bluuebunny/crossref_metadata_2025_split huggingface dataset:
Endolymphatic duct and sac decompression: A new technique for Ménière’s disease treatment
Authors: Salvinelli Fabrizio , Bonifacio Francesca , Greco Fabio , Cavicchioni Giulio , Frari Valeria , Pierri Michelangelo , Trivelli Maurizio , Iacoangeli Maurizio 
Published: September 2022

Background:
The present article aims to introduce the endolymphatic duct and sac decompression technique (DASD) and to give a spotlight on its benefits in Ménière’s disease (MD) treatment.

Methods:
Eighty-two patients with intractable MD which met the inclusion criteria were recruited and underwent DASD. This technique allows a meningeal decompression of the duct and the sac from the posterior cranial fossa to the labyrinthine block. The authors considered as main outcomes, the change of the dizziness handicap inventory (DHI) results, with the evaluations of the three sub-scales (Functional scale, Physical scale, and Emotional scale); ear fullness and tinnitus change on the perceptions of the patient; and hearing stage with four-Pure Tone Average (500 hz-1000 hz-2000 hz-4000 hz). The differences between the preoperative and the postoperative score were evaluated. A comparison with the literature was conducted.

Results:
After a 14-month follow-up, patients that underwent DASD reported a remarkable improvement of the symptoms in all three functional scales, confirmed by the total DHI. The difference between preoperative and postoperative scores is statistically significant. The data describe an ear fullness and tinnitus improvement. The multi-frequency tonal average before and after the surgery does not suggest a worsening of the value for any of 82 patients.

Conclusion:
The modification of sac surgery includes the endolymphatic duct in the decompression area allowing inner ear functional improvement, vertigo control, ear fullness improvement with minimal risk of facial nerve paralysis, and hearing loss. DASD is an improved old surgical technique.
Factors affecting the choice of becoming a neurosurgeon in the western region of Saudi Arabia
Authors: Alghamdi Khalid Talal , Alamoudi Ahmad Abdullah , Bomonther Mohammed Abdullah , Alasmari Haitham Ali , Nejaim Kenan Hatem , Samman Afnan Mahfouz , Alzahrani Moajeb Turki , Algahtani Abdulhadi Y. 
Published: September 2022

Background:
The preference of medical specialty for students can start even before enrollment into medical school, or as late as following their graduation. During their senior years, students often get a prospective on the working environment and the difficulties faced in the field. This, along with other factors, can strongly alter their career choice. This study aims to explore the degree of interest in neurosurgical specialty among medical students and the factors influencing their choice of becoming a neurosurgeon in the western region of Saudi Arabia.

Methods:
This is a cross-sectional study which was done across three universities of the western region of Saudi Arabia including King Saud bin Abdulaziz University for Health Sciences, Umm Al Qura University, and King Abdulaziz University.

Results:
A sample of 1023 students from the second medical year up to the internship was conducted, and out of them, 585 (57.2%) were males and 438 (42.8%) were females. Three hundred and fifty-nine (35.1%) of the students were interested in neurosurgery, while 664 (64.9%) were not. The data show that females have more interest (40.8% of females) compared to males (35.1% of males). Furthermore, there was a general trend toward a decrease in the interest in neurosurgery with time. The impact on patients “rewarding feeling” was the most reported attraction to the specialty, followed by income. Stress was the most reported deterring factor among students. Neurosurgery is one of the most challenging specialties, yet it is still considered one of the most competitive ones.

Conclusion:
Many factors have been found to influence medical students’ choices to apply for neurosurgical training as we described. Interestingly, we noted higher interest among female students, and among college freshmen compared to their counterparts. Further studies should be conducted on a larger scale to analyze these findings.
Trigeminal neuralgia due to intracranial venous reflux following central venous disease in a patient on hemodialysis: A case report
Authors: Hanakita Shunya , Endo Masamichi , Saito Akira , Oya Soichi 
Published: September 2022

Background:
A wide variety of conditions can cause trigeminal neuralgia (TN).

Case Description:
We describe a rare case of a 77-year-old female patient on hemodialysis presenting with severe TN on the right side of the face for several weeks. She underwent multiple revisions using catheter for brachiocephalic venous stenosis over 6 years after a therapeutic arteriovenous fistula (AVF) was created in the left forearm. Her facial pain was consistent with Type 1 TN and remained intractable even after carbamazepine treatment. The initial magnetic resonance imaging did not demonstrate arterial compression on the right trigeminal nerve; instead, the vein adjacent to the right trigeminal nerve showed a hyperintense signal. In addition, the contralateral cortical veins and transverse sigmoid sinus were dilated. Angiography from the left brachial artery revealed intracranial venous reflux (IVR) through the left jugular vein due to an occluded brachiocephalic vein. Her pain was relieved immediately after her left upper arm was compressed with a sphygmomanometer to decrease the shunt. Surgical elimination of the AVF on the left forearm resulted in complete resolution of TN. Postoperative radiological examination revealed the resolution of IVR, and her TN has not recurred by her 6-month follow-up.

Conclusion:
The radiological diagnosis of IVR might be complicated because the true causative lesion for focal neurological symptoms might be remotely located. IVR following central venous disease should be a differential when patients on hemodialysis present neurological symptoms.
Sinking skin syndrome in a decompressive craniectomy series: Clinical and radiological features
Authors: Santander Xavier , Hidalgo Yolanda García , Flores José Carlos , Gómez-Jordana Blanca 
Published: September 2022

Background:
The sinking skin syndrome (SSS) is a particular complication after a decompressive craniectomy (DC). It still remains a poorly understood and underestimated entity.

Methods:
Retrospective case series of craniectomized patients with and without SSS. Clinical and radiological features (DC diameter, shape of craniectomy flap, and midline deviation) were described and relative volumes of intracranial loss were quantified.

Results:
Twenty-seven patients (63% with SSS). The most common indication for DC was traumatic brain injury: 48.15%. The p50 diameter of DC was 12.8 cm for patients with SSS and 11.1 cm for patients without (Z score = 0.32). DC area was 81.5 cm2 for patients with SSS and 71.43 cm2 for patients without the syndrome (Z score = 0.61). According to the shape of the craniectomy flap, we classified our patients as: «same level» (51.8%), «sunken» (25.9%), and «extracranial herniation» (14.8%). Two patients (7.4%) had paradoxical herniation. Midline deviation was present in 12 (70.6%) patients with SSS. The 3rd ventricle volume average was 1.2 cc for patients with SSS versus 2.35 cc for patients without (Z score = 0.04). About 94.11% of patients (16 out of 17) clearly improved after replacement of the cranial defect.

Conclusion:
In our series, low 3rd ventricle volumes had a good relation with SSS. The presence of a sunken flap does not guarantee SSS per se and we propose the following radiologic description: A = sunken, B = same level, C = extracranial herniation, and D = paradoxical. Replacement of the skull defect is the main treatment.
Brain abscess after meningioma removal caused by Citrobacter freundii infection in an adult
Authors: Costanzo Roberta , Scalia Gianluca , Ponzo Giancarlo , Furnari Massimo , Iacopino Domenico Gerardo , Nicoletti Giovanni Federico , Umana Giuseppe Emmanuele 
Published: September 2022

Background:
Citrobacter species are an unusual cause of cerebral abscess in infant. In particular, Citrobacter freundii can invade and replicate in human brain microvascular endothelial cells with a selective neurovirulence, producing ventriculitis and brain abscess mainly in the infant. A delayed brain abscess caused by C. freundii species in adult patients and after surgery is an occurrence that has not yet been reported in the literature.

Case Description:
The authors reported a case of a 60-year-old patient that presented a delayed postoperative brain abscess following resection of a left parietal convexity meningioma. A resurgery was performed, with bone flap removal, debridement, and culture of the purulent content of the previous surgical cavity. The microbiological examination showed the isolation of C. freundii. Postoperatively, the patient improved, with progressive headache reduction and right upper limb weakness improvement. She was continued on medical therapy for 4 weeks, until inflammatory index and white blood cells count gained normal range, then, she was admitted to a neurorehabilitation center.

Conclusion:
A delayed brain abscess caused by C. freundii in adult patients and after surgery is an occurrence that has not yet been reported in the literature, with a consequent complex management, due to the lack of clear guidelines.
El control de la hipertensión arterial, una asignatura pendiente
Authors: Sosa Liprandi Álvaro , Baranchuk Adrián , López-Santi Ricardo , Wyss Fernando , Piskorz Daniel , Puente Adriana , Ponte-Negretti Carlos I , Muñera-Echeverri Ana , Piñeiro Daniel José 
Published: September 2022

RESUMEN

El adecuado diagnóstico, tratamiento y control de la hipertensión arterial (HTA) continúa siendo una asignatura pendiente en nuestro intento de reducir la incidencia de mortalidad cardiovascular prematura y discapacidades, siendo esta una realidad a nivel mundial y particularmente cierta en la región de las Américas.

A pesar de contar con adecuados algoritmos diagnósticos y eficientes esquemas de tratamiento, la brecha entre el conocimiento médico y la realidad nos muestra la gran dificultad para que nuestras recomendaciones sean adoptadas por nuestros pacientes. La adherencia representa un gran desafío y la adecuada comprensión de sus dimensiones resulta básico al momento de diseñar estrategias para mejorar el control de la HTA. Es claro que disponer y diseminar información adecuada es una parte de la solución, pero no menos importante son las acciones que garanticen su implementación. Es por lo que damos la bienvenida a guías de práctica clínica que intenten abordar esta problemática. La reciente publicación de guía de la Organización Mundial de la Salud en hipertensión arterial es un claro ejemplo de este tipo de iniciativas.

Los programas de implementación posiblemente sean uno de los mayores desafíos de la medicina contemporánea. El desarrollo de intervenciones multimodales en el primer nivel de atención con el objetivo de mejorar su capacidad resolutiva y promover el desarrollo de redes integradas de servicios de salud, impresiona ser el camino mas adecuado para alcanzar niveles adecuados de control de la HTA.

Estamos convencidos del importante rol que nuestras sociedades científicas tienen con estas iniciativas dando apoyo, soporte y articulando la interacción con los diferentes actores involucrados.
Impacto de la Iniciativa HEARTS en una institución de salud de segundo nivel en Colombia
Authors: Rivas Rivas Sofía , Serna Tobón Danna Camila , Mahecha Gallego Karol Yuliana , Tejada Cardona María Paula , Castrillón Spitia Juan Daniel , Moreno Gutierrez Paula Andrea , Agudelo Ramírez Alexandra 
Published: September 2022

RESUMEN

Objetivo.

Identificar el impacto de la iniciativa HEARTS en los pacientes con hipertensión arterial atendidos en un hospital colombiano.

Métodos.

Estudio cuasiexperimental, retrospectivo entre 2017 y 2019 con pacientes hipertensos mayores de 18 años, incluidos en la estrategia HEARTS, atendidos en el Hospital Santa Mónica del municipio de Dosquebradas, departamento de Risaralda. La unidad de análisis fue la historia clínica. Se evaluaron las metas de presión arterial (definido en la Iniciativa HEARTS como un paciente con presión arterial sistólica <140 mmHg y <90 mmHg en la presión diastólica) al momento del ingreso al programa HEARTS y un año después. Se incluyeron variables sociodemográficas, farmacológicas, clínicas, metas de presión arterial y cumplimiento de la iniciativa. Se realizaron análisis descriptivos y se aplicó regresión logística binaria (p <0.05).

Resultados.

Se analizaron 372 pacientes de los cuales 262 eran mujeres (70,4%). La edad media fue de 66,3 ± 12,2 años. En la primera consulta de control se reportaron 285 pacientes (76,6%) que presentaron cifras de tensión arterial en metas, en la segunda consulta este logro fue alcanzado por el 84,1% de los pacientes (n=313 diferencia media: 7,5%, IC95%: 1,8 a 13,1; p=0,005). Después de la implementación de la Iniciativa HEARTS el 77,4% en los pacientes (n=288) continuaron con el manejo inicial. Cumplir las recomendaciones HEARTS aumenta la probabilidad de estar en las metas (p=0,033; OR= 2,688; IC= 1,081 - 6,684).

Conclusiones.

La implementación de la Iniciativa HEARTS impactó favorablemente las cifras de tensión arterial en pacientes con hipertensión, con beneficios adicionales en variables que disminuyen el riesgo cardiovascular.
Avanzando para mejorar el acceso a los medicamentos y tecnologías sanitarias para las enfermedades cardiovasculares
Authors: Giron Nora , Lim Christopher , Vallini Juliana , Hallar Kemel 
Published: September 2022

RESUMEN

Los objetivos del presente artículo son describir las intervenciones realizadas por el Fondo Estratégico de Organización Panamericana de la Salud, para facilitar el acceso y disponibilidad de medicamentos antihipertensivos y dispositivos para la medición de la presión arterial a los países de la Región de las Américas en apoyo a la implementación de la Iniciativa HEARTS; y presentar los resultados preliminares de los análisis de los precios de los medicamentos antihipertensivos.

La metodología del estudio incluyó la revisión de informes realizados por el Fondo Estratégico durante los años 2019-2020, la evaluación de las modalidades de adquisición y revisión de las bases de datos de compras públicas para 5 medicamentos antihipertensivos, y el análisis comparativo con el precio obtenido por el Fondo Estratégico. Se identificaron diferencias que oscilaron entre 20% y 99%, lo que evidencia oportunidades de ahorro significativas. Asimismo, se presentan las acciones interprogramáticas desarrolladas en apoyo a la Iniciativa HEARTS, entre las que se destacan la inclusión de medicamentos antihipertensivos recomendados por la Organización Mundial de la Salud; la consolidación de la demanda regional y el establecimiento de precios competitivos con acuerdos a largo plazo para gestionar la adquisición de productos genéricos de calidad; y la definición de especificaciones técnicas y requisitos regulatorios para apoyar con la adquisición de dispositivos para la medición de la presión arterial. A través de este mecanismo, los Estados Miembros pueden disminuir sus costos significativamente, extendiendo cobertura del tratamiento y diagnóstico a más personas.
Resultados preliminares de la Iniciativa HEARTS en México: facilitadores y barreras de los sistemas de información
Authors: Casales-Hernández María Guadalupe , Molina-Cuevas Virginia , Gloria-Hernández Laura Elena , Díaz-Aguilera Miguel Angel , Malo-Serrano Hugo Miguel 
Published: September 2022

RESUMEN

Objetivo.

Comparar la diferencia en la cobertura y proporción de pacientes controlados con hipertensión arterial sistémica entre diciembre de 2020 y diciembre de 2021 en los establecimientos de salud con implementación de la Iniciativa HEARTS, y explorar los facilitadores y las barreras relacionados con los sistemas de información en México.

Métodos.

Estudio observacional ecológico descriptivo. Se compararon los resultados de los establecimientos de salud que han iniciado la implementación de la Iniciativa HEARTS (n=29) en Chiapas y Sonora, respecto a las variables de cobertura de atención y control de la hipertensión, en 4 periodos (semestres) del 2020 al 2021.

Resultados.

Existe mayor número de mujeres en tratamiento y en control respecto de los hombres en los diferentes grupos de edad. Se identificaron algunas barreras (p. ej.multiplicidad de sistemas, falta de interoperabilidad, conectividad limitada a internet en los establecimientos de salud) y facilitadores (p. ej.acceso libre a la información, disponibilidad de datos desde años previos, generación de estimaciones y proyecciones) en los sistemas de información.

Conclusiones.

El 55% de los establecimientos bajo implementación (16 establecimientos) mejoraron la proporción de pacientes controlados en el periodo analizado. Es importante monitorear indicadores a nivel de procesos, lo cual debe ir acompañado de una redistribución de las funciones de los equipos de salud y asegurar el abastecimiento de medicamentos para potenciar la efectividad de la estrategia. Se sugiere fortalecer la implementación con los impulsores clave para el control de la hipertensión.
Der gotische Muttergottes‑Altar von Guttstadt (1426)
Authors: Jakutowicz Joanna 
Published: September 2022

This article offers a stylistic analysis of the Marian altar from the church of the Redeemer and All Saints in Dobre Miasto in the voivodship of Warmia and Masuria. The altar was set up in 1426 as an altar for morning mass. It remains incomplete to this day: several Gothic figures were replaced by later pieces of sculpture, and the altar was provenance is also questionable of the centrally located sculpture of Mary and Child.
The literature up to now has pointed out stylistic analogies with the altar in Pörschken (Nowo‑Moskowskoje), at present in the collection of the Castle Museum in Malbork, and with the altar from Sokolica (Falkenau), which is at present in the collection Museum of the Archdiocese of Warmia in Olsztyn. Stylistic analysis makes it possible to establish that the closest analogy to the Dobre Miasto altar is the altar from Pörschken, while the somewhat later retable from Sokolica has many features in common with the altar from Rauma (Finland), which was a Prussian export.
It is, however, an open question as to the location of the Prussian provincial woodcarving workshop that probably produced the altars in Dobre Miasto and Pörschken, drawing on the at that time rather old‑fashioned tradition of figures of the Madonna on lions. The literaturę suggests Malbork or Gdańsk, but because of stylistic similarities to the Elbląg Apostolic College and the links of the Elbląg Rector Mikołaj Wulsack with Dobre Miasto, Elbląg, too, must be considered.
TARADHIN PRINCIPLE IN FIDUCIARY GUARANTEE PARATE EXECUTION AFTER THE DECISION OF THE CONSTITUTIONAL COURT NO. 18/PUU-XVII/2019
Authors: Tun Samudra Muhammad 
Published: September 2022

This article was analyzes the principle of Willingness in the Execution of fiduciary guarantees after the decision of the Constitutional Court Number 18/PUU-XVII/2019, in practice Parate execution can be carried out either with or without the consent of the debtor, such conditions often lead to acts of coercion and violence from fiduciary guarantee holders, even giving opportunities to arbitrary acts committed by fiduciary recipients (creditors) and degrading the dignity of the debtor. From the research conducted, it was found that the application of the principle of willingness in the Parate Execution of fiduciary guarantees by the Constitutional Court provides benefits and prevents harm to debtor and creditors, this can be seen from the main idea of ​​the Court which states that parate Executions should no longer be carried out without an agreement of the customer's and the customer's willingness to return the collateral. If the customer does not admit the defaulted, then the fiduciary holder can submit an application through fiat Execution to the Court.
BİST Gıda ve İçecek Sektörü Endeksinin Zayıf Formda Etkinliğinin Sınanması
Authors: DALLI Tuğçe , UĞUR Burak 
Published: September 2022

Etkin piyasa hipotezi, hisse senetlerine ait fiyatların rassal ve birbirinden bağımsız oluştuğunu ve ilgili hisse senetlerinin bugünkü fiyatlarına bakılarak gelecekte olması beklenen fiyatının tahmin edilemeyeceğini ifade etmektedir. Piyasaların etkin olması kaynakların etkin dağılımı açısından önemli olmaktadır. Zira piyasanın etkin olması etkin fonlamanın gerçekleştiği durumu göstermektedir.
Çalışma, BİST Gıda ve İçecek Endeksinin zayıf formda etkin olup olmadığını test etmeye yöneliktir. Bu kapsamda ilgili endeksin Kasım 2019- Eylül 2021 dönemine ait aylık kapanış fiyatları dikkate alınmıştır. Aylık kapanış fiyatlarına ADF, PP, KPSS birim kök testleriyle birlikte varyans oran testi uygulanmıştır. Analiz sonucunda BIST Gıda ve İçecek Endeksinin zayıf formda etkin olduğu bulgulanmıştır.
Government's Strategy in Minimizing Violence Against Children In Lhokseumawe City
Authors: Yani Ahmad , Alwi Alwi , Aisyah Ti , Muryali Muryali 
Published: September 2022

The Government's Strategy in Minimizing Violence against Children in the Office of Women's Empowerment, Child Protection, Population Control, and Family Planning of Lhokseumawe City. The problem that occurs in this study is cases of violence against children that continue to occur every year, especially cases of child abuse (Aged 5-12 years) where in 2016 there were 5 cases, in 2017 it increased by 15 cases and then in 2018 it decreased by 4 cases then in 2019 (Second Quarter) increased to 5 cases, so that reliable strategies from the government are needed to reduce cases of violence. The focus of this research is on how the strategy is carried out by the government and what are the obstacles faced when implementing the strategy. The purpose of this study is to find out how the strategy to minimize violence against children and what obstacles are faced by DP3AP2KB Lhokseumawe City. This research uses a qualitative approach with a descriptive method. In collecting data, researchers make observations, interviews, and documentation. The results of the research that have been obtained by researchers explain that the strategy carried out in minimizing violence against children is to carry out prevention and handling efforts and in implementing the strategy experience obstacles, namely the allocation of the budget for child protection is still limited and the strengthening of human resources (HR) is still weak, causing the programs that have been planned to be still less than optimal, and the lack of public awareness and knowledge to report/follow up on violence that occurs which causes perpetrators to experience less deterrent effects. With this problem, DP3AP2KB of Lhokseumawe City must continue to improve its performance optimally and thoroughly so that acts of violence against children do not occur again.
The use of ultraviolet radiation in medical practice
Authors: Sarkisyan N. G. , Paskhina А. I. , Shageev G. Y. , Melikyan S. G. 
Published: September 2022

Currently, diff erent physiotherapy methods are widely used in medicine. One of these methods is ultraviolet (UV) treatment. It is frequently used in healthcare practice as a disinfectant. However, it has a wide range of biological eff ects. The aim of this study is to summarize known eff ects of ultraviolet radiation and evaluate applications of UV treatment in medicine, especially in dentistry. Methods. We conducted literature review using PubMed, Google School, eLibrary, РИНЦ, UpToDate, Elsevier, Scopus databases. 65 articles were analyzed during the research. The study is divided into 4 sections describing biological eff ect of UV and its usage in disinfection, diagnosis and treatment. Results. The study confi rms that UV is an eff ective method used for treating somatic and dental diseases. The results show potential benefi ts of UV application as an additional antiseptic and disinfectant that has very few side effects.