meses e um ano. Resultados: A etiologia mais frequente das fraturas foram os acidentes automobilísticos (68,3%), e o tipo de fratura, o B (54,4%); 57 pacientes foram considerados politraumatizados e 82,3% apresentavam lesão medular. O tratamento cirúrgico foi empregado em 96,2% dos casos, sendo a via posterior a mais utilizada com objetivo de estabilização, descompressão medular, correção do alinhamento da coluna, diminuição da dor e mobilização precoce. Conclusão: As incidências, as causas, os tipos de fraturas e os manejos destas foram analisados e comparados com a literatura e os resultados confirmaram a gravidade das lesões neste segmento da coluna, o número elevado de lesões associadas, a raridade de recuperação neurológica, assim como o benefício do tratamento cirúrgico por via posterior.
Motor function evaluation of hydrocephalus children
Authors: de Melo Costa Aida Carla Santana , Pereira Carlos Umberto , Farias Cândido Edna Aragão 
Published: January 2018

Abstract
Objectives: To evaluate the kinetic functional condition of children with hydrocephalus; to identify the condition of the muscle tone; to verify the static and dynamic functional activities; and to verify the association between tone changes and functional activities. Method: A cross-sectional, descriptive, exploratory and field study, using qualitative and quantitative approach, performed at the University Hospital in Aracaju city, from August 2009 to March 2010. Results: From 50 evaluated children, 30 (60%) had hypertonia; 10 (20%) were hypotonic; and 10 (20%) did not show muscle tone alteration. The age average was considerably lesser in hypertonic children and higher in hypotonic and without tone alteration children. The average of carried through surgeries was more expressive in hypertonic children. Motor sequels had been present in 92% of the sample. The static functional activities, as well as dynamic functional activities, were lower in hypertonic children (p < 0,0001) and higher in hypotonic and normal tone children. Conclusions: Muscle tone exacerbation is more present in hydrocephalus children and motor function is impaired, being the neuropsychomotor development delayed more evident in spastic children group and less pronounced in children with normal muscle tone.
Aneurismas intracranianos gigantes: aspectos morfológicos, clínicos e operatórios
Authors: dos Santos Marcio Luiz Tostes , dos Santos Rosângela Minto Tostes , Spotti Antonio Ronaldo , Tognola Waldir Antônio 
Published: January 2018

ResumoAneurismas intracranianos gigantes são definidos como aqueles em que o seu maior diâmetro ultrapassa 25 mm, sendo considerados entidade clínico-patológica que difere dos aneurismas de diâmetro menor quanto a incidência de ruptura, apresentação clínica e dificuldade de terapêutica. O tratamento do aneurisma gigante pode ser conservador, endovascular ou neurocirúrgico, e essa decisão depende de fatores como localização anatômica e características do aneurisma, condição médica, idade do doente, habilidades cirúrgicas e possibilidade de tratamento endovascular ou bypass. Apesar de o avanço no conhecimento da patogenia, hemodinâmica, morfologia, de a melhoria nos métodos de diagnóstico por imagem e de o desenvolvimento de técnicas endovasculares e microcirúrgicas terem possibilitado melhor resultado de tratamento, aneurismas gigantes apresentam prognóstico ruim e continuam desafiando os limites de técnicas neurocirúrgicas.
Lesões olfatórias pós-traumáticas
Authors: Cannoni Luiz Fernando , Haddad Luciano , Saade Nelson , Esteves Veiga José Carlos 
Published: January 2018

Resumo
Objetivo: Documentar a incidência de lesões traumáticas do nervo olfatório, assim como a etiologia traumática; correlacionar as lesões do nervo olfatório com achados radiológicos (lesões cranianas e intracranianas) e estudar lesões múltiplas de nervos cranianos. Métodos: Vinte e quatro pacientes admitidos no Serviço de Emergência da Santa Casa de Misericórdia de São Paulo com lesão traumática do nervo olfatório foram incluídos. Os pacientes foram divididos em três grupos, de acordo com o escore da escala de coma de Glasgow (ECG): trauma leve (ECG de 13 a 15), moderado (ECG de 9 a 12) e grave (ECG de 3 a 8), assim como em diferentes graus de lesão do olfatório, como hiposmia, anosmia e parosmia, distribuição quanto a gênero, presença de fraturas, lesões intracranianas, fístulas liquóricas e mecanismo de trauma. Resultados: Dos 24 casos, 15 lesões ocorreram em conjunto com outros nervos cranianos e em nove casos houve lesão exclusiva do nervo olfatório. O atropelamento foi a causa mais comum de lesão do nervo olfatório de forma isolada, assim como nas lesões de múltiplos nervos. Hematomas extradurais foram as lesões intracranianas mais frequentes e a ausência de fraturas predominou nos indivíduos estudados. Conclusão: Neuropatia traumática do olfatório deve ser pesquisada na admissão do paciente (quando possível), sobretudo quando houver evidência de traumas frontais ou occipitais.
Spinous process fractures after chiropractic massage in a previously healthy subject
Authors: Botelho Ricardo Vieira , Fernandes de Oliveira Matheus , Sousa Ulysses Oliveira , Rotta José Marcus 
Published: January 2018

AbstractIncreasing available alternative therapies to the treatment of back pain and sometimes difficult access to specialized medical evaluations allowed a widespread use of alternative therapies for the treatment of back pain. We describe a case with a consequence of massage therapy in a patient with initial symptoms of back pain resulting in spinous process fractures. She promptly searched medical attendance and cervical plain radiograph revealed avulsion of spinous processes of C6 and C7 in their outer third. Due to benign nature of lesion, without evidence of instability and spinal cord injury, the subject was managed conservatively, with application of a Philadelphia collar and analgesic medication. We reinforce the need of medical attention before beginning any therapeutic method in order to identify previous alterations and plan an adequate programming.
Older Adults’ Utilization of Community Resources Targeting Fall Prevention and Physical Activity
Authors: McMahon Siobhan K , Park Young Shin , Lewis Beth , Guan Weihua , Oakes J Michael , Wyman Jean F , Rothman Alexander J 
Published: January 2018

Abstract

Background and Objectives
Despite the availability of community resources, fall and inactivity rates remain high among older adults. Thus, in this article, we describe older adults’ self-reported awareness and use of community resources targeting fall prevention and physical activity.

Research Design and Methods
In-depth, semistructured interviews were conducted in Phase 1 with community center leaders (n = 5) and adults (n = 16) ≥70 years old whose experience with community programs varied. In Phase 2, surveys were administered to intervention study participants (n = 102) who were ≥70 years old, did not have a diagnosis of dementia, and reported low levels of physical activity.

Results
Four themes emerged from Phase 1 data: (a) identifying a broad range of local community resources; (b) learning from trusted sources; (c) the dynamic gap between awareness and use of community resources; and (d) using internal resources to avoid falls. Phase 2 data confirmed these themes; enabled the categorization of similar participant-identified resources (10); and showed that participants who received encouragement to increase community resource use, compared to those who did not, had significantly greater odds of using ≥1 resource immediately postintervention, but not 6 months’ postintervention.

Discussion and Implications
Although participants in this study were aware of a broad range of local community resources for physical activity, they used resources that support walking most frequently. Additionally, receiving encouragement to use community resources had short-term effects only. Findings improve our understanding of resources that need bolstering or better dissemination and suggest researchers identify best promotion, dissemination, implementation strategies.
Anthony Burgess
Authors: Clarke Jim 
Published: January 2018

John Anthony Burgess Wilson (b. 1917–d. 1993) was a prominent British-born novelist, composer, critic, essayist, journalist, playwright, poet, and librettist of the post–World War II period. His best-known work remains A Clockwork Orange (first published in 1962; see Burgess 2010 and Burgess 2012, cited under Critical Editions), a violent morality-tale novella that he later repeatedly disavowed. However, in the 21st century critics have also turned attention to other parts of his extensive output, identifying, in particular, his Malayan Trilogy (1956–1959) as an early example of postcolonial fiction written from the colonial perspective. His reputation also rests upon his longest novel, Earthly Powers, a satire of the airport blockbuster of the 1970s, and his novels about the Elizabethan playwrights William Shakespeare and Christopher Marlowe, entitled Nothing like the Sun and A Dead Man in Deptford, respectively. He was the author of thirty-two novels, two verse novels, two children’s books, two volumes of autobiography, at least ten major translations, nine book-length literary studies, two studies of popular linguistics, a volume of short stories, multiple libretti, thousands of pieces of journalism, numerous film and TV scripts, and hundreds of pieces of original musical composition. Despite an upturn in critical attention toward his work, much of his nonfiction remains uncollected and many of his novels are currently out of print, though a critical edition of his collected fiction is under way. His major theme, according to both himself and his early critics, was the limitations of human free will. He derived this concept from his upbringing as a Lancastrian Catholic, an influence that shaped much of his thinking for the rest of his life and writing career. Many of his major works feature artists and writers as protagonists, indicating a fixation on aesthetics and the artistic process. Additionally, he often fictionalized the lives of historical personages, from Shakespeare to Napoleon to Jesus Christ. Critics have identified his fiction as particularly significant in relation to the boundary of colonial and postcolonial literature, and that between modernism and postmodernism.
Potentially Preventable Stillbirth in a Diverse U.S. Cohort
Authors: Page Jessica M. , Thorsten Vanessa , Reddy Uma M. , Dudley Donald J. , Hogue Carol J. Rowland , Saade George R. , Pinar Halit , Parker Corette B. , Conway Deborah , Stoll Barbara J. , Coustan Donald , Bukowski Radek , Varner Michael W. , Goldenberg Robert L. , Gibbins Karen , Silver Robert M. 
Published: January 2018

OBJECTIVE:
To estimate the proportion of potentially preventable stillbirths in the United States.

METHODS:
We conducted a secondary analysis of 512 stillbirths with complete evaluation enrolled in the Stillbirth Collaborative Research Network from 2006 to 2008. The Stillbirth Collaborative Research Network was a multisite, geographically, racially, and ethnically diverse, population-based case–control study of stillbirth in the United States. Cases of stillbirth underwent standard evaluation that included maternal interview, medical record abstraction, biospecimen collection, postmortem examination, placental pathology, and clinically recommended evaluation. Each stillbirth was assigned probable and possible causes of death using the Initial Causes of Fetal Death algorithm system. For this analysis, we defined potentially preventable stillbirths as those occurring in nonanomalous fetuses, 24 weeks of gestation or greater, and weighing 500 g or greater that were 1) intrapartum, 2) the result of medical complications, 3) the result of placental insufficiency, 4) multiple gestation (excluding twin–twin transfusion), 5) the result of spontaneous preterm birth, or 6) the result of hypertensive disorders of pregnancy.

RESULTS:
Of the 512 stillbirths included in our cohort, causes of potentially preventable stillbirth included placental insufficiency (65 [12.7%]), medical complications of pregnancy (31 [6.1%]), hypertensive disorders of pregnancy (20 [3.9%]), preterm labor (16 [3.1%]), intrapartum (nine [1.8%]), and multiple gestations (four [0.8%]). Twenty-seven stillbirths fit two or more categories, leaving 114 (22.3%) potentially preventable stillbirths.

CONCLUSION:
Based on our definition, almost one fourth of stillbirths are potentially preventable. Given the predominance of placental insufficiency among stillbirths, identification and management of placental insufficiency may have the most immediate effect on stillbirth reduction.
Risk Factors, Incidence, and Morbidity Associated With Obstetric Clostridium difficile Infection
Authors: Ruiter-Ligeti Jacob , Vincent Sophie , Czuzoj-Shulman Nicholas , Abenhaim Haim Arie 
Published: January 2018

OBJECTIVE:
To evaluate the risk factors, incidence, and morbidity associated with the diagnosis of obstetric Clostridium difficile infection.

METHODS:
We performed a retrospective cohort study on women admitted for delivery using the Healthcare Cost and Utilization Project Nationwide Inpatient Sample from the United States. The delivery admission records of pregnant women were reviewed between 1999 and 2013. After adjusting for demographic and clinical characteristics, we assessed risk factors for the diagnosis of C difficile infection using unconditional logistic regression.

RESULTS:
Of the total 13,881,592 births in our cohort, we identified 2,757 (0.02%) admissions for delivery complicated by a diagnosis of C difficile infection. During the study period, the rate of C difficile infection diagnoses among women hospitalized for delivery doubled from 15 (95% CI 11.87–16.96) to 30 (24.42–31.78) per 100,000 deliveries per year (P<.001). Risk factors associated with the diagnosis of C difficile infection included age older than 35 years, multiple gestations, smoking, Crohn's disease, ulcerative colitis, long-term antibiotic use, pneumonia, pyelonephritis as well as cesarean or perineal wound infection. The diagnosis of C difficile infection in pregnancy was associated with a significant increase in maternal death (8.0/1,000 vs 0.1/1,000, adjusted odds ratio [OR] 56.8, 95% CI 35.8–90.1). Furthermore, there was an increase in sepsis (46.4/1,000 vs 0.6/1,000, adjusted OR 59.1, 95% CI 48.8–71.6), paralytic ileus (58.0/1,000 vs 1.5/1,000, adjusted OR 33.1, 95% CI 27.5–39.8), venous thromboembolism (38.4/1,000 vs 3.1/1,000, adjusted OR 8.1, 95% CI 6.5–10.2), and hospital stays greater than 2 weeks (173.0/1,000 vs 6.5,1,000, adjusted OR 24.3, 95% CI 21.6–27.4) among pregnant women with C difficile infection.

CONCLUSION:
The diagnosis of C difficile infections in pregnancy has increased over the past 15 years and this diagnosis is associated with significant maternal morbidity and mortality.
Antecedents of Abnormally Invasive Placenta in Primiparous Women
Authors: Baldwin Heather J. , Patterson Jillian A. , Nippita Tanya A. , Torvaldsen Siranda , Ibiebele Ibinabo , Simpson Judy M. , Ford Jane B. 
Published: January 2018

OBJECTIVE:
To evaluate the association between prior invasive gynecologic procedures and the risk of subsequent abnormally invasive placenta (ie, placenta accreta, increta, and percreta).

METHODS:
We conducted a population-based data linkage study including all primiparous women who delivered in New South Wales, Australia, between 2003 and 2012. Data were obtained from linked birth and hospital admissions with a minimum lookback period of 2 years. Prior procedures invasive of the uterus were considered including gynecologic laparoscopy with instrumentation of the uterus; hysteroscopy, including operative hysteroscopy; curettage, including suction curettage and surgical termination; and endometrial ablation. Modified Poisson regression was used to determine the association between the number of prior gynecologic procedures and risk of abnormally invasive placenta.

RESULTS:
Eight hundred fifty-four cases of abnormally invasive placenta were identified among 380,775 deliveries included in the study (22.4/10,000). In total, 33,296 primiparous women had at least one prior procedure (8.7%). Among women with abnormally invasive placenta, 152 (17.8%) had undergone at least one procedure compared with 33,144 (8.7%) among women without abnormally invasive placenta (P<.01). After adjustment, the relative risk was 1.5 for one procedure (99% CI 1.1–1.9), 2.7 for two procedures (99% CI 1.7–4.4), and 5.1 for three or more procedures (99% CI 2.7–9.6). Abnormally invasive placenta was also positively associated with maternal age, socioeconomic advantage, mother being Australia-born, placenta previa, hypertension, multiple births, use of assisted reproductive technology, and female fetal sex.

CONCLUSION:
Women with a history of prior invasive gynecologic procedures were more likely to develop abnormally invasive placenta. These insights may be used to inform management of pregnancies in women with a history of gynecologic procedures.
Subsequent Pregnancy Outcomes in Patients With Peripartum Cardiomyopathy
Authors: Codsi Elisabeth , Rose Carl H. , Blauwet Lori A. 
Published: January 2018

OBJECTIVE:
To describe cardiac and obstetric outcomes in subsequent pregnancies of patients with peripartum cardiomyopathy and to report demographic and clinical characteristics of index pregnancies.

METHODS:
We conducted a retrospective cohort study of all pregnant patients with prior peripartum cardiomyopathy seen at the Mayo Clinic from January 2000 through March 2017. Maternal and neonatal outcome data of index and all subsequent pregnancies were abstracted, and all echocardiography examinations were individually reviewed.

RESULTS:
Twenty-five patients with prior peripartum cardiomyopathy were included; all except one had recovered left ventricular (LV) function (LV ejection fraction 50% or greater) before the subsequent pregnancy. Forty-three subsequent pregnancies were identified: six (14.0%) miscarriages, four (9.3%) terminations, and 33 (76.7%) live births. The rate of peripartum cardiomyopathy relapse was 20.9%; median LV ejection fraction nadir in patients with relapse was 43% (range 35–45%). None had LV ejection fraction decline to the level of their index pregnancy. No cardiac arrests or deaths were observed, and all patients with relapse recovered LV function. Median gestational age at delivery for all live births in subsequent pregnancies was 39.0 weeks (range 36 6/7–41 3/7 weeks).

CONCLUSION:
Patients with a history of peripartum cardiomyopathy who recover LV function are at risk for a transient minor decrease in LV ejection fraction during future pregnancies, but obstetric and neonatal outcomes are often favorable.
Effect of Cesarean Delivery on Long-term Risk of Small Bowel Obstruction
Authors: Abenhaim Haim A. , Tulandi Togas , Wilchesky Machelle , Platt Robert , Spence Andrea R. , Czuzoj-Shulman Nicholas , Suissa Samy 
Published: January 2018

OBJECTIVE:
To evaluate the association of cesarean deliveries on the incidence of small bowel obstruction.

METHODS:
We formed a population-based cohort of all women with a first live birth between 1998 and 2007 using the U.K. Clinical Practice Research Datalink. Women were followed until 2015, the occurrence of a small bowel obstruction, or loss to follow-up. Cesarean delivery was identified from the Hospital Episode Statistics and small bowel obstruction events were identified using the Classification of Interventions and Procedures and International Classification of Diseases, 10th Revision codes. Cox proportional hazard models, with cesarean delivery defined as a time-dependent exposure, estimated the adjusted hazard ratios and 95% CIs of small bowel obstruction associated with cesarean delivery.

RESULTS:
The cohort included 81,480 women with a median follow-up of 8.0 years (range 6 months to 16.6 years), during which 575 new small bowel obstructions occurred (incidence 9.1/10,000 person-years). Risk of small bowel obstruction was higher among women with a cesarean delivery compared with women without (16.3 vs 6.4 patients/10,000 person-years, odds ratio [OR] 2.54, 95% CI 2.15–3.00). Increasing number of cesarean deliveries was associated with an increasing risk of small bowel obstruction (OR 1.61, 95% CI 1.46–1.78, per additional cesarean delivery). Repeated small bowel obstructions were more common among women with a cesarean delivery and the association remained when restricting to small bowel obstruction requiring surgical management.

CONCLUSION:
Although rare, small bowel obstructions are increased among women who have undergone a cesarean delivery. With increasing rates of cesarean deliveries worldwide, small bowel obstructions and related morbidities may become a more prevalent women's health concern.