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Sample records for dural tipo adulto

  1. Manejo nutricio del adulto con diabetes mellitus tipo 2

    OpenAIRE

    Claudia Hunot Alexander

    2001-01-01

    El manejo nutricio del adulto con diabetes tipo2, es la parte angular en el tratamiento de esta enfermedad. Es un proceso que requiere de unconocimiento profundo de nutrición y alimenta-ción, en donde el profesional de la salud recibeun entrenamiento a profundidad en esta áreacon la finalidad de transmitir esta información alos pacientes. El establecimiento de un plan decuidado nutricio, implementado a través del pro-ceso de terapia médico nutrimental, involucrael trabajo multidisciplinario d...

  2. Autocuidado en el adulto mayor con diabetes tipo 2. Monterrey, México.

    OpenAIRE

    Flores-Pérez, Martha Nelly; Garza-Elizondo, María Eugenia; Hernández-Cortés, Perla Lizeth

    2016-01-01

    Objetivos: determinar diferencias de autocuidado por edad ysexo en adultos mayores con diabetes tipo 2, que acuden a la consulta de medicina familiar. Material y métodos: estudio descriptivo de corte trasversal. La muestra estuvo constituida por 109 adultos mayores (63 Mujeres y 46 Hombres). Se aplicó el Resumen de Actividades de Autocuidado en Diabetes, se utilizó estadística descriptiva (frecuencias simples y relativas, medidas de dispersión e IC95%), U de Mann-Whitney y diferencia de propo...

  3. Autocuidado en el adulto mayor con diabetes tipo 2. Monterrey, México.

    OpenAIRE

    Flores-Pérez, Martha Nelly; Garza-Elizondo,María Eugenia; Hernández-Cortés, Perla Lizeth

    2016-01-01

    Objetivos: determinar diferencias de autocuidado por edad ysexo en adultos mayores con diabetes tipo 2, que acuden a la consulta de medicina familiar. Material y métodos: estudio descriptivo de corte trasversal. La muestra estuvo constituida por 109 adultos mayores (63 Mujeres y 46 Hombres). Se aplicó el Resumen de Actividades de Autocuidado en Diabetes, se utilizó estadística descriptiva (frecuencias simples y relativas, medidas de dispersión e IC95%), U de Mann-Whitney y diferencia de propo...

  4. Diabetes Mellitus tipo 1: controle glicêmico e fatores de risco cardiovasculares em adultos

    OpenAIRE

    GONÇALVES, Alessandra Rocha

    2012-01-01

    Objetivo: Avaliar o estado nutricional, o controle glicêmico e a prevalência dos fatores de risco cardiovasculares em pacientes adultos com diabetes mellitus tipo 1 (DM1), atendidos no ambulatório de nutrição e endocrinologia do Hospital Geral de Goiânia (HGG). Metodologia: Estudo transversal, realizado entre março e agosto/2011, cujos critérios de inclusão foram: diagnóstico consolidado da doença há pelo menos seis meses, idade maior ou igual a dezenove anos e menor que ses...

  5. Lipoperóxidos, actividad antioxidante y factores prooxidantes en adultos mayores con diabetes mellitus tipo 2

    OpenAIRE

    Ricardo Blanco Hernández; Mirna Ruíz Ramos; Martha A. Sánchez Rodríguez; Víctor Manuel Mendoza Núñez

    2004-01-01

    Antecedentes: La diabetes mellitus tipo 2 (DM) es una enfermedad crónico-degenerativa de alta prevalencia durante el envejecimiento que ha sido asociada con el estrés oxidativo (EOx), sin embargo las evidencias científicas no son del todo concluyentes. Objetivo: Determinar la relación de los niveles plasmáticos de lipoperóxidos (LPO), actividad antioxidante y factores pro-oxidantes con la DM tipo 2 en adultos mayores. Material y métodos: Se llevó a cabo un estudio de tipo transversal, compara...

  6. Autopsia verbal en hombres adultos con diabetes tipo 2: estudio cualitativo

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    Geu Mendoza-Catalán

    2017-09-01

    Full Text Available Introducción: La diabetes mellitus tipo 2 (DMT2 es un padecimiento crónico cuya incidencia se incrementa en forma alarmante. El objetivo fue identificar los factores asociados al no autocuidado en hombres con muerte prematura y diagnóstico de DMT2. Materiales y Métodos: Se realizaron seis entrevistas cualitativas a familiares de hombres con DMT2 que fallecieron por complicaciones de su enfermedad, utilizando la metodología de la autopsia verbal. Los resultados se analizaron mediante el análisis de contenido. Resultados: Dentro de los factores que surgieron como limitantes para el autocuidado fueron: la negación de la DMT2, el trabajo, el machismo, preferencia en los alimentos, apoyo familiar, el consumo de alcohol, el consumo de tabaco y la depresión. Discusión: Los hombres con DMT2 se ven influenciados por diversas circunstancias que limitan cuidarse, atenderse y por consiguiente presentar desventajas de salud, complicaciones e incluso una muerte temprana. Conclusiones: Desde la perspectiva de enfermería los resultados ayudan a comprender el comportamiento de los hombres ante esta enfermedad en donde se requiere cuidado constante, a la par que una conciencia legítima de que no se deja de ser hombre por cuidarse.  Cómo citar este artículo: Mendoza-Catalán G, Gallegos-Cabriales EC, Figueroa-Perea JG. Autopsia verbal en hombres adultos con diabetes tipo 2: estudio cualitativo. Rev Cuid. 2017; 8(3: 1786-98. http://dx.doi.org/10.15649/cuidarte.v8i3.420

  7. Trasplante cardiaco con éxito tras asistencia biventricular tipo Berlin-Heart EXCOR en pacientes adultos

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    Pablo Díez-Villanueva

    2016-03-01

    Full Text Available Las asistencias ventriculares son dispositivos mecánicos de asistencia circulatoria capaces de generar un flujo sanguíneo que permite apoyar o sustituir la función cardíaca en situaciones de insuficiencia cardiaca terminal y refractaria. El uso de estos dispositivos como puente al trasplante es cada vez mayor en nuestro país. La asistencia ventricular tipo Berlin-Heart EXCOR (Berlin−Heart AG, Berlin, Germany es un dispositivo de asistencia pulsátil que se utiliza principalmente como puente al trasplante cardiaco cuando se requiere asistencia biventricular en pacientes adultos, en presencia de disfunción ventricular derecha importante. La experiencia con estos pacientes en nuestro país, dada su complejidad y frecuentes complicaciones, ha sido malos hasta la fecha. Presentamos los tres primeros casos de pacientes adultos trasplantados con éxito en España tras el implante de una asistencia biventricular de media duración tipo Berlin−Heart EXCOR. Los tres pacientes eran varones, con edad media de 65 años, y el tiempo medio de asistencia fue de 150 días. El implante de este tipo de asistencia permitió estabilizar la situación hemodinámica del primero de los pacientes (previamente en soporte con ECMO veno-arterial en situación de shock cardiogénico refractario y normalizar las resistencias vasculares pulmonares de los otros dos (hipertensión pulmonar severa previa al implante que contraindicaba el trasplante cardiaco permitiendo realizar el trasplante con éxito.

  8. Resgate vegetativo por alporquia de genótipos adultos de urucum (Bixa orellana L.

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    Nilton César Mantovani

    2010-09-01

    Full Text Available Este trabalho teve por objetivos avaliar a técnica de alporquia visando ao resgate vegetativo de genótipos de urucum (Bixa orellana L. e a obtenção de plantas fornecedoras de propágulos para processos de propagação clonal. Foram utilizadas dez plantas matrizes de urucum, com 12 anos de idade, obtidas partindo do cruzamento artificial entre os genótipos "Fruto Verde Piloso" X "Fruto Vermelho Liso". Os alporques foram realizados em ramos de 1 a 2 cm de diâmetro, utilizando-se como substrato uma mistura de vermiculita e musgo. Foi avaliado o efeito (1 do tipo de anelamento da casca dos ramos (total ou parcial, com 1 cm de comprimento, (2 do AIB (ácido indol-3-butírico a 0 e 4,92 mM aplicado em papel filtro e (3 do tipo de proteção dos alporques (filmes plásticos transparente ou preto ou tecido tencel, no enraizamento de alporque dos dez genótipos. A técnica de alporquia proporcionou o enraizamento de ramos dos dez genótipos avaliados, com eficiência variável de 20 a 100%, havendo efeito do genótipo sobre a frequência de enraizamento. A sobrevivência desses alporques foi de 100% após o plantio quando estes foram produzidos com anelamento total, tratados com AIB e protegidos com plástico transparente. Em casa de vegetação os alporques desenvolveram ramos partindo da brotação de gemas caulinares constituindo estoques de explantes apropriados para serem utilizados como estacas ou como fontes de segmentos nodais para a propagação in vitro desta espécie.

  9. Local e tipo das refeições realizadas por adultos em cidade de médio porte

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    Juliana Pires Carús

    2014-02-01

    Full Text Available OBJETIVO : Descrever as refeições realizadas por adultos quanto ao local e tipo de preparação consumido em cidade de médio porte, do sul do Brasil. MÉTODOS : Estudo transversal, de base populacional, na cidade de Pelotas, RS, em 2012. A amostragem foi realizada em dois estágios, tendo os setores censitários do Censo Demográfico de 2010 como unidade amostral primária. Foram coletadas informações sobre o local das refeições (em casa ou fora de casa e sobre o tipo de preparação consumida em casa (comida caseira, lanches, comida de restaurante nos dois dias prévios à entrevista, utilizando-se questionário padronizado. RESULTADOS : Participaram do estudo 2.927 adultos: 59,0% mulheres, 60,0% com idade abaixo de 50 anos e 58,0% estava trabalhando. Foram obtidas informações sobre 11.581 refeições nos dois dias anteriores à entrevista, sendo 25,0% delas realizadas fora de casa, no almoço, e 10,0% no jantar. Quanto às refeições realizadas em casa, a maioria dos participantes referiu ter consumido comida preparada em casa, tanto no almoço quanto no jantar. A maioria das refeições fora de casa (64,0% no almoço e 61,0% no jantar foram realizadas no local de trabalho, majoritariamente preparadas em casa. As refeições fora de casa foram realizadas principalmente por pessoas do sexo masculino, jovens, com alta escolaridade. Quanto à ocupação, os grupos que tiveram refeições mais frequentemente em restaurantes foram trabalhadores do comércio, empresários, professores e profissionais de nível superior. CONCLUSÕES : Apesar das mudanças que vêm sendo registradas nos padrões de alimentação do brasileiro, adultos residentes em cidades de médio porte ainda se alimentam majoritariamente em casa e de comida caseira.

  10. Incertidumbre en adultos diabéticos tipo 2 a partir de la teoría de Merle Mishel

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    Isabel Patricia Gómez-Palencia

    2015-01-01

    Full Text Available Objetivo: describir el nivel de incertidumbre de adultos con diabetes mellitus tipo 2 atendidos en instituciones prestadoras de servi- cios de salud en Cartagena (Colombia. Materiales y métodos: estudio descriptivo a partir de una muestra de 163 pacientes que tuvieran como mínimo dos meses de haber sido diagnosticados con diabetes mellitus tipo 2. El instrumento utilizado fue la escala de la Incerti- dumbre ante la enfermedad de Mishel y para el análisis de los datos fue utilizado el paquete estadístico SPSS versión 20.0. Resultados: del total de participantes 76,1 % mostraron un nivel de incertidumbre regular. El fenómeno de la incertidumbre está más relacionado con la incapacidad para identificar si ha mejorado o no (86,5 % , de predecir o explicar la causa de un malestar físico (76,7 % o predecir el cambio de los síntomas (60,1 % . Conclusiones: para enfermería, abarcar este fenómeno permite una mejor aproximación al análisis de los desafíos y las expectativas de quienes viven con una enfermedad crónica y así proporcionar cuidados que permitan un proceso de adaptación óptimo, que apoyen y enriquezcan la práctica enfermera.

  11. Conhecimento dos pacientes portadores de diabetes mellitus tipo 2 inseridos no Programa de Saúde ao Adulto

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    Eliana de Fatima Martins Greghi

    2017-01-01

    Full Text Available Introdução: O diabetes mellitus tipo 2 (DM2 é considerado um problema de saúde pública, passível de intervenções direcionadas às prevenções de complicações, em especial aos pacientes assistidos na Atenção Básica. Objetivo: Identificar o conhecimento dos pacientes portadores de DM2 inseridos no Programa de Saúde ao Adulto. Método: Trata-se de um estudo descritivo, tipo exploratório, com abordagem quantitativa, desenvolvido na Unidade de Saúde da Família, localizada em uma cidade do interior do estado de São Paulo. Resultados: Participaram voluntariamente 60 pacientes diagnosticados com DM2, desses, 39 (65,0% eram do sexo feminino e 21 (35,0% do sexo masculino. O período de doença, relatado pela maioria dos pacientes, foi inferior a 10 anos e 53 (88,3% pacientes alegaram conhecer as complicações ocasionadas pela doença. A maioria das informações dadas sobre as complicações aos pacientes foi realizada pela equipe de enfermagem, seguida por médicos e multiprofissionais. Relataram como complicações: amputação (n=16; 26,6%; feridas (n=4; 6,6%; infecção (n=6; 10,0%. Além disso, 6 (10,0% pacientes desconheciam quaisquer tipos de complicações e 28 (46,6% possuíam conhecimento de mais de uma complicação. A maioria dos pacientes (n=59; 98,3% considera o DM2 uma doença grave que impõe mudanças no cotidiano e intensas alterações da rotina de vida. Conclusão: Os resultados apontam que o Programa de Saúde ao Adulto repercutiu favoravelmente no conhecimento dos pacientes sobre o DM2 e sobre as possíveis complicações.

  12. Cumplimiento del tratamiento farmacológico de la diabetes mellitus de tipo 2 en adultos mayores: influencia de los factores familiares

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    Damary Elizabeth Alcaíno Díaz; Nataly del Carmen Bastías Rivas; Carolina Andrea Benavides Contreras; Daniela Carolina Figueroa Fuentealba; Carolina Elena Luengo Martínez

    2014-01-01

    Los adultos mayores diabéticos son un grupo vulnerable de la población, con condiciones y necesidades que requieren de una mayor atención. Es por este motivo que la familia constituye una parte fundamental en la facilitación de los cuidados y el control de la enfermedad. Objetivo: relacionar el cumplimiento del tratamiento farmacológico de la diabetes mellitus de tipo 2 y los factores familiares de los adultos mayores de un centro de salud familiar. Estudio correlacional, de corte transversal...

  13. Autopercepción de calidad de vida en adultos mayores con diabetes mellitus tipo 2

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    Noé Alfaro-Alfaro; María del Rayo Carothers Enriquez; Yesica Sughey González Torres

    2006-01-01

    La Diabetes Mellitus tipo 2 (DM2), es una enfermedad crónico- degenerativa de alta prevalencia, es la primera causa de consulta de especialidades, la segunda en medicina familiar y la causa más importante de pensión por invalidez en el Instituto Mexicano del Seguro Social. Los enfermos presentan complicaciones macro y microvasculares, cuando no existe buen control, afecta tanto su funcionalidad física, psicológica, social y calidad de vida (CV). El objetivo de este artículo fue determinar la ...

  14. Dural ectasia

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    Neha Gupta

    2014-01-01

    Full Text Available Dural ectasia is one of the likely causes of incomplete or failed spinal anaesthesia. Its association with diseases like Marfans syndrome, neurofibromatosis, osteogenesis imperfecta, vertebral fracture, postopertative adhesions, trauma etc., is often overlooked as a reason for inadequate spinal anaesthesia. Greater than normal volume of cerebrospinal fluid in the lumber theca in dural ectasia is postulated to restrict the spread of intrathecally injected Local anaesthetic. Here, we report a case of failed spinal anaesthesia but successful epidural anaesthesia in later setting in a patient with dural ectasia.

  15. Avaliação da qualidade de vida em pacientes adultos com neurofibromatose tipo 1

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    Júlia Schneider Protas

    2016-01-01

    Base teórica: A qualidade de vida é uma variável amplamente estudada nas ciências da saúde e tem se tornado, cada vez mais, um indicativo importante na avaliação dos estados e desfechos de saúde. As doenças crônicas se caracterizam por curso prolongado, por vezes acompanhando o portador por toda sua vida, o que pode influenciar a percepção que o indivíduo tem de si mesmo e de sua vida. A Neurofibromatose tipo 1 (NF1) é uma doença crônica, genética, que atinge cerca de 1:3500 nascimentos. Além...

  16. Estilo de vida en pacientes adultos con Diabetes mellitus tipo 2

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    Pedro César Cantú-Martínez

    2014-10-01

    Full Text Available Antecedentes: se examina y describe el estilo de vida de pacientes con Diabetes mellitus tipo 2, los cuales asistieron al control de diabetes en diferentes Centros de Salud Urbanos del Área Metropolitana de Monterrey, N.L., México, para estudiar los determinantes individuales y establecer la relación entre el estilo de vida evaluado y el percibido.Método: la muestra fue no aleatoria, seleccionada por conveniencia, en el orden de asistencia a consulta. La población fue de 65 pacientes, que contaron con características muy similares, de acuerdo con el diagnóstico de diabetes mellitus tipo 2 y que accedieron voluntariamente a participar, en el periodo julio-septiembre del año 2012. Se utilizó el instrumento denominado IMEVID, para explorar el estilo de vida y se relacionó con la percepción de los pacientes y sus dimensiones.Resultado: se colige que un 29,23% consideraba tener un “buen estilo de vida”, porcentaje que correspondió a una clasificación “saludable”, mientras que la mayor concentración se tiene un inadecuado estilo de vida (70,77%, con dos clasificaciones de los participantes; luego, un 56,92% se caracteriza por una conducta “moderadamente saludable” y solamente el 13,85% de estos se catalogó como “poco saludable”. Se detectó una correlación significativa entre el estilo de vida evaluado y las dimensiones consideradas, excepto con el estado emocional. Asimismo, se estableció una relación entre el estilo de vida evaluado y el percibido por los participantes.Conclusión: el paulatino esclarecimiento del concepto denominado “estilo de vida” ha permitido redimensionar la noción del estado de “salud-enfermedad”. Los resultados concuerdan con otras investigaciones desarrolladas en México.

  17. Ejercicio de resistencia muscular en adultos con diabetes mellitus tipo 2 Exercício de resistência muscular em adultos com diabetes mellitus tipo 2 Endurance training in adults with diabetes mellitus type 2

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    Karina Asunción Muñoz Canché

    2005-02-01

    Full Text Available Objetivos. Probar la efectividad del ejercicio de resistencia muscular en las cifras de hemoglobina glucosilada (HbA1c, en la fuerza muscular y en la fortaleza muscular percibida; explorar la influencia de la dieta, otros ejercicios, hipoglucemiantes y manifestaciones asociadas a episodios de hipoglucemia o hiperglucemia sobre el control glucémico de adultos con diabetes mellitus tipo 2 provenientes de los consultorios de endocrinología de dos hospitales públicos de la Ciudad de Monterrey, México. Procedimientos básicos. Se usó un diseño de 12 semanas de grupo control no equivalente con dos grupos, experimental (n1 = 14 y control (n2 = 11. Los participantes contaron con la recomendación de su médico para participar. Las sesiones de ejercicio fueron de una hora, dos veces por semana. Resultados. El grupo experimental mostró decremento significativo en el porcentaje de HbA1c, e incremento en la fuerza muscular y fortaleza muscular percibida (p Objetivos: Provar a efetividade do exercício de resistência muscular nas taxas de hemoglobina A glicosilada (HbA1c, na força muscular e no fortalecimento muscular percebido, explorar a influência da dieta, outros exercícios, hipoglicemiantes e manifestações associadas a episódios de hipoglicemia ou hiperglicemia sobre o controle glicêmico de adultos com diabetes mellitus tipo 2, provenientes dos consultórios de endocrinologia de dois hospitales públicos da Cidade de Monterrey, México. Procedimentos básicos: Foi utilizado um desenho de 12 semanas de grupo controle não equivalente com dois grupos, experimental (n1=14 e controle (n2=11. Os participantes tiveram recomendação de seu médico para participar. As sessões de exercício foram de uma hora, duas vezes por semana. Resultados: O grupo experimental apresentou decréscimo significativo nas taxas de HbA1c, incremento na força muscular e fortalecimento muscular percebido (pObjectives. Test the effects of an endurance training

  18. Asociación entre el consumo de macronutrientes de la dieta y caries en adultos y adultos mayores diabéticos tipo 2

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    Giacaman,RA; T Rojas Quintanilla; Soto Poblete,A

    2012-01-01

    Objetivos: Se ha reportado una mayor tasa de caries en pacientes con diabetes mellitus tipo 2 (DM), probablemente debido a cambios en los patrones de dieta. El objetivo de este estudio fue determinar si existe una asociación entre la composición de macronutrientes de la dieta y la caries en sujetos con DM. Métodos: Una muestra compuesta por 33 sujetos con DM y 37 controles sin la patología fue examinada para determinar la experiencia de caries mediante el índice COPD y la prevalencia de carie...

  19. Asociación entre el consumo de macronutrientes de la dieta y caries en adultos y adultos mayores diabéticos tipo 2

    OpenAIRE

    Giacaman,RA; Rojas Quintanilla,T; Soto Poblete,A

    2012-01-01

    Objetivos: Se ha reportado una mayor tasa de caries en pacientes con diabetes mellitus tipo 2 (DM), probablemente debido a cambios en los patrones de dieta. El objetivo de este estudio fue determinar si existe una asociación entre la composición de macronutrientes de la dieta y la caries en sujetos con DM. Métodos: Una muestra compuesta por 33 sujetos con DM y 37 controles sin la patología fue examinada para determinar la experiencia de caries mediante el índice COPD y la prevalencia de carie...

  20. Cefalea recurrente pospunción dural en una paciente con síndrome de Chiari tipo I no conocido Recurrent postdural puncture headache in a woman with undiagnosed Chiari I malformation

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    M.A. Rodríguez-Navarro

    2009-03-01

    Full Text Available Objetivo: Identificar el riesgo de complicaciones neurológicas de la anestesia espinal en los pacientes con un síndrome de Chiari tipo I preexistente y diferenciarlo del llamado "Chiari I adquirido" causado por un síndrome de hipotensión intracraneal, radiológicamente difícil de distinguir del anterior. Caso clínico: Mujer de 37 años, que tras recibir una punción dural durante la realización de una epidural analgésica para el parto, presentó cefalea pospunción dural (CPPD recurrente. Se practicó resonancia magnética (RM cerebral que puso de manifiesto malformación de Chiari tipo I (desplazamiento caudal de las amígdalas cerebelosas por el orificio magno y engrosamiento difuso de las meninges. Aunque no lo había manifestado con anterioridad a la realización de la técnica epidural, la paciente presentaba cefaleas crónicas que se exacerbaban con las maniobras de Valsalva. La paciente fue tratada con analgésicos, cafeína y corticoides, y quedó asintomática. Tras 6 meses de seguimiento se realizó una nueva RM de control donde se observó la persistencia de los cambios anatómicos que definen el síndrome de Chiari tipo I, pero ausencia de las alteraciones meníngeas. Discusión: Tras una punción dural se puede producir el llamado "síndrome de hipotensión intracraneal", motivado por la alteración del flujo y presiones del líquido cefalorraquídeo entre los compartimientos craneal y espinal. La pérdida continua de líquido cefalorraquídeo por el orificio de la punción originaría un gradiente de presión negativa que "empuja" las amígdalas cerebelosas hacia el orificio magno. ¿Es más acusado el cambio de presiones en aquellos pacientes con alteraciones previas, como el síndrome de Chiari? ¿Justifica la persistencia de una CPPD, a pesar del tratamiento? Conclusión: Es preciso realizar una correcta evaluación clínica previamente a una anestesia espinal puesto que las complicaciones neurológicas pueden ser graves

  1. Cumplimiento del tratamiento farmacológico de la diabetes mellitus de tipo 2 en adultos mayores: influencia de los factores familiares

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    Damary Elizabeth Alcaíno Díaz

    2014-03-01

    Full Text Available Los adultos mayores diabéticos son un grupo vulnerable de la población, con condiciones y necesidades que requieren de una mayor atención. Es por este motivo que la familia constituye una parte fundamental en la facilitación de los cuidados y el control de la enfermedad. Objetivo: relacionar el cumplimiento del tratamiento farmacológico de la diabetes mellitus de tipo 2 y los factores familiares de los adultos mayores de un centro de salud familiar. Estudio correlacional, de corte transversal. Se aplicaron las escalas: APGAR familiar, Escala multidimensional de apoyo social y Cuestionario de Morisky-Green. Conclusiones: el cumplimiento del tratamiento tiene asociación estadísticamente significativa con la estructura familiar, la disfunción familiar, el sexo masculino, la presencia de pareja y el apoyo social. La mayoría de los participantes cumplidores se encontraban en el nivel alto o medio.

  2. Medidas faciais antropométricas de adultos segundo tipo facial e sexo Adult facial anthropometric measurements according to facial type and gender

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    Rossana Ribeiro Ramires

    2011-04-01

    Full Text Available OBJETIVO: descrever medidas antropométricas faciais de adultos, segundo tipo facial e sexo. MÉTODOS: participaram 105 adultos leucodermas, 34 (32,4% homens e 71 (67,6% mulheres, com idades entre 20 e 40 anos, de uma clínica particular de ortodontia de Belo Horizonte, Minas Gerais. Foram comparados os achados da análise cefalométrica para determinação do tipo de face com sete medidas antropométricas faciais diretas: altura facial anterior- násio ao mentoniano; distância bizigomática- zigomático esquerdo ao direito; altura do terço facial inferior- subnasal ao mentoniano; altura da face média- násio ao estômio; altura do queixo- supramentoniano ao mentoniano; altura da face inferior- estômio ao mentoniano; e altura facial posterior- condílio ao gônio. RESULTADOS: para o sexo masculino, os tipos faciais classificados por meio da cefalometria apresentaram diferenças estatisticamente significantes para os valores médios das medidas antropométricas: altura facial anterior, altura do terço facial inferior, altura da face média e altura da face inferior. Para o sexo feminino, diferenças estatisticamente significantes foram encontradas nas medidas: altura facial anterior, altura do terço facial inferior, altura da face média, altura da face inferior e altura facial posterior. CONCLUSÃO: houve dimorfismo sexual para todas as medidas antropométricas obtidas, as quais tiveram valores médios maiores para o sexo masculino quando comparados ao feminino. Os tipos faciais classificados por meio da cefalometria apresentaram diferenças estatisticamente significantes para quatro medidas antropométricas do sexo masculino e cinco do feminino.PURPOSE: to describe anthropometric measurements in adults according to facial type and gender. METHODS: 105 Caucasian adults took part, 34 male (32.4% and 71 female (67.6% with ages between 20 and 40-year old, in a private orthodontic clinic in Belo Horizonte, Minas Gerais, Brazil. The findings

  3. Treino em auto-observação e adesão à dieta em adulto com diabetes tipo 2

    Directory of Open Access Journals (Sweden)

    Eleonora Arnaud Pereira Ferreira

    Full Text Available Este estudo verificou os efeitos do treino de auto-observação sobre a adesão à dieta em um adulto com diabetes Tipo 2. A coleta de dados ocorreu por meio de entrevistas no domicílio do participante. Após levantamento da linha de base, iniciou-se o treino no uso de protocolos para registro de automonitoramento (Passo 1, seguido de treino do relato verbal do paciente sobre a sua alimentação no dia anterior (Passo 2 e de treino no planejamento da adesão à dieta (Passo 3. O cálculo do Índice de Adesão à Dieta (IAD do paciente e seus relatos verbais nortearam a análise dos resultados, que indicaram aumento na frequência de respostas de auto-observação do comportamento alimentar e no IAD no Passo 1. Esse ganho foi mantido no Passo 2 e maximizado com o treino no planejamento da adesão à dieta no Passo 3.

  4. Diabetes autoinmune del adulto en diabéticos tipo 2: frecuencia y características LADA in type 2 diabetics: frequency and characteristics

    Directory of Open Access Journals (Sweden)

    Eduardo Cabrera-Rode

    2001-04-01

    Full Text Available Se realizó este trabajo para conocer frecuencia, características clínico-bioquímicas, inmunológicas y genéticas de la diabetes autoinmune en adultos (LADA en 1 000 diabéticos tipo 2 con edades ³ 35 años con distintos tiempos de duración de la diabetes. Se les determinó glucemia, anticuerpos antiislotes pancreáticos (ICA, anti-GAD65, anti-ICA512bdc/IA2, antimicrosomales tiroideos (AMT, antigástricos parietales (AGP, antinucleares (AN, microalbuminuria y péptido C en ayunas. Se encuestaron y se registraron algunas características clínicas. Se dividieron en 2 grupos según la presencia de ICA. Todos los diabéticos tipo 2 + para autoanticuerpos antiislotes (ICA y/o anti-GAD65 fueron identificados como LADA. Se detectó el 3,4 % de diabético tipo 2 con ICA +, en los diabéticos tipo 2 ICA- el 22,0 % presentó anticuerpos anti-GAD65. Se encontró que los diabéticos tipo 2 ICA+ eran más jóvenes, la duración de su diabetes era menor, presentaron menor IMC, disminución de los niveles de péptido C en ayunas, menos antecedentes familiares (padres de DM2, valores menores en las tensiones arteriales diastólicas y sistólicas, mayor presencia de anticuerpos anti-GAD65, AMT y AGP en comparación con los diabéticos tipo 2 ICA-. Se observó que los diabéticos tipo 2 ICA+ (LADA tienen características específicas que los asemejan a los diabéticos tipo 1, esto implicaría variaciones importantes en su tratamiento y evolución con respecto a los diabéticos tipo 2 ICA-. Se observó una baja frecuencia de ICA y alta de GAD en los diabéticos tipo 2 cubanos, las cuales fueron diferentes a la encontrada en poblaciones caucasianas. Los anticuerpos anti-GAD65 fueron superiores a los ICA para detectar los LADA. Las características clínicas e inmunológicas de estos pacientes muestran la lenta progresión de la destrucción autoinmune de las células b con implicaciones terapéuticas.This paper was aimed at knowing the frequency, clinico

  5. Educación, actividad física y obesidad en adultos con diabetes tipo 2 desde la perspectiva del autocuidado de Orem

    Directory of Open Access Journals (Sweden)

    Lidia Guadalupe Compean-Ortiz

    2013-01-01

    Full Text Available Describir la relación de la actividad física (pasos/día/ejercicio con la obesidad (índice de masa corporal, circunferencia de cintura y grasa corporal en adultos con diabetes tipo 2. Se planteó además: 1 determinar la relación de la educación/comprensión en diabetes con la actividad física/ejercicio, y 2 establecer diferencias de actividad física/ejercicio y obesidad/sobrepeso de acuerdo con variables sociodemográficas. Materiales y métodos : diseño descriptivo correlacional, muestra aleatoria de 124 pacientes de 17 centros comunitarios de Tampico, Tamaulipas, México. Las mediciones incluyeron: podómetro New-Life Style 2000, cuestionarios de autocuidado y Perfil de Cuidado en Diabetes, IMC, CC y grasa corporal. Los datos se analizaron con medidas de tendencia central, correlación de Spearman, prueba U de Mann-Whitney y Kruskal Wallis. Resultados: el promedio de pasos/día mostró relación inversa con el IMC (r s = - 0,282, p < 0,01 y la CC (r s = - 0,300, p < 0,01. La comprensión en diabetes tuvo relación positiva con el ejercicio (r s = 0,179, p = 0,04. Las mujeres fueron quienes tuvieron mayor porcentaje de grasa corporal (p < 0,05. Conclusiones: los hallazgos tienen implicacio- nes importantes para el ejercicio práctico de la profesión de enfermería que juega un papel esencial en el fomento de la activi dad física y otros comportamientos básicos de autocuidado a través de la educación. La educación basada en teoría se hace necesaria para el avance en el conocimiento de la disciplina.

  6. Leucemia em adultos e proximidade de residências das linhas de alta tensão em Uberlândia: estudo do tipo caso-controle

    Directory of Open Access Journals (Sweden)

    Maria Clara Nunes de Matos

    2016-12-01

    Full Text Available Introdução: A relação entre doenças crônicas e poluição gerada por campos eletromagnéticos tem sido alvo de estudos nos últimos 37 anos e tem demonstrado a importância do ambiente como fator condicionante da saúde. O objetivo dessa investigação é avaliar a associação entre casos de leucemia e proximidade das residências em relação às linhas de alta tensão. Métodos: Trata-se de um estudo do tipo caso-controle com 1439 pacientes com leucemias (CID 10, C91-95, maiores de 18 anos, diagnosticados em Uberlândia MG, entre 1999-2015. Os controles foram pareados segundo a proximidade das residências em relação às linhas de alta tensão, idade e sexo. Resultados: Foi identificado risco aumentado de leucemia entre adultos que moram mais próximos às linhas de alta tensão, comparados àqueles que moram a mais de 200m. O maior risco foi encontrado para os que vivem até 50m da linha (OR=1,68; 95%IC=1,41-2,53. Foi observada a probabilidade de ocorrência de leucemia levando em consideração fatores de confundimento (sexo e idade, destacando-se maior chance entre indivíduos do sexo masculino, com mais de 60 anos e que residem até 50m da linha de transmissão (54,96%. Conclusão: Os resultados encontrados sugerem de forma consistente um efeito dose-resposta, evidenciando a possibilidade de aumento de risco de leucemia para indivíduos que residem mais próximo às redes de alta tensão.

  7. Self-Care Behaviors and Health Indicators in Adults with Type 2 Diabetes Conductas de autocuidado e indicadores de salud en adultos con diabetes tipo 2 Condutas de autocuidado e indicadores de saúde em adultos com diabetes tipo 2

    Directory of Open Access Journals (Sweden)

    Lidia Guadalupe Compeán Ortiz

    2010-08-01

    Full Text Available This descriptive correlational study aimed to analyze self-care behaviors and their relationship with health indicators represented by glycemic control, lipid profile, Body Mass Index [BMI], waist circumference and body fat percentage in a sample of 98 adults with type 2 diabetes in an area of Nuevo Leon, Mexico (August 2005/May 2006. The results showed a low self-care behaviors index ( or = 36.94, SD=15.14. A significant relationship was found between self-care behaviors and glycosilated hemoglobin [HbA1c] (r s=-.379, pSe trata de un estudio descriptivo y correlacional que tuvo como objetivo analizar las conductas de autocuidado y su relación con indicadores de salud, representados por el control de la glucemia, perfil de lípidos, IMC, circunferencia de cintura y porcentaje de grasa corporal, en una muestra aleatoria de 98 adultos con diabetes tipo 2 de un zona periférica de la ciudad de Nuevo León, en México; los datos fueron recolectados entre agosto del 2005 y mayo del 2006. Los resultados mostraron un índice de autocuidado bajo (promedio= 36,94 y desvío estándar=15,14. Se encontró correlación significativa entre el autocuidado y la HbA1c (r s= 0,379, pEstudo descritivo correlacional que teve como objetivo analisar as condutas de autocuidado e a sua relação com indicadores de saúde, representados pelo controle glicêmico, perfil de lipídios, índice de massa corpórea (IMC, circunferência da cintura e porcentagem de gordura corporal, em amostra aleatória de 98 adultos com diabetes tipo 2, de uma zona conturbada em Nuevo León, México (agosto 2005/maio 2006. Os resultados mostraram índice de autocuidado baixo ( ou = 36,94, dp=15,14. Encontrou-se correlação significativa entre o autocuidado e a hemoglobina glicolisada (HbA1c (r s=0,379, p<0,001, triglicerídeos (r s=0,208, p=0,040, IMC (r s=0,248, p=0,014 e gordura corporal (r s=0,221, p=0,029. A análise multivariada revelou influência do autocuidado em HbA1c, IMC e

  8. Añadir quimioterapia después de la radioterapia mejora la supervivencia de adultos con un tipo de tu

    Science.gov (United States)

    Adultos con gliomas de grado bajo, una forma de tumor cerebral, que recibieron tratamiento con quimioterapia después de la radioterapia vivieron más tiempo que pacientes que recibieron solo radioterapia, según los resultados de seguimiento a largo plazo d

  9. Ortodoncia en adultos

    Directory of Open Access Journals (Sweden)

    Hidalgo B. Ester, Dra.M

    2013-11-01

    Full Text Available Existe la creencia de que los tratamientos de ortodoncia sólo se pueden realizar en adolescentes. Desde la década del 70, a nivel internacional y nacional cada vez más son los adultos que están dispuestos a tener frenillos para solucionar su problema. En este artículo se describe la motivación del paciente, indicaciones y contraindicaciones de tratamiento, limitación de los resultados, tipos de aparatos usados y se presentan casos clínicos. Se concluye que no existe límite de edad para realizar tratamientos de ortodoncia en adultos.

  10. Dural enhancement in pituitary macroadenomas

    Energy Technology Data Exchange (ETDEWEB)

    Cattin, F. [Dept. of Neuroradiology, University Hospital of Besancon (France); Dept. of Neuroradiology, Jean Minjoz Hospital, Besancon (France); Bonneville, F.; Andrea, I.; Barrali, E.; Bonneville, J.F. [Dept. of Neuroradiology, University Hospital of Besancon (France)

    2000-07-01

    We describe the normal dural enhancement patterns of the sellar region and determine whether the duramater is affected by pituitary macroadenomas. Dural enhancement appeared to be usually abnormal in 20 patients with pituitary macroadenoma compared with 20 control patients, mainly at the planum sphenoidale and carotid sulcus. However dural changes are subtle and their recognition requires knowledge of the normal enhancement patterns. Dural changes, reported in a variety of inflammatory and infectious dural diseases and after surgery, are not specific and may be also seen in pituitary macroadenomas. (orig.)

  11. Asociación entre el consumo de macronutrientes de la dieta y caries en adultos y adultos mayores diabéticos tipo 2 Association between dietary macronutrients and caries in type 2 diabetic adults and elderly

    OpenAIRE

    RA Giacaman; T Rojas Quintanilla; Soto Poblete,A

    2012-01-01

    Objetivos: Se ha reportado una mayor tasa de caries en pacientes con diabetes mellitus tipo 2 (DM), probablemente debido a cambios en los patrones de dieta. El objetivo de este estudio fue determinar si existe una asociación entre la composición de macronutrientes de la dieta y la caries en sujetos con DM. Métodos: Una muestra compuesta por 33 sujetos con DM y 37 controles sin la patología fue examinada para determinar la experiencia de caries mediante el índice COPD y la prevalencia de carie...

  12. Asociación entre el consumo de macronutrientes de la dieta y caries en adultos y adultos mayores diabéticos tipo 2 Association between dietary macronutrients and caries in type 2 diabetic adults and elderly

    OpenAIRE

    RA Giacaman; Rojas Quintanilla,T; Soto Poblete,A

    2012-01-01

    Objetivos: Se ha reportado una mayor tasa de caries en pacientes con diabetes mellitus tipo 2 (DM), probablemente debido a cambios en los patrones de dieta. El objetivo de este estudio fue determinar si existe una asociación entre la composición de macronutrientes de la dieta y la caries en sujetos con DM. Métodos: Una muestra compuesta por 33 sujetos con DM y 37 controles sin la patología fue examinada para determinar la experiencia de caries mediante el índice COPD y la prevalencia de carie...

  13. Relación entre tipo y cantidad de carbohidratos dietarios con el perfil lipídico y ApoB100 en adultos

    OpenAIRE

    Ojeda-Arredondo, Myriam; Departamento de Nutrición y Bioquímica. Facultad de Ciencias. Pontificia Universidad Javeriana, Bogotá, D.C.; Escobar, Juliana; Departamento de Nutrición y Bioquímica. Facultad de Ciencias. Pontificia Universidad Javeriana, Bogotá, D.C.; Guerra, Martha; Departamento de Nutrición y Bioquímica. Facultad de Ciencias. Pontificia Universidad Javeriana, Bogotá, D.C.; Alvarado, Martha; Departamento de Nutrición y Bioquímica. Facultad de Ciencias. Pontificia Universidad Javeriana, Bogotá, D.C.

    2010-01-01

    Objetivo. Establecer si existe relación entre el tipo y la cantidad de carbohidratos dietarios consumidos habitualmente con los niveles plasmáticos de lípidos, lipoproteínas y apolipoproteína B100 (ApoB100) Materiales y métodos. La muestra estuvo conformada por la base de datos de 144 de profesores de la Universidad Javeriana que previamente hicieron parte de otra investigación y de la cual se empleo la información sobre su alimentación, niveles plasmáticos de lípidos, lipoproteínas y ApoB100...

  14. Asociación entre el consumo de macronutrientes de la dieta y caries en adultos y adultos mayores diabéticos tipo 2 Association between dietary macronutrients and caries in type 2 diabetic adults and elderly

    Directory of Open Access Journals (Sweden)

    RA Giacaman

    2012-08-01

    Full Text Available Objetivos: Se ha reportado una mayor tasa de caries en pacientes con diabetes mellitus tipo 2 (DM, probablemente debido a cambios en los patrones de dieta. El objetivo de este estudio fue determinar si existe una asociación entre la composición de macronutrientes de la dieta y la caries en sujetos con DM. Métodos: Una muestra compuesta por 33 sujetos con DM y 37 controles sin la patología fue examinada para determinar la experiencia de caries mediante el índice COPD y la prevalencia de caries radiculares con ICDAS II. Se aplicó una encuesta de dieta de reporte de 24 horas. Para determinar la composición de la dieta, los alimentos fueron clasificados acorde al contenido de macronutrientes; carbohidratos, proteínas y lípidos (gramos/día, kilocalorías y porcentaje del nutriente/día. Resultados: Los resultados fueron analizados mediante Kruskal-Wallis y Mann-Whitney. Un análisis de correlación y un modelo de regresión lineal se utilizaron para analizar la asociación entre composición de macronutrientes y la tasa de caries coronales y radiculares, con un nivel de significancia del 95%. Resultados: Los pacientes diabéticos tipo 2 mostraron mayor número de dientes perdidos por caries, más dientes obturados y más caries radiculares (pObjectives: Higher caries rates have been reported for type 2 diabetes mellitus patients (DM. Changes in dietary patterns may be partly responsible. The aim of this study was to examine a potential association between dietary macronutrient composition and caries experience in DM patients. Methods: Thirty three adults with DM and thirty seven controls, not affected by DM, were examined to assess coronal caries through DMFT index and root caries by ICDAS II. A 24-hr diet recall survey was used to determine dietary macronutrient composition supplemented with standardized tables and expressed as grams /day, kilocalories/nutrient and percentage of nutrient/day. Results were compared using Kruskal-Wallis and

  15. A quantidade e o tipo recomendados de exercícios para o desenvolvimento e a manutenção da aptidão cardiorrespiratória e muscular em adultos saudáveis

    Directory of Open Access Journals (Sweden)

    1998-06-01

    ísica para o resto da vida. Cada vez mais indivíduos estão se envolvendo em treinamento de endurance e outras formas de atividade física, e dessa forma torna-se clara a necessidade de estabelecer orientações para a prescrição de exercícios. Com base nas evidências científicas existentes a respeito de prescrição de exercícios para adultos saudáveis e na necessidade de orientações, o Colégio Americano de Medicina do Esporte estabelece as seguintes recomendações para a quantidade e o tipo de treinamento necessários para o desenvolvimento e a manutenção da aptidão cardiorrespiratória, composição corporal e força e endurance musculares no adulto saudável: 1.Freqüência de treinamento: 3 a 5 vezes por semana. 2.Intensidade de treinamento: 60 a 90% da freqüência cardíaca máxima (FCmáx, ou 50 a 85% do consumo máximo de oxigênio (VO2máx ou da reserva de FCmáx*. 3.Duração do treinamento: 20 a 60 minutos de atividade aeróbica contínua. A duração está relacionada com a intensidade da atividade; dessa forma, uma intensidade mais baixa deve ser mantida por um período maior de tempo. Pela importância da "aptidão total" e o fato de ser mais prontamente atingida em programas de duração mais longa, e devido aos riscos potenciais e problemas de aderência associados com atividades de alta intensidade, recomenda-se atividade de intensidade leve a moderada com maior duração para o adulto não atleta. 4.Tipo de atividade: qualquer atividade que mobilize grandes grupos musculares, possa ser mantida continuamente e seja de natureza rítmica e aeróbica, como, por exemplo, caminhada, corrida/jogging, andar de bicicleta ou exercício no cicloergômetro, esqui cross-country (de planície, dança, pular corda, remo, subir escadas, nadar, patinar e diversas outras atividades lúdicas de endurance. 5.Treinamento contra resistência: o treinamento de força de intensidade moderada, suficiente para desenvolver e manter a massa corporal magra (MCM deve

  16. DESENVOLVIMENTO DO PROTÓTIPO DE UM ALIMENTO A BASE DE AVEIA E SOJA ENRIQUECIDO COM PREBIÓTICOS, VITAMINAS E MINERAIS PARA ATENDER ÀS NECESSIDADES NUTRICIONAIS DE ADULTOS E IDOSOS BRASILEIROS

    Directory of Open Access Journals (Sweden)

    SARASPATHY NAIDOO TERROSO GAMA DE MENDONÇA

    2009-07-01

    Full Text Available

    Mediante a utilização de um questionário sobre hábitos de consumo e da técnica focal de entrevistas, obteve-se um perfil de comportamento de consumo de alimentos processados e in natura de duas amostras da população adulta e idosa brasileira. A primeira foi realizada com 73 voluntários do Núcleo de Estudos da Terceira Idade (NETI da Universidade Federal de Santa Catarina, em Florianópolis, estado de Santa Catarina e a segunda com 295 participantes, selecionados aleatoriamente na cidade de Serranópolis do Iguaçu, estado do Paraná. Os dados coletados revelaram que ambas as populações têm expectativas quanto a alimentos saudáveis e apresentaram dificuldades na leitura do texto de rotulagem dos alimentos. Face aos resultados apresentados, este trabalho visou o desenvolvimento do protótipo de um alimento a base de aveia e soja, enriquecido com minerais, vitaminas e prebióticos, de forma a atender não somente às expectativas apontadas mas também às necessidades fisiológicas e sensoriais desta população. Apresenta também como sugestão para o painel secundário do texto de rotulagem, um tamanho de fonte de letra acima de 10 para melhor visualização das informações nutricionais constantes nos rótulos dos alimentos. PALAVRAS-CHAVE: Expectativas de consumo; adultos; idosos; alimento enriquecido; prebióticos.

  17. Post-dural puncture headache

    Directory of Open Access Journals (Sweden)

    Ghaleb A

    2012-01-01

    Full Text Available Ahmed Ghaleb1, Arjang Khorasani2, Devanand Mangar31Department of Anesthesiology, University of Arkansas for Medical Sciences, Little Rock, AR, 2Anesthesiology Residency Program, Advocate Illinois Masonic Medical Center, Chicago, IL, 3Florida Gulf to Bay Anesthesiology, Tampa General Hospital, Tampa, FL, USAAbstract: Since August Bier reported the first case in 1898, post-dural puncture headache (PDPH has been a problem for patients following dural puncture. Clinical and laboratory research over the last 30 years has shown that use of smaller-gauge needles, particularly of the pencil-point design, are associated with a lower risk of PDPH than traditional cutting point needle tips (Quincke-point needle. A careful history can rule out other causes of headache. A postural component of headache is the sine qua non of PDPH. In high-risk patients < 50 years, post-partum, in the event a large-gauge needle puncture is initiated, an epidural blood patch should be performed within 24–48 hours of dural puncture. The optimum volume of blood has been shown to be 12–20 mL for adult patients. Complications caused by autologous epidural blood patching (AEBP are rare.Keywords: post-dural puncture headache, gauge, needles, cause, risk, incidence

  18. Dural tail sign in spinal meningiomas

    Energy Technology Data Exchange (ETDEWEB)

    Alorainy, Ibrahim A. [Department of Radiology and Diagnostic Imaging, College of Medicine and King Khalid Univerity Hospital, King Saud University, P.O. Box 9047, Riyadh 11413 (Saudi Arabia)]. E-mail: alorainy@ksu.edu.sa

    2006-12-15

    Objective: To study the association between the 'dural tail sign' and spinal meningiomas on MR imaging. Methods: Retrospective review of MR examinations of all pathologically proven spinal meningiomas from 1998 to 2005 was performed. Lesions were evaluated for size, signal intensity, enhancement pattern, and presence or absence of dural tail. The dural tail length and direction in reference to the meningioma were also evaluated. Results: Seven spinal meningiomas were identified in seven patients. One lesion was purely extradural, while the remaining were intradural extramedullary. Dural tail was present in four cases (57%) and its length ranged between 5 and 21 mm. The tail was seen cranial and caudal to the meningioma in three cases and only cranially in one. Coronal images were available in three cases and in two of these; the dural tail was clearly depicted. Conclusions: 'Dural tail sign' is as common in spinal meningiomas as in cranial meningiomas.

  19. A tiny dural arteriovenous fistula

    Institute of Scientific and Technical Information of China (English)

    ZHANG Peng 张 鹏; ZHU Fengshui 朱风水; LING Feng 凌 锋; Christophe COGNARD

    2003-01-01

    @@ Pulsatile tinnitus is commonly encountered in approximately 10% of a given population.1 Since causes of the disease vary, selecting appropriate protocols of imaging strategies is quite challenging.2 Vascular anormalies or diseases including anormalies of the carotid arteries and jugular veins, intracranial arteriovenous malformation and dural arteriovenous fistula (DAVF) are major causative factors of the disease. Before imaging studies, history inquiry and physical examination are important for detect the possible causes of pulsatile tinnitus. Different imaging examinations are depended on histories and clinical signs of different patients.

  20. Desenvolvimento e avaliação de um protocolo de atenção farmacêutica intensiva com metodologia educacional de empoderamento para adultos com Diabetes mellitus tipo 2 - estudo translacional fase 1

    OpenAIRE

    Cavalheiro, Silvia Ferreira Lima [UNESP

    2011-01-01

    No Brasil estima-se a existência de aproximadamente 12 milhões de adultos com Diabetes Mellitus (DM) e destes entre 54 a 76% apresentam taxas de mau controle. Esta situação torna o DM um sério problema de saúde pública, devido tanto ao número de pessoas afetadas como aos custos envolvidos no seu controle e no tratamento de suas complicações. A previsão é que em 2030 haverá um crescimento de 67,11% nesta população. Tal situação demonstra a necessidade de melhora urgente no atendimento ou a ins...

  1. Dosagem do peptídeo C sérico ao acaso em adultos com diagnóstico clínico de diabetes mellitus tipo 1

    OpenAIRE

    Rodacki, Melanie; Zajdenverg,Lenita; Milech, Adolpho; de Oliveira, José Egídio Paulo

    2008-01-01

    OBJETIVO: A dosagem de peptídeo C (PC) pode ser útil para a classificação do Diabetes mellitus (DM). O objetivo deste estudo foi investigar a associação entre o diagnóstico clínico de DM tipo 1 e os níveis séricos de PC randômico. MÉTODOS: Foi feita dosagem de PC ao acaso em pacientes de origem multiétnica com diagnóstico clínico de DM tipo 1 na idade adulta ( > 18 anos). RESULTADOS: Estudamos 51 pacientes, sendo 28 mulheres (54,9%) e 23 homens (45,1%), 36 brancos (70,6%) e 15 não-brancos (29...

  2. Management of accidental dural puncture and post-dural puncture headache after labour: a Nordic survey

    DEFF Research Database (Denmark)

    Darvish, B; Gupta, A; Alahuhta, S

    2011-01-01

    a major risk with epidural analgesia is accidental dural puncture (ADP), which may result in post-dural puncture headache (PDPH). This survey was conducted to explore the incidence of ADP, the policy for management of PDPH and the educational practices in epidural analgesia during labour...

  3. Embryological Consideration of Dural Arteriovenous Fistulas

    Science.gov (United States)

    TANAKA, Michihiro

    2016-01-01

    The topographical distribution of dural arteriovenous fistulas (DAVFs) was analyzed based on the embryological anatomy of the dural membrane. Sixty-six consecutive cases of intracranial and spinal DAVFs were analyzed based on the angiography, and each shunt point was identified according to the embryological bony structures. The area of dural membranes was categorized into three different groups: a ventral group located on the endochondral bone (VE group), a dorsal group located on the membranous bone (DM group) and a falcotentorial group (FT group) located in the falx cerebri, tentorium cerebelli, falx cerebelli, and diaphragm sellae. The FT group was designated when the dural membrane was formed only with the dura propria (meningeal layer of the dura mater) and not from the endosteal dura. Cavernous sinus, sigmoid sinus, and anterior condylar confluence was categorized to VE group, which had a female predominance, more benign clinical presentations, and a lower rate of cortical and spinal venous reflux. Transverse sinus, confluence, and superior sagittal sinus belonged to the DM group. Olfactory groove, falx, tent of the cerebellum, and nerve sleeve of spinal cord were categorized to the FT group, which presented later in life and which had a male predominance, more aggressive clinical presentations, and significant cortical and spinal venous reflux. The DAVFs was associated with the layers of the dural membrane characterized by the two different embryological bony structures. The FT group was formed only with the dura propria as an independent risk factor for aggressive clinical course and hemorrhage of DAVFs. PMID:27250699

  4. Associação entre níveis pressóricos e o consumo alimentar de uma dieta tipo DASH em indivíduos adultos de Porto Alegre

    OpenAIRE

    Analisa Celestini

    2007-01-01

    Fundamento: Recomendações para controle da hipertensão contemplam controle de peso, restrição de sódio e consumo de bebidas alcoólicas, além de adesão à dieta DASH (Dietary Approaches to Stop Hypertension). Objetivo: Avaliar a associação entre consumo de dieta tipo DASH e pressão arterial, na população adulta de Porto Alegre. População e Métodos: Estudo transversal (Síndrome de Obesidade e Fatores de Risco para Obesidade -SOFT), desenvolvido em uma amostra populacional, incluiu 1629 indivíduo...

  5. Estudo da coerência do eletrencefalograma para a banda de frequência alfa em indivíduos adultos normais e com provável demência do tipo Alzheimer

    Directory of Open Access Journals (Sweden)

    ANGHINAH RENATO

    2000-01-01

    Full Text Available Estudamos a coerência inter-hemisférica do espectro do eletrencefalograma (EEG obtido pela transformada rápida de Fourier, da região occipital do escalpo (eletrodos O1 e O2 para a banda de frequência alfa (alfa1 - 8,0 a 10,0 Hz e alfa2 -10,1 a 12,5 Hz em indivíduos normais maiores de 50 anos e pacientes com diagnóstico provável de demência do tipo Alzheimer (DTA, no intuíto de observar se há diferenças entre estes parâmetros que contribuam com o diagnóstico desta enfermidade. Encontramos diminuição na coerência inter-hemisférica dos indivíduos com DTA para ambas as sub-bandas do ritmo alfa. Acreditamos que a análise de coerência do EEG possa ser um método de grande auxílio no diagnóstico de DTA

  6. Dural AVM supplied by the ophthalmic artery.

    LENUS (Irish Health Repository)

    Flynn, T H

    2012-02-03

    Dural arteriovenous malformations in the anterior cranial fossa are rare and are especially prone to haemorrhage. These lesions are usually treated by surgical excision. We report the embolization of an anterior cranial fossa DAVM using an endovascular approach via the ophthalmic artery.

  7. Double spinal dural sheath: a cadaveric case report

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    Loughenbury P

    2010-03-01

    Full Text Available A previously unreported variation in the anatomy of the spinal dural sheath was observed during routine cadaveric dissection, consisting of a duplication of the dural layer, with layers adherent throughout their length. The double dural sheath completely enveloped the spinal cord and nerve roots, and extended from C2 to L5: both layers were of similar thickness to a single dural sheath. Duplication of the dura mater in the form of two complete dural sheaths has not been previously observed and/or reported in a cadaveric study. However, areas of localised duplication of the ventral aspect of the dural sheath have been observed during intra-operative dissection, particularly in association with idiopathic herniation of the spinal cord. Complete duplication of the spinal dura mater is of clinical interest in spinal surgery, particularly in relation to idiopathic spinal cord herniation.

  8. Evolutionary History of Multiple Dural Fistula

    Directory of Open Access Journals (Sweden)

    Braulio Martinez-Burbano MD

    2016-12-01

    Full Text Available Intracranial dural arteriovenous fistulas (DAVFs are abnormal communications between arteries and veins or dural venous sinuses, which sit between the sheets of the dura. They represent 10% to 15% of intracranial vascular malformations. Clinical manifestations and prognosis depend on the pattern of venous drainage and location. The clinical presentation of DAVF may be mistaken for vascular or nonvascular brain pathologies. For that reason, within the differential diagnosis come a wide range of conditions, such as secondary headaches, encephalopathies, dementias including those with rapid progression, neurodegenerative diseases, inflammatory processes, or tumors typically at the orbital level or in the cavernous sinus. Diagnosis requires a high degree of suspicion because of the multiplicity of symptoms and presentations, making this pathology an entity that provides a major challenge for clinicians, yet early and multidisciplinary treatment of high-grade fistulas improve the possibility of avoiding poor or unfavorable outcomes for the patient.

  9. Multiple Dural Tuberculomas Presenting as Leptomeningeal Carcinomatosis

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    Hasan Kocaeli

    2011-01-01

    Full Text Available Objective and Importance. We present the rare occurrence of multiple dural-based tuberculomas mimicking leptomeningeal carcinomatosis in a young immunocompetent patient. Clinical Presentation. A 36-year-old man presented with a 2-month history of generalized epileptic activity and altered perception. Neurological examination was remarkable for bilateral Babinski's sign. Cranial magnetic resonance imaging (MRI revealed multiple dural-based enhancing lesions with cerebral edema. Intervention. A right frontal craniotomy was performed for diagnosis. Histological examination revealed multiple confluent necrotizing and nonnecrotizing granulomas with giant cells which was consistent with tuberculosis (TB, and the patient was placed on anti-TB therapy for 24 months. Conclusion. To the best of our knowledge isolated diffuse involvement of the dura mater by TB, mimicking leptomeningeal carcinomatosis, as the sole manifestation of disease has not been reported before. Since pachymeningeal TB is rarely suspected when atypical radiological appearance is combined with the absence of systemic disease, biopsy is inevitably required for diagnosis.

  10. Evolutionary History of Multiple Dural Fistula

    Science.gov (United States)

    Martinez-Burbano, Braulio; Correa Diaz, Edgar Patricio; Jácome Sánchez, Carolina

    2016-01-01

    Intracranial dural arteriovenous fistulas (DAVFs) are abnormal communications between arteries and veins or dural venous sinuses, which sit between the sheets of the dura. They represent 10% to 15% of intracranial vascular malformations. Clinical manifestations and prognosis depend on the pattern of venous drainage and location. The clinical presentation of DAVF may be mistaken for vascular or nonvascular brain pathologies. For that reason, within the differential diagnosis come a wide range of conditions, such as secondary headaches, encephalopathies, dementias including those with rapid progression, neurodegenerative diseases, inflammatory processes, or tumors typically at the orbital level or in the cavernous sinus. Diagnosis requires a high degree of suspicion because of the multiplicity of symptoms and presentations, making this pathology an entity that provides a major challenge for clinicians, yet early and multidisciplinary treatment of high-grade fistulas improve the possibility of avoiding poor or unfavorable outcomes for the patient. PMID:28203571

  11. Giant arachnoid granulation mimicking dural sinus thrombosis.

    Science.gov (United States)

    Ayaz, Ercan; Atalay, Basak; Baysal, Begumhan; Senturk, Senem; Aslan, Ahmet

    2017-01-01

    Arachnoid granulations (AG) are composed of dense, collagenous connective tissue that includes clusters of arachnoid cells. They tend to invaginate into the dural sinuses, through which cerebrospinal fluid enters the venous system. AG are most commonly seen at the junction between the middle and lateral thirds of the transverse sinuses near the entry sites of the superficial veins. Presently described is the case of a 21-year-old female who presented at the clinic with recurrent headaches. Magnetic resonance (MR) imaging revealed a 3.5-cm lesion, which extended from confluens sinuum through the superior sagittal sinus. The lesion had created a scallop-shaped area of erosion in the neighboring occipital bone. To exclude sinus thrombosis, MR venography was performed, which displayed a maintained venous flow around the lesion. Headaches were treated symptomatically with medical therapy. Giant AG can be misdiagnosed as dural sinus thrombosis. MR imaging combined with MR venography is the most useful diagnostic tool to differentiate giant AG from dural sinus thrombosis.

  12. INFLUÊNCIA DE DIFERENTES TIPOS DE ELETRODOS SOBRE OS VALORES DA BIOIMPEDÂNCIA CORPORAL E NA ESTIMATIVA DE MASSA MAGRA (MM EM GATOS ADULTOS INFLUENCE OF DIFFERENT TYPES OF ELECTRODES ON THE BIOELECTRICAL IMPEDANCE VALUES AND IN THE ESTIMATION OF LEAN BODY MASS (LBM IN ADULT CATS

    Directory of Open Access Journals (Sweden)

    Thassila Caccia Feragi Cintra

    2010-04-01

    Full Text Available A bioimpedância (BIC é um método que aplica à tecnologia da impedância no estudo da composição corporal pela avaliação da diferença da condutividade elétrica dos tecidos. Os resultados da BIC são expressos pelas medidas primárias de resistência (R e reatância (Xc. Neste experimento, o método foi desenvolvido para verificar a viabilidade do uso de três diferentes tipos de eletrodos sobre a reprodutibilidade dos valores de R e Xc em gatos adultos. As médias de R e Xc com adesivos e agulhas de acupuntura não diferiram entre si (p?0,05, e os menores valores dos coeficientes de variação obtidos com estes eletrodos sinalizaram para uma melhor reprodutibilidade dos resultados quando comparados com os da agulha hipodérmica. Os diferentes tipos de eletrodos não interferiram nos valores da massa magra (MM estimada por equação específica, porém a agulha de acupuntura mostrou ser o eletrodo mais estável e de melhor aplicabilidade. A MM determinada com os diferentes tipos de eletrodos foi superior (p?0,05 à obtida com a absorciometria de raios-x de dupla energia (DEXA, provavelmente decorrente da equação utilizada na sua estimativa.

    PALAVRAS-CHAVES: Composição corporal, felinos, impedância, massa magra.
    The bioelectrical impedance is a method that applies impedance technology in the study of physical composition by evaluation of electrical conductivity difference on each organism tissue. The results of bioelectrical impedance (BIC are expressed by the resistance (R and reactance (Xc primary measures. This study was carried out to verify the viability of the use of three different electrodes on the repeatability of R and Xc values in adult cats. The averages of R and Xc estimated by adhesive and acupuncture needles did not differ from each other (p?0.05 and the smaller values of the variation coefficient acquired with these electrodes signaled for a better reproducibility of the results when compared with

  13. La enseñanza de la oralidad : En talleres de inglés para adultos mayores

    OpenAIRE

    Enríquez, Silvia Cecilia

    2007-01-01

    Los cursos de adultos mayores se diferencian de los cursos regulares de adultos por diversas razones, la mayoría relacionadas con la edad y los intereses de los alumnos. La bibliografía sobre este tipo de cursos es muy escasa, razón por la cual los docentes y la coordinación de la sección de Adultos Cursos Especiales de la Escuela de Lenguas de la UNLP, en la cual se dictan cursos de inglés para adultos mayores, ha encarado la tarea de observar y reunir información, muchas veces a partir del ...

  14. Spinal dural arteriovenous fistulas. Diagnostics and therapy; Spinale durale arteriovenoese Fisteln. Diagnostik und Therapie

    Energy Technology Data Exchange (ETDEWEB)

    Reith, W.; Kettner, M.; Simgen, A.; Yilmaz, U. [Universitaetsklinikum des Saarlandes, Klinik fuer Diagnostische und Interventionelle Neuroradiologie, Homburg/Saar (Germany)

    2012-05-15

    Spinal dural arteriovenous fistulas are rare spinal vascular malformations which can cause progressive paraparesis and paraplegia if not treated. As symptoms are unspecific diagnosis is often delayed and clinical outcome is dependent on early therapy. While magnetic resonance imaging (MRI) is the first choice imaging procedure, selective spinal digital subtraction angiography is necessary to analyze the angioarchitecture and to plan the treatment. This article provides an overview on the epidemiology, etiology, clinical aspects and imaging features as well as therapeutic aspects of spinal dural arteriovenous fistulas. Knowledge of spinal vascular anatomy is the basis for understanding spinal dural arteriovenous fistulas. (orig.) [German] Spinale durale arteriovenoese Fisteln (dAVF) sind seltene spinale vaskulaere Malformationen, die unbehandelt zu einer progredienten Paraparese und Paraplegie fuehren koennen. Da die klinischen Symptome oft unspezifisch sind, werden sie haeufig erst in einem spaeteren Stadium diagnostiziert. Die Erkrankungshaeufigkeit ist mit 5-10 Neuerkrankungen/1 Mio. Einwohner/Jahr relativ selten, ueber 80% der Betroffenen sind Maenner. Der unbehandelt schlechte klinische Verlauf der dAVF sowie die Moeglichkeit der Therapie, deren Erfolg von einer fruehzeitigen Behandlung abhaengt, macht sie jedoch zu einer wichtigen Erkrankung. Die Diagnose ist haeufig im MRT zu stellen, zur genauen Darstellung der Fistel ist eine selektive spinale Subtraktionsangiographie jedoch notwendig. Ziel dieses Artikels ist, einen Ueberblick ueber die Epidemiologie, Aetiologie, Klinik und bildgebende Verfahren sowie therapeutischen Moeglichkeiten dieser spinalen vaskulaeren Malformation zu geben. Voraussetzung zum grundlegenden Verstaendnis der duralen AVF sind genaue Kenntnisse der vaskulaeren spinalen Gefaessversorgung. (orig.)

  15. Tentorial artery embolization in tentorial dural arteriovenous fistulas

    Energy Technology Data Exchange (ETDEWEB)

    Rooij, Willem Jan van; Sluzewski, Menno [St. Elisabeth Ziekenhuis, Department of Radiology, Tilburg (Netherlands); Beute, Guus N. [St. Elisabeth Ziekenhuis, Department of Neurosurgery, Tilburg (Netherlands)

    2006-10-15

    The tentorial artery is often involved in arterial supply to tentorial dural fistulas. The hypertrophied tentorial artery is accessible to embolization, either with glue or with particles. Six patients are presented with tentorial dural fistulas, mainly supplied by the tentorial artery. Two patients presented with intracranial hemorrhage, two with pulsatile tinnitus and one with progressive tetraparesis, and in one patient the tentorial dural fistula was an incidental finding. Different endovascular techniques were used to embolize the tentorial artery in the process of endovascular occlusion of the fistulas. All six tentorial dural fistulas were completely occluded by endovascular techniques, confirmed at follow-up angiography. There were no complications. When direct catheterization of the tentorial artery was possible, glue injection with temporary balloon occlusion of the internal carotid artery at the level of the tentorial artery origin was effective and safe. Different endovascular techniques may be successfully applied to embolize the tentorial artery in the treatment of tentorial dural fistulas. (orig.)

  16. Dural cavernous haemangioma of posterior cranial fossa.

    Directory of Open Access Journals (Sweden)

    Goel A

    1993-10-01

    Full Text Available A rare case of extracerebral dural cavernous angioma sited near the sigmoid sinus is reported. This 60 yr old male patient gave history of episodic ataxia of left sided limbs experienced twice on same day and occasional giddiness. Examination did not reveal any findings. A mass was diagnosed on CT Scan following which angiography was carried out. The features matched with those of a meningioma. Retro-sigmoid craniectomy was performed. Occipital artery was coagulated. Tumor was dissected out. Post-operative course of the patient was uneventful. Histopathology revealed that the mass was a cavernous haemangioma.

  17. Traumatic dural venous sinus thrombosis: A Mini Review

    Directory of Open Access Journals (Sweden)

    Moscote-Salazar Luis Rafael

    2016-09-01

    Full Text Available The dural venous sinus thrombosis is a benign disease, representing about 1% of cerebral vascular events. In some cases the development of the disease increased intracranial pressure or symptomatic epilepsy. The development towards a dural venous sinus thrombosis is rare, but is a condition to be considered before the development of ischemic vascular events and a history of recent head trauma. Intracranial hematomas or skull fractures can lead to the establishment of obstructive pathology of the dural venous sinuses. The knowledge of this entity is necessary for the critical care staff and neurosurgery staff.

  18. Clinicopathological aspects and their relation to prognosis in adult-type granulosa cell tumor of the ovary Aspectos clinicopatológicos e sua relação com o prognóstico em tumor de células da granulosa do tipo adulto do ovário

    Directory of Open Access Journals (Sweden)

    Maurício De Angelo Andrade

    2009-10-01

    Full Text Available INTRODUCTION AND OBJECTIVE: The adult granulosa cell tumors (AGCT correspond to less than 5% of ovarian neoplasias. They are considered low malignant potential tumors and may recur after many years. The differential diagnosis must be made with other primary or metastatic ovarian neoplasias. The aim was to analyze clinical and pathological aspects of AGCT and relate them to its evolution. METHOD: in a 10- year (1995-2004 review of the files from University of Campinas Clinical Hospital, Brazil, 20 AGCT cases were found. The clinical records and slides were reviewed and age, symptoms, macro and microscopic aspects, diagnostic staging and recurrence were considered. When there was intraoperative biopsy, its accuracy was evaluated. RESULTS: Age ranged from 27 to 79 years (mean: 53 and the follow-up from 12 to 96 months (mean: 42. The main symptoms were post-menopause bleeding (45%, abdominal pain (35% and palpable mass (25%. Most tumors were yellowish (60% and the solid aspect (40% was more common than the cystic or solid-cystic. The histological patterns were 40% solid, 15% macrofollicular and 45% combined forms. All of them with low mitotic index. Only three out of nine intraoperative frozen sections were accurately diagnosed. The clinical staging was 13 cases in Ia (65%, one case Ic and 6 IIIc. In three out of 14 hysterectomies there was simple endometrial hyperplasia with no atypia. Only the disease staging was significantly associated with recurrence (p INTRODUÇÃO E OBJETIVO: O tumor de células da granulosa tipo adulto (TCGA corresponde a menos de 5% das neoplasias ovarianas. São de baixo potencial de malignidade, podem recorrer depois de muitos anos, e o diferencial deve ser feito com outras neoplasias primárias ou metastáticas. Analisamos os aspectos clínicos e patológicos do tumor, relacionando-os à evolução. MÉTODOS: Na revisão de 10 anos dos arquivos do laboratório de Anatomia Patológica do Hospital das Clínicas da

  19. Autorrelatos do amor no ciclo vital adulto

    Directory of Open Access Journals (Sweden)

    José Augusto Evangelho Hernandez

    2015-07-01

    Full Text Available Esta pesquisa transversal comparou grupos de pessoas de diferentes faixas etárias, adultos jovens, maduros e maiores de 50 anos. Foram verificadas possíveis modificações do amor ao longo do ciclo vital adulto. Participaram 211 sujeitos de ambos os sexos, envolvidos em tipos variados de relações amorosas, que responderam à Escala Triangular do Amor de Sternberg. Os resultados da análise de variância multivariada mostraram interações significativas entre os componentes do amor e as faixas etárias e entre os componentes do amor e o sexo dos participantes. Análises univariadas revelaram diferenças significativas em intimidade entre as faixas etárias. Além disso, os níveis de paixão, intimidade e compromisso dos homens foram mais elevados do que os das mulheres. Estes resultados foram discutidos à luz da literatura que aborda a Teoria Triangular do Amor.

  20. Dural puncture: an overlooked cause of cerebral venous thrombosis.

    Science.gov (United States)

    Guner, Derya; Tiftikcioglu, Bedile Irem; Uludag, Irem Fatma; Oncel, Dilek; Zorlu, Yasar

    2015-03-01

    Cerebral venous thrombosis (CVT) accounts for 0.5-1 % of all strokes. Although dural puncture is proposed as one of the rare risk factors, this association has only been mentioned in anecdotal reports. Headache, i.e., usually the first and the most frequent clinical symptom on admission, is often attributed to the dural puncture itself. We investigated the frequency of CVT following a recent dural puncture in our stroke database, together with the other risk factors. The computerized medical records of patients (n = 10,740) registered in our tertiary-care neurology clinic stroke database were reviewed retrospectively. Patients diagnosed with CVT were reanalyzed. Patients who had a dural puncture in the preceding 7 days were included in the study. A total of 46 patients were diagnosed with CVT. Nine patients (19.6 %) had a recent dural puncture before the onset of the symptoms. Patients were younger than 45 years and had at least one more predisposing condition for thromboembolism other than the dural puncture. All patients have received either spinal anesthesia or intrathecal chemotherapy. Dural puncture seems to trigger CVT particularly in patients with predisposing disorders. Although reported as an extremely rare complication, our data indicate a much higher association. This case series emphasize the importance of reevaluation of patients with persistent/progressive headache following dural puncture. The effect of change in the biochemical composition of CSF due to intrathecal drug administration in pathogenesis is not known. Larger controlled trials are warranted to clarify the causal relationship between lumbar puncture and/or intrathecal drug administration and CVT.

  1. La inflación de los adultos mayores en Colombia

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    Álvaro Montenegro

    2016-12-01

    Full Text Available Este artículo compara el comportamiento de la inflación para el hogar promedio y diversos tipos de hogares de adultos mayores en Colombia. Los resultados indican que, en promedio, los adultos mayores gastan una mayor proporción de su ingreso en vivienda y salud y una menor proporción en educación, y que experimentaron una mayor inflación que la población en general entre diciembre de 2008 y mayo de 2015. Los hogares de adultos mayores más pobres gastan una mayor proporción en vivienda y alimentación, y para estos la inflación fue mayor que para los de adultos mayores de altos ingresos.

  2. Dacriocistocele no adulto

    Directory of Open Access Journals (Sweden)

    Silvia Helena Tavares Lorena

    2014-10-01

    Full Text Available A dacriocistocele representa um saco lacrimal dilatado e é frequentemente considerada como tendo uma etiologia congênita. No entanto, dacriocistocele é uma doença rara em adultos. A característica clínica se caracteriza por um abaulamento indolor na região medial da órbita, inferior ao ligamento cantal medial. O teste de excreção lacrimal, endoscopia, tomografia computadorizada e ressonância magnética são utilizados para fazer o diagnóstico de dacriocistocele. Semelhante a pacientes pediátricos, marsupialização endoscópica do cisto nasal e a colocação de stent parece ser a terapêutica adequada. Em alguns casos o tratamento consiste na dacriocistorrinostomia externa

  3. Spinal dural ossification causing neurological signs in a cat.

    Science.gov (United States)

    Antila, Johanna M; Jeserevics, Janis; Rakauskas, Mindaugas; Anttila, Marjukka; Cizinauskas, Sigitas

    2013-06-19

    A six-year-old Ragdoll cat underwent examination due to a six-month history of slowly progressive gait abnormalities. The cat presented with an ambulatory tetraparesis with a neurological examination indicating a C1-T2 myelopathy. Radiographs of the spine showed a radiopaque irregular line ventrally in the vertebral canal dorsal to vertebral bodies C3-C5. In this area, magnetic resonance imaging revealed an intradural extramedullary/extradural lesion compressing the spinal cord. The spinal cord was surgically decompressed. The cause of the spinal cord compression was dural ossification, a diagnosis confirmed by histopathological examination of the surgically dissected sample of dura mater. The cat gradually improved after the procedure and was ambulating better than prior to the surgery. The cat's locomotion later worsened again due to ossified plaques in the dura causing spinal cord compression on the same cervical area as before. Oral prednisolone treatment provided temporary remission. Ten months after surgery, the cat was euthanized due to severe worsening of gait abnormalities, non-ambulatory tetraparesis. Necropsy confirmed spinal cord compression and secondary degenerative changes in the spinal cord on cervical and lumbar areas caused by dural ossification. To our knowledge, this is the first report of spinal dural ossification in a cat. The reported cat showed neurological signs associated with these dural changes. Dural ossification should be considered in the differential diagnosis of compressive spinal cord disorders in cats.

  4. Progressive versus Nonprogressive Intracranial Dural Arteriovenous Fistulas: Characteristics and Outcomes.

    Science.gov (United States)

    Hetts, S W; Tsai, T; Cooke, D L; Amans, M R; Settecase, F; Moftakhar, P; Dowd, C F; Higashida, R T; Lawton, M T; Halbach, V V

    2015-10-01

    A minority of intracranial dural arteriovenous fistulas progress with time. We sought to determine features that predict progression and define outcomes of patients with progressive dural arteriovenous fistulas. We performed a retrospective imaging and clinical record review of patients with intracranial dural arteriovenous fistula evaluated at our hospital. Of 579 patients with intracranial dural arteriovenous fistulas, 545 had 1 fistula (mean age, 45 ± 23 years) and 34 (5.9%) had enlarging, de novo, multiple, or recurrent fistulas (mean age, 53 ± 20 years; P = .11). Among these 34 patients, 19 had progressive dural arteriovenous fistulas with de novo fistulas or fistula enlargement with time (mean age, 36 ± 25 years; progressive group) and 15 had multiple or recurrent but nonprogressive fistulas (mean age, 57 ± 13 years; P = .0059, nonprogressive group). Whereas all 6 children had fistula progression, only 13/28 adults (P = .020) progressed. Angioarchitectural correlates to chronically elevated intracranial venous pressures, including venous sinus dilation (41% versus 7%, P = .045) and pseudophlebitic cortical venous pattern (P = .048), were more common in patients with progressive disease than in those without progression. Patients with progressive disease received more treatments than those without progression (median, 5 versus 3; P = .0068), but as a group, they did not demonstrate worse clinical outcomes (median mRS, 1 and 1; P = .39). However, 3 young patients died from intracranial venous hypertension and intracranial hemorrhage related to progression of their fistulas despite extensive endovascular, surgical, and radiosurgical treatments. Few patients with dural arteriovenous fistulas follow an aggressive, progressive clinical course despite treatment. Younger age at initial presentation and angioarchitectural correlates to venous hypertension may help identify these patients prospectively. © 2015 by American Journal of Neuroradiology.

  5. Llanto del adulto

    Directory of Open Access Journals (Sweden)

    Alegría Majluf

    2013-09-01

    Full Text Available Se presentan los resultados de un primer estudio transcultural del llanto del adulto que comprende 30 países, entre los que se encuentra el Perú. Vingerhoets et al. (1997 de la Universidad de Tilburg, Holanda, analizan las causas, tendencia y frecuencia del llanto, emociones y sentimientos que inducen al llanto, diferencias y similitudes entre los países y los sexos. Los autores encuentran que las mujeres tienden a llorar con más frecuencia e intensidad que los varones, advirtiendo que en algunos países las mujeres establecen mayor relación entre la tendencia al llanto y el ciclo menstrual que en otros. The results of a first cross-cultural study on adult crying in 30 countries including Peru are presented. Vingerhoets et al. (1997 from the University of Tilburg have analyzed motives, tendencies and frequency of crying, emotions and feelings that provoke crying, as well as differences and similarities among countries and sexes. Results show that women have a tendency to cry more frequently and intensively than men. It has also been noted that, in certain countries, there is a link between crying in women and their monthly period.

  6. Hiperplasia fibrosa inflamatoria y posibles factores asociados en adultos mayores

    OpenAIRE

    Rodríguez Zegarra, Anita F.; Facultad de Estomatología, Universidad Peruana Cayetano Heredia. Lima,; Sacsaquispe-Contreras, Sonia; Facultad de Estomatología, Universidad Peruana Cayetano Heredia. Lima,

    2014-01-01

    El propósito del estudio fue determinar la prevalencia de hiperplasia fibrosa inflamatoria (HFI)asociada al uso de prótesis dental removible y sus factores asociados como: sexo, grado deinstrucción, edad, compromiso sistémico, estado nutricional e higiene oral del sujeto; tipo ytiempo de uso de la prótesis, tamaño y ubicación de la lesión en adultos mayores residentes delAlbergue Central “Ignacia Rodulfo Vda. de Canevaro”. Se evaluaron 91 sujetos mayores de 60años (80,67+7,65), que portaban p...

  7. MR diagnosis of dural sinus thrombosis. Diagnostico por RM de las trombosis de senos durales

    Energy Technology Data Exchange (ETDEWEB)

    Rovira Caellas, A.; Turon Estrada, A.; Alvarez Sabin, J.; Lozano Sanchez, M.; Castao Duque, Ch.; Grive Isern, E.; Sumalla Sue, J. (Hospital General Vall d' Hebron Barcelona (Spain))

    1994-01-01

    Four adult patients were diagnosed as having dural sinus thrombosis (DST) by means of magnetic resonance (MR). In the three cases of acute thrombosis, MR disclosed diffuse or segmental hyperintensity in the sinuses involved, which persisted regardless of the sequence and orientation of the plane selected. MR angiography (MRA) provided diagnostic information that proved useful in the chronic case, as well as in the two cases in which follow-up was carried out to determine the degree to which permeability was restored to the sinuses involved. MR diagnosis of DST can produce false positives and negatives, the causes of which should be known, as well as the ways to avoid them, in order to prevent diagnostic errors. MR, when applied and interpreted correctly, can be considered the first, and in many cases the only, choice as a diagnostic method in DST. (Author)

  8. Prevalence of obesity and metabolic syndrome components in Mexican adults without type 2 diabetes or hypertension Prevalencia de obesidad y componentes del síndrome metabólico en adultos mexicanos sin diabetes tipo 2 o hipertensión arterial

    Directory of Open Access Journals (Sweden)

    Rosalba Rojas-Martínez

    2012-02-01

    Full Text Available OBJECTIVE: To describe the number of Mexican adults with undiagnosed diabetes and arterial hypertension and their association with obesity. MATERIAL AND METHODS: The study included a sub-sample of 6 613 subjects aged 20 years or more who participated in the 2006 National Health and Nutrition Survey (ENSANUT 2006. Subjects with a previous diagnosis of diabetes or hypertension (n=1 861 were excluded. Prevalences and standard errors were estimated, taking into account the complex sample design. RESULTS: 6.4 million adults have obesity and undiagnosed impaired fasting glucose. Almost two million more have fasting glucose levels diagnostic for diabetes. As for arterial blood pressure, 5.4 million adults had prehypertension. Another 5.4 million adults had blood pressure levels suggestive of probable hypertension. A total of 21.4 million Mexican adults with obesity had at least one further component of the metabolic syndrome. CONCLUSIONS: A large proportion of adults with obesity-related metabolic comorbidities remains undiagnosed in Mexico.OBJETIVO: Estimar el número de adultos mexicanos que tienen diabetes o hipertensión arterial no diagnosticadas y el riesgo de tales condiciones asociado a la obesidad. MATERIAL Y MÉTODOS: Se analiza una submuestra de 6 613 sujetos mayores de 20 años que participaron en la Encuesta Nacional de Salud y Nutrición 2006. Los sujetos con diagnóstico previo de diabetes o hipertensión arterial fueron excluidos (n=1 861. Las prevalencias y errores estándar fueron estimados considerando el diseño complejo de la muestra. RESULTADOS: 6.4 millones de adultos tienen obesidad y glucemia anormal de ayuno. Casi dos millones más tienen una glucemia de ayuno diagnóstica de diabetes En cuanto a la presión arterial, 5.4 millones tienen prehipertensión. El mismo número de casos tienen valores diagnósticos de hipertensión. Un total de 21.4 millones de adultos con obesidad tienen al menos un componente del síndrome metab

  9. Unintentional cervical dural tap treated with lumbar blood patch

    NARCIS (Netherlands)

    Lebrun, C.; Peek, D.; Vanelderen, P.J.L.; Zundert, J. van

    2014-01-01

    Cervical radicular pain presents itself as pain radiating from the neck to the arm. If conservative treatment fails, a cervical epidural steroid injection can be considered. A rare but possible complication resulting from the interlaminar approach is unintentional cervical dural puncture that may re

  10. Congenital osteolytic dural fibrosarcoma presenting as a scalp swelling.

    Science.gov (United States)

    Brohi, Shams Raza; Dilber, Muzamil

    2012-08-01

    An extremely rare case of congenital dural fibrosarcoma is reported in a 2 months old child who presented with scalp swelling since birth. CT scan revealed an osteolytic lesion compressing the underlying atrophic brain. Tumour was completely excised and duroplasty was done with a patch graft. Postoperative CSF leak was managed with aspirations and lumbar puncture.

  11. Meduloepitelioma en el adulto

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    Nelson Inzulza Barrientos

    2014-07-01

    Full Text Available El meduloepitelioma es un tumor muy poco frecuente en adultos, encontrándose descritos en la literatura solo una decena de casos. Se presenta la historia de un paciente sometido a enucleación de su ojo derecho por sospecha de melanoma coroideo. La biopsia informó neoplasia de estirpe neural de comportamiento biológico incierto, y el estudio inmunohistoquímico informó neoplasia neuroendocrina de bajo grado. Se realizó estudio de extensión sistémica que resultó negativo. El paciente no se somete a controles durante 6 años, volviendo a consultar por una gran ocupación orbitaria derecha, manejada mediante exenteración orbitaria. La biopsia informó neoplasia maligna de estirpe neural, y la histoquímica concluyó meduloepitelioma pigmentado maligno ocular con extensión a la órbita. El paciente evolucionó con signos de remisión completa de la lesión, sin embargo un año y medio después comenzó con un aumento de volumen rápidamente progresivo, que compromete toda la región orbitaria derecha. Se presenta el caso a comité oncológico, indicando estudio de extensión sistémica mediante citología de LCR, TAC de tórax, abdomen y pelvis que resultaron normales; el cintigrama óseo evidenció actividad osteoblástica patológica en macizo facial, y la RMN de cerebro evidenció invasión intra y extracraneal, con ocupación de los senos paranasales. Con estos antecedentes se le ingresó en el programa de cuidados paliativos y alivio del dolor, realizándose radioterapia paliativa, con remisión parcial de tamaño tumoral y sintomatología.

  12. Factores asociados al maltrato del adulto mayor de Antioquia, 2012

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    Sara M. Cano

    2015-07-01

    Full Text Available Objetivo: determinar los factores asociados al maltrato del adulto mayor del departamento de Antioquia en el año 2012. Metodología: mediante estudio descriptivo transversal, se caracterizaron los factores demográficos, económicos y de salud mental de la población adulta mayor de Antioquia para el año 2012, con el fin de aportar al análisis de la situación de salud y condiciones de vida del adulto mayor. El estudio se basó en los resultados del instrumento aplicado por la Universidad ces a 4.215 adultos de sesenta años y más de edad, en el cual se indagó sobre percepción de maltrato, funcionamiento cognitivo, nivel de depresión, nivel de ansiedad, apoyo social, escala de recursos sociales, entre otras; los resultados se expandieron a 654.473 adultos del departamento. Resultados: el 72,8% de adultos del departamento son mujeres, 53,7% vive en Medellín, 55% tiene primaria incompleta, 72,9% pertenece a estratos socioeconómicos 1 y 2, 45,1% no registraron ingresos en el último mes, 26,3% tiene riesgo de depresión y 34,4% tiene riesgo de ansiedad, 2,5% reportó haber sufrido descuido, 5,0% necesidades afectivas ignoradas, 1,7% algún caso de agresión física, 0,4% agresión sexual y 1,3%, afirmó haber sufrido maltrato económico. Las variables estrato socioeconómico, tipo de vivienda, etnia, riesgo de depresión, riesgo de ansiedad, riesgo de deterioro cognitivo y red de apoyo fueron las que más ayudaron a explicar la presencia de maltrato. Conclusión: enfrentar este problema requiere de una atención integral a las necesidades de los adultos mayores, participación de todos los sectores de la sociedad y conciencia transgeneracional.

  13. Application of biological dural graft made by meninges from porkers

    Institute of Scientific and Technical Information of China (English)

    Peng Liu; Shengping Huang; Songtao Qi

    2007-01-01

    BACKGROUND: Presently, over 40 kinds of dural grafts have been successively used in clinic. Among them, lyophilized human dura mater with good histocompatibility and less complications is applied most widely. But there are a few reports on cases of infected spongiform encephalopathy following application of lyodura. More ideal repair materials deserve to be further investigated.OBJECTIVE: To investigate the efficiency and safety of biological dural graft made by meninges from porkers to repair meningeal injury.DESIGN: A self-control observation.SETTING: Wuhan General Hospital of Guangzhou Military Area Command of Chinese PLA.MATERIALS: Sixteen New Zealand Rabbits, of either gender, weighing from 2 to 3 kg, of clean grade Ⅱ,with the age of 0.5 - 1 year, were involved in this experiment. The involved rabbits were provided by the Animal Experimental Center of the First Military Medical University of Chinese PLA. Biological surgical patch (dural graft) was developed by Guangdong Guanhao Biotechnological Co.,Ltd. It was processed by using meninges from porkers by tissue engineering technology.METHODS: This experiment was carried out in the Experimental Center of the 157 Hospital of Chinese PLA between December 2003 and June 2004. ① The experimental rabbits were anesthetized. Dura mater was exposed from two sides ofpostmedial line of coronal suture. A rectangular dura mater about 8 mm × 8mm in size was cut off. Then a biological surgical patch (dural graft) was sheared into insert with 8 mm diameter and sutured. The left dura mater was untouched and used as control. Scalp was sutured, and postoperative wound healing and recovery were observed. ②The anesthetized rabbits were sacrificed at postoperative 3, 14, 30 and 90 days, 4 rabbits once. The whole head was cut off, and its scalp was removed.Afterwards, the head was fixed by formalin. Tissues in operative site were obtained, performed routine paraffin embedding, sliced and conducted HE staining, finally, the

  14. Dosagem do peptídeo C sérico ao acaso em adultos com diagnóstico clínico de diabetes mellitus tipo 1 Random C peptide measurement in adults with clinical diagnosis of type 1 diabetes

    OpenAIRE

    Melanie Rodacki; Lenita Zajdenverg; Adolpho Milech; José Egídio Paulo de Oliveira

    2008-01-01

    OBJETIVO: A dosagem de peptídeo C (PC) pode ser útil para a classificação do Diabetes mellitus (DM). O objetivo deste estudo foi investigar a associação entre o diagnóstico clínico de DM tipo 1 e os níveis séricos de PC randômico. MÉTODOS: Foi feita dosagem de PC ao acaso em pacientes de origem multiétnica com diagnóstico clínico de DM tipo 1 na idade adulta ( > 18 anos). RESULTADOS: Estudamos 51 pacientes, sendo 28 mulheres (54,9%) e 23 homens (45,1%), 36 brancos (70,6%) e 15 não-brancos (29...

  15. Imaging diagnosis of dural and direct cavernous carotid fistulae

    Energy Technology Data Exchange (ETDEWEB)

    Santos, Daniela dos; Monsignore, Lucas Moretti; Nakiri, Guilherme Seizem; Cruz, Antonio Augusto Velasco e; Colli, Benedicto Oscar; Abud, Daniel Giansante, E-mail: danisantos2404@gmail.com [Universidade de Sao Paulo (HCFMRP/USP), Ribeirao Preto, SP (Brazil). Faculdade de Medicina. Hospital das Clinicas

    2014-07-15

    Arteriovenous fistulae of the cavernous sinus are rare and difficult to diagnose. They are classified into dural cavernous sinus fistulae or direct carotid-cavernous fistulae. Despite the similarity of symptoms between both types, a precise diagnosis is essential since the treatment is specific for each type of fistula. Imaging findings are remarkably similar in both dural cavernous sinus fistulae and carotid-cavernous fistulae, but it is possible to differentiate one type from the other. Amongst the available imaging methods (Doppler ultrasonography, computed tomography, magnetic resonance imaging and digital subtraction angiography), angiography is considered the gold standard for the diagnosis and classification of cavernous sinus arteriovenous fistulae. The present essay is aimed at didactically presenting the classification and imaging findings of cavernous sinus arteriovenous fistulae. (author)

  16. Dural arteriovenous fistulae after forehead knife-cut injury

    Institute of Scientific and Technical Information of China (English)

    朱刚; 陈志; 冯华

    2004-01-01

    @@ Dural arteriovenous fistulae (DAVF) is a rare intracranial vascular disease. It is pathologically characterized by direct shunting of the intracranial artery and vein, which results in cerebral ischemia, intracranial hemorrhage, neural deficit and intracranial murmur. The etiological mechanism of DAVF is not well known, but most researchers think it is associated with congenital abnormal development, especially abnormal development of dural blood vessels at the stage of embryogenesis. Recently, some researchers have found that DAVF is also associated with some acquired factors. This article reports a case who developed DAVF within 2 years after debridement of frontal bone fragmentation, depressed fracture, left frontal lobe contusion and superior sagittal sinus injury due to forehead knife-cut injury. The pathogenic mechanism was explored through a review of the related literatures.

  17. Bilateral subdural hematoma secondary to accidental dural puncture

    Directory of Open Access Journals (Sweden)

    Sofía Ramírez

    2015-08-01

    Full Text Available We report the case of a 25-year-old woman, who received epidural analgesia for labor pain and subsequently presented post-dural puncture headache. Conservative treatment was applied and epidural blood patch was performed. In the absence of clinical improvement and due to changes in the postural component of the headache, a brain imaging test was performed showing a bilateral subdural hematoma. The post-dural puncture headache is relatively common, but the lack of response to established medical treatment as well as the change in its characteristics and the presence of neurological deficit, should raise the suspicion of a subdural hematoma, which although is rare, can be lethal if not diagnosed and treated at the right time.

  18. Intracranial dural arteriovenous fistula with spinal medullary venous drainage

    Energy Technology Data Exchange (ETDEWEB)

    Wiesmann, M.; Padovan, C.S.; Pfister, H.W.; Yousry, T.A. [Muenchen Univ. (Germany). Abt. fuer Neuroradiologie

    2000-10-01

    We report on a 46-year-old patient in whom an intracranial dural arteriovenous (AV) fistula, supplied by a branch of the ascending pharyngeal artery, drained into spinal veins and produced rapidly progressive symptoms of myelopathy and brainstem dysfunction including respiratory insufficiency. Magnetic resonance imaging studies demonstrated brainstem oedema and dilated veins of the brainstem and spinal cord. Endovascular embolization of the fistula led to good neurological recovery, although the patient had been paraplegic for 24 h prior to embolization. This case demonstrates the MRI characteristics of an intracranial dural AV fistula with spinal drainage and illustrates the importance of early diagnosis and treatment. Even paraplegia may be reversible, if angiography is performed and the fistula treated before ischaemic and gliotic changes become irreversible. (orig.)

  19. Solitary spinal dural syphilis granuloma mimicking a spinal meningioma.

    Science.gov (United States)

    Zhou, Heng-Jun; Zhan, Ren-Ya; Chen, Man-Tao; Cao, Fei; Zheng, Xiu-Jue

    2014-01-01

    Dural granuloma is extremely rare. To our knowledge, there has no case reported solitary spinal dural syphilis granuloma worldwide so far. Here we report our findings in a 49-year-old woman, who presented with 10-year progressive left lower-limb numbness and two weeks of right lower-limb numbness. Magnetic resonance imaging (MRI) suggested a homogeneous enhanced spindle-shaped lesion, 2.9 × 1.5 cm in size, occupying the spinal intradural extramedullary space, at the level of Thoracic (T)-2/3, which mimicked the appearance of spinal meningioma. The Treponema pallidum particle agglutination (TPPA) test titer of 1:8, and the venereal diseases research laboratory of cerebral spinal fluid (VDRL-CSF) was reactive, so confirmed neurosyphilis was considered. After formal anti-syphilis treatment, posterior laminectomy surgery was performed, and the lesion was completely separated and extirpated. Final histopathologic diagnosis of the lesion was confirmed as chronic granulomatous inflammation, combined with the neurosyphilis history, spinal dural syphilis granuloma was finally diagnosed. Postoperatively, the patient recovered without any further treatment.

  20. Primary Dural Repair in Minimally Invasive Spine Surgery

    Directory of Open Access Journals (Sweden)

    Raqeeb M. Haque

    2013-01-01

    Full Text Available We describe an effective surgical technique in primary repair of the spinal dura during minimally invasive spine surgery (MISS. Objective. Minimally invasive spine surgery includes the treatment of intradural lesions, and proper closure of the dura is necessary. However, primary dural closure can be difficult due to the restricted space of MIS retractors and the availability of appropriate surgical instrumentation. Methods. We describe the use of a needle already used in the pediatric neurosurgical arena that can facilitate easier and safer closure of spinal dura through MISS retractors in two illustrative intradural cases. Results and Discussion. The primary dural closure technique is described and patient demographics are included. The instruments specifically used for the intradural closure through MIS retractor systems include (1 4-0 Surgilon braided nylon (Covidien, Dublin, Ireland with a CV-20 taper 1/2 circle, 10 mm diameter needle; (2 Scanlan (Saint Paul, MN, USA dura closure set. Conclusion. Successful primary dural repair can be performed on primary and incidental durotomies during minimally invasive spinal surgery. We describe the novel use of a 10 mm diameter needle to help surgeons safely and efficiently close the dura with more ease than previously described.

  1. Dosagem do peptídeo C sérico ao acaso em adultos com diagnóstico clínico de diabetes mellitus tipo 1 Random C peptide measurement in adults with clinical diagnosis of type 1 diabetes

    Directory of Open Access Journals (Sweden)

    Melanie Rodacki

    2008-06-01

    Full Text Available OBJETIVO: A dosagem de peptídeo C (PC pode ser útil para a classificação do Diabetes mellitus (DM. O objetivo deste estudo foi investigar a associação entre o diagnóstico clínico de DM tipo 1 e os níveis séricos de PC randômico. MÉTODOS: Foi feita dosagem de PC ao acaso em pacientes de origem multiétnica com diagnóstico clínico de DM tipo 1 na idade adulta ( > 18 anos. RESULTADOS: Estudamos 51 pacientes, sendo 28 mulheres (54,9% e 23 homens (45,1%, 36 brancos (70,6% e 15 não-brancos (29,4% com idade média ao diagnóstico de 27,9 (±7,5 anos e duração média da doença de 9,9 (±7,2 anos. Oito pacientes (15,7% apresentaram PC > 1,5 ng/ml indicativo de função pancreática preservada. Neste grupo, foi detectado índice de massa corporal mais elevado (26,05 vs 23,05 kg/m²; p=0,006 e maior proporção de não-brancos (62,5% vs 23,3%; p=0,039 do que naqueles com PC baixo. CONCLUSÃO: A maioria dos pacientes com diagnóstico clínico de DM tipo 1 apresenta PC baixo. Entretanto, a secreção pancreática de insulina parece preservada em uma quantidade significativa de pacientes com quadro clínico indicativo de DM tipo 1. É possível que estes pacientes apresentem alguma forma atípica de DM, ainda não completamente compreendida, com características de DM tipo 1 e tipo 2 superpostas.OBJECTIVE: C peptide measurement can be helpful for classification of diabetes mellitus (DM. The aim of this study was to investigate the association between clinical diagnosis of type 1 diabetes (T1D and levels of random C peptide. METHODS: Random C peptide was measured in adults of multi-ethnic background who had been classified as having T1D according to their clinical presentation. All individuals were > 18 years old at onset. RESULTS: The study included 51 adults, 28 (54.9% females and 23 (45.1% males, 36 (70.6% Caucasian and 15 (29.4% non-Caucasian. Their mean age at onset and duration of DM mean age were 27.9 (± 7.5 years and 9.9 (±7.2 years

  2. Prevalencia de trastornos temporomandibulares en el adulto mayor institucionalizado

    Directory of Open Access Journals (Sweden)

    Zenia Masiel Criado Mora

    Full Text Available Introducción: los trastornos temporomandibulares (TTM son una serie de signos y síntomas buco faciales de etiología multifactorial. En Cuba existen varias investigaciones que tratan sobre los TTM %sobre todo en jóvenes dentados% no conociéndose amplias referencias de este tipo de estudio en el adulto mayor. Objetivo: identificar la prevalencia de TTM en los adultos mayores institucionalizados, los signos y síntomas más frecuentes según edad y sexo. Métodos: se realizó un estudio descriptivo transversal en 113 adultos mayores de ambos sexos, institucionalizados en dos hogares de ancianos de la Habana, de marzo a abril de 2012. Se aplicó una encuesta donde se recogió sexo, edad, signos y síntomas. Las manifestaciones clínicas evaluadas fueron: la presencia de dolor muscular, dificultad al movimiento de abertura y cierre, dolor articular, dolor muscular articular, ruidos articulares, limitación de la abertura bucal, limitación de los movimientos de lateralidad y propulsión, desviación de la mandíbula. Resultados: el 40,70 % de los adultos mayores estudiados, presentaron afectación en la articulación temporomandibular. Los ruidos articulares fue el síntoma con mayor predominio en todos los grupos etarios (76,08 %, afectando al 82,35 % de los hombres y al 72,41 % de las mujeres. Seguido por el dolor muscular que se manifestó en el 52,17 % de los afectados, con mayor porcentaje en mujeres (58,62 % que en hombres (41,17 %. La dificultad para realizar los movimientos de abertura y cierre se detectó en el 28,26 % de los afectados con mayor prevalencia en el sexo femenino (34,48 % que en el masculino (17,14 %. Conclusiones. se observó una elevada prevalencia de TTM en los adultos mayores estudiados. Los signos y síntomas más frecuentes por edad y sexo fueron los ruidos articulares y el dolor muscular y la dificultad para realizar los movimientos de abertura y cierre.

  3. Uso regular de serviços odontológicos entre adultos: padrões de utilização e tipos de serviços Regular use of dental care services by adults: patterns of utilization and types of services

    Directory of Open Access Journals (Sweden)

    Maria Beatriz J. Camargo

    2009-09-01

    Full Text Available O objetivo deste estudo foi avaliar o uso regular de serviços odontológicos entre adultos, identificando grupos nos quais esse comportamento é mais freqüente. O estudo foi realizado em Pelotas, Rio Grande do Sul, Brasil, com desenho transversal de base populacional, envolvendo 2.961 indivíduos, que responderam um questionário estruturado. A prevalência de uso regular encontrada foi de 32,8%. Estiveram positivamente associadas ao uso de forma regular as seguintes características: ser do sexo feminino, ter idade The aim of this study was to estimate the prevalence of regular use of dental services by adults and identify groups where this behavior is more frequent. A cross-sectional population-based study was carried out in Pelotas, southern Brazil, including 2,961 individuals who answered a standardized questionnaire. Overall prevalence of regular use of dental services was 32.8%. The following variables were positively associated with regular use: female gender, age > 60 years, no partner, high educational level, high economic status, private service user, good/excellent self-rated oral health, and no perceived need for dental treatment. Those who had received orientation on prevention and expressed a favorable view towards the dentist had higher odds of being regular users. Especially among lower-income individuals, regular use was infrequent (15%. When restricting the analysis to users of public dental services, schooling was still positively associated with the outcome. Dental services, especially in the public sector, should develop strategies to increase regular and preventive use.

  4. TIPO TOTAL DE INJUSTO

    OpenAIRE

    Guimarães, Rodrigo Suzana

    2008-01-01

    Neste estudo, faz-se a releitura do injusto penal com base na teoria dos elementos negativos do tipo, analisando o seu acerto e a necessidade de sua aplicação para o desenvolvimento do Direito Penal brasileiro. A teoria dos elementos negativos do tipo surgiu na Alemanha do século XIX, por obra de Adolf Merkel, como forma de buscar a solução para uma lacuna deixada pelo antigo Código Penal alemão sobre o erro relativo aos pressupostos fáticos de uma causa de justificação. Merkel e seus seguido...

  5. Violencia intrafamiliar en el adulto mayor que vive en el distrito de Breña, Perú

    OpenAIRE

    Jack Roberto Silva-Fhon; Antonia Defilia Del Río-Suarez; Silvia Natividad Motta-Herrera; Suzele Cristina Coelho Fabricio-Wehbe; Rosalina Aparecida Partezani-Rodrigues

    2015-01-01

    Antecedentes. La violencia hacia el adulto mayor es un problema social que ocurre dentro de la familia y que, por miedo, no es denunciado. Esto dificulta el trabajo del personal multiprofesional de salud para la detección, denuncia y prevención de estos casos. Objetivo. Identificar la prevalencia, los tipos de violencia intrafamiliar, su asociación con variables sociodemográficas y la presencia de síntomas depresivos en el adulto mayor que vive en la comunidad de estudio. Materiales y métodos...

  6. Vivencias de los adultos j?venes con autoimagen alterada por estrabismo. Implicancias para el hacer de enfermer?a.

    OpenAIRE

    Mino Yglesias, Mar?a Esther

    2014-01-01

    El presente estudio se realiz? con el objetivo de develar las vivencias de los adultos j?venes con autoimagen alterada por estrabismo y, sus implicancias para el hacer de enfermer?a, que concurrieron a la consulta externa del Instituto Regional de Oftalmolog?a de Trujillo. La metodolog?a es cualitativa de modalidad fenomenol?gica de tipo estructural, dentro de la perspectiva de Martin Heidegger. La muestra estuvo conformada por ocho adultos j?venes de ambos sexos, entre los veinte y trein...

  7. Efficacy and safety of small intestinal submucosa in dural defect repair in a canine model.

    Science.gov (United States)

    He, Shu-Kun; Guo, Jin-Hai; Wang, Zhu-le; Zhang, Yi; Tu, Yun-Hu; Wu, Shi-Zhou; Huang, Fu-Guo; Xie, Hui-Qi

    2017-04-01

    Dural defects are a common problem, and inadequate dural closure can lead to complications. Several types of dural substitute materials have recently been discarded or modified owing to poor biocompatibility or mechanical properties and adverse reactions. The small intestinal submucosa (SIS) is a promising material used in a variety of applications. Based on the limitations of previous studies, we conducted an animal study to evaluate the efficacy and safety of the SIS in preclinical trials. Twenty-four male beagle dogs were subjected to surgical resection to produce dural defects. SIS or autologous dural mater was patched on the dural defect. Gross and histological evaluations were carried out to evaluate the efficacy and safety of the therapy. Our findings demonstrated that the SIS, which stimulated connective and epithelial tissue responses for dural regeneration and functional recovery without immunological rejection, could provide prolonged defect repair and prevent complications. The mechanical properties of the SIS could be adjusted by application of multiple layers, and the biocompatibility of the material was appropriate. Thus, our data suggested that this material may represent an alternative option for clinical treatment of dural defects.

  8. Postpartum post-dural puncture headache: is your differential diagnosis complete?

    NARCIS (Netherlands)

    Bleeker, C.P.; Hendriks, I.M.; Booij, L.H.D.J.

    2004-01-01

    We describe a patient with an intracerebral haemorrhage following an accidental dural puncture during an attempted epidural for pain relief in labour. Anaesthetists need to include intracerebral haemorrhage in the differential diagnosis of post-dural puncture headache in the puerperium.

  9. Dural ectasia as a cause of widening of the internal auditory canals in neurofibromatosis

    Energy Technology Data Exchange (ETDEWEB)

    Egelhoff, J.C.; Ball, W.S.; Towbin, R.B.; Seigel, R.S.; Eckel, C.G.

    1987-01-01

    Patients with neurofibromatosis have an increased incidence of acoustic neuroma, which is often bilateral. We present three patients with neurofibromatosis and enlarged internal auditory canals secondary to dural ectasia, without associated acoustic neuromata. Air CT cisternography and Metrizamide CT cisternography was needed in differentiating dural ectasia from acoustic neuroma in two patients.

  10. TIPOS DE DISCURSO

    OpenAIRE

    Garcia, Afrânio; UERJ

    2012-01-01

    O professor Adilson Citelli, em seu excelente livro Linguageme persuasão, apresenta cinco tipos de discurso:§ discurso dominante§ discurso autorizado§ discurso polêmico,§ discurso lúdico§ discurso autoritário.

  11. Optimal cutoff points for the detection of undiagnosed type 2 diabetes, hypertension and metabolic syndrome in Mexican adults Puntos de corte óptimos para la detección de diabetes tipo 2, hipertensión y síndrome metabólico no diagnosticados en adultos mexicanos

    Directory of Open Access Journals (Sweden)

    Rosalba Rojas-Martínez

    2012-02-01

    Full Text Available OBJECTIVE: To compare the waist circumference cutoff points established by the American Heart Association and the National Heart, Lung and Blood Institute (AHA/NHLBI with those of the International Diabetes Federation (IDF for the screening of diabetes, hypertension, and metabolic syndrome in Mexican adults. MATERIAL AND METHODS: This study comprised a subsample of the ENSANUT 2006. Subjects without diabetes and hypertension and non-pregnant women were included. Sensitivity, specificity, and predictive values were compared using AUC and the positive likelihood ratio test [LR(+]. RESULTS: In subjects aged ≥40 years, sensitivity for detection of diabetes and hypertension was higher for the IDF thresholds (85.34 and 86.87%, respectively compared with those of the AHA/NHLBI (59.49 and 52.41%, respectively. LR(+ were higher for IDF thresholds compared with AHA/NHLBI. Similar results in subjects aged ≥65 years were observed. CONCLUSIONS: The measurement of abdominal obesity defined by the IDF was a better screening tool for diabetes and hypertension, considering that initially a high sensitivity and low cost tool at population level is required.OBJETIVO: Comparar los puntos de corte de circunferencia de cintura de la American Heart Association and the National Heart, Lung and Blood Institute (AHA/NHLBI y la International Diabetes Federation (IDF para escrutinio de diabetes, hipertensión arterial y síndrome metabólico en adultos mexicanos. MATERIAL Y MÉTODOS: Se analizó una submuestra de la ENSANUT 2006 incluyendo sujetos sin diabetes o hipertensión y mujeres no embarazadas. Se comparó la sensibilidad, especificidad y valores predictivos mediante AUC y la razón de verosimilitudes positiva [LR(+]. RESULTADOS: En personas ≥40 años, la sensibilidad para detección de diabetes e hipertensión usando el criterio de la IDF fue de 85.34% (LR(+=1.1 y 86.87% (LR(+=1.1; mientras que para el criterio de la AHA/NHLBI fue de 59.49% (LR(+=1.34 y 52

  12. Dural ectasia and FBN1 mutation screening of 40 patients with Marfan syndrome and related disorders: role of dural ectasia for the diagnosis.

    Science.gov (United States)

    Attanasio, Monica; Pratelli, Elisa; Porciani, Maria Cristina; Evangelisti, Lucia; Torricelli, Elena; Pellicanò, Giannantonio; Abbate, Rosanna; Gensini, Gian Franco; Pepe, Guglielmina

    2013-07-01

    Marfan syndrome is an autosomal dominant disorder of connective tissue caused by mutations in the gene encoding fibrillin-1 (FBN1), a matrix component of microfibrils. Dural ectasia, i.e. enlargement of the neural canal mainly located in the lower lumbar and sacral region, frequently occurs in Marfan patients. The aim of our study was to investigate the role of dural ectasia in raising the diagnosis of Marfan syndrome and its association with FBN1 mutations. We studied 40 unrelated patients suspected for MFS, who underwent magnetic resonance imaging searching for dural ectasia. In all of them FBN1 gene analysis was also performed. Thirty-seven patients resulted affected by Marfan syndrome according to the '96 Ghent criteria; in 30 of them the diagnosis was confirmed when revaluated by the recently revised criteria (2010). Thirty-six patients resulted positive for dural ectasia. The degree of dural ectasia was grade 1 in 19 patients, grade 2 in 11 patients, and grade 3 in 6 patients. In 7 (24%) patients, the presence of dural ectasia allowed to reach a positive score for systemic feature criterion. Twenty-four patients carried an FBN1 mutation, that were represented by 13 missense (54%), and 11 (46%) mutations generating a premature termination codon (PTC, frameshifts and stop codons). No mutation was detected in the remaining 16 (6 patients with MFS and 10 with related disorders according to revised Ghent criteria). The prevalence of severe (grade 2 and grade 3) involvement of dura mater was higher in patients harbouring premature termination codon (PTC) mutations than those carrying missense-mutations (8/11 vs 2/13, P = 0.0111). Our data emphasizes the importance of dural ectasia screening to reach the diagnosis of Marfan syndrome especially when it is uncertain and indicates an association between PTC mutations and severe dural ectasia in Marfan patients.

  13. Idiopathic dural herniation of the thoracic spinal cord

    Energy Technology Data Exchange (ETDEWEB)

    Hausmann, O.N. [National Hospital for Neurology and Neurosurgery, London (United Kingdom). Lysholm Radiological Dept.; Moseley, I.F. [National Hospital for Neurology and Neurosurgery, London (United Kingdom). Lysholm Radiological Dept.

    1996-08-01

    Symptomatic anterior or anterolateral dural herniation of the spinal cord is rare, and not uncommonly misdiagnosed, both clinically and radiologically. We present four patients with a radiological diagnosis of herniation of the thoracic spinal cord, and review the current literature. All affected patients have been adults, typcially presenting with long-standing, unexplained sensory symptoms and eventually developing a Brown-Sequard syndrome, with or without motor changes. Herniation occurs in the upper or midthoracic region, between the T2 and T8 levels. (orig.)

  14. Intracranial dural arterio-venous fistula presenting with progressive myelopathy.

    LENUS (Irish Health Repository)

    Ogbonnaya, Ebere Sunny

    2011-01-01

    Spinal dural arterio-venous fistula (DAVF) is rare and usually involves the thoracic segments. The classical presentation is a slowly progressive ataxia. Clinical presentation of intracranial DAVF depends on the site of the DAVF, as well as the vessels involved. Patients may present with pulsatile tinnitus, occipital bruit, headache, dementia, visual impairment as well as neurological deterioration distant from the DAVF as a result of venous hypertension and cortical haemorrhage. The authors present a rare case of progressive myelopathy secondary to an intracranial DAVF.

  15. Novalis Stereotactic Radiosurgery for Spinal Dural Arteriovenous Fistula.

    Science.gov (United States)

    Sung, Kyoung-Su; Song, Young-Jin; Kim, Ki-Uk

    2016-07-01

    The spinal dural arteriovenous fistula (SDAVF) is rare, presenting with progressive, insidious symptoms, and inducing spinal cord ischemia and myelopathy, resulting in severe neurological deficits. If physicians have accurate and enough information about vascular anatomy and hemodynamics, they achieve the good results though the surgery or endovascular embolization. However, when selective spinal angiography is unsuccessful due to neurological deficits, surgery and endovascular embolization might be failed because of inadequate information. We describe a patient with a history of vasospasm during spinal angiography, who was successfully treated by spinal stereotactic radiosurgery using Novalis system.

  16. Delayed postoperative dural arteriovenous fistula presenting with progressive dementia.

    Science.gov (United States)

    Higashida, Tetsuhiro

    2015-12-09

    A 64-year-old woman underwent right suboccipital craniotomy to treat spontaneous cerebrospinal fluid (CSF) otorrhoea. Although the CSF leak was cured, the patient developed pulsatile tinnitus, ambulatory disturbance and progressive dementia. Four years after the surgery, she presented with generalised seizure. Cerebral angiography showed a dural arteriovenous fistula at the right transverse-sigmoid sinus, which was associated with sinus occlusion, retrograde blood flow in the sinus and diffuse intracranial cortical venous reflux. A combination of endovascular transarterial embolisation and transvenous embolisation with direct sinus puncture was performed. After the procedure, the patient's mental status and cognitive function improved significantly.

  17. Foramen magnum dural arteriovenous fistula presenting with epilepsy

    Science.gov (United States)

    Manisor, Monica; Aloraini, Ziad; Chibarro, Salvatore; Proust, Francois; Quenardelle, Véronique; Wolff, Valérie; Beaujeux, Rémy

    2015-01-01

    Intracranial dural arteriovenous fistulas (dAVFs) with perimedullary drainage represent a rare subtype of intracranial dAVF. Patients usually experience slowly progressive ascending myelopathy and/or lower brainstem signs. We present a case of foramen magnum dural arteriovenous fistula with an atypical clinical presentation. The patient initially presented with a generalised tonic-clonic seizure and no signs of myelopathy, followed one month later by rapidly progressive tetraplegia and respiratory insufficiency. The venous drainage of the fistula was directed both to the left temporal lobe and to the perimedullary veins (type III + V), causing venous congestion and oedema in these areas and explaining this unusual combination of symptoms. Rotational angiography and overlays with magnetic resonance imaging volumes were helpful in delineating the complex anatomy of the fistula. After endovascular embolisation, there was complete remission of venous congestion on imaging and significant clinical improvement. To our knowledge, this is the first report of a craniocervical junction fistula presenting with epilepsy. PMID:26472637

  18. Cobertura vacinal de adultos deficientes visuais e as características sociodemográficas

    Directory of Open Access Journals (Sweden)

    Lorita Marlena Freitag Pagliuca

    2014-01-01

    Full Text Available Se evaluaran la cobertura vacunal y las características sociodemográficas de adultos deficientes visuales. Investigación exploratoria, descriptiva y cuantitativa, con 41 adultos de asociación de ciegos de Fortaleza-CE, Brasil, de febrero a mayo/2011. Se realizó entrevista con instrumento semiestructurado con nombre, sexo, escolaridad y situación vacunal. Los resultados señalaron grupo predominante del sexo masculino (63,41%; edad entre 20-49 años (95,92% y escolaridad secundaria (79,92%. Recordaron tener recibido vacuna doble tipo adulto (82,93%, tríplice viral (51,22%, fiebre amarilla (21,95%, influenza según estaciones (29,27% e, no recibieron pneumocócica y hepatitis B. Intervalos de confianza señalaron que la mayoría de las personas con deficiencia, según recuerdo, se encontraba vacunada con doble adulto y tríplice viral. Las personas con deficiencia visual no reciben cartilla de vacunación adecuada para lectura, están parcialmente inmunizadas y susceptibles a enfermedades inmunoprevinibles. Medidas de intervención de enfermería son necesarias para planes de acciones a las principales medidas de prevención.

  19. Cranial dural arteriovenous shunts. Part 1. Anatomy and embryology of the bridging and emissary veins.

    Science.gov (United States)

    Baltsavias, Gerasimos; Parthasarathi, Venkatraman; Aydin, Emre; Al Schameri, Rahman A; Roth, Peter; Valavanis, Anton

    2015-04-01

    We reviewed the anatomy and embryology of the bridging and emissary veins aiming to elucidate aspects related to the cranial dural arteriovenous fistulae. Data from relevant articles on the anatomy and embryology of the bridging and emissary veins were identified using one electronic database, supplemented by data from selected reference texts. Persisting fetal pial-arachnoidal veins correspond to the adult bridging veins. Relevant embryologic descriptions are based on the classic scheme of five divisions of the brain (telencephalon, diencephalon, mesencephalon, metencephalon, myelencephalon). Variation in their exact position and the number of bridging veins is the rule and certain locations, particularly that of the anterior cranial fossa and lower posterior cranial fossa are often neglected in prior descriptions. The distal segment of a bridging vein is part of the dural system and can be primarily involved in cranial dural arteriovenous lesions by constituting the actual site of the shunt. The veins in the lamina cribriformis exhibit a bridging-emissary vein pattern similar to the spinal configuration. The emissary veins connect the dural venous system with the extracranial venous system and are often involved in dural arteriovenous lesions. Cranial dural shunts may develop in three distinct areas of the cranial venous system: the dural sinuses and their interfaces with bridging veins and emissary veins. The exact site of the lesion may dictate the arterial feeders and original venous drainage pattern.

  20. Prevalence of dural ectasia in Loeys-Dietz syndrome: comparison with Marfan syndrome and normal controls.

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    Atsushi K Kono

    Full Text Available BACKGROUND AND PURPOSE: Dural ectasia is well recognized in Marfan syndrome (MFS as one of the major diagnostic criteria, but the exact prevalence of dural ectasia is still unknown in Loeys-Dietz syndrome (LDS, which is a recently discovered connective tissue disease. In this study, we evaluated the prevalence of dural ectasia in LDS according by using qualitative and quantitative methods and compared our findings with those for with MFS and normal controls. MATERIAL AND METHODS: We retrospectively studied 10 LDS (6 males, 4 females, mean age 36.3 years and 20 MFS cases (12 males, 8 females, mean age 37.1 years and 20 controls (12 males, 8 females, mean age 36.1 years both qualitatively and quantitatively using axial CT images and sagittal multi-planar reconstruction images of the lumbosacral region. For quantitative examination, we adopted two methods: method-1 (anteroposterior dural diameter of S1> L4 and method-2 (ratio of anteroposterior dural diameter/vertebral body diameter>cutoff values. The prevalence of dural ectasia among groups was compared by using Fisher's exact test and the Tukey-Kramer test. RESULTS: In LDS patients, the qualitative method showed 40% of dural ectasia, the quantitative method-1 50%, and the method-2 70%. In MFS patients, the corresponding prevalences were 50%, 75%, and 85%, and in controls, 0%, 0%, and 5%. Both LDS and MFS had a significantly wider dura than controls. CONCLUSIONS: While the prevalence of dural ectasia varied depending on differences in qualitative and quantitative methods, LDS as well as MFS, showed, regardless of method, a higher prevalence of dural ectasia than controls. This finding should help the differentiation of LDS from controls.

  1. Microvascular anatomy of spinal dural arteriovenous fistulas: arteriovenous connections and their relationships with the dura mater.

    Science.gov (United States)

    Takai, Keisuke; Komori, Takashi; Taniguchi, Makoto

    2015-10-01

    OBJECT The microvascular anatomy of spinal dural arteriovenous fistulas (AVFs), especially the relationships of the vessels with the dura mater, has yet to be angiographically demonstrated in detail and proven histologically. METHODS From January 2012 through April 2014, a total of 7 patients with spinal dural AVFs in the thoracic region underwent open microsurgical obliteration at Tokyo Metropolitan Neurological Hospital. The microvascular anatomy of spinal dural AVFs was comprehensively assessed by using advanced microangiography, including 3D computer graphics and intraoperative indocyanine green video angiography, and by histological findings. RESULTS The 2 microangiography techniques revealed the spatial course and in vivo blood flow of the meningeal vessels and their relationships with the dura mater in sufficient detail. The meningeal branch of the intercostal artery split into multiple meningeal vessels on the outer dural surface adjacent to the root sleeve. After crossing the dura mater to the inner dural surface, these vessels gathered and joined a single intradural draining vessel. On the inner dural surface, the single draining vessel was fed by the surrounding multiple meningeal vessels, which appeared to be caput medusae. Histological findings revealed that the structure of the meningeal branch of the intercostal artery corresponded to that of a normal artery. The structure of intradural draining vessels corresponded to that of a vein modified by retrograde arterial inflow. On the inner dural surface, more than 1 meningeal artery gathered and joined with the proximal radiculomedullary vein. CONCLUSIONS Spinal dural AVFs are located on the inner dural surface, where multiple direct AV connections between more than 1 meningeal feeding artery and a single proximal radiculomedullary vein occur at the site where the vein connects to the dura mater.

  2. A ultra-sonografia do pâncreas é eficaz em diagnosticar o diabete melito tipo 1 e tipo 2?

    Directory of Open Access Journals (Sweden)

    Pimenta Walkyria de Paula

    2002-01-01

    Full Text Available Este trabalho foi realizado para verificar se a ultra-sonografia do pâncreas oferece dados auxiliares na classificação de diabéticos adultos dos tipos 1 e 2. O tamanho e a ecogenicidade do pâncreas foram determinados pela ultra-sonografia em 81 diabéticos, sendo 20 do tipo 1 e 61 do tipo 2 (53 obesos e oito não-obesos. Os pacientes tipo 2 obesos diferiram dos demais por apresentarem área total e diâmetro ântero-posterior do corpo do pâncreas significativamente maiores. Quanto à ecogenicidade pancreática, esta estava aumentada com maior freqüência nos diabéticos tipo 2 obesos que nos diabéticos tipo 1. Consideramos, assim, que a ultra-sonografia do pâncreas constitui metodologia auxiliar na classificação de diabéticos entre os tipo 1 e 2, sendo menos eficaz quando os últimos não são obesos.

  3. A ultra-sonografia do pâncreas é eficaz em diagnosticar o diabete melito tipo 1 e tipo 2?

    Directory of Open Access Journals (Sweden)

    Walkyria de Paula Pimenta

    2002-07-01

    Full Text Available Este trabalho foi realizado para verificar se a ultra-sonografia do pâncreas oferece dados auxiliares na classificação de diabéticos adultos dos tipos 1 e 2. O tamanho e a ecogenicidade do pâncreas foram determinados pela ultra-sonografia em 81 diabéticos, sendo 20 do tipo 1 e 61 do tipo 2 (53 obesos e oito não-obesos. Os pacientes tipo 2 obesos diferiram dos demais por apresentarem área total e diâmetro ântero-posterior do corpo do pâncreas significativamente maiores. Quanto à ecogenicidade pancreática, esta estava aumentada com maior freqüência nos diabéticos tipo 2 obesos que nos diabéticos tipo 1. Consideramos, assim, que a ultra-sonografia do pâncreas constitui metodologia auxiliar na classificação de diabéticos entre os tipo 1 e 2, sendo menos eficaz quando os últimos não são obesos.

  4. Trombose do seio dural em idade pediátrica

    Directory of Open Access Journals (Sweden)

    Filipe Mira Ferreira

    2015-06-01

    Full Text Available A trombose do seio dural é uma situação clínica rara, que resulta normalmente da complicação de processos infecciosos dos seios perinasais. Os sintomas e sinais são extremamente variados e inespecíficos sendo o diagnóstico feito através da ressonância magnética nuclear. Esse trabalho relata a ocorrência de trombose do seio dural em um paciente com idade pediátrica. Paciente com 10 anos de idade, sexo masculino, foi enviado ao serviço de urgência devido à diplopia e endotropia no olho esquerdo. No exame oftalmológico foi detectado papiledema bilateral, diplopia binocular e endotropia do olho esquerdo. Apresentava acuidade visual de 10/10 bilateralmente. Diante da suspeita de lesão ocupando espaço do sistema nervoso central, foi realizada ressonância magnética nuclear que confirmou o diagnóstico de TSD. Para avaliar a pressão intracraniana foi efetuada uma punção lombar com manometria, e esta demonstrou uma pressão intracraniana de 20mmHg (normal: <15mmHg. Perante isto a criança ficou internada para tratamento médico (enoxaparina de baixo peso molecular 1,5 mg/kg/dia subcutâneo (60 mg/dia, prednisolona 35 mg/dia oral e acetazolamida 250 mg/dia oral durante 10 dias. Após 1 mês de follow-up verificou-se agravamento oftalmológico. A realização de nova punção lombar apresentou uma pressão intracraniana de 40 mmHg que não cedia ao tratamento médico. Após discussão multidisciplinar do caso optou-se pela realização de derivação lombo-peritoneal. A necessidade de uma grande dose de suspeição clínica, tanto para o diagnóstico inicial quanto para a monitorização das complicações, tornam a abordagem da trombose do seio dural um processo singular.

  5. Intraoperative image updating for brain shift following dural opening.

    Science.gov (United States)

    Fan, Xiaoyao; Roberts, David W; Schaewe, Timothy J; Ji, Songbai; Holton, Leslie H; Simon, David A; Paulsen, Keith D

    2016-09-09

    OBJECTIVE Preoperative magnetic resonance images (pMR) are typically coregistered to provide intraoperative navigation, the accuracy of which can be significantly compromised by brain deformation. In this study, the authors generated updated MR images (uMR) in the operating room (OR) to compensate for brain shift due to dural opening, and evaluated the accuracy and computational efficiency of the process. METHODS In 20 open cranial neurosurgical cases, a pair of intraoperative stereovision (iSV) images was acquired after dural opening to reconstruct a 3D profile of the exposed cortical surface. The iSV surface was registered with pMR to detect cortical displacements that were assimilated by a biomechanical model to estimate whole-brain nonrigid deformation and produce uMR in the OR. The uMR views were displayed on a commercial navigation system and compared side by side with the corresponding coregistered pMR. A tracked stylus was used to acquire coordinate locations of features on the cortical surface that served as independent positions for calculating target registration errors (TREs) for the coregistered uMR and pMR image volumes. RESULTS The uMR views were visually more accurate and well aligned with the iSV surface in terms of both geometry and texture compared with pMR where misalignment was evident. The average misfit between model estimates and measured displacements was 1.80 ± 0.35 mm, compared with the average initial misfit of 7.10 ± 2.78 mm between iSV and pMR, and the average TRE was 1.60 ± 0.43 mm across the 20 patients in the uMR image volume, compared with 7.31 ± 2.82 mm on average in the pMR cases. The iSV also proved to be accurate with an average error of 1.20 ± 0.37 mm. The overall computational time required to generate the uMR views was 7-8 minutes. CONCLUSIONS This study compensated for brain deformation caused by intraoperative dural opening using computational model-based assimilation of iSV cortical surface displacements. The u

  6. Massive granular cell ameloblastoma with dural extension and atypical morphology

    Directory of Open Access Journals (Sweden)

    Vandana Raghunath

    2014-01-01

    Full Text Available Ameloblastomas are rare histologically benign, locally aggressive tumors arising from the oral ectoderm that occasionally reach a gigantic size. Giant ameloblastomas are a rarity these days with the advent of panoramic radiography in routine dental practice. Furthermore, the granular cell variant is an uncommon histological subtype of ameloblastoma where the central stellate reticulum like cells in tumor follicles is replaced by granular cells. Although granular cell ameloblastoma (GCA is considered to be a destructive tumor with a high recurrence rate, the significance of granular cells in predicting its biologic behavior is debatable. However, we present a rare case of giant GCA of remarkable histomorphology showing extensive craniofacial involvement and dural extension that rendered a good prognosis following treatment.

  7. MR imaging of dural sinus thrombosis: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Si Kyung; Han, Chun Hwan; Lee, Moon Ok; Park, Kyung Joo; Lee, Joo Hyuk [Kang Nam General HosPital, Public Corporation, Seoul (Korea, Republic of)

    1993-01-15

    We present a case of angiographically confirmed transverse and sigmoid sinus thrombosis, image with MR, in a 20 year old male with a history of otitis media and maxillary sinusitis. T1-weighted image demonstrated an iso signal intensity mass with tubular-shaped low signal intensity in right transverse and sigmoid sinus. The thrombus had high signal intensity on T2-weighted image. The signal intensity of the thrombus on Gd-DTPA enhanced T1-weighted image was unusually high similar to that of transverse sinus. Although dural sinus thrombosis has a non-specific MR signal intensity, findings of MRI in this case may serve as an aid in future evaluation of venous thrombosis.

  8. Spinal dural arteriovenous fistula: Imaging features and its mimics

    Energy Technology Data Exchange (ETDEWEB)

    Jeog, Ying; Ting, David Yen; Hsu, Hui Ling; Huang, Yen Lin; Chen, Chi Jen; Tseng, Ting Chi [Dept. of Radiology, aipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan (China)

    2015-10-15

    Spinal dural arteriovenous fistula (SDAVF) is the most common spinal vascular malformation, however it is still rare and underdiagnosed. Magnetic resonance imaging findings such as spinal cord edema and dilated and tortuous perimedullary veins play a pivotal role in the confirmation of the diagnosis. However, spinal angiography remains the gold standard in the diagnosis of SDAVF. Classic angiographic findings of SDAVF are early filling of radicular veins, delayed venous return, and an extensive network of dilated perimedullary venous plexus. A series of angiograms of SDAVF at different locations along the spinal column, and mimics of serpentine perimedullary venous plexus on MR images, are demonstrated. Thorough knowledge of SDAVF aids correct diagnosis and prevents irreversible complications.

  9. Acute paraplegia following embolization of spinal dural arteriovenous fistula

    Institute of Scientific and Technical Information of China (English)

    HUANG Cheng-guang; QI Xiang-qian; CHEN Huai-rui; L(U) Li-quan; WU Xiao-jun; BAI Ru-lin; LU Yi-cheng

    2011-01-01

    Embolization therapy has been used as the initial treatment for spinal dural arteriovenous fistula (SDAVF) only for certain patients or in certain medical institutions due to its minimal invasiveness, but the recurrence of embolization remains a clinical challenge. The recurrent patient usually exhibits a gradual onset of symptoms and progressive deterioration of neurological function. Developing paraplegia several hours after embolization is commonly seen in patients with venous thrombosis-related complications, for which anticoagulation therapy is often administered. This article reports on a SDAVF patient who had weakness of both lower extremities before embolization and developed complete paraplegia several hours after embolization therapy, later confirmed by angiography as fistula recurrence. The symptoms were relieved gradually after second embolization. The pathophysiology of this patient is also discussed.

  10. Perfusion-weighted MRI of spinal dural arteriovenous fistula

    Energy Technology Data Exchange (ETDEWEB)

    Yanaka, K.; Matsumaru, Y.; Uemura, K.; Matsumura, A.; Nose, T. [Department of Neurosurgery, Institute of Clinical Medicine, University of Tsukuba, Ibaraki (Japan); Anno, I. [Department of Radiology, Institute of Clinical Medicine, University of Tsukuba, Ibaraki (Japan)

    2003-10-01

    A 72-year-old woman was admitted with rapidly progressive paraplegia and sphincter disturbance. T2-weighted images of the thoracic spine showed intramedullary high signal with flow voids suggesting dilated medullary veins. Conventional spinal angiography demonstrated a dural arteriovenous fistula draining into perimedullary veins. Perfusion-weighted MRI demonstrated a prolonged mean transit time and increased blood volume in the high-signal area. The loss of normal perfusion gradient and venous hypertension and were thought to produce these differences. The time-to-peak was almost identical in the high-signal and isointense areas, although the bolus of contrast medium arrived earlier in the former. Arteriovenous shunting was thought to cause faster inflow. These changes may have resulted in increased blood volume in the spinal cord. The high signal has been attributed to oedema due to venous congestion, but there has been no histological confirmation. Perfusion MRI in this case supports this hypothesis. (orig.)

  11. Insertion of an intrathecal catheter following accidental dural puncture : a meta-analysis

    NARCIS (Netherlands)

    Heesen, M.; Kloehr, S.; Rossaint, R.; Walters, M.; Straube, S.; van de Velde, M.

    Background: Inserting an intrathecal catheter after accidental dural puncture in parturients to prevent postdural puncture headache is becoming increasingly popular. We aimed to identify relevant published articles investigating this intervention and subject data to a meta-analysis. Methods: A

  12. Valoración funcional del adulto mayor relacionado con el abandono familiar.

    Directory of Open Access Journals (Sweden)

    Jenny Fernanda Villarroel Vargas

    2017-03-01

    Full Text Available Introducción: Se estima que entre el 2000 al 2050 la población mundial envejecida ascenderá del 11% al 22 %, con ello el incremento de las diversas enfermedades o trastornos propios de la edad. Objetivo: Establecer la relación entre capacidad funcional del adulto mayor con el abandono familiar en el barrio La Calera Centro, Latacunga, 2015-2016. Métodos: Se realizó un estudio observacional descriptivo de corte trasversal, donde previo consentimiento informado participaron 70 adultos mayores, a quienes se les aplicó escalas para valoración de la capacidad funcional, así como la encuesta para valorar abandono familiar y aspectos sociodemográficos de la población. Para el análisis estadístico se utilizó el test de Chi Cuadrado de Pearson con un nivel de significancia del 0,05. Resultados: Se reportó el abandono en el 75,7% de los adultos mayores y tuvo significancia con respecto a la capacidad funcional y la estructura familiar (p=0,002. Hubo relación  entre capacidad funcional y abandono familiar, así como también predominio de los adultos mayores entre los 65 a 74 años, sexo femenino, sin ninguna actividad laboral y analfabetos. Hubo relación significativa entre capacidad funcional, edades geriátricas y ocupación; y de igual manera entre la estructura familiar y el abandono. La capacidad funcional y la estructura familiar fueron factores asociados al abandono.    Conclusiones: La dependencia del adulto mayor condicionó a diferentes tipos de maltrato, destacando el abandono familiar.

  13. Manifestaciones de violencia intrafamiliar hacia adultos mayores diabéticos. Pinar del Rio, 2012

    Directory of Open Access Journals (Sweden)

    María de la Caridad Casanova Moreno

    Full Text Available Introducción: la violencia contra el adulto mayor es un problema que requiere de sensibilización por parte del equipo de salud para ser visualizado. Objetivo: caracterizar las manifestaciones de violencia intrafamiliar hacia el adulto mayor diabético en un consultorio de la provincia de Pinar del Río. Métodos: se realizó un estudio descriptivo transversal durante el primer semestre del año 2012, en el Consultorio número 10 del Policlínico Universitario "Hermanos Cruz". El universo (U=86 estuvo constituido por el total de adultos mayores diabéticos; la muestra quedó conformada por 52 adultos mayores diabéticos. Las variables estudiadas fueron: edad, sexo, tipo de maltrato recibido, notificación, principal agresor e identificar la necesidad de información sobre el tema. Para la recolección de información se diseñó y aplicó un cuestionario por el equipo de investigación. Se utilizó el porcentaje como medida de resumen. Resultados: el grupo de edad más maltratado fue el de 60 a 69 años, predominando el sexo femenino. Los agresores más cercanos resultaron ser los hijos. La muestra estudiada manifestó que existe una insuficiente divulgación sobre el tema. Conclusiones: en el consultorio donde se realizó la investigación existen manifestaciones de violencia intrafamiliar en adultos mayores diabéticos, a pesar de que la comunidad no la reconoce como uno de sus problemas de salud.

  14. Adhesive arachnoiditis causing cauda equina syndrome in ankylosing spondylitis: CT and MRI demonstration of dural calcification and a dorsal dural diverticulum

    Energy Technology Data Exchange (ETDEWEB)

    Bilgen, I.G.; Yunten, N.; Ustun, E.E. [Ege Univ., Dept. of Radiology, Izmir (Turkey); Oksel, F.; Gumusdis, G. [Ege Univ., Dept. of Rheumatology, Izmir (Turkey)

    1999-07-01

    We present the radiological features of a 42-years-old man with long-standing inactive ankylosing spondylitis (AS), demonstrating that arachnoiditis is a cause of a cauda equina syndrome (CES) in this disease. CT showed a dorsal arachnoid diverticulum causing scalloped erosion of the laminae, and punctate and curvilinear dural calcification. MRI revealed adhesion and convergence of the cauda equina dorsally into the arachnoid pouch, causing the dural sca to appear empty canal. To the best of our knowledge, dural calcification on CT is a new finding in AS, which may be related to the CES. Our findings support the hyopthesis that chronic adhesive arachnoiditis with subsequent loss of meningeal elasticity may be the main cause of CES in AS. (orig.)

  15. Dural arteriovenous fistulas of the cavernous sinus - clinical case and treatment

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    Chiriac A.

    2014-06-01

    Full Text Available The purpose of our article is to present the results of our treatment of dural arteriovenous fistula of the cavernous sinus by glue embolization of the external carotid artery feeders. By this case presentation we try to clarify the clinical course, with the dural carotid cavernous fistula (CCF, characterizing a pallet of symptoms, paying special attention to radiological finding and endovascular treatment.

  16. Endovascular treatment of dural fistulas with the venous outflow of laterocavernous sinus

    Energy Technology Data Exchange (ETDEWEB)

    Lv Xianli; Jiang Chuhan; Li Youxiang; Lv Ming [Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, No. 6, Tiantan Xili, Chongwen, Beijing, 100050 (China); Wu Zhongxue, E-mail: ttyyzjb@sina.co [Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, No. 6, Tiantan Xili, Chongwen, Beijing, 100050 (China)

    2010-08-15

    Objective: To report our findings concerning the laterocavernous sinus (LCS) drainage of dural fistulas, focusing our attention on the important implications in treatment of the LCS, which is one of the principal drainage pathways of the superficial middle cerebral vein (SMCV). Methods: Consecutive 32 patients with dural fistulas treated endovascularly between 2005 and 2008 were reviewed. Seven patients had angiographic features such as dural fistulas draining with SMCV via LCS. Clinical records for these 7 patients were focused to determine their presenting symptoms, angiographic features, endovascular treatments, and clinical outcomes. Results: Over 3 years, 7 patients had 7 dural fistulas drained with SMCV via LCS were treated. Six-vessel angiography confirmed the presence of the dural fistulas. All fistulas were Cognard Type III featured by leptomeningeal veins drainage. One fistula involving the lesser sphenoid wing and 6 fistulas involving CS were supplied by external carotid artery branches with or without dural branches of the internal carotid artery. LCS was identified as a contiguous to SMCV drainage in these cases. One patient was treated with transvenous coil embolization alone, two with transvenous a combination of Onyx and coil embolization, and 4 with transarterial embolization. An angiographic obliteration and clinical cure was achieved in all patients. Complication was local hair loss due to X-ray radiation in one patient. Conclusion: It is very important to diagnose the presence of LCS in dural fistulas during the diagnostic angiography. It is believed that the knowledge of LCS might be relevant for the understanding and treatment of dural fistulas involving the LCS.

  17. Evaluation of Non-Watertight Dural Reconstruction with Collagen Matrix Onlay Graft in Posterior Fossa Surgery

    Science.gov (United States)

    Lobo, Bjorn; Lim, Joshua; Sade, Burak; Oya, Soichi; Lee, Joung H.

    2016-01-01

    Objective Many surgeons advocate for watertight dural reconstruction after posterior fossa surgery given the significant risk of cerebrospinal fluid (CSF) leak. Little evidence exists for posterior fossa dural reconstruction utilizing monolayer collagen matrix onlay graft in a non-watertight fashion. Our objective was to report the results of using collagen matrix in a non-watertight fashion for posterior fossa dural reconstruction. Methods We conducted a retrospective review of operations performed by the senior author from 2004–2011 identified collagen matrix (DuraGen) use in 84 posterior fossa operations. Wound complications such as CSF leak, infection, pseudomeningocele, and aseptic meningitis were noted. Fisher's exact test was performed to assess risk factor association with specific complications. Results Incisional CSF leak rate was 8.3% and non-incisional CSF leak rate was 3.6%. Incidence of aseptic meningitis was 7.1% and all cases resolved with steroids alone. Incidence of palpable and symptomatic pseudomeningocele in follow-up was 10.7% and 3.6% respectively. Postoperative infection rate was 4.8%. Previous surgery was associated with pseudomeningocele development (p<0.05). Conclusion When primary dural closure after posterior fossa surgery is undesirable or not feasible, non-watertight dural reconstruction with collagen matrix resulted in incisional CSF leak in 8.3%. Incidence of pseudomeningocele, aseptic meningitis, and wound infection were within acceptable range. Data from this study may be used to compare alternative methods of dural reconstruction in posterior fossa surgery. PMID:26885286

  18. Urticaria pigmentosa en el adulto

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    Jhon Alexander Ávila Rueda

    2012-08-01

    Full Text Available La urticaria pigmentosa es una de las formas más comunes de las mastocitosis, las cuales corresponden a una serie de procesos caracterizados por un aumento anormal de los mastocitos en diversos órganos y tejidos corporales. En la urticaria pigmentosa la manifestación es exclusiva de la piel, caracterizada por la presencia de lesiones maculopapulares de 2.5 a 5 mm de diámetro, de un color que puede oscilar entre rojo y café, distribuyéndose generalmente en tronco y extremidades respetando palmas y plantas. Cerca de la mitad de los lesiones presenta rubor localizado, prurito y ampollas. Su incidencia y prevalencia son desconocidas; sin embargo, su aparición es más común en niños que en adultos. El diagnóstico depende en gran manera de un adecuado examen físico complementado con estudios de laboratorio e histopatología. El tratamiento de elección constituye la administración de antihistamínicos orales.

  19. Inmunodeficiencias primarias por déficit de anticuerpos en adultos

    OpenAIRE

    María Mercedes Bello Rodríguez; Olga Lina Pupo Rodríguez; María del Carmen García Nieblas; Enelis Reyes Reyes

    2014-01-01

    Se realizó una investigación sobre los pacientes con inmunodeficiencias primarias por déficit de anticuerpos, atendidos en el servicio de inmunología del Hospital General “Dr. Ernesto Guevara” de Las Tunas, con el objetivo de caracterizar las inmunodeficiencias por déficit de anticuerpos en pacientes adultos, atendiendo al tipo de inmunoglobulina afectada, el sexo y la edad, así como las principales manifestaciones clínicas. Se evaluaron un total de diez pacientes tratados por esta causa entr...

  20. Validación de la Escala de Bienestar Subjetivo en cuidadores familiares de adultos mayores

    OpenAIRE

    López Dávalos, German; Universidad de Sonora; Domínguez Guedea, Miriam Teresa; Universidad de Sonora; Ochoa Marcobich, María Paola; Universidad de Sonora; Montiel Carvajal, María Martha; Universidad de Sonora; Laborín Álvarez, Jesús Francisco; Universidad de Sonora; Domínguez Guedea, Rosario Leticia; Universidad de Sonora; Valéz Lizárraga, Lília Lizeth; Universidad de Sonora; Zazueta Montaño, Denisse; Universidad de Sonora; Ibarra Flores, Elba; Universidad de Sonora

    2013-01-01

    El objetivo del presente trabajo fue la validación exploratoria de la Escala de Bienestar Subjetivo en cuidadores familiares de adultos mayores con diabetes mellitus tipo 2. Participaron 142 cuidadores familiares de la ciudad de Hermosillo, Sonora. La EBEMS, que reveló cuatro factores que explican el 55% de la varianza del constructo, resultó válida y confiable al identificar la situación afectiva y satisfacción con la vida, referentes valiosos en el diseño e implementación de programas de ap...

  1. Un estudio exploratorio de capacidades emocionales en adultos mayores

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    Zoe S. Bello Dávila

    2012-01-01

    Full Text Available Abstract The study of the emotional world of the elderly is a fundamental requisite for guaranteeing the well-being and health of this group. The objective of this research paper was to characterize a group of elderly people according to their motional capabilities. The group consisted of 122 elderly persons: 107 female, 15 male. All attendants participated in a “Círculo de Abuelos” (Circle of Grandparents. The study was descriptive, it sought to gather information about the responses of older adults in situations of emotional content by completing a questionnaire. The results provided a profile of capacities where areas of strength and weakness are clearly distinguished. Selfconfidence and the possibility of fulfilling projects are among the strengths while the weaknesses are found in interpersonal or intrapersonal managing of emotions. These results have led to a better understanding of the emotional world of the elderly and guide future educational activities. Resumen El estudio del mundo emocional de los adultos mayores es un requisito fundamental para garantizar el estado de bienestar y salud de los mismos. El presente artículo de investigación se fijó como objetivo caracterizar a un grupo de ancianos, en función de sus capacidades emocionales. Los participantes fueron 122 ancianos, en concreto 107 mujeres y 15 hombres, que asisten a un “Círculo de Abuelos”. El estudio fue de tipo descriptivo, pues pretendió recoger información acerca de las respuestas de los adultos mayores ante situaciones de contenido emocional que se exploran por medio de un cuestionario elaborado al efecto. Los resultados ofrecen un perfil de capacidades en que la autoconfianza y la posibilidad de elaborar proyectos se erigen como fortalezas, mientras que las debilidades se expresan en las dificultades para el manejo emocional tanto a nivel intra como interpersonal. Estos resultados han permitido lograr una mejor comprensión del mundo emocional del

  2. Resistência de genótipos de feijoeiro a Bemisia tabaci biótipo B Resistance of bean genotypes to Bemisia tabaci biotype B

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    Lucas Castro Torres

    2012-01-01

    Full Text Available O estudo de genótipos de feijoeiro resistentes à mosca-branca Bemisia tabaci (Genn. biótipo B (Hemiptera: Aleyrodidae é de grande importância devido aos danos ocasionados por essa praga à cultura. Neste trabalho, foram estudados a atratividade para adultos, a preferência para oviposição em testes com e sem chance de escolha, o ciclo ovo-adulto e o tipo e número de tricomas presentes nos folíolos. Os experimentos foram realizados em casa de vegetação avaliando-se, inicialmente, cem genótipos de feijoeiro. A resistência do tipo não-preferência para alimentação e/ou antibiose foi observada nos genótipos ARC-3, IAC-Alvorada e Canário 101, sendo a emergência de adultos fortemente influenciada pelos genótipos. Também se observou correlação negativa moderada entre o número de ovos e o número de tricomas glandulares, e correlação positiva muito forte entre o número de ovos e o número de tricomas tectores unciformes.The study of bean genotypes resistant to the whitefly Bemisia tabaci (Genn. B biotype (Hemiptera: Aleyrodidae has been of great importance due to the damage caused by this pest. In this research, bean genotypes were evaluated regarding attractiveness to whitefly adults, the preference for oviposition in free-choice and non choice tests, egg-to-adult development time and characterized for the presence, type and number of trichomes. The experiments were carried out under greenhouse conditions initially evaluating 100 bean genotypes. The non-preference type of resistance for feeding and/or antibiosis was observed in the genotypes ARC-3, IAC-Alvorada and Canário 101, and the emergence of adults was strongly influenced by the genotypes. It was also observed a moderate negative correlation between the number of eggs and the number of glandular trichomes, as well as a very strong positive correlation between the number of eggs and the number of unciform non-glandular trichomes.

  3. Patrones alimentarios y estado nutricional durante el período de adaptación al uso de prótesis dentales en adultos mayores

    OpenAIRE

    Bianchini, Natalia

    2014-01-01

    La salud bucal es fundamental para una correcta alimentación. El uso de prótesis dentales en el adulto mayor es cada vez más frecuente lo cual hace que se hayan desarrollado distintos tipos de prótesis para cada tratamiento. Esto implica una adaptación a su uso para una masticación y alimentación eficaz. Objetivo: Determinar cuál es la relación entre los patrones alimentarios y el estado nutricional de los adultos, entre 55 y 80 años, que se implantan prótesis dentarias en u...

  4. Calidad del cuidado de enfermería y satisfacción del usuario adulto del servicio de emergencia del hospital la caleta – Chimbote. 2015.

    OpenAIRE

    Urrutia Mundaca, Silvia

    2016-01-01

    La investigación tuvo como objetivo general, determinar la calidad del cuidado de enfermería en relación al grado de satisfacción del usuario adulto en el servicio de emergencia del Hospital La Caleta de Chimbote, 2015. La investigación fue cuantitativa, de tipo descriptivo correlacional. La muestra estuvo constituida por 217 pacientes adultos, para la recolección de datos se utilizaron dos instrumentos: Una encuesta sobre nivel de calidad del cuidado y otra para medir la satisfacción del usu...

  5. Maltrato institucional a adultos mayores

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    Miriam Rubio Acuña

    Full Text Available El maltrato institucional se refiere a cualquier forma de abuso que ocurre en servicios dirigidos a los ancianos. Esta revisión bibliográfica muestra que el maltrato se presenta con mayor frecuencia en residencias de larga estadía y el tipo más frecuente es la negligencia. Los factores asociados son los que tienen relación con el residente y con el ambiente. Las principales estrategias son invertir recursos sociosanitarios, sensibilizar a la población respecto al maltrato de los ancianos, considerar las necesidades de estos, fortalecer la formación de pregrado de los profesionales de salud en este ámbito y realizar educación continua. El maltrato es un problema social que debe ser abordado de manera integral.

  6. Delayed cerebrospinal fluid leak after watertight dural closure with a polyethylene glycol hydrogel dural sealant in posterior fossa surgery: case report.

    Science.gov (United States)

    Jito, Junya; Nitta, Naoki; Nozaki, Kazuhiko

    2014-01-01

    A polyethylene glycol (PEG) hydrogel sealant recently has been approved as an adjunct to sutured dural closure in Japan. We treated consecutive six patients with PEG hydrogel sealant in posterior fossa operation. Three of six cases suffered delayed cerebrospinal fluid (CSF) leak after watertight dural closure with the PEG hydrogel sealant, although there was no leak case which was treated with fibrin glue, before 2 years until the adoption of the new material. These patients underwent posterior fossa craniotomy and discharged without remarkable CSF leak. The pseudomeningocele under the occipital wound caused the CSF leak occurr from 5th to 7th week postoperatively. All CSF leak cases needed surgical repair. At the repair, the PEG hydrogel was liquefied and almost absorbed. A fistula on the closure line and a dead space after the absorption of the PEG hydrogel was observed. When the absorbable PEG hydrogel sealant plugs in small gaps of sutured dura, its properties to prevent adhesion might suppress healing process of dural closure, so that CSF could leak through the gaps and collect as a pseudomeningocele in the dead space after absorption of the PEG hydrogel. In posterior fossa surgery a PEG hydrogel sealant should be applied when dural edges are closed tightly without any gaps.

  7. Ictus en adultos jóvenes

    OpenAIRE

    García Olivera, Miguel

    2017-01-01

    Los accidentes cerebrovasculares suponen una causa importante de morbimortalidad en los países occidentales. A pesar de que ocurren frecuentemente en pacientes de edad avanzada, hay estudios recientes que indican un aumento en la incidencia de ictus en adultos jóvenes. A los factores de riesgo típicos de los ACV en adultos, como hipertensión arterial, diabetes, hiperlipoproteinemia o fibrilación auricular, hay que sumarles otros trastornos que aumentan la probabilidad de esta patología en pac...

  8. Diabetes mellitus en adultos mayores costarricenses

    OpenAIRE

    Gilbert Brenes-Camacho; Luis Rosero-Bixby

    2007-01-01

    El propósito del artículo es describir la prevalencia de la diabetes mellitus (DM) entre los adultos mayores costarricenses. Se analiza la magnitud de la prevalencia, los problemas de medición de la misma, así como los factores asociados con la enfermedad, la enfermedad controlada, y el tener niveles altos de hemoglobina glicosilada (HbA1C) entre la población sin diagnóstico previo de DM. Una cuarta parte de los adultos mayores de Costa Rica padecen de DM y cerca de la mitad de los que la pad...

  9. Cervical Myelopathy Caused by Intracranial Dural Arteriovenous Fistula

    Science.gov (United States)

    Kim, Won Young; Kim, Jin Bum; Nam, Taek Kyun; Kim, Young Baeg

    2016-01-01

    Intracranial dural arteriovenous fistula (dAVF) usually results in various problems in the brain. But it can be presented as a myelopathy, which may make early diagnosis and management to be difficult. We recently experienced a case of cervical myelopathy caused by intracranial dAVF. A 60-year-old man presented with a 3-year history of gait disturbance due to a progressive weakness of both legs. Neurological examination revealed spastic paraparesis (grade IV) and Babinski sign on both sides. Magnetic resonance imaging showed serpentine vascular signal voids at C2-T1 on T2-weighted image with increased signal intensity and swelling of spinal cord at C1-C4. We performed a brain computed tomography angiography and found intracranial dAVF with multiple arteriovenous shunts. Venous drainages were noted at tentorial veins and cervical perimedullary veins. After Onyx embolization, the patient showed gradual improvement in motor power and gait disturbance. The venous drainage pattern is a well-known prognostic factor of dAVF. In our case, the intracranial dAVF drained to spinal perimedullary vein, which seemed to result in the ischemic myelopathy. Although it is rare condition, it sometimes can cause serious complications. Therefore, we should keep in mind the possibility of intracranial dAVF when a patient presents myelopathy. PMID:27437016

  10. Cirurgia metabólica: cura para diabete tipo 2

    OpenAIRE

    Zeve,Jorge Luiz de Mattos; Tomaz, Carlos Alberto Bezerra

    2011-01-01

    INTRODUÇÃO: O diabete melito tipo 2 é doença metabólica caracterizada por hiperglicemia crônica que está associada com dano e insuficiência de vários órgãos. A evolução da doença é a causa mais comum de cegueira, amputações e insuficiência renal em adultos no ocidente, além de aumentar a incidência de infarto agudo do miocárdio e acidente vascular cerebral, com maior mortalidade dos pacientes. A associação dele com obesidade é relevante. Os pacientes obesos diabéticos quando submetidos ao tra...

  11. RESGATE VEGETATIVO POR ALPORQUIA DE GENÓTIPOS ADULTOS DE URUCUM (Bixa orellana L.

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    Nilton César Mantovani

    2010-01-01

    Full Text Available This study aimed to evaluate the usefulness of an air layering technique for vegetative rescue of annatto (Bixa orellana L. genotypes and obtainment of propagules for vegetative propagation. Ten 12 year-old annatto stock plants, whose genotypes are derived from artificial crossing between "Hairy-green capsule" X "Smooth-red capsule" were used in this study. Air layering adventitious roots were induced in branches (1-2 cm diameter using as substrate a mixture of vermiculite and moss. The effects of (1 the type of girdling (total or partial, 1 cm in length, (2 IBA (indole-3-butyric acid at 0 and 4.92 mM solution in paper filter and (3 the covering with either transparent or dark plastic films and tencel were evaluated. The technique of air layering provided rooted branches for the 10 genotypes evaluated, with efficiency ranging from 20 to 100%, and a genotype effect was observed on rooting frequency. Under greenhouse conditions, the survival of layers derived from totally girdled stems treated with IBA and protected with transparent plastic was 100%. Established layers provided vigorous branching from which shoot apexes or nodal segment explants were obtained for in vitro establishment and propagation of this species.

  12. Hipoglicemias de Ayuno en el Adulto

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    Alfredo Jácome Roca

    1987-08-01

    Full Text Available

    Las hipoglicemias espontáneas (o no inducidas por medicamentos pueden presentarse bien en ayunas o en estados postprandiales (como reacción a la ingesta por lo que se han llamado también reactivas o funcionales. Las hipoglicemias que se observan en estado de ayuno se han denominado en su mayoría “orgánicas”, pues usualmente tienen relación con alguna lesión tisular (tumor, necrosis, atrofia en donde además puede haber exceso o deficiencia de una o varias hormonas (1.

    La hipoglicemia orgánica más común es la asociada con los insulinomas (tumores productores de insulina, tema que he revisado previamente con algún detalle (2; igual he hecho con las reactivas y las farmacotóxicas (3. En este artículo me ocuparé de las hipoglicemias de ayuno (observadas en el adulto distintas a las del insulinoma. Son éstas las asociadas a hipofunción endocrina, con deficiencia de las hormonas contrarreguladoras de la insulina (hipopituitarismos, insuficiencia suprarrenal crónica, supresión del eje hipófisis-suprarrenales postadministración de esteroides, hiperplasia suprarrenal congénita; cuando hay producción excesiva de factores insulinosímiles de crecimiento, consumo excesivo de glucosa o lesiones que interfieren con la gluconeogénesis (como en la neoplasia masiva; trastorno de la producción hepática de glucosa (como en la enfermedad hepato celular severa; falla en la producción de glucosa, aumento de la vida media de la insulina (insuficiencia renal crónica; falla relativa de producción, consumo o pérdidas excesivas de glucosa (como se observa en el ejercicio severo, glicosuria renal, embarazo y ayuno prolongado, donde los descensos de la glicemia son usualmente asintomáticos.

    No existe una cifra específica por debajo de la cual se produzcan siempre síntomas, pero un nivel que podría servir de referencia es el de 45 mgrs/dl. Algunos pacientes acostumbrados a hipoglicemia crónica (insulinomas, síndrome de

  13. Bacterial Cellulose Membranes Used as Artificial Substitutes for Dural Defection in Rabbits

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    Chen Xu

    2014-06-01

    Full Text Available To improve the efficacy and safety of dural repair in neurosurgical procedures, a new dural material derived from bacterial cellulose (BC was evaluated in a rabbit model with dural defects. We prepared artificial dura mater using bacterial cellulose which was incubated and fermented from Acetobacter xylinum. The dural defects of the rabbit model were repaired with BC membranes. All surgeries were performed under sodium pentobarbital anesthesia, and all efforts were made to minimize suffering. All animals were humanely euthanized by intravenous injection of phenobarbitone, at each time point, after the operation. Then, the histocompatibility and inflammatory effects of BC were examined by histological examination, real-time fluorescent quantitative polymerase chain reaction (PCR and Western Blot. BC membranes evenly covered the surface of brain without adhesion. There were seldom inflammatory cells surrounding the membrane during the early postoperative period. The expression of inflammatory cytokines IL-1β, IL-6 and TNF-α as well as iNOS and COX-2 were lower in the BC group compared to the control group at 7, 14 and 21 days after implantation. BC can repair dural defects in rabbit and has a decreased inflammatory response compared to traditional materials. However, the long-term effects need to be validated in larger animals.

  14. Ossification of the Posterior Petroclinoid Dural Fold: A Cadaveric Study with Neurosurgical Significance

    Science.gov (United States)

    Kimball, David; Kimball, Heather; Matusz, Petru; Tubbs, R. Shane; Loukas, Marios; Cohen-Gadol, A. Aaron

    2015-01-01

    Objectives The roof of the porus trigeminus, composed of the posterior petroclinoid dural fold, is an important landmark to the skull base surgeon. Ossification of the posterior petroclinoid dural fold is an anatomical variation rarely mentioned in the literature. Such ossification results in the trigeminal nerve traversing a bony foramen as it enters Meckel cave. The authors performed this study to better elucidate this anatomical variation. Design Fifteen adult cadaveric head halves were subjected to dissection of the middle cranial fossa. Microdissection techniques were used to examine the posterior petroclinoid dural folds. Skull base osteology was also studied in 71 dry human skulls with attention paid to the attachment point of the posterior petroclinoid dural folds at the trigeminal protuberances. Setting Cadaver laboratory Main Outcome Measures Measurements were made using a microcaliper. Digital images were made of the dissections. Results Completely ossified posterior petroclinoid folds were present in 20% of the specimens. Of the 142 dry skull sides examined, 9% had large trigeminal protuberances. Conclusions Based on this study, the posterior petroclinoid dural fold may completely ossify in adults that may lead to narrowing of the porus trigeminus and potential compression of the trigeminal nerve at the entrance to Meckel cave. PMID:26225315

  15. Watertight dural closure! An in vitro study to explore the myth

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    Sudipkumar Sengupta

    2013-01-01

    Full Text Available Aim: The watertight closure of the dura mater is fundamental to intracranial supratentorial procedures in neurosurgery. Controversies exist claiming the superiority of one closure technique over another. But is ′Water-tight′ dural closure really achievable ? An in vitro study system was developed to test the pressures at which dural incisions, closed with sutures, leaked. Materials and Methods: Bovine dura was secured to the lower end of an open ended calibrated plastic cylinder. Multiple interrupted stitches were applied over a two 2 cm length of the dura without any incision. Similarly a 2 cm incision was made and closed with interrupted and continuous stitches. Cylinder was filled with colored saline gradually. Height of the water column at which sutured dura leaked was recorded. The tests were conducted with the dura both in lax and tense conditions. Inlay closure technique was also tested on the same model using a dural substitute. Results: Even without an incision, needle puncture sites over a dura, leak, at a very low hydrostatic pressure (30 < mm of H2O, though a continuous interlocking suture performs slightly better than an interrupted suture technique. If the needle puncture sites are closed with glue, both the suture techniques can achieve a watertight closure against a hydrostatic pressure of 240 mm of H2O. Conclusion : In the experimental model described, ′Water-tight′ dural closure appears to be impossible with suture closure of a dural defect.

  16. Immunohistochemical study in dural arteriovenous fistula and possible role of ephrin-B2 for development of dural arteriovenous fistula

    Institute of Scientific and Technical Information of China (English)

    Wuttipong Tirakotai 王宝隆; BIAN Liu-guan 卞留贯; Helmut Bertalanffy; Siegfried Bien; Ulrich Sure

    2004-01-01

    Background Although there were several clinical and experimental studies discussing the pathogenesis of dural arteriovenous fistula (DAVF), the pathological process leading to intracranial DAVF so far remains unknown. In this study, we investigated the expression of vascular growth factors in order to elucidate the possible role of these factors for the development of DAVF and to study the biological activity of this uncommon lesion.Methods We examined the histological features, proliferative and angiogenic capacities of the tissue specimens obtained from 6 patients who underwent surgery at our institution. Immunohistochemical staining for vascular endothelial growth factor (VEGF), its receptors Flk-1 and Flt-1, ephrin-B2, MIB-1 and proliferating cell nuclear antigen (PCNA) was performed using standard immunohistochemical techniques. Results A positive immunostaining was found for all antibodies studied except MIB-1, whereas nuclear endothelial expression of PCNA was observed in only 3/6 cases. VEGF stained positive in all of the available specimens (6/6). Flk-1 showed a positive immunoreaction in only 2/6 cases and Flt-1 in 4/6 cases. Ephrin-B2 was expressed in the majority (5/6) of the cases.Conclusions These results support the hypothesis that DAVFs might be acquired dynamic vascular malformations with low biological activity. Vascular growth factors like VEGF and ephrin-B2 might play a pivotal role in the formation of DAVF.

  17. Diabetes mellitus en adultos mayores costarricenses

    Directory of Open Access Journals (Sweden)

    Gilbert Brenes-Camacho

    2007-01-01

    Full Text Available El propósito del artículo es describir la prevalencia de la diabetes mellitus (DM entre los adultos mayores costarricenses. Se analiza la magnitud de la prevalencia, los problemas de medición de la misma, así como los factores asociados con la enfermedad, la enfermedad controlada, y el tener niveles altos de hemoglobina glicosilada (HbA1C entre la población sin diagnóstico previo de DM. Una cuarta parte de los adultos mayores de Costa Rica padecen de DM y cerca de la mitad de los que la padecen, no la tienen controlada. Los factores asociados con la prevalencia de la enfermedad son los usuales destacados por la literatura científica: actividad física, obesidad e historia familiar de DM. Se halla evidencia de un posible problema de acceso diferencial a servicios de control de DM, ya que los adultos mayores que habitan fuera de la gran área metropolitana de San José tienen un riesgo menor de tener controlada su enfermedad. Los adultos mayores sin pensión también tienen un riesgo mayor de tener niveles altos de HbA1C.

  18. Diabetes mellitus en adultos mayores costarricenses

    Directory of Open Access Journals (Sweden)

    Rosero-Bixby, Luis

    2007-07-01

    Full Text Available El propósito del artículo es describir la prevalencia de la diabetes mellitus (DM entre los adultos mayores costarricenses. Se analiza la magnitud de la prevalencia, los problemas de medición de la misma, así como los factores asociados con la enfermedad, la enfermedad controlada, y el tener niveles altos de hemoglobina glicosilada (HbA1C entre la población sin diagnóstico previo de DM. Una cuarta parte de los adultos mayores de Costa Rica padecen de DM y cerca de la mitad de los que la padecen, no la tienen controlada. Los factores asociados con la prevalencia de la enfermedad son los usuales destacados por la literatura científica: actividad física, obesidad e historia familiar de DM. Se halla evidencia de un posible problema de acceso diferencial a servicios de control de DM, ya que los adultos mayores que habitan fuera de la gran área metropolitana de San José tienen un riesgo menor de tener controlada su enfermedad. Los adultos mayores sin pensión también tienen un riesgo mayor de tener niveles altos de HbA1C.

  19. SVB en el adulto: parada cardiorespiratoria

    OpenAIRE

    2010-01-01

    Procedimiento a seguir ante una parada cardiorespiratoria en el adulto. El sujeto esta inconsciente, no respira y no presenta pulso. Compresiones toracicas y ventilaciones (30:2). Revalorización periódica cada dos minutos, hasta que acude el equipo de soporte vital avanzado.

  20. SVB en el adulto: parada respiratoria

    OpenAIRE

    2010-01-01

    Procedimiento a seguir ante una parada respiratoria en el adulto. El sujeto esta inconsciente, no respira pero presenta pulso. Ventilaciones cada 5 segundos y revalorización periódica del estado de la víctima, cada dos minutos.

  1. Sobrecarga y calidad de vida del cuidador principal del adulto mayor

    Directory of Open Access Journals (Sweden)

    Jack Roberto Silva Fhon

    2016-09-01

    Full Text Available Objetivo: Determinar la sobrecarga de trabajo y la calidad de vida del cuidador principal del adulto mayor atendido en un consultorio de geriatría. Metodología: Estudio cuantitativo, descriptivo, de corte transversal, realizado con 183 adultos mayores y sus respectivos cuidadores atendidos en un consultorio de geriatría. Para la recolección de los datos, fueron utilizados los instrumentos de perfil demográfico para el adulto mayor y su cuidador Escala de Zarit y The Medical Outcomes Study 36-item (sf-36. El análisis se realizó por medio de la estadística descriptiva y de la prueba de correlación de Spearman, con un nivel de significancia de p ≤ 0,05. Resultados: En los adultos mayores, hubo predominio del sexo masculino; la edad promedio fue de 74,8 años y estaban casados/as. En los cuidadores, predominó el sexo femenino; la edad promedio fue de 44,3 años. El total de cuidadores tenían estudios superiores, estaban casados/as y eran hijos/as de los adultos mayores. Según la evaluación con la Escala de Zarit, el 18,1% presentó algún tipo de sobrecarga; en cuanto a la calidad de vida, las dimensiones con menor puntuación fueron Salud general, Salud mental y Vitalidad. Se obtuvo una correlación inversa entre la puntuación total de la Escala de Zarit y todas las dimensiones de la calidad de vida. Conclusión: Se observó que el desgaste de la calidad de vida se debe a la sobrecarga en el cuidado del adulto mayor. Por lo tanto, se hace necesario acompañar el estado de salud de los cuidadores con la finalidad de prevenir alteraciones físicas y mentales.

  2. Valoración de impacto del programa de recuperación funcional en pacientes adultos mayores con depresión que ingresaron al Hospital del Día, del Hospital de Atención Integral del Adulto Mayor en el período Abril 2013 a Marzo 2014.

    OpenAIRE

    2015-01-01

    Objetivos: Evaluar el impacto del Programa de Recuperación Funcional, implementado en el Hospital del Día del Hospital de Atención Integral del Adulto Mayor, en los pacientes con diagnóstico de Depresión, en el periodo de Abril del 2013 a Marzo del 2014 . Materiales y métodos: Se realizó un estudio observacional, transversal de período, descriptivo e inferencial de tipo retro-prospectivo en pacientes adultos mayores deprimidos, fueron evaluados en forma global, abordando prioritariamente su e...

  3. Valoración de impacto del programa de recuperación funcional en pacientes adultos mayores con depresión que ingresaron al Hospital del Día, del Hospital de Atención Integral del Adulto Mayor en el período Abril 2013 a Marzo 2014.

    OpenAIRE

    Villarreal Cadena, Sonia del Rocío; Tituaña Cuichán, Aída del Pilar

    2015-01-01

    Objetivos: Evaluar el impacto del Programa de Recuperación Funcional, implementado en el Hospital del Día del Hospital de Atención Integral del Adulto Mayor, en los pacientes con diagnóstico de Depresión, en el periodo de Abril del 2013 a Marzo del 2014 . Materiales y métodos: Se realizó un estudio observacional, transversal de período, descriptivo e inferencial de tipo retro-prospectivo en pacientes adultos mayores deprimidos, fueron evaluados en forma global, abordando prioritariamente su e...

  4. Uso de medicamentos en adultos mayores de Bogotá, Colombia

    Directory of Open Access Journals (Sweden)

    Carlos Cano-Guitierrez

    Full Text Available Objetivos. Determinar la frecuencia y tipo de medicamentos que utiliza un grupo de adultos mayores que viven en lacapital colombiana, y cuáles son potencialmente inapropiados, con base en los criterios revisados de Beers. Materiales y métodos. Los datos fueron obtenidos del estudio SABE (estudio de salud, bienestar y envejecimiento que se llevó a cabo en áreas urbanas y rurales de Bogotá en el 2012. Se utilizó la prueba U de Mann-Whitney para analizar las diferencias por sexo en los diferentes grupo de edad con relación al número de medicamentos tomados. Resultados. Un total de 1268 (63,4% de los adultos mayores fueron mujeres; entre los participantes, 1514 (75,7% tenían 5 años de educación básica o menos. El promedio de medicamentos tomados en general fue de 3,24 siendo mayor en mujeres (3,50 que en hombres (2,79. Un total de 549 sujetos (27,4% reportaron recibir cinco medicamentos o más. De los medicamentos utilizados, 443 (6,9% eran potencialmente inapropiados de acuerdo con los criterios de Beers. La prevalencia autorreportada de hipertensión fue de 56,9% y para diabetes de 17,5%. Solo 311 sujetos (15,6% no tomaban ningún medicamento. Conclusiones. El uso de medicamentos inapropiados es un problema importante que afecta a los adultos mayores en Bogotá. Estudios adicionales deberán identificar factores que aumentan el riesgo de polifarmacia y uso inapropiado de medicamentos y diseñar intervenciones para prevenir el uso inapropiado de medicamentos entre adultos mayores.

  5. Estrategia educativa para incrementar el nivel de información sobre violencia intrafamiliar en los adultos mayores.

    Directory of Open Access Journals (Sweden)

    Yanelis Emilia Tabio Henry

    2015-09-01

    Full Text Available Se realizó una investigación cuasi experimental que comprendió de tres fases: la primera fase consistió en un estudio de tipo descriptivo longitudinal prospectivo a 32 adultos mayores que constituyen la muestra, que fueron atendidos en el Centro Comunitario de Salud Mental perteneciente al municipio de Jatibonico, provincia Sancti Spíritus. En la segunda fase se diseñó una estrategia educativa con participación comunitaria y en la tercera fase se realizó la evaluación de la estrategia, desde el 1ro de enero del 2010 al 31 de diciembre del 2012, con el objetivo de incrementar el nivel de información sobre violencia intrafamiliar en los adultos mayores. Los adultos mayores que fueron víctimas de violencia en su mayoría son mujeres, entre 70 -79 años, jubiladas, con vínculo conyugal. Los agresores fueron las hijas, que conviven con la víctima, siendo el maltrato psicológico el que predominó, el principal síntoma encontrado después del maltrato fue la insatisfacción con su vida. La estrategia educativa se caracterizó por elevar el nivel de información sobre la violencia intrafamiliar a los familiares de los adultos mayores violentados desde la perspectiva de trabajo educativo y comunitario.

  6. ''Dural tail'' adjacent to acoustic neuroma on MRI: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Lunardi, P. (Dept. of Neurological Sciences-Neurosurgery, Univ. ' ' La Sapienza' ' , Rome (Italy)); Mastronardi, L. (Dept. of Neurological Sciences-Neurosurgery, Univ. ' ' La Sapienza' ' , Rome (Italy)); Nardacci, B. (Dept. of Neurological Sciences-Neurosurgery, Univ. ' ' La Sapienza' ' , Rome (Italy)); Acqui, M. (Dept. of Neurological Sciences-Neurosurgery, Univ. ' ' La Sapienza' ' , Rome (Italy)); Fortuna, A. (Dept. of Neurological Sciences-Neurosurgery, Univ. ' ' La Sapienza' ' , Rome (Italy))

    1993-04-01

    A 'dural tail' on Gd-DTPA-enhanced MRI has been often observed adjacent to meningiomas and considered to be useful in distinguishing meningioma of the cerebellopontine angle from acoustic neuroma. However, demonstration of a dural tail adjacent to an acoustic neuroma indicates that this sign is not specific. (orig.)

  7. 231. Cirugía cardíaca en adultos con cardiopatías congénitas: ¿qué pacientes y patologías intervenimos actualmente?

    Directory of Open Access Journals (Sweden)

    E.C. Ruiz-Solano

    2012-04-01

    Conclusiones: La cirugía congénita sobre pacientes adultos representa una actividad de relevancia en la cirugía cardíaca de hoy día. Nuestros resultados evidencian que este tipo de intervenciones se puede llevar a cabo con una baja morbimortalidad.

  8. Sentido del humor en el adulto mayor

    Directory of Open Access Journals (Sweden)

    Catalina M. Labarca R.

    2012-09-01

    Full Text Available El humor es un fenómeno poco estudiado dentro del contexto de la psicología, menos aún, en el adulto mayor, grupo etario que se encuentra en constante crecimiento dentro de nuestro país.En tal sentido, la investigación, guiada por los planteamientos de Carbelo (2007 y DAnello (2010, denominada sentido del humor en el adulto mayor, tuvo por objetivo, determinar el significado que tiene este fenómeno para el adulto mayor. Para ello, se realizó un estudio de corte cualitativo,donde se utilizó la Entrevista en Profundidad como método de recolección de la información. Los informantes fueron 4 adultos mayores (2 hombres y 2 mujeres con edades comprendidas entre 60 y 73 años de edad, los cuales fueron seleccionados como una muestra de propósito. Para el análisis, se utilizó la Teoría Fundamentada, concluyéndose que para el adulto mayor, cuando el sentido del humor se convierte en parte de la personalidad, es un factor protector de la salud, da sentido de pertenencia y cambia positivamente el ambiente, trayendo como consecuencia una mejor calidad de vida, siendo esto último el principal significante que surgió del análisis de la información. Igualmente, se determinó que el sentido del humor es una construcción social que se va elaborando a lo largo de la vida y que se afianza en esta etapa vital.

  9. [Rapidly progressive dementia and parkinsonism associated to multiple dural arteriovenous fistulas].

    Science.gov (United States)

    Mejia, P; Piedra, L M; Merchan-Del Hierro, X

    2017-03-01

    Introduccion. Las demencias rapidamente progresivas son un grupo poco frecuente de enfermedades caracterizadas por un deterioro cognitivo y otras alteraciones neurologicas que evolucionan en el transcurso de semanas a meses. Su etiologia es diversa e incluye un gran numero de condiciones neurodegenerativas, toxicas, metabolicas, autoinmunes, infecciosas y vasculares. Caso clinico. Varon de 69 años, que ingreso por demencia rapidamente progresiva y parkinsonismo causado por multiples fistulas arteriovenosas durales tratadas exitosamente mediante terapia endovascular. Conclusion. Las fistulas arteriovenosas durales son conexiones anomalas entre las arterias durales y los senos venosos o venas corticales que constituyen una causa inusual de demencia rapidamente progresiva, pero que debe considerarse, dada la disponibilidad de un tratamiento especifico con reversion de los sintomas.

  10. Dural cavernous sinus fistulas. Diagnostic and endovascular therapy

    Energy Technology Data Exchange (ETDEWEB)

    Benndorf, Goetz [Baylor College of Medicine, Houston, TX (United States). Dept. of Radiology; Ben Taub General Hospital, Houston, TX (United States). Interventional Neuroradiology

    2010-07-01

    Dural cavernous sinus fistulas (DCSFs) represent a benign vascular disease, consisting in an arteriovenous shunt at the cavernous sinus. In the absence of spontaneous resolution, the fistula may lead to eye redness, swelling, proptosis, chemosis, ophthalmoplegia and visual loss. Although modern imaging techniques have improved the diagnostic, patients with low-flow DCSFs are still misdiagnosed. These patients can get erroneously treated for infections and inflammation for months or years and are at risk of visual loss. Early and proper diagnosis helps to avoid deleterious clinical course of the disease. This volume provides a complete guide to clinical and radiological diagnosis as well as to therapeutic management of DCSF with emphasis on modern minimal invasive treatment options. It commences with an informative description of relevant anatomy. After sections on the classification, etiology and pathogenesis of DCSF, the clinical symptomatology of the disease is described in detail. The role of modern non-invasive imaging tools is then addressed with the use of computed tomography, magnetic resonance imaging and ultrasound. Intra-arterial digital subtraction angiography (DSA), although invasive, remains the gold standard and is mandatory for clinical decision-making and strategy in endovascular treatment. Hence, a throughout consideration is given to both, 2D-DSA and 3D rotational angiography, including recent technological advancements such as Dual Volume (DV) imaging and angiographic computed tomography (ACT). After a short section on arteriovenous hemodynamics, the therapeutic management of DCSFs is described in detail. In particular, various transvenous techniques, required for successful endovascular occlusion of DCSF, are discussed in depth. This well-illustrated volume will be invaluable to all who may encounter DCSF in their clinical practice. (orig.)

  11. Endovascular and surgical treatment of spinal dural arteriovenous fistulas

    Energy Technology Data Exchange (ETDEWEB)

    Andres, Robert H. [University of Berne (Switzerland). Department of Neurosurgery; University of Berne (Switzerland). Department of Diagnostic and Interventional Neuroradiology; Stanford University Medical Center, Department of Neurosurgery, Stanford, CA (United States); University of Berne (Switzerland). Inselspital; Barth, Alain [University of Berne (Switzerland). Department of Neurosurgery; Medical University of Graz, Department of Neurosurgery, Graz (Austria); University of Berne (Switzerland). Inselspital; Guzman, Raphael [University of Berne (Switzerland). Department of Neurosurgery; Stanford University Medical Center, Department of Neurosurgery, Stanford, CA (United States); University of Berne (Switzerland). Inselspital; Remonda, Luca; El-Koussy, Marwan; Schroth, Gerhard [University of Berne (Switzerland). Department of Diagnostic and Interventional Neuroradiology; University of Berne (Switzerland). Inselspital; Seiler, Rolf W.; Widmer, Hans R. [University of Berne (Switzerland). Department of Neurosurgery; University of Berne (Switzerland). Inselspital

    2008-10-15

    The aim of this retrospective study was to evaluate the clinical outcome of patients with spinal dural arteriovenous fistulas (SDAVFs) that were treated with surgery, catheter embolization, or surgery after incomplete embolization. The study included 21 consecutive patients with SDAVFs of the thoracic, lumbar, or sacral spine who were treated in our institution from 1994 to 2007. Thirteen patients were treated with catheter embolization alone. Four patients underwent hemilaminectomy and intradural interruption of the fistula. Four patients were treated by endovascular techniques followed by surgery. The clinical outcome was assessed using the modified Aminoff-Logue scale (ALS) for myelopathy and the modified Rankin scale (MRS) for general quality of life. Patient age ranged from 44 to 77 years (mean 64.7 years). Surgical as well as endovascular treatment resulted in a significant improvement in ALS (-62.5% and -31.4%, respectively, p<0.05) and a tendency toward improved MRS (-50% and -32%, respectively) scores. Patients that underwent surgery after endovascular treatment due to incomplete occlusion of the fistula showed only a tendency for improvement in the ALS score (-16.7%), whereas the MRS score was not affected. We conclude that both endovascular and surgical treatment of SDAVFs resulted in a good and lasting clinical outcome in the majority of cases. In specific situations, when a secondary neurosurgical approach was required after endovascular treatment to achieve complete occlusion of the SDAVF, the clinical outcome was rather poor. The best first line treatment modality for each individual patient should be determined by an interdisciplinary team. (orig.)

  12. Modificaciones tegumentarias de larvas y adultos durante el cuidado parental en Minyobates virolinensis (Amphibia: Anura: Dendrobatidae Modificaciones tegumentarias de larvas y adultos durante el cuidado parental en Minyobates virolinensis (Amphibia: Anura: Dendrobatidae

    Directory of Open Access Journals (Sweden)

    Pérez Gloria R. de

    1992-09-01

    Full Text Available We studied the histology and cytology of the adult and tadpole skin during the transport of tadpoles by adult males of Minyobates virolinensis.  Integumentary modifications associated with this transport are seen in cells of the ventral larval epithelium. Of the four cellular types observed in the outer layer of the larval epidermis, two are associated with the attachment to the adult: type I cells have a complex of long microvilli anchored in an intertegumentary matrix, and type II cells have several secretory granules at the apical cellular surface and their secretion contributes to form this matrix. The other two types are found throughout the surface of the larval epidermis. The intertegumentary matrix (acid glycoproteins attach the tadpole to the nurse frog's back. The epidermis of the nurse frog is similar to that of adult males and females without tadpoles on the back; however, several corneal layers are accumulated on the skin surface of nurse frogs and two types of mucous glands secrete acid glycoproteins to the matrix. The intertegumentary matrix may originate from the tegument of both tadpole and adult. Se realiza el estudio histológico y citológico del tegumento de la larva y del adulto durante el transporte del renacuajo por el macho de Minyobates virolinensis. Se observan modificaciones tegumentarias asociadas a este transporte en células del epitelio ventral del renacuajo. Se describen cuatro tipos celulares en la capa más externa de la epidermis de la larva; dos de éstos están asociados con la adhesión al adulto: el tipo celular I tiene un complejo de microvellosidades largas ancladas en la matriz intertegumentaria, el tipo II contiene gránulos de secreción en la superficie apical de las células y su secreción contribuye a formar esta matriz. Los otros dos tipos celulares son comunes en toda la superficie de la epidermis larval. La matriz intertegumentaria (glicoproteínas ácidas prende al renacuajo sobre el dorso de

  13. Hypoxia facilitates neurogenic dural plasma protein extravasation in mice : a novel animal model for migraine pathophysiology

    OpenAIRE

    Anika Hunfeld; Daniel Segelcke; Ingo Bäcker; Badreddine Mecheri; Kathrin Hemmer; Elisabeth Dlugosch; Michael Andriske; Frank Paris; Xinran Zhu; Hermann Lübbert

    2015-01-01

    Migraine animal models generally mimic the onset of attacks and acute treatment processes. A guinea pig model used the application of meta-chlorophenylpiperazine (mCPP) to trigger immediate dural plasma protein extravasation (PPE) mediated by 5-HT2B receptors. This model has predictive value for antimigraine drugs but cannot explain the delayed onset of efficacy of 5-HT2B receptor antagonists when clinically used for migraine prophylaxis. We found that mCPP failed to induce dural PPE in mice....

  14. Dural Reduction Surgery: A Treatment Option for Frontotemporal Brain Sagging Syndrome.

    Science.gov (United States)

    Mostofi, Emily; Schievink, Wouter I; Sim, Valerie L

    2016-07-01

    Frontotemporal brain sagging syndrome is a dementia associated with hypersomnolence, personality changes, and features of intracranial hypotension on magnetic resonance imaging. The literature is sparse with respect to treatment options; many patients simply worsen. We present a case in which this syndrome responded to lumbar dural reduction surgery. Postoperative magnetic resonance imaging indicated normalization of brain sagging and lumbar intrathecal pressure. Although no evidence of cerebrospinal leak was found, extremely thin dura was noted intraoperatively, suggesting that a thin and incompetent dura could result in this low-pressure syndrome. Clinicians who encounter this syndrome should consider dural reduction surgery as a treatment strategy.

  15. Dural arteriovenous fistula at the foramen magnum: Report of a case and clinical-anatomical review.

    Science.gov (United States)

    Llácer, José L; Suay, Guillermo; Piquer, José; Vazquez, Victor

    2016-01-01

    Arterial supply and venous drainage at the foramen magnum is variable. Two main forms of clinical presentation, intracranial and spinal, can be differentiated when a dural arteriovenous fistula (DAVF) is found at this level. We describe a case of a 68-year-old patient with a progressive paraparesis, diagnosed of dural arteriovenous fistula located at the posterior lip of foramen magnum. We review, in this setting, the vascular radiological anatomy of those fistulas and its important correlation with neurologic clinical symptoms. Copyright © 2016 Sociedad Española de Neurocirugía. Published by Elsevier España. All rights reserved.

  16. Prevalência da escoliose lombar em adultos Prevalencia de la escoliosis lumbar en adultos Prevalence of lumbar scoliosis in adults

    Directory of Open Access Journals (Sweden)

    Djalma Castro de Amorim Junior

    2011-01-01

    Full Text Available OBJETIVO: Avaliar a prevalência da escoliose degenerativa do adulto (tipo de novo em uma amostra da população brasileira. MÉTODOS: foram estudados 1149 exames radiográficos simples de abdome na incidência anteroposterior, realizados no Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, no período de julho de 2008 a fevereiro de 2009. RESULTADOS: a prevalência da escoliose do adulto na amostra da população estudada foi de 1,74%, sendo maior na faixa etária entre 60 e 69 anos. Não foi observada diferença estatisticamente significativa (p = 0,41 entre os sexos, e a medida média do ângulo da escoliose foi de 19,1º. CONCLUSÃO: A PREVAlência da escoliose do adulto na amostra da população estudada está dentro dos resultados já apresentados na literatura.OBJETIVO: Evaluar la prevalenciade la escoliosis degenerativa del adulto (tipo de 'novo' en una muestra de la población. MÉTODOS: Se estudiaron 1149 radiografías de abdomen simple en proyección anteroposterior; esto se realizó en el Hospital de la Facultad de Medicina de Ribeirão Preto de julio de 2008 a febrero de 2009. RESULTADOS: La preponderanciade la escoliosis en la población de la muestra de adultos estudiados fue de 1,74%, siendo mayor en el grupo entre 60 y 69 años. No hubo diferencias significativas (p = 0,41 entre los sexos, y la medida promediodel ángulo de la escoliosis fue de 19,1º. CONCLUSIÓN: La prevalencia de la escoliosis en la muestra de adultos de la población estudiada está de acuerdo con los resultados presentados en la literatura.OBJECTIVE: to evaluate the prevalence of adult degenerative scoliosis (de novo in a sample of the population. METHODS: We studied 1149 plain anteroposterior abdominal radiographs in achieved in the Hospital das Clínicas of the Faculty of Medicine of Ribeirão Preto from July 2008 to February 2009. RESULTS: The prevalence of scoliosis in the adult population sample studied was 1.74%, being higher in the

  17. Intervenciones musicales para la ansiedad odontológica en pacientes pediátricos y adultos

    OpenAIRE

    Marta Sanjuán Navais

    2016-01-01

    La ansiedad odontológica ha sido identificada como un problema común tanto en niños como en adultos. La ansiedad odontológica se refiere a un estado de aprensión de que algo terrible va a suceder en relación con el tratamiento dental y se combina con una sensación de pérdida de control. Se informa que uno de cada seis adultos sufren algún tipo de ansiedad y en los niños entre un 5,7% y el 19,5%. Los pacientes con ansiedad odontológica tienden a descuidar el cuidado dental, lo cual plantea un ...

  18. Aprendizaje en adultos y participación social: una perspectiva austriaca

    Directory of Open Access Journals (Sweden)

    Werner LENZ

    2009-11-01

    Full Text Available RESUMEN: En paralelo con el aumento cuantitativo de la participación de los adultos en educación en la mayor parte de los países occidentales, el artículo destaca la necesidad de promover la vertiente cualitativa de este tipo de participación. Para ello se trata básicamente de promover un tipo de educación dirigida a personas adultas basada en el desarrollo de los aspectos afectivos y emocionales, de la interacción personal, del desarrollo de los procesos de auto-aprendizaje, concediendo un papel más activo al individuo; en suma, un tipo de educación que suponga, además de otros elementos, la construcción de conocimiento y la producción de cultura. El fondo del artículo destaca la idea de que la participación educativa de los adultos debe servir para promover un efectivo desarrollo democrático que trascienda el marco particular de cada país, contribuyendo, en nuestro contexto, al impulso de la Europa Unida.SUMMARY: Together whit the increase cuantitative of adult participation in the occidental countries, this article proposes the necessity to promote a type of eduction for adults persons that develop emotional and affective aspects, to develop self-learning processes and facilitate personal interactions in social context. Specificaly the acquisition of information and the construction of knowledge and, also, producing of culture. This kind of adult education must contribute to effective effort to expand democratic particpation into European Union.

  19. Bienestar Subjetivo en Adultos Mayores Venezolanos

    Directory of Open Access Journals (Sweden)

    Marisela Virginia Arraga Barrios

    2010-01-01

    Full Text Available Se determinó el bienestar subjetivo de adultos mayores venezolanos, mediante estudio descriptivo, no experimental, de campo, con 633 personas entre 60 y 85 años a quienes se les aplicó la Escala de felicidad de Lima-adaptada. Los resultados mostraron que el 78,4% de los participantes posee alto nivel de Bienestar subjetivo, el 19,6% moderado y el 2,1% bajo. De las cuatro dimensiones que conforman la variable, "Satisfacción con la vida", "Alegría de vivir" y "Sentido positivo de la vida" obtuvieron puntajes superiores al 62%, mientras que "Realización personal" alcanzó el 51%. Esto sugiere un alto nivel de felicidad en adultos mayores venezolanos y reflejan el regocijo y complacencia por los logros alcanzados en su vida, lo que pudiera constituirse en un predictor de salud, interesante de indagar.

  20. LA AMBIDIESTRÍA EN ADULTOS

    Directory of Open Access Journals (Sweden)

    NIXON OSORIO ROJAS

    2015-03-01

    Full Text Available El resultado de la ambidiestria en un adulto podría ser difícil ver, pero el siguiente texto nos da a entender que si se pude llagar a ese estado, con una prueba  y con un resultado como el que tenemos en el siguiente texto.  Que nos regala pruebas de su desarrollo en una edad avanzada

  1. The in vivo effect of adrenomedullin on rat dural and pial arteries

    DEFF Research Database (Denmark)

    Juhl, L.; Petersen, K. A.; Larsen, E. H.

    2006-01-01

    Adrenomedullin is related to the calcitonin gene-related peptide (CGRP) family and is present in cerebral blood vessels. It may be involved in migraine mechanisms. We measured the change in dural and pial artery diameter, mean arterial blood pressure and local cerebral blood flow flux (LCBFFlux...... adrenomedullin-(22-52). I.v. infusion of 15 µg kg- 1 adrenomedullin (n = 8) induced dilatation of dural (32 ± 7.5%) and pial (18 ± 5.5%) arteries, a reduction in mean arterial blood pressure (19 ± 3%) and an increase in LCBFFlux (16 ± 8.4%). The duration of the responses was 25 min for the dural artery, while...... arterial blood pressure. No significant inhibition of LCBFFlux was found. The antagonist alone had no effect on mean arterial blood pressure or LCBFFlux. In conclusion, we suggest that adrenomedullin in the rat cranial circulation dilates dural and pial arteries, reduces mean arterial blood pressure...

  2. Imaging findings in patients with ventral dural defects and herniation of neural tissue

    Energy Technology Data Exchange (ETDEWEB)

    Baur, A.; Staebler, A.; Reiser, M. [Department of Diagnostic Radiology, Klinikum Grosshadern, Ludwig-Maximilians-Universitaet, Marchioninistrasse 15, D-81 377 Munich (Germany); Psenner, K. [Department of Diagnostic Radiology, Allgemeines Regionalkrankenhaus Bozen (Italy); Hamburger, C. [Department of Neurosurgery, Klinikum Grosshadern, Ludwig-Maximilians-Universitaet, Marchioninistrasse 15, D-81 377 Munich (Germany)

    1997-10-01

    The aim of this paper is to describe clinical and imaging findings in three patients with ventral dural defects and herniation of the spinal cord or cauda equina. The literature is reviewed and the clinical, radiological and operative findings are compared. Three patients with ventral dural defects of different etiologies are presented. One patient gave a longstanding history of ankylosing spondylitis, the second patient presents 37 years after spinal trauma, and the third patient presents with spontaneous spinal cord herniation. All patients had typically slowly progressive neurological symptoms with multiple hospitalizations until diagnosis was made. Characteristic findings in postmyelographic CT included a ventral or ventrolateral displacement with deformation of the spinal cord or the cauda equina. Sagittal MRI showed this abrupt and localized anterior deviation of the spinal cord or the cauda equina to the posterior portions of a vertebral body with or without a bony vertebral defect optimally. Additionally, due to the ventral displacement of the spinal cord, the dorsal subarachnoid space was relatively enlarged without evidence of an arachnoid cyst, in all patients. Magnetic resonance imaging and postmyelographic CT can diagnose ventral dural defects with spinal cord herniation or nerve root entrapment. Dural defects must be considered in the presence of neurological symptoms in cases of longstanding ankylosing spondylitis, late sequelae of fractures of vertebral bodies, and without history of spinal trauma or surgery. (orig.). With 3 figs.

  3. Endovascular management of dural fistulas into the cavernous sinus. A systematic review

    Directory of Open Access Journals (Sweden)

    Moscote-Salazar Luis Rafael

    2014-06-01

    Full Text Available Background: Dural fistula to the cavernous sinus (DFCS is an infrequent pathology that consists in the anomalous communication between the meningeal branches of the internal carotid artery (ICA and/or the external carotid artery (ECA and the cavernous sinus. Aim: To perform a systematic review to evaluate clinical and imaging findings in DFCS, and current indications for treatment.

  4. Dural sinus thrombosis - A rare manifestation of internal jugular venous occlusion

    Directory of Open Access Journals (Sweden)

    Pooja Binnani

    2012-01-01

    Full Text Available The dural sinus thrombosis is an uncommon complication of a commonly done procedure of central venous catheterisation. We present a case of massive hemorrhagic venous infarct with gross cerebral edema due to dural sinus thrombosis along with right internal jugular vein thrombus. A 21-year-old male patient presented to the emergency department with fever and swelling of the right neck four days following discharge after his prior hospitalization two weeks ago for acute renal failure due to severe gastroenteritis, when he underwent hemodialysis through right internal jugular access. On presentation, he was conscious, with swelling on right side of the neck, which was diagnosed as right internal jugular vein occlusion. However, he rapidly dete-riorated and developed signs of raised intracranial pressure despite being on treatment with heparin. He was diagnosed as having massive hemorrhagic cerebral venous infarct with gross cerebral edema complicated with shift of the ventricles to the left due to dural sinus thrombosis. Despite emergency decompressive craniotomy, he succumbed in the next two days due to coning. Asymptomatic catheter-related thrombosis is frequent in the intensive care units, but major complications like retrograde extension into dural sinus causing thrombosis is rare. A high index of suspicion is required to diagnose this major catastrophe for an early and meaningful intervention.

  5. Surgical resection without dural reconstruction of a lumbar meningioma in an elderly woman

    Science.gov (United States)

    Takahashi, Jun; Kato, Hiroyuki; Ebara, Sohei; Takahashi, Hideto

    2009-01-01

    Meningiomas of the spine occur in the thoracic spine in approximately 80%, followed in frequency by the cervical and lumbar regions. The treatment of spinal meningiomas is complete surgical resection. As intraspinal meningiomas are almost always adherent to the dura, extensive dural resection or diathermic treatment of the dural attachment is usually performed to prevent tumor recurrence. The authors present the case of lumbar spinal meningioma in 82-year-old woman. Successful resection with preservation of the dura mater using the technique of Saito et al. (Spine 26:1805-1808, 2001) is described: After lumbar laminectomy a small incision was made in the surface of the spinal dura. The dura mater was separated into its inner and outer layers, and the tumor was resected with inner layer alone, preserving the outer layer. The outer layer is simply closed to achieve a watertight seal. The pathologic diagnosis was metaplastic (osseous) meningioma. Almost full recovery of the neurologic deficit was attained. Neither complication nor tumor recurrence has occurred in the 5 years since surgery. Dural preservation during surgical resection of spinal meningioma obviates the need for dural reconstruction and should reduce surgical morbidity. However, the patient should be followed long-term to watch for recurrence. PMID:19219468

  6. [Childhood transverse sinus dural arteriovenous fistula treated with endovascular and direct surgery: a case report].

    Science.gov (United States)

    Niizuma, Kuniyasu; Sakata, Hiroyuki; Koyama, Shinya; Kon, Hiroyuki; Chonan, Masashi; Sasaki, Tatsuya; Nishijima, Michiharu; Ezura, Masayuki; Tominaga, Teiji

    2012-11-01

    Infantile dural arteriovenous fistula is a rare cerebrovascular malformation carrying a poor prognosis with an anatomic cure of only 9%. Endovascular embolization is mainly selected to treat this entity, aiming to obtain normal development of the patients. We present a case of a 20-month-old girl with epilepsy. Digital subtraction angiography revealed a dural arteriovenous fistula involving the right transverse sinus. The arteriovenous fistula was fed by multiple dural branches from the middle meningeal, occipital, meningohypophyseal, and anteroinferior cerebellar arteries. The right transverse sinus was transvenously embolized with platinum coils. Although the shunt flow remained, the patient was liberated from epilepsy. Nine months later, the patient suffered from a recurrence of epilepsy. Digital subtraction angiography demonstrated some increase in shunt flow. Right middle meningeal, occipital, posterior deep temporal, and tentorial arteries were transarterially embolized using N-butyl cyanoacrylate, followed by complete surgical resection of the right transverse sinus. The shunt flow disappeared after surgery, and her epilepsy improved significantly. Our experience suggests that the combination of endovascular and surgical treatment is effective for recurrent infantile dural arteriovenous fistula.

  7. Differentiating the headache of cerebral venous thrombosis from post-dural puncture: A headache for anaesthesiologists

    Directory of Open Access Journals (Sweden)

    Khaja Mohideen Sherfudeen

    2016-01-01

    Full Text Available Cerebral venous thrombosis (CVT is a rare complication of lumbar puncture. Occasionally, the clinical picture of CVT may mimic post-dural puncture headache (PDPH resulting in delayed diagnosis. A case of PDPH progressing to CVT is presented and the pathophysiology, diagnostic challenges and management options discussed in this article.

  8. Insertion of an intrathecal catheter following accidental dural puncture : a meta-analysis

    NARCIS (Netherlands)

    Heesen, M.; Kloehr, S.; Rossaint, R.; Walters, M.; Straube, S.; van de Velde, M.

    2013-01-01

    Background: Inserting an intrathecal catheter after accidental dural puncture in parturients to prevent postdural puncture headache is becoming increasingly popular. We aimed to identify relevant published articles investigating this intervention and subject data to a meta-analysis. Methods: A syste

  9. Dural-based infantile hemangioma of the posterior fossa: Case report

    Directory of Open Access Journals (Sweden)

    Hakeem J Shakir

    2016-01-01

    Conclusion: Although hemangiomas are benign entities, our patient′s lesion was in the posterior fossa causing compression and hydrocephalus that necessitated resection. We encourage others to consider the possibility of hemangioma in the differential diagnosis of dural-based posterior fossa lesions in infants.

  10. 28 CASES OF TRAUMATIC POSTERIOR FOSSA EXTRA DURAL HEMATOMA OUR EXPERIENCE : CASE SERIES

    Directory of Open Access Journals (Sweden)

    Hayagriva

    2015-04-01

    Full Text Available A retrospective study of 28 1 cases of traumatic posterior fossa Extra dural hematoma 2,3 in K ing George Hospital, V isakhapatnam from A ugust 2012 to February 2015 . This study was aimed to present the experience in treating patients with traumatic posterior fossa extra dural hematoma 2 and to discuss the clinical features, risk factors 4 and outcome . 5 Posterior fossa e xtradural hematoma 2,3 uncommon but potentially fatal condition. The incidence of posterior fossa extra dural hematoma 2,3 among intracranial extra dural hematomas has been reported 4% to 7%. Occipital skull bone fracture with venous sinus bleeding that resulted in a posterior fossa extradural haematoma . 2 low Gcs [or] hematoma more than 10ml were subjected to evacuation . Since the volume of the posterior fossa 6 is small, patients deteriorate early because of compression of vital structures in the brain stem, development of obstructive hydrocephalus, which is visible in the CT scan in only thirty percent of cases

  11. Recurrence Rates After Surgical or Endovascular Treatment of Spinal Dural Arteriovenous Fistulas : A Meta-analysis

    NARCIS (Netherlands)

    Bakker, Nicolaas A.; Uyttenboogaart, Maarten; Luijckx, G. J.; Eshghi, Omid S.; Mazuri, Aryan; Metzemaekers, Jan D. M.; Groen, Rob J. M.; Van Dijk, J. Marc C.

    2015-01-01

    BACKGROUND:There is an increasing tendency to treat spinal dural arteriovenous fistulas (SDAVFs) endovascularly despite the lack of clear evidence favoring embolization over surgery.OBJECTIVE:To compare the initial failure and recurrence rates of primary treatment of SDAVFs by surgery and endovascul

  12. A dural lymphatic vascular system that drains brain interstitial fluid and macromolecules.

    Science.gov (United States)

    Aspelund, Aleksanteri; Antila, Salli; Proulx, Steven T; Karlsen, Tine Veronica; Karaman, Sinem; Detmar, Michael; Wiig, Helge; Alitalo, Kari

    2015-06-29

    The central nervous system (CNS) is considered an organ devoid of lymphatic vasculature. Yet, part of the cerebrospinal fluid (CSF) drains into the cervical lymph nodes (LNs). The mechanism of CSF entry into the LNs has been unclear. Here we report the surprising finding of a lymphatic vessel network in the dura mater of the mouse brain. We show that dural lymphatic vessels absorb CSF from the adjacent subarachnoid space and brain interstitial fluid (ISF) via the glymphatic system. Dural lymphatic vessels transport fluid into deep cervical LNs (dcLNs) via foramina at the base of the skull. In a transgenic mouse model expressing a VEGF-C/D trap and displaying complete aplasia of the dural lymphatic vessels, macromolecule clearance from the brain was attenuated and transport from the subarachnoid space into dcLNs was abrogated. Surprisingly, brain ISF pressure and water content were unaffected. Overall, these findings indicate that the mechanism of CSF flow into the dcLNs is directly via an adjacent dural lymphatic network, which may be important for the clearance of macromolecules from the brain. Importantly, these results call for a reexamination of the role of the lymphatic system in CNS physiology and disease.

  13. Crescimento de genótipos de frangos tipo caipira

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    R. C. Veloso

    2015-10-01

    Full Text Available RESUMOObjetivou-se com este trabalho comparar o padrão de crescimento, mediante ajustes das respectivas curvas de crescimento por modelos não lineares, bem como estudar o desenvolvimento de cortes de carcaça em relação ao peso da carcaça em diferentes genótipos de frangos tipo caipira. Foram utilizados 840 pintos de um dia, machos, distribuídos em delineamento inteiramente ao acaso, dos seguintes genótipos da linhagem Redbro: Caboclo, Carijó, Colorpak, Gigante Negro, Pesadão Vermelho, Pescoço Pelado e Tricolor. As aves foram alojadas em 28 boxes, sendo 30 aves/boxe, em galpão de alvenaria com acesso a um piquete de 45m², com quatro repetições. O peso corporal individual dos frangos foi medido ao nascer, aos 14, 28, 42, 56, 70 e 84 dias de idade. Para a determinação das curvas de crescimento do peso corporal das aves, os dados coletados foram avaliados por meio dos modelos não lineares: Brody, Gompertz, Logístico, Richards e von Bertalanffy. Foi empregado o PROC NLIN do SAS, utilizando-se o método interativo de Gauss-Newton. Os critérios usados para escolha do modelo de melhor ajuste da curva de crescimento foram o coeficiente de determinação, o desvio padrão assintótico, o desvio médio absoluto dos resíduos e o índice assintótico. As análises para obtenção dos coeficientes alométricos foram realizadas por meio do PROC GLM do SAS para os genótipos Carijó, Colorpak, Pesadão Vermelho, Pescoço Pelado e Tricolor. Foram avaliados os pesos da carcaça, do peito, das coxas, das sobrecoxas, das pernas e das asas das aves abatidas aos 85 dias de idade. Apenas as equações propostas por Gompertz, von Bertalanffy e Logístico atingiram a convergência, e o modelo proposto por von Bertalanffy foi o mais adequado para descrever o crescimento dos genótipos de frangos caipiras. Todos os cortes avaliados apresentaram crescimento tardio em relação ao peso da carcaça em genótipos de frangos tipo caipira.

  14. Experimental inflammation following dural application of complete Freund's adjuvant or inflammatory soup does not alter brain and trigeminal microvascular passage

    DEFF Research Database (Denmark)

    Lundblad, Cornelia; Haanes, Kristian A; Grände, Gustaf

    2015-01-01

    , following dural application of complete Freund's adjuvant (CFA) or inflammatory soup (IS) on brain and trigeminal microvascular passage. METHODS: In order to address this issue, we induced local inflammation in male Sprague-Dawley-rats dura mater by the addition of CFA or IS directly on the dural surface......) in a major way. However, [(51)Cr]-EDTA readily passed the TG by >30 times compared to the CNS. Application of CFA or IS did not show altered transfer constants. CONCLUSIONS: With these experiments we show that dural IS/CFA triggered TG inflammation, did not increase the BBB passage, and that the TG...

  15. Los adultos con discapacidad motriz y sus familiares: la organización del hogar, los afectos y el trabajo

    OpenAIRE

    María Pía Venturiello

    2014-01-01

    El objetivo de este artículo es analizar las percepciones de los adultos con discapacidad motriz mayores de 50 años y sus familiares acerca de las principales dificultades que encuentran en su desempeño laboral, familiar y en la organización del hogar, según aspectos económicos y sociales en el Gran Buenos Aires. Para cumplir con este objetivo se desarrolló un abordaje metodológico de tipo cualitativo. Se entrevistó a 39 personas con discapacidad motriz y a 17 familiares. Los resultados indic...

  16. Determinantes sociales de salud y consumo de alimentos en adultos mayores concurrentes a centros de jubilados de Mar del Plata

    OpenAIRE

    Bigne, Sofía

    2014-01-01

    La OMS (2005) define los Determinantes Sociales de Salud como las condiciones en que las personas nacen, crecen, viven, trabajan y envejecen, incluidos el sistema de salud. Objetivo: Identificar los determinantes sociales que caracterizan a la población de adultos mayores que asisten a diferentes centros de jubilados de la ciudad de Mar del Plata durante el 2014 y su perfil de salud. Material y métodos: El presente trabajo de investigación es de tipo descriptivo y de c...

  17. Evaluación de los contactos interoclusales en modelos articulados de pacientes adultos-jóvenes

    OpenAIRE

    Tarazona Cebrián, Rossy; Ortiz Culca, Fernando

    2009-01-01

    Objetivo: Determinar el número y tipo de contactos interoclusales en modelos de adultos-jóvenes montados en articulador semajustable. Material y método: La muestra estuvo constituida por 19 alumnos de la Facultad de Odontología de la Universidad de San Martín de Porres con dentición permanente natural completa. Se tomaron impresiones de ambas arcadas con silicona de adición (Elite Zhermac); el vaciado se realizó con yeso extraduro (Fujirock); los modelos fueron troquelados con bipine...

  18. Estrategia educativa para incrementar el nivel de información sobre violencia intrafamiliar en los adultos mayores.

    OpenAIRE

    Yanelis Emilia Tabio Henry; Ester L. Cabrera Pedraza; Manuel Antonio Cruz Hernández

    2015-01-01

    Se realizó una investigación cuasi experimental que comprendió de tres fases: la primera fase consistió en un estudio de tipo descriptivo longitudinal prospectivo a 32 adultos mayores que constituyen la muestra, que fueron atendidos en el Centro Comunitario de Salud Mental perteneciente al municipio de Jatibonico, provincia Sancti Spíritus. En la segunda fase se diseñó una estrategia educativa con participación comunitaria y en la tercera fase se realizó la evaluación de la estrategia, desd...

  19. Establishment of an animal model of dural venous sinus embolism

    Institute of Scientific and Technical Information of China (English)

    Peixian Zhang; Chongzhi Zhang; Yi Qin; Quanrui Ma; Jianying Du; Ying Cai

    2008-01-01

    BACKGROUND: The pathological mechanism of secondary brain lesion following an embolism remains unclear. The establishment of an animal model that imitates the clinical pathophysiological processes is crucial to better study this disease during a certain time window.OBJECTIVE: To establish a new animal model of dural venous sinus embolism that is simple, has a high success rate, and emulates the pathophysiological course of clinical disease.DESIGN, TIME AND SETTING: A randomized block design trial was performed at the Department of Anatomy, Ningxia Medical College between March and December 2007.MATERIALS: Fifty-eight healthy, adult, Sprague Dawley rats were used in the present study. Plastic emboli, with a total length of 0.4cm, were self-made. Each plastic embolus had a conical anterior segment; the largest diameter being 0.12cm. The posterior segment became gradually thin and flat, with a width of 0.2cm and length of 0.1cm.METHODS: The fifty-eight rats were randomly divided into three groups: control (n=6), embolism (n=26), and sham-embolism (n=26) groups. In the embolism group, a solid embolus was slowly inserted and fixed into the posterior part of the superior sagittal sinus against the flow of blood. The posterior segment was detained outside the superior sagittal sinus for fixing. In the sham-embolism group, rats were subjected only to sinus sagittalis superior exposure. In the control group, rats received no treatments. In both the embolism and the sham-embolism groups, the rat brains were resected at 6 hours, 1,3, and 5 days post-surgery.MAIN OUTCOME MEASURES: (1) Brain surface appearance in the embolism and sham-embolism groups. (2) Thrombosis in the embolism group. (3) Cerebrospinal fluid content in the above-mentioned two groups.RESULTS: In the embolism group, the model success rate was 92%(24/26). There was visible thrombosis in the superior sagittal sinus. Cerebral edema was noticeable under a microscope. These changes were visible at 6 hours after

  20. Caracterización de la familia del adulto mayor

    Directory of Open Access Journals (Sweden)

    Yahima Limia Núñez

    2014-08-01

    Full Text Available El envejecimiento en la familia constituye un problema mundial y nacional, teniendo en cuenta esa premisa se realizó un estudio de tipo descriptivo, con el uso de técnicas cuantitativas y cualitativas, para caracterizar las familias donde viven adultos mayores, pertenecientes al área de salud del policlínico docente Dr. Gustavo Aldereguía Lima. Se seleccionaron al azar diez familias del área incluida en el consultorio médico de la familia 94-01 que cumplieran con los criterios de inclusión, las que se caracterizaron a través de las variables socio-psicológicas: estructura, crisis, funcionamiento y percepción familiar; los datos se obtuvieron a partir de las técnicas de entrevista a la familia, la prueba de percepción de funcionamiento familiar (FF-SIL y la prueba de percepción de las relaciones familiares. En las familias estudiadas predominó la existencia de una estructura pequeña; nuclear y unigeneracional; multigeneracional. Las funciones que mejor cumplieron las familias fueron la económica y la educativo-cultural; y las crisis normativas que predominaron fueron la jubilación, el envejecimiento y la enfermedad. El funcionamiento familiar que prevaleció fue el funcional; los indicadores más afectados fueron los roles, la permeabilidad, la comunicación y la adaptabilidad; en la percepción familiar predominaron las familias armónicas, seguidas de las poco armónicas. Los indicadores más afectados fueron el sistema de apoyo, la comunicación y el desempeño de roles. Se concluyó que las familias presentaron fundamentalmente una estructura pequeña y nuclear, son funcionales y son armónicas

  1. Hipertensión arterial y estilo de vida en adultos mayores de la Micro Red de Salud Revolución San Román, Juliaca - 2015

    OpenAIRE

    Zela Ari, Luzmila; E.P. Enfermeria, Universidad Peruana Unión - Juliaca; Mamani Chambi, Wilfreda; Mamani Limachi, Ruth Ester

    2016-01-01

    El objetivo de este estudio fue determinar la relación entre Hipertensión Arterial y Estilo de vida en adultos mayores. La Metodología utilizada fue de tipo no experimental, corte transversal y correlacional. La muestra estuvo conformada por 103 adultos mayores de 60 años a 90 de edad a quiénes se aplicó el cuestionario de perfil de estilo de vida (PEPS_I) de Nola Pender adaptada que consta de 6 dimensiones: responsabilidad en salud, ejercicio, nutrición, manejo de estrés, no consumo de tabac...

  2. Hipertensión arterial y estilo de vida en adultos mayores de la Micro Red de Salud Revolución San Román, Juliaca - 2015

    OpenAIRE

    Zela Ari, Luzmila; E.P. Enfermeria, Universidad Peruana Unión - Juliaca; Mamani Chambi, Wilfreda; Mamani Limachi, Ruth Ester

    2016-01-01

    El objetivo de este estudio fue determinar la relación entre Hipertensión Arterial y Estilo de vida en adultos mayores. La Metodología utilizada fue de tipo no experimental, corte transversal y correlacional. La muestra estuvo conformada por 103 adultos mayores de 60 años a 90 de edad a quiénes se aplicó el cuestionario de perfil de estilo de vida (PEPS_I) de Nola Pender adaptada que consta de 6 dimensiones: responsabilidad en salud, ejercicio, nutrición, manejo de estrés, no consumo de tabac...

  3. Temporal-based pericranial flaps for orbitofrontal Dural repair: A technical note and Review of the literature

    Directory of Open Access Journals (Sweden)

    Esther Dupépé

    2016-03-01

    Conclusions: A temporal-based pericranial flap represents an alternative vascularized pedicle flap to the classic frontal-based pericranial flap used in orbitofrontal dural repair. In certain clinical settings, the temporal-based flap may be preferable.

  4. Delimitação entre os lenhos juvenil e adulto de Pinus elliottii engelm

    Directory of Open Access Journals (Sweden)

    Gilmara Pires de Moura Palermo

    2013-02-01

    Full Text Available Durante o crescimento, as árvores produzem diferentes tipos de tecido lenhoso. O xilema produzido nos primeiros anos até certa idade cambial é denominado lenho juvenil e apresenta propriedades físicas, mecânicas, químicas e anatômicas diferentes do xilema produzido após certa idade cambial, isto é, quando as células do câmbio já amadureceram. Dessa forma, um prévio conhecimento sobre a qualidade da matéria-prima produzida é de fundamental importância para melhor aplicabilidade do material. Com base nesse contexto, este trabalho objetivou, a partir de dados de comprimento de traqueídeos e densidade da madeira, delimitar a idade de transição entre os lenhos juvenil e adulto. Para isso, coletaram-se três árvores de Pinus elliottii var. elliottii Engelm., com 35 anos de idade, provenientes da Estação Experimental de Itapetininga, localizada em São Paulo, Brasil. De cada árvore, retiraram-se discos de aproximadamente 5 cm de espessura, extraídos a 0,05 m do solo, que foram utilizados para determinação radial da densidade pelo método de atenuação da radiação gama e comprimento dos traqueídeos. Os resultados da análise de regressão linear indicaram que o lenho juvenil está limitado aos sete primeiros anos de crescimento da árvore e o lenho adulto é formado após os 20 anos de idade. No lenho adulto há diferenças significativas entre as idades médias obtidas através do comprimento dos traqueídeos e da densidade da madeira.

  5. Prevalencia de polifarmacia en adultos mayores residentes de asilos de Hermosillo, Sonora

    Directory of Open Access Journals (Sweden)

    Andrés Canale Segovia

    2014-12-01

    Full Text Available El término polifarmacia se refiere a la utilización de múltiples fármacos por una persona, de manera constante. Debido a que los adultos mayores constituyen el grupo etario con mayor prevalencia de enfermedades crónico-degenerativas, la polifarmacia es un fenómeno común en poblaciones geriátricas. No se conoce con precisión cuál es la prevalencia en un grupo de ancianos asilados del estado de Sonora. Se realizó un estudio transversal, para estimar la prevalencia de polifarmacia en una muestra no probabilística de adultos mayores residentes de asilos de ancianos de Hermosillo, Sonora. La prevalencia de polifarmacia (definida como consumo concomitante de 4 o más fármacos fue de 36.1%, sin diferencias significativas respecto al tipo de enfermedades crónicas padecidas, así como a la edad y sexo de los ancianos asilados. Los sujetos con polifarmacia tuvieron un exceso de riesgo, superior a 10 veces, cuando la prescripción farmacológica era realizada por más de un médico, y tuvieron 5 veces más probabilidad de presentar algún efecto adverso a medicamentos respecto a los sujetos con ausencia de polifarmacia. La polifarmacia es un fenómeno que requiere mayor atención, control e investigación futura, toda vez que los adultos mayores son el grupo poblacional con mayor tendencia de crecimiento en México.

  6. Transvenous Coil Embolization for Dural Arteriovenous Fistulas of the Ophthalmic Sheath: Report of Two Cases and Review of the Literature

    Science.gov (United States)

    Hwang, Juyoung; Jo, Kyung-Il; Yeon, Je Young; Hong, Seung-Chyul

    2016-01-01

    We present two patients with a dural arteriovenous fistula (dAVF) of the ophthalmic sheath who developed progressive exophthalmos, conjunctival chemosis, and visual loss. These symptoms mimic those of cavernous sinus dAVFs. Dural AVFs of the ophthalmic sheath are extremely rare and their clinical management is controversial. We successfully treated these two patients by transvenous coil embolization. Transvenous embolization appears to be a safe and effective method to treat dAVFs of the ophthalmic sheath.

  7. El dolor en el adulto mayor.

    OpenAIRE

    José Alfonso Maestre

    2009-01-01

    Se hace una revisión del dolor en el adulto mayor como grupo poblacional en aumento, destacando aspectos generales y comparativos con otros grupos de edad. Se revisan tópicos básicos como clasificaciones, cuantificaciones, fisiopatología y se resalta el manejo de equipo, mencionando como parte primordial el componente de rehabilitación que en muchas ocasiones no se tiene en cuenta como método terapéutico de elección durante el manejo conservador del dolor en personas mayores.

  8. El dolor en el adulto mayor.

    Directory of Open Access Journals (Sweden)

    José Alfonso Maestre

    2009-11-01

    Full Text Available Se hace una revisión del dolor en el adulto mayor como grupo poblacional en aumento, destacando aspectos generales y comparativos con otros grupos de edad. Se revisan tópicos básicos como clasificaciones, cuantificaciones, fisiopatología y se resalta el manejo de equipo, mencionando como parte primordial el componente de rehabilitación que en muchas ocasiones no se tiene en cuenta como método terapéutico de elección durante el manejo conservador del dolor en personas mayores.

  9. Relacionamentos pessoais e sociais : amizade em adultos

    OpenAIRE

    Souza,Luciana Karine de; Hutz,Claudio Simon

    2008-01-01

    A amizade é um relacionamento importante para o desenvolvimento social, emocional e cognitivo; no entanto a maioria dos estudos trata da amizade na infância e na adolescência, havendo pouca ênfase na investigação de adultos. O presente trabalho apresenta uma revisão da literatura sobre relacionamentos de amizade na adultez, procurando descrever criticamente a produção científica na área. Estudos brasileiros indicam que relacionamentos de amizade no nosso país podem ser comparados aos de outra...

  10. O potencial evocado cognitivo em adultos normais

    Directory of Open Access Journals (Sweden)

    Franco Glaucio M.

    2001-01-01

    Full Text Available O objetivo deste estudo foi avaliar os resultados do potencial cognitivo auditivo em um grupo de adultos normais. Os testes foram realizados registrando-se a resposta evocada em Cz e Fz. Os dados obtidos foram analisados estatisticamente. São descritas neste trabalho as latências médias de N1, P2, P2AP, N2 e P3, a amplitude de P3, bem como o desvio padrão destas variáveis. Comentam-se algumas dificuldades encontradas na interpretação do teste destacando as limitações de seu uso clínico.

  11. Enfermedades endocrinas en el adulto mayor

    Directory of Open Access Journals (Sweden)

    B. Carlos García, Dr.

    2013-09-01

    A pesar de la heterogeneidad, múltiple co morbilidad y escasa literatura en que se incluye adultos mayores, se proponen algunas recomendaciones para el tratamiento individual del paciente diabético anciano, se revisan las particularidades del diagnóstico y tratamiento del híper e hipotiroidismo, algunas ideas en relación al manejo de la osteoporosis en la mujer mayor y el hombre anciano. Finalmente se aborda la dificultad diagnóstica del hipogonadismo tardío con las indicaciones y contra indicaciones del uso de testosterona.

  12. en diferentes tipos de matrimonio

    Directory of Open Access Journals (Sweden)

    Mirta Margarita Flores Galaz

    2005-01-01

    Full Text Available En el presente estudio se analizan los estilos de poder y los estilos de negociación del conflicto utilizados por parejas yucatecas, así como la relación entre cada uno de los factores de los estilos de poder y de negociación por tipo de matrimonio, de acuerdo a los ingresos individuales de las esposas y en nivel de trabajo.

  13. La evaluación del aprendizaje de una segunda lengua en los alumnos adultos

    OpenAIRE

    Cuadrado Moreno, José

    2005-01-01

    En la primera parte de esta comunicación primer lugar una introducción a la teoría de la evaluación del aprendizaje lingüístico, para cual introduzco una serie de conceptos relacionados con la teoría de la evaluación y realizo una clasificación de los diferentes tipos de pruebas lingüísticas. En la segunda parte paso a explicar el sistema norteamericano de evaluación del aprendizaje de los alumnos adultos que están participando en programas para el aprendizaje del inglés como segunda lengua m...

  14. Prevalencia de los trastornos del sueño en el adulto mayor

    Directory of Open Access Journals (Sweden)

    Pando-Moreno Manuel

    2001-01-01

    Full Text Available El presente es un estudio realizado con adultos mayores de la Ciudad de Guadalajara, México, que viven en domicilios particulares. De ellos, el 58% de los hombres y el 76% de las mujeres presentaron al menos un síntoma de trastornos del sueño, según el "Cuestionario General de Salud de Goldberg"; el 8,5% registró positivo en el total de los reactivos. Conforme a los criterios del DSM IV, un 33,3% podría ser considerado "caso" de trastorno del sueño. Estos posibles casos estarían asociados al género, al grado de estudio y con la presencia de depresión; pero no con el estado civil ni la edad. Ante la gran cantidad de "posibles casos" encontrados, que no han sido previamente detectados ni se encuentran en ningún tipo de tratamiento ad hoc, se recomienda promover cursos de actualización en esta materia para los profesionales de la salud (principalmente médicos y enfermeras, de manera que se facilite la detección oportuna de los casos, así como incrementar y mejorar la accesibilidad de los servicios de salud mental para la población de la tercera edad, e incrementar las actividades de educación para la salud para el adulto mayor y los cuidadores de éstos.

  15. Prevalencia de los trastornos del sueño en el adulto mayor

    Directory of Open Access Journals (Sweden)

    Manuel Pando-Moreno

    Full Text Available El presente es un estudio realizado con adultos mayores de la Ciudad de Guadalajara, México, que viven en domicilios particulares. De ellos, el 58% de los hombres y el 76% de las mujeres presentaron al menos un síntoma de trastornos del sueño, según el "Cuestionario General de Salud de Goldberg"; el 8,5% registró positivo en el total de los reactivos. Conforme a los criterios del DSM IV, un 33,3% podría ser considerado "caso" de trastorno del sueño. Estos posibles casos estarían asociados al género, al grado de estudio y con la presencia de depresión; pero no con el estado civil ni la edad. Ante la gran cantidad de "posibles casos" encontrados, que no han sido previamente detectados ni se encuentran en ningún tipo de tratamiento ad hoc, se recomienda promover cursos de actualización en esta materia para los profesionales de la salud (principalmente médicos y enfermeras, de manera que se facilite la detección oportuna de los casos, así como incrementar y mejorar la accesibilidad de los servicios de salud mental para la población de la tercera edad, e incrementar las actividades de educación para la salud para el adulto mayor y los cuidadores de éstos.

  16. In utero magnetic resonance imaging for diagnosis of dural venous sinus ectasia with thrombosis in the fetus

    Energy Technology Data Exchange (ETDEWEB)

    Fanou, Evgenia Maria [University Hospital of North Staffordshire, Stoke-on-Trent (United Kingdom); Reeves, Mike J.; Griffiths, Paul D. [Royal Hallamshire Hospital, University of Sheffield, Academic Unit of Radiology, Sheffield (United Kingdom); Howe, David T. [Princess Anne Hospital, Wessex Fetal Medicine Unit, Southampton (United Kingdom); Joy, Harriet [University Hospital of Southampton, Department of Radiology, Southampton (United Kingdom); Morris, Susan [University Hospital of Wales, Radiology Department, Cardiff, Wales (United Kingdom); Russell, Sarah [St. Mary' s Hospital, Radiology Department, Manchester (United Kingdom)

    2013-12-15

    Dural venous sinus ectasia with thrombosis (DVSET) in the fetus is a rare condition that can be diagnosed prenatally with the use of fetal MR imaging, yet with limited indication of long-term clinical significance. To describe and evaluate the diagnostic value of fetal MR imaging in the prenatal diagnosis of dural venous sinus ectasia with thrombosis and its clinical significance. We report a series of nine fetuses with dural venous sinus ectasia with thrombosis. The mothers, located in four feto-maternal centres, were referred for fetal MR imaging due to space occupying lesions identified on second-trimester antenatal ultrasound. In all but one case the dural venous sinus ectasia with thrombosis was in the vicinity of the venous confluence (VC) with various extension in the posterior dural sinuses. Antenatal follow-up imaging was performed in seven cases and showed progression in one, stable appearances in one and regression in five cases. Three pregnancies were terminated. In the remaining six cases there was no reported neurological deficit at up to 44 months of clinical follow-up. This is among the largest series of postnatal clinical follow-up in cases of prenatal diagnosis of dural venous sinus ectasia with thrombosis in the literature. Clinical follow-up suggests a good prognosis when antenatal follow-up shows partial or complete thrombus resolution. (orig.)

  17. O LÚDICO NOS ADULTOS: UM ESTUDO EXPLORATÓRIO NOS FREQÜENTADORES DO CEPE - NATAL/RN

    Directory of Open Access Journals (Sweden)

    Andréa Francos Ferreira

    2007-12-01

    Full Text Available O presente artigo tem como objetivo analisar a manifestação do fenômeno lúdico nos adultos, que freqüentam o Clube dos Empregados da Petrobrás em Natal/RN. Tal estudo está pautado sob a concepção e perspectiva do lúdico, enquanto fenômeno social. Para se atingir o objetivo utilizou-se uma metodologia caracterizada como qualitativa, sendo, também, do tipo exploratória. Os dados foram coletados, através de diversas visitas ao local, durante o mês de maio de 2003, dentre as quais foram utilizados questionários de entrevistas com o dirigente da Instituição e os com usuários do Clube, além de observação não-participante a qual utilizou-se de métodos descritivos visando colher detalhadamente as características do objeto em estudo. Os resultados obtidos vieram evidenciar e dar veracidade às afirmações feitas pelos estudiosos do lazer, de que o ser humano, à medida que vai se tornando adulto deixa para trás o significado do lúdico, devido ao uso da racionalidade exacerbada e, também, por causa das convenções impostas pela sociedade. Palavras-chave: CEPE/RN, Lúdico e Adulto.

  18. Dural ectasia of the optic nerve sheath: is it always benign?

    Directory of Open Access Journals (Sweden)

    Berker Bakbak

    2009-11-01

    Full Text Available Berker Bakbak1, Hava Dönmez2, Tülay Kansu3, Hayyam Kiratli41Hacettepe University Institute of Neurological Sciences and Psychiatry, Neuro-ophthalmology Unit, Ankara, Turkey; 2Diskapi Yildirim Beyazid Education and Research Hospital Neurology Clinic, Ankara, Turkey; 3Hacettepe University Medical Faculty, Department of Neurology, Neuro-Ophthalmology Unit, Ankara, Turkey; 4Hacettepe University Medical Faculty, Department of Ophthalmology, Ocular Oncology Unit, Ankara, TurkeyAbstract: A 36-year-old woman with a 3-month history of progressive visual loss had papilledema, dilatation of the optic nerve sheaths and normal cerebrospinal fluid pressures. She was diagnosed as dural ectasia of the optic nerve sheaths and surgical decompression was performed. In this case report, severe visual loss is described as a serious complication of this rare disease and the importance of early surgical intervention is emphasized.Keywords: optic nerve, dural ectasia, meningocele

  19. Dural metastases from prostate carcinoma: A systematic review of the literature apropos of six patients

    Energy Technology Data Exchange (ETDEWEB)

    Vasconcelos Sobreira Guedes, Bruno de, E-mail: b_guedes@hotmail.com [Santa Casa de Misericordia de Sao Paulo - Servico de Diagnostico por Imagem, Rua Dr. Cesario Motta Junior 112, Vila Buarque, Sao Paulo CEP 01221-020, SP (Brazil); Rocha, Antonio Jose da, E-mail: antonio.rocha@uol.com.br [Santa Casa de Misericordia de Sao Paulo - Servico de Diagnostico por Imagem, Rua Dr. Cesario Motta Junior 112, Vila Buarque, Sao Paulo CEP 01221-020, SP (Brazil); Pereira Pinto Gama, Hugo, E-mail: hugo.gama@fleury.com.br [Santa Casa de Misericordia de Sao Paulo - Servico de Diagnostico por Imagem, Rua Dr. Cesario Motta Junior 112, Vila Buarque, Sao Paulo CEP 01221-020, SP (Brazil); Silva, Carlos Jorge da, E-mail: carlos.silva@fleury.com.br [Santa Casa de Misericordia de Sao Paulo - Servico de Diagnostico por Imagem, Rua Dr. Cesario Motta Junior 112, Vila Buarque, Sao Paulo CEP 01221-020, SP (Brazil)

    2011-11-15

    Intracranial metastases are a rare manifestation of prostate carcinoma and the dura mater is the most affected site. We report a series of six patients with dural prostate metastases (DPM) and perform a systematic review of the current literature in order to depict imaging trademarks of this condition. This review points to a magnetic resonance imaging (MRI) pattern of meningeal involvement characterized by a diffuse smooth thickening, nodular appearance or dural-based masses. We also demonstrate an osteoblastic pattern of lesions, particularly in sphenoid wing, by computed tomography (CT) scans. We suggest that these imaging findings may support an elevated index of suspicion of DPM in elderly men, including those patients without urologic symptoms.

  20. Selective Transvenous Coil Embolization of Dural Arteriovenous Fistula: A Report of Three Cases

    OpenAIRE

    2007-01-01

    We herein report three cases of dural arteriovenous fistula (DAVF) in which the venous outlet immediately adjacent to the fistula was selectively embolized. Case 1: A 69-year-old man presented with a subarachnoid hemorrhage (SAH). Angiography demonstrated a DAVF in the left superior petrous sinus. Case 2: A 59-year-old woman presented with dizziness. Angiography demonstrated a DAVF adjacent to great vein of Galen. The DAVF drained through the great vein of Galen with retrograde leptomeningeal...

  1. Effects of ionotropic glutamate receptor antagonists on rat dural artery diameter in an intravital microscopy model

    DEFF Research Database (Denmark)

    Chan, K Y; Gupta, S; de Vries, R;

    2010-01-01

    studies have shown that glutamate receptor antagonists affect the pathophysiology of migraine. This study investigated whether antagonists of NMDA (ketamine and MK801), AMPA (GYKI52466) and kainate (LY466195) glutamate receptors affected dural vasodilatation induced by alpha-CGRP, capsaicin......During migraine, trigeminal nerves may release calcitonin gene-related peptide (CGRP), inducing cranial vasodilatation and central nociception; hence, trigeminal inhibition or blockade of craniovascular CGRP receptors may prevent this vasodilatation and abort migraine headache. Several preclinical...

  2. Dural arteriovenous fistula of the lesser sphenoid wing region treated with Onyx: technical note

    Energy Technology Data Exchange (ETDEWEB)

    Rezende, Marco Tulio Salles; Piotin, Michel; Mounayer, Charbel; Spelle, Laurent; Abud, Daniel Giansante [Fondation Rothschild, Department of Interventional Neuroradiology, Paris (France); Moret, Jacques [Fondation Rothschild, Department of Interventional Neuroradiology, Paris (France); Hopital de la Fondation Rothschild, Service de Neuroradiologie Interventionnelle, Paris, CEDEX 19 (France)

    2006-02-15

    A 45-year-old man presented with acute right orbital pain and right-sided headache. Magnetic resonance imaging (MRI) and cerebral angiography revealed a dural arteriovenous fistula (DAVF) of the lesser sphenoid wing region. The lesion was endovascularly treated by transarterial embolization with Onyx (ethyl vinyl alcohol; Micro Therapeutics, Irvine, Calif.). We review some anatomical and therapeutic features involving DAVFs of this region and describe the feasibility of the use of Onyx in the treatment of these lesions. (orig.)

  3. Grado de control metabólico y de factores de riesgo cardiovascular en pacientes con diabetes tipo 2 con y sin enfermedad cardiovascular

    OpenAIRE

    Gerardo Garzón; Ángel Gil; Ana María Herrero; Fernando Jiménez; María José Cerezo; Cristina Domínguez

    2015-01-01

    Objetivo: Determinar la proporción de pacientes con diabetes tipo 2 con y sin enfermedad cardiovascular que tienen controlada la glucemia y los factores de riesgo cardiovascular. Métodos: Estudio transversal realizado en 40 centros de salud de atención primaria de Madrid en el año 2013, con 49.658 pacientes adultos con diabetes tipo 2 diagnosticada con y sin enfermedad cardiovascular. Se obtuvieron datos secundarios de registros electrónicos de la historia clínica de atención primaria: hem...

  4. Apoyos en los hogares con al menos un adulto mayor en el Estado de México

    Directory of Open Access Journals (Sweden)

    Lilian CERVANTES

    2013-01-01

    sus corresidentes y los que proporcionan algún tipo de ayuda a estos últimos. La fuente de información que se utiliza es la Encuesta sobre Envejecimiento Demográfico en el Estado de México (esedem 2008, realizada por el Centro de Investigación y Estudios Avanzados de la Población de la Universidad Autónoma del Estado de México (cieap-uaem. Los resultados muestran que los adultos mayores viven principalmente en hogares nucleares y desempeñan papeles en los cuales no solamente tienen que hacerse responsables de sí mismos, sino de otras personas. En la entidad, 42.2 por ciento de las personas mayores recibe algún tipo de ayuda informal y 16.3 por ciento la otorga; los intercambios de apoyos se efectúan con los hijos, la nuera y el yerno, los cónyuges, los nietos y los padres de los adultos mayores.

  5. Transvenous embolization of dural arteriovenous fistula of cavernous region by multiple venous routes

    Institute of Scientific and Technical Information of China (English)

    CHEN Huai-rui; BAI Ru-lin; HUANG Cheng-guang; LI Bin; LU Yi-cheng

    2007-01-01

    Objective: To evaluate the safety and efficiency of transvenous embolization of dural arteriovenous fistula of cavernous region by multiple venous routes. Methods: Twenty seven patients with dural arteriovenous fistula uf cavernous region were treated by transvenous embolization with micro-coils. The transvenous routes included inferior petrosal sinus, superior ophthalmic vein and facial vein. Results: Clinical cure was achieved in 23 cases and significant improvement of symptoms in 4 cases. Complete angiographic obliteration was documented in 22 patients (82%). Residual shunting were left in 2 patients via pterygoid drainage and 1 case via inter-cavernous sinus, 2 cases via inferior petrosal sinus, disappeared one month later by manual compression carotid artery. Headache and vomiting were the most common symptoms after embolization. Three patients had diplopia and relieved within two months after embolization.There was no permanent procedure-related morbidity. The clinic follow up ranged from 5 months to 6 years, and there was not recurrence case. Conclusion: Transvenous embolization via different venous routes is a safe and efficient method for dural arteriovenous fistula of cavernous region treatment.

  6. Persistent post-dural-puncture headache treated with epidural infusion of dextran.

    Science.gov (United States)

    Aldrete, J A

    1994-05-01

    A retrospective review was done on medical records of 13 patients with persistent post-dural-puncture headaches after one or more epidural blood patches. Headache occurred in nine patients with post-laminectomy syndrome after "wet taps" while performing epidural blocks. In two patients post-dural-puncture headache appeared after long term implanted intrathecal catheters were removed. In two other cases headache developed after spinal anesthesia. Treatment included bed rest, intravenous hydration and at least one epidural blood patch; three patients were given 60 milliliters of epidural saline, without success. Eight epidural catheters were inserted through the lumbar access and five through the caudal approach. Initially, a bolus of 20 milliliters of dextran-40 was given followed by an infusion of 3 mL/hr, until 12 hours after the head pain and any other related symptoms subsided. In all patients the headache disappeared within 20 hours after initiating therapy (9.55 mean hours, SD +/- 0.79). In five patients headache ceased in less than five hours. Nausea and photo-phobia subsided earlier. Patients with post-dural-puncture headache resistant to other treatments, including at least one epidural blood patch, were successfully treated by a bolus followed by continuous epidural infusion of dextran-40.

  7. Large capillary hemangioma of the temporal bone with a dural tail sign: A case report

    KAUST Repository

    YANG, GUANG

    2014-05-13

    The present study reports a rare case of large capillary hemangioma of the temporal bone with a dural tail sign. A 57-year-old female presented with pulsatile tinnitus and episodic vertigo associated with a ten-year history of an intermittent faint headache. Magnetic resonance imaging revealed a mass in the right petrous bone, which was hypointense on T1-weighted images and heterogeneously hyperintense on T2-weighted images, and showed a dural tail sign following gadolinium administration. Pre-operatively, this tumor was believed to be a meningioma. During surgery, the vascular tumor was removed by a modified pterional approach. A histopathological examination indicated that the tumor was a capillary hemangioma. Although intraosseous capillary hemangiomas are rare, they most frequently affect the temporal bone. Hemangiomas of the temporal bone may mimic other more common basal tumors. The diagnosis is most often made during surgical resection. The dural tail sign is not specific for meningioma, as it also occurs in other intracranial or extracranial tumors. The treatment of intratemporal hemangiomas is complete surgical excision, with radiotherapy used for unresectable lesions. To the best of our knowledge, the present study is the fourth case of intraosseous intracranial capillary hemangioma, but the largest intratemporal hemangioma to be reported in the literature to date.

  8. Hypoxia facilitates neurogenic dural plasma protein extravasation in mice: a novel animal model for migraine pathophysiology.

    Science.gov (United States)

    Hunfeld, Anika; Segelcke, Daniel; Bäcker, Ingo; Mecheri, Badreddine; Hemmer, Kathrin; Dlugosch, Elisabeth; Andriske, Michael; Paris, Frank; Zhu, Xinran; Lübbert, Hermann

    2015-12-08

    Migraine animal models generally mimic the onset of attacks and acute treatment processes. A guinea pig model used the application of meta-chlorophenylpiperazine (mCPP) to trigger immediate dural plasma protein extravasation (PPE) mediated by 5-HT2B receptors. This model has predictive value for antimigraine drugs but cannot explain the delayed onset of efficacy of 5-HT2B receptor antagonists when clinically used for migraine prophylaxis. We found that mCPP failed to induce dural PPE in mice. Considering the role 5-HT2B receptors play in hypoxia-induced pulmonary vessel muscularization, we were encouraged to keep mice under hypoxic conditions and tested whether this treatment will render them susceptible to mCPP-induced dural PPE. Following four-week of hypoxia, PPE, associated with increased transendothelial transport, was induced by mCPP. The effect was blocked by sumatriptan. Chronic application of 5-HT2B receptor or nitric oxide synthase blockers during hypoxia prevented the development of susceptibility. Here we present a migraine model that distinguishes between a migraine-like state (hypoxic mice) and normal, normoxic mice and mimics processes that are related to chronic activation of 5-HT2B receptors under hypoxia. It seems striking, that chronic endogenous activation of 5-HT2B receptors is crucial for the sensitization since 5-HT2B receptor antagonists have strong, albeit delayed migraine prophylactic efficacy.

  9. A method for morphological characterization of dural ectasia in Marfan syndrome.

    Science.gov (United States)

    Iacono, Maria I; Passera, Katia; Magrassi, Lorenzo; Dore, Roberto; Lago, Paolo; Arbustini, Eloisa; Mainardi, Luca T

    2009-01-01

    In this paper we reported a novel method to detect and quantify dural ectasia in Marfan syndrome. Firstly, the dural sacs of 8 Marfan patients were segmented by applying an unsupervised Fuzzy C-Means method on T2-weighed magnetic resonance images. Then, for each patient a tubular model of the dural sac was extracted by detecting and removing the existent pathological extrusions. The segmented images together with the resulting tube were then rendered using a marching cubes algorithm. The proposed algorithm represents a first attempt to quantify and to morphologically characterize the pathological ectasia that usually accompanies the Marfan disorder. The generated 3D reconstruction and the opportunity to overlap them with a physiological model provides the clinician with a tool for a panoramic view of the structures and a means for a more accurate inspection of ectasia. In addition the extracted parameters furnish quantitative and reproducible measures that could be useful as discriminative indexes for an automatic and more objective diagnosis.

  10. Large capillary hemangioma of the temporal bone with a dural tail sign: A case report.

    Science.gov (United States)

    Yang, Guang; Li, Chenguang; Chen, Xin; Liu, Yaohua; Han, Dayong; Gao, Xin; Kawamoto, Keiji; Zhao, Shiguang

    2014-07-01

    The present study reports a rare case of large capillary hemangioma of the temporal bone with a dural tail sign. A 57-year-old female presented with pulsatile tinnitus and episodic vertigo associated with a ten-year history of an intermittent faint headache. Magnetic resonance imaging revealed a mass in the right petrous bone, which was hypointense on T1-weighted images and heterogeneously hyperintense on T2-weighted images, and showed a dural tail sign following gadolinium administration. Pre-operatively, this tumor was believed to be a meningioma. During surgery, the vascular tumor was removed by a modified pterional approach. A histopathological examination indicated that the tumor was a capillary hemangioma. Although intraosseous capillary hemangiomas are rare, they most frequently affect the temporal bone. Hemangiomas of the temporal bone may mimic other more common basal tumors. The diagnosis is most often made during surgical resection. The dural tail sign is not specific for meningioma, as it also occurs in other intracranial or extracranial tumors. The treatment of intratemporal hemangiomas is complete surgical excision, with radiotherapy used for unresectable lesions. To the best of our knowledge, the present study is the fourth case of intraosseous intracranial capillary hemangioma, but the largest intratemporal hemangioma to be reported in the literature to date.

  11. Intracranial Dural Metastasis of Ewing's Sarcoma: a Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Eung Yeop; Lee, Seung Koo; Kim, Dong Joon; Kim, Jin Na; Lee, Kyu Sung; Jung, Woo Hee; Kim, Dong Ik [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2008-02-15

    Ewing's sarcoma is a malignant bone tumor that can occur anywhere in the body, but it is most commonly observed in the long bones of the arms and legs, the pelvis and in the chest. The predominant sites of metastasis include the lung (38%), bone (including the spine; 31%), and the bone marrow (11%). Metastasis of Ewing's sarcoma to the central nervous system (CNS) is relatively rare, and most of the previous reports have demonstrated involvement of the bony calvarium or brain parenchyma. We describe here the imaging findings of dural metastasis of Ewing's sarcoma, and these imaging findings have not been previously reported on in the medical literature. In conclusion, dural metastasis of Ewing's sarcoma is very rare and its imaging characteristics are similar to those of a primary tumor, which mimic the findings of a schwannoma or meningioma. Despite its rarity, secondary Ewing's sarcoma may be included in the differential diagnosis of extra-axial dural masses.

  12. A New Absorbable Synthetic Substitute With Biomimetic Design for Dural Tissue Repair.

    Science.gov (United States)

    Shi, Zhidong; Xu, Tao; Yuan, Yuyu; Deng, Kunxue; Liu, Man; Ke, Yiquan; Luo, Chengyi; Yuan, Tun; Ayyad, Ali

    2016-04-01

    Dural repair products are evolving from animal tissue-derived materials to synthetic materials as well as from inert to absorbable features; most of them lack functional and structural characteristics compared with the natural dura mater. In the present study, we evaluated the properties and tissue repair performance of a new dural repair product with biomimetic design. The biomimetic patch exhibits unique three-dimensional nonwoven microfiber structure with good mechanical strength and biocompatibility. The animal study showed that the biomimetic patch and commercially synthetic material group presented new subdural regeneration at 90 days, with low level inflammatory response and minimal to no adhesion formation detected at each stage. In the biological material group, no new subdural regeneration was observed and severe adhesion between the implant and the cortex occurred at each stage. In clinical case study, there was no cerebrospinal fluid leakage, and all the postoperation observations were normal. The biomimetic structure and proper rate of degradation of the new absorbable dura substitute can guide the meaningful reconstruction of the dura mater, which may provide a novel approach for dural defect repair.

  13. The incidence of dural tears after complete resection of lumbar synovial cysts and the relation to the outcome.

    Science.gov (United States)

    Klessinger, Stephan

    2016-05-01

    Synovial cysts in the lumbar spine are uncommon causes of radicular pain. In cases where conservative treatment fails, surgical resection is recommended. Dural adhesions are common intraoperative findings; therefore, the removal of the cyst may sometimes result in dural tears. The frequency of dural tears is greater with synovial cysts than in other lumbar surgeries. Clinical parameters and characteristics seen on magnetic resonance imaging were assessed to investigate the correlation between the outcome after surgery of lumbar synovial cysts and dural tears. This study was designed as a retrospective practice audit. Patient data were drawn from an electronic medical record system. Included were consecutive patients after microsurgical resection of symptomatic lumbar synovial cysts between May 2013 and November 2015. The surgical report was evaluated retrospectively regarding the extent of decompression and cyst resection as well as surgery-related complications. Pre-operative magnet resonance imaging was assessed concerning the reason for compression of the neural structures, the dimension of the cyst, and the signal of the cyst content in T2 images. In a follow-up examination about four weeks after surgery, the patient satisfaction index was evaluated. Forty-four consecutive patients after resection of a lumbar synovial cyst met the inclusion criteria. The mean patient satisfaction index was 2.0±1.0. Twenty-nine patients of the 38 patients with follow-up (76.3%) with a satisfaction index of 1 or 2 were rated as favorable. One revision surgery was necessary because of a cerebrospinal fluid fistula. Furthermore, in 4 patients an incidental durotomy occurred without any symptoms after surgery. Accordingly, the rate of dural tears was 11.4%. Dural tears were significantly more common in patients with a satisfaction index of 3 or 4 (P=0.04). Sixty percent of the patients with dural tears were operated on in level L5/S1 compared to 3 patients without a dural tear (P=0

  14. Novel dural incision and closure procedure for preventing postoperative cerebrospinal fluid leakage during the surgical removal of dumbbell-shaped spinal tumors: technical note.

    Science.gov (United States)

    Ito, Kiyoshi; Aoyama, Tatsuro; Nakamura, Takuya; Hanaoka, Yoshiki; Horiuchi, Tetsuyoshi; Hongo, Kazuhiro

    2016-11-01

    The authors report on a new method for removing dumbbell-shaped spinal tumors that avoids the risk of postoperative cerebrospinal fluid (CSF) leakage. Adequate visualization of the intra- and extradural components of the tumor is achieved with the use of separate dural incisions. First, the dura mater is opened along the dural theca to provide adequate visualization of the intradural portion of the mass; then, a second incision is made along the nerve root to remove the extradural component. Meticulous suturing is essential in intradural lesion cases; however, the dura mater is usually thin and fragile in such cases. During suturing with a needle and thread, the dura mater can become lacerated proximal to the needle holes and result in CSF leakage. In the authors' technique, instead of using a needle and thread, nonpenetrating vascular clips were used to close the dural incisions. When operating on dumbbell-shaped spinal tumors, the authors found that the "separate-dural-incision method" was preferable to the conventional T-shaped dural incision method because no dural defects occurred after the intradural procedure and meticulous dural closure with vascular clips was achieved. The authors conclude that the novel separate-dural-incision method for removing dumbbell-shaped tumors and the use of nonpenetrating vascular clips permits reliable dural closure, prevents postoperative CSF leakage, and promises good postoperative clinical results.

  15. Violencia intrafamiliar en el adulto mayor que vive en el distrito de Breña, Perú

    Directory of Open Access Journals (Sweden)

    Jack Roberto Silva-Fhon

    2015-07-01

    Full Text Available Antecedentes. La violencia hacia el adulto mayor es un problema social que ocurre dentro de la familia y que, por miedo, no es denunciado. Esto dificulta el trabajo del personal multiprofesional de salud para la detección, denuncia y prevención de estos casos. Objetivo. Identificar la prevalencia, los tipos de violencia intrafamiliar, su asociación con variables sociodemográficas y la presencia de síntomas depresivos en el adulto mayor que vive en la comunidad de estudio. Materiales y métodos. Estudio cuantitativo, descriptivo y transversal con 369 adultos mayores en el distrito de Breña, Lima (Perú. Se utilizaron el Canadian Task Force on the Periodic Health Examination y la Escala de Depresión Geriátrica como instrumentos de datos sociodemográficos. Para el análisis de los datos se aplicó estadística descriptiva y regresión logística. Resultados. Predominó el sexo femenino, el adulto mayor más joven, el estado civil casado y la conformación familiar por el cónyuge. La prevalencia de violencia intrafamiliar fue 79.7% y de síntomas depresivos 48.2%. Prevaleció la violencia financiera. En la regresión se verificó que aquel que no trabaja tiene mayor chance de sufrir violencia. Entre más años de estudio, disminuye el riesgo de sufrir violencia. Asimismo, aquel que no presenta síntomas depresivos no sufre violencia. Conclusiones. Se verificó que el adulto mayor necesita de atención permanente. El personal de salud debe reconocer síntomas y señales en el adulto mayor que sufre violencia y que presenta síntomas depresivos; debe ofrecer información sobre la importancia de denunciar estos casos para favorecer un envejecimiento saludable y con calidad.

  16. Patrones de diseño para mejorar la accesibilidad y uso de aplicaciones sociales para adultos mayores

    Directory of Open Access Journals (Sweden)

    Huizilopoztli Luna García

    2015-07-01

    Full Text Available El objetivo de este artículo fue proponer una colección no exhaustiva de 36 patrones para el diseño de interacciones en aplicaciones sociales para adultos mayores. La propuesta representa un punto de partida confiable para facilitar, a diseñadores/desarrolladores, la integración de usabilidad en las interfaces de estas tecnologías con el fin de fomentar su aceptación, uso y adopción entre los adultos mayores. Esta propuesta se basa en esfuerzos previos comúnmente expresados como criterios y guías de diseño para definir los posibles problemas de usabilidad en este tipo de interfaces, y se concentra en reforzar estos enfoques mediante la integración de una mayor descripción de tales anomalías y alternativas de solución bajo una estructura de patrones útil para los diseñadores/desarrolladores. Se realizó un estudio de usabilidad con la técnica «evaluación heurística» (comúnmente utilizada en interacción hombre-máquina para obtener la percepción de los usuarios sobre un diseño particular. El trabajo se llevó a cabo desde dos perspectivas: el punto de vista de expertos técnicos y la percepción de un grupo social de adultos mayores. Los resultados reflejaron que los patrones propuestos propician la creación de interfaces bien diseñadas capaces de ofrecer una mejor experiencia de uso y promueven un impacto positivo en la calidad de vida de los adultos mayores.

  17. A importância das aulas práticas para alunos jovens e adultos: uma abordagem investigativa sobre a percepção dos alunos do PROEF II

    Directory of Open Access Journals (Sweden)

    Adriana Cristina Souza LEITE

    Full Text Available Resumo: Este trabalho analisa a importância das aulas práticas no ensino de Ciências Naturais para os alunos de duas turmas, com perfis diferentes, do Segundo Segmento do Projeto de Ensino Fundamental de Jovens e Adultos da Universidade Federal de Minas Gerais (PROEF II. O trabalho analisa o conceito de aulas práticas para esses alunos, a aceitação e as impressões pessoais dos mesmos em relação a estas aulas na disciplina de Ciências Naturais. Os resultados demonstram que os alunos jovens e adultos gostam desse tipo de aula e se sentem motivados quando a mesma é proposta, principalmente quando elas ocorrem no laboratório e, desse modo, o desenvolvimento dessas aulas pode ser uma importante ferramenta no ensino de ciências para os alunos jovens e adultos.

  18. Nivel de autotrascendencia en un grupo de adultos mayores mexicanos

    OpenAIRE

    Raúl Fernando Guerrero Castañeda; Ricardo Lara Pérez

    2017-01-01

    Introducción: La autotrascendencia es una expansión multidimensional personal, una conexión con los demás, el entorno y/o una entidad superior, está relacionada con el bienestar personal del adulto mayor. Objetivo: Determinar el nivel de autotrascendencia de un grupo de adultos mayores mexicanos. Materiales y Métodos: Estudio descriptivo de corte transversal; realizado en tres centros gerontológicos de Celaya, Guanajuato, México, muestra probabilística aleatoria n=118. Se incluyeron adultos m...

  19. INTERVENCIÓN PSICOLÓGICA EN ADULTOS MAYORES

    Directory of Open Access Journals (Sweden)

    Ana Fernanda Rodríguez Uribe

    2010-01-01

    Full Text Available El objetivo de este artículo es plantear una propuesta de intervención psicológica dirigida a adultos mayores institucionalizados y no institucionalizados; para ello se tomó como referencia la situación actual del adulto, los estudios realizados entorno a esta etapa y específicamente lo relacionado con el diseño de programas de intervención, para finalmente exponer la propuesta de intervención psicológica que pretende no solo mejorar la calidad de vida del adulto mayor, sino abarcarlo desde sus diversas áreas de funcionamiento.

  20. Temas para la asistencia al adulto mayor

    OpenAIRE

    Romero Cabrera, Ángel Julio

    2008-01-01

    El reto del envejecimiento demográfico y los complejos y peculiares problemas clínicos de los adultos mayores justifican la formación y capacitación de los profesionales para la asistencia médica a estas personas. El resultado consiste en un libro con información sistematizada sobre temas básicos para ofrecer una adecuada atención clínica a los ancianos, conjugando los elementos del método clínico con los de la evaluación geriátrica, a lo que se añade un instrumento evaluativo para retroalime...

  1. Control Metabólico en Pacientes Diabéticos Tipo 1: Evaluación del Programa de Garantías Explícitas de Salud

    OpenAIRE

    2007-01-01

    Objetivos: Evaluar el impacto de la implementación del programa de Garantías Explícitas de Salud en el control metabólico de; la diabetes tupo 1 en adultos. Diseño: Transversal descriptivo. Lugar: Hospital Carlos Van Buren, Valparaíso, Chile. Participantes:; Pacientes con diabetes tipo 1 que se controlan en la Unidad de Endocrinología de Adultos del hospital que se encuentran; incorporados al programa. Intervenciones: Revisión de historias clínicas. Principales medidas de resultados:...

  2. Caracteristicas antropometricas de adultos mayores participantes en competencias deportivas

    National Research Council Canada - National Science Library

    Ramos Bermudez, Santiago; Moreno Bolivar, Hilario

    2011-01-01

    Objetivo: determinar el perfil antropometrico que presentaron los participantes en las competencias deportivas de la Olimpiada Nacional 2009 del adulto mayor, en aspectos como talla, peso, indice de masa corporal (IMC...

  3. Estabilidad de supositorios de naproxeno para uso infantil y adulto

    National Research Council Canada - National Science Library

    Yania Suárez Pérez; Oscar García Pulpeiro; Mabert Placert Álvarez

    ... y química del analito en las nuevas formulaciones. Métodos: se realizó el estudio de estabilidad para formulaciones en fase de desarrollo de supositorios de naproxeno para uso infantil y adulto, teniendo en cuenta...

  4. [Accidental Dural Puncture and Post-dural Puncture Headache in the Obstetric Population: Eight Years of Experience].

    Science.gov (United States)

    Antunes, Maria Vaz; Moreira, Adriano; Sampaio, Catarina; Faria, Aida

    2016-04-01

    Introdução: A punção acidental da dura é uma importante complicação da anestesia regional e a cefaleia pós-punção continua a ser causa de morbilidade na população obstétrica. O objetivo do nosso estudo foi calcular a incidência de punção acidental e cefaleia pós-punção no nosso Centro Hospitalar e avaliar a sua abordagem entre os anestesiologistas obstétricos. Material e Métodos: Realizámos uma auditoria retrospetiva, entre janeiro de 2007 e dezembro de 2014. Revimos as folhas de registo das doentes em que ocorreu punção inadvertida da dura ou cefaleia pós-punção. Excluímos as doentes submetidas a bloqueio subaracnoideu. Utilizámos o SPSS 22.0 no tratamento estatístico dos dados. Resultados: Obtivémos 18 497 bloqueios neuro-axiais e 58 punções acidentais da dura (0,3%). Após punção detetada, em 71,4% o cateter epidural foi re-posicionado e 21,4% tiveram cateteres intra-tecais. Quarenta e cinco (77,6%) desenvolveram cefaleia e a instituição de medidas profiláticas ocorreu em 76,1%. O tratamento conservador foi efetuado em todas as doentes. O blood patch epidural foi realizado em 32,8% com um sucesso de 84,2%. Discussão: A incidência de cefaleia pós-punção não está relacionada com o tipo de parto ou a inserção do cateter intra-tecal. A re-colocação do cateter epidural mantém-se a abordagem de eleição após punção. A instituição de medidas profiláticas é uma prática comum, apesar do baixo grau de eficácia. Realizámos blood patch epidural após falência do tratamento conservador. Conclusão: A incidência de punção inadvertida e cefaleia pós-punção foi semelhante à da literatura. Apesar de ser uma complicação comum, existe falta de consenso na sua abordagem.

  5. Adultos mayores cuidadores: sobrecarga y dimensión afectiva

    Directory of Open Access Journals (Sweden)

    Serrana Banchero

    2017-05-01

    Full Text Available Este trabajo plantea la relación entre la sobrecarga del cuidador y la dimensión afectiva del cuidado en personas mayores cuidadoras. En la actualidad el cuidado es entendido como una problemática social pública, y por lo tanto objeto de políticas públicas. Uruguay es un país envejecido debido a los cambios socio-demográficos que han acontecido por lo que han aumentado las situaciones de dependencia y las demandas de cuidados. De este modo, las personas mayores no solo son receptores sino también proveedores de cuidados. El cuidado implica la dimensión material, económica y afectiva, y los cuidadores como consecuencia de su tarea de cuidar, pueden experimentar el síndrome de sobrecarga del cuidador. Se trata de un diseño cuali-cuantitativo y consiste en un estudio de caso utilizando entrevistas individuales con aplicación de instrumentos según la categorización de la muestra finalista que fue Personas Mayores Cuidadoras y no Cuidadoras. Se analizará la variable sobrecarga del cuidador con las características de la relación cuidador-cuidado. La muestra es finalista y se constituyó por 74 personas mayores usuarios regulares del Subprograma Adultos Mayores del Programa Apex-Cerro (UdelaR de la ciudad de Montevideo, Uruguay. Los resultados mostraron que aparece una visión totalizante del cuidado, así como relatos autorreferenciales. El 29,7% son personas mayores cuidadoras, de los cuales el 15,7% presentan el síndrome de sobrecarga del cuidador (siendo todas mujeres y la edad mediana de 65,5 años. En el análisis de la dimensión afectiva del cuidado se observan características de un tipo de vínculo co-dependiente entre el cuidador y el cuidado.

  6. Diabetes tipo 2, obesidad y cetoacidosis diabética en niños. Reporte de caso.

    OpenAIRE

    Manrique, Helard; Servicio de Endocrinología, Hospital Nacional Arzobispo Loayza Lima; Pinto, Miguel; Servicio de Endocrinología, Hospital Nacional Cayetano Heredia. Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia. Lima.; Ramirez-Saba, Alfonso; Facultad de Medicina Alberto Hurtado, Universidad Peruana Cayetano Heredia Lima.; Zapana, Alexander; Servicio de Endocrinología, Hospital Nacional Alcides Carrión Lima.; Aro-Guardia, Pedro; Servicio de Endocrinología, Hospital Nacional Arzobispo Loayza Lima.

    2011-01-01

    Se reporta el caso de una niña con obesidad que acudió a nuestro hospital por presentar cetoacidosis diabética. El manejo inicial incluyó hidratación enérgica e insulina endovenosa. El análisis de anticuerpos anti-GAD fue negativo y el péptido C fue normal. El control metabólico a largo plazo fue con metformina, dieta y ejercicio.Tradicionalmente, la diabetes tipo 2 ha sido considerada una enfermedad de adultos. Sin embargo, a med...

  7. Diabetes tipo 2, obesidad y cetoacidosis diabética en niños. Reporte de caso.

    OpenAIRE

    Helard Manrique; Miguel Pinto; Alfonso Ramirez-Saba; Alexander Zapana; Pedro Aro-Guardia

    2011-01-01

    Se reporta el caso de una niña con obesidad que acudió a nuestro hospital por presentar cetoacidosis diabética. El manejo inicial incluyó hidratación enérgica e insulina endovenosa. El análisis de anticuerpos anti-GAD fue negativo y el péptido C fue normal. El control metabólico a largo plazo fue con metformina, dieta y ejercicio.Tradicionalmente, la diabetes tipo 2 ha sido considerada una enfermedad de adultos. Sin embargo, a med...

  8. EVALUACION DEL EFECTO EPIGENETICO DE LA INACTIVIDAD FISICA EN EL ORIGEN DE LA DIABETES MELLITUS TIPO 2: ESTUDIO EXPERIMENTAL

    OpenAIRE

    MARQUEZ ANDRADE, JOSE LUIS

    2010-01-01

    La Diabetes mellitus tipo 2 (DM2) es una enfermedad multifactorial que está relacionada con obesidad y bajos niveles de actividad física. Las investigaciones previas comúnmente han asociado la DM2 con los niveles de actividad física en la adultez. Sin embargo, poco es lo que se conoce acerca del rol de la inactividad física, en estadíos tempranos del desarrollo, en la predisposición a un fenotipo insulino resistente el cual puede estar relacionado con DM2 cuando el sujeto adulto es expuesto a...

  9. Significado de ser docente para el adulto mayor sanfernandino

    OpenAIRE

    Martina, Martha; Facultad de Medicina, UNMSM; Santos, Gladys; Facultad de Medicina, UNMSM; Lema, Julia; Facultad de Medicina, UNMSM

    2013-01-01

    Objetivos: Comprender el significado de ser docente para el adulto mayor de la Facultad de Medicina de San Marcos y describir las motivaciones que determinan, de alguna forma, su decisión de postergar su retiro, no obstante haber cumplido con los requisitos legales para la jubilación. Diseño: Estudio de caso cualitativo. Institución: Facultad de Medicina, UNMSM. Participantes: Docentes adulto mayores de la Facultad de Medicina. Intervenciones: Entrevista a profundidad. Principales medidas de ...

  10. Dural based primary osteosarcoma in right fronto-temporal region:Case report with review of literature

    Directory of Open Access Journals (Sweden)

    Ghosal Nandita

    2010-01-01

    Full Text Available We report a case of primary dural based osteosarcoma in the right fronto-temporal convexity in a 43-year-old female who presented with a short history of seizure and headache. Radiologic evaluation revealed a well defined brightly enhancing extra-axial lesion in the right fronto-temporal region with a dural tail around the sylvian fissure. The overlying bone was uninvolved. Paraffin section of the tumor showed plump cells with moderate nuclear and cellular pleomorphism with eosinophilic extracellular material (osteiod between the cells. At a few places, lace like osteiod was seen encasing individual cells signifying osteiod being formed by tumor cells. Immunohistochemistry for epithelial membrane antigen was focally positive and negative for S-100 protein and glial fibrillary acidic protein. A final histopathological diagnosis of dural based primary osteosarcoma of the right fronto-temporal region was rendered. To the best of our knowledge this will be the eighth such case in literature.

  11. In situ precise electrospinning of medical glue fibers as nonsuture dural repair with high sealing capability and flexibility

    Science.gov (United States)

    Lv, Fu-Yan; Dong, Rui-Hua; Li, Zhao-Jian; Qin, Chong-Chong; Yan, Xu; He, Xiao-Xiao; Zhou, Yu; Yan, Shi-Ying; Long, Yun-Ze

    2016-01-01

    Purpose In this work, we propose an in situ precise electrospinning of medical glue fibers onto dural wound for improving sealing capability, avoiding tissue adhesion, and saving time in dural repair. Methods N-octyl-2-cyanoacrylate, a commercial tissue adhesive (medical glue), can be electrospun into ultrathin fibrous film with precise and homogeneous deposition by a gas-assisted electrospinning device. Results The self-assembled N-octyl-2-cyanoacrylate film shows high compactness and flexibility owing to its fibrous structure. Simulation experiments on egg membranes and goat meninges demonstrated that this technology can repair small membrane defects quickly and efficiently. Conclusion This method may have potential application in dural repair, for example, working as an effective supplementary technique for conventional dura suture. PMID:27621616

  12. Endovascular management of dural carotid-cavernous sinus fistulas in 141 patients

    Energy Technology Data Exchange (ETDEWEB)

    Kirsch, M. [Alfried Krupp Krankenhaus, Klinik fuer Radiologie und Neuroradiologie, Essen (Germany); Universitaetsklinikum Greifswald, Institut fuer Diagnostische Radiologie und Neuroradiologie, Greifswald (Germany); Henkes, H.; Liebig, T.; Weber, W.; Golik, S.; Kuehne, D. [Alfried Krupp Krankenhaus, Klinik fuer Radiologie und Neuroradiologie, Essen (Germany); Esser, J. [Universitaetsklinikum Essen, Zentrum fuer Augenheilkunde, Essen (Germany)

    2006-07-15

    Introduction: The purpose of this study was to evaluate the single-centre experience with transvenous coil treatment of dural carotid-cavernous sinus fistulas. Methods: Between November 1991 and December 2005, a total of 141 patients (112 female) with dural carotid-cavernous sinus fistula underwent 161 transvenous treatment sessions. The patient files and angiograms were analysed retrospectively. Clinical signs and symptoms included chemosis (94%), exophthalmos (87%), cranial nerve palsy (54%), increased intraocular pressure (60%), diplopia (51%), and impaired vision (28%). Angiography revealed in addition cortical drainage in 34% of the patients. Partial arterial embolization was carried out in 23% of the patients. Transvenous treatment comprised in by far the majority of patients complete filling of the cavernous sinus and the adjacent segment of the superior and inferior ophthalmic vein with detachable coils. Complete interruption of the arteriovenous shunt was achieved in 81% of the patients. A minor residual shunt (without cortical or ocular drainage) remained in 13%, a significant residual shunt (with cortical or ocular drainage) remained in 4%, and the attempted treatment failed in 2%. There was a tendency for ocular pressure-related symptoms to resolve rapidly, while cranial nerve palsy and diplopia improved slowly (65%) or did not change (11%). The 39 patients with visual impairment recovered within the first 2 weeks after endovascular treatment. After complete interruption of the arteriovenous shunt, no recurrence was observed. The transvenous coil occlusion of the superior and inferior ophthalmic veins and the cavernous sinus of the symptomatic eye is a highly efficient and safe treatment in dural carotid-cavernous sinus fistulas. In the majority of patients a significant and permanent improvement in clinical signs and symptoms can be achieved. (orig.)

  13. Dural neurogenic inflammation induced by neuropathic pain is specific to cranial region.

    Science.gov (United States)

    Filipović, B; Matak, I; Lacković, Z

    2014-05-01

    Up to now, dural neurogenic inflammation (DNI) has been studied primarily as a part of migraine pain pathophysiology. A recent study from our laboratory demonstrated the occurrence of DNI in response to peripheral trigeminal nerve injury. In this report, we characterize the occurrence of DNI after different peripheral nerve injuries in and outside of the trigeminal region. We have used the infraorbital nerve constriction injury model (IoNC) as a model of trigeminal neuropathic pain. Greater occipital nerve constriction injury (GoNC), partial transection of the sciatic nerve (ScNT) and sciatic nerve constriction injury (SCI) were employed to characterize the occurrence of DNI in response to nerve injury outside of the trigeminal region. DNI was measured as colorimetric absorbance of Evans blue plasma protein complexes. In addition, cellular inflammatory response in dural tissue was histologically examined in IoNC and SCI models. In comparison to the strong DNI evoked by IoNC, a smaller but significant DNI has been observed following the GoNC. However, DNI has not been observed either in cranial or in lumbar dura following ScNT and SCI. Histological evidence has demonstrated a dural proinflammatory cell infiltration in the IoNC model, which is in contrast to the SCI model. Inflammatory cell types (lymphocytes, plasma cells, and monocytes) have indicated the presence of sterile cellular inflammatory response in the IoNC model. To our knowledge, this is the first observation that the DNI evoked by peripheral neuropathic pain is specific to the trigeminal area and the adjacent occipital area. DNI after peripheral nerve injury consists of both plasma protein extravasation and proinflammatory cell infiltration.

  14. Four-dimensional computed tomography angiographic evaluation of cranial dural arteriovenous fistula before and after embolization

    Energy Technology Data Exchange (ETDEWEB)

    Tian, Bing, E-mail: bing.tian@hotmail.com; Xu, Bing, E-mail: aishanli0102@126.com; Lu, Jianping, E-mail: tianbing2003@163.com; Liu, Qi, E-mail: liuqimd@126.com; Wang, Li, E-mail: wangli_changhai@163.com; Wang, Minjie, E-mail: cjr.wangminjie@vip.163.com

    2015-06-15

    Highlights: • 4D CTA showed excellent agreement with DSA with regard to identification of feeding arteries and drainage veins. • The most important finding was 4D CTA in determining the impact of DAVF treatment with transarterial embolization. • 4D CTA provides images similar to those obtained with DSA both before and after treatment. - Abstract: Purpose: This study aimed to evaluate the usefulness of four-dimensional CTA before and after embolization treatment with ONYX-18 in eleven patients with cranial dural arteriovenous fistulas, and to compare the results with those of the reference standard DSA. Patients and Methods: Eleven patients with cranial dural arteriovenous fistulas detected on DSA underwent transarterial embolization with ONYX-18. Four-dimensional CTA was performed an average of 2 days before and 4 days after DSA. Four-dimensional CTA and DSA images were reviewed by two neuroradiologists for identification of feeding arteries and drainage veins and for determining treatment effects. Interobserver and intermodality agreement between four-dimensional CTA and DSA were assessed. Results: Forty-two feeding arteries were identified for 14 fistulas in the 11 patients. Of these, 36 (85.71%) were detected on four-dimensional CTA. After transarterial embolization, one patient got partly embolized, and the fistulas in the remaining 10 patients were completely occluded. The interobserver agreement for four-dimensional CTA and intermodality agreement between four-dimensional CTA and DSA were excellent (κ = 1) for shunt location, identification of drainage veins, and fistula occlusion after treatment. Conclusion: Four-dimensional CTA images are highly accurate when compared with DSA images both before and after transarterial embolization treatment. Four-dimensional CTA can be used for diagnosis as well as follow-up of cranial dural arteriovenous fistulas in clinical settings.

  15. Transsphenoidal cyst cisternostomy with a keyhole dural opening for sellar arachnoid cysts: technical note.

    Science.gov (United States)

    Oyama, Kenichi; Fukuhara, Noriaki; Taguchi, Manabu; Takeshita, Akira; Takeuchi, Yasuhiro; Yamada, Shozo

    2014-04-01

    A less invasive transsphenoidal approach with a keyhole dural opening for intrasellar arachnoid cysts is described. This approach was used to address seven sellar cystic lesions with suprasellar extension; they were six intrasellar arachnoid cysts (IACs) and one Rathke's cleft cyst (RCC). In all cases, preoperative MRI revealed cerebrospinal fluid (CSF) intensity on both T1- and T2-weighted images. On preoperative contrast-enhanced MRI, five of the six IACs manifested posterior displacement of the flattened pituitary gland toward the dorsum sellae; one of the six IACs and the RCC exhibited a flattened pituitary gland on the anterior surface of the cyst. Wide cyst cisternostomy through a keyhole dural opening was carried out safely using a microscope with the support of a thin angled endoscope (30° and/or 70°, diameter 2.7 mm). As we aimed to avoid iatrogenic injury of the pituitary function, we found it difficult to obtain a sufficiently wide and precise opening of the cyst wall when the pituitary gland was located on the anterior surface of the cyst wall. Our approach facilitates safe cyst cisternostomy as wide as that obtainable by transcranial manipulation. In addition, CSF leakage is prevented by dural plasty using the fascia lata and stitching with 6-0 monofilament sutures. This technique can be adapted to address various sellar cystic lesions. However, as the posterior or anterior displacement of the normal pituitary gland in the presence of IACs or RCCs, respectively, affects the width of the cyst opening, our technique is more suitable for IACs than RCCs.

  16. Conduta na lesão dural intraoperatória em artrodese da coluna lombar Conducta en lesión de duramadre intraoperatoria en artrodesis de la columna lumbar Management of intraoperatory dural tear in lumbar spine arthrodesis

    Directory of Open Access Journals (Sweden)

    Fabiano de Mendonça Grandese

    2010-12-01

    Full Text Available OBJETIVO: estudo retrospectivo de pacientes com lesão dural intraoperatória de cirurgia da coluna vertebral lombar, conduzido por meio de um protocolo independente da extensão da lesão, complicações associadas e resultados após seguimento mínimo de um ano. MÉTODOS: um total de 10 pacientes com durotomia acidental em cirurgias de descompressão e artrodese da coluna vertebral lombar, no período de Janeiro de 2007 a Janeiro de 2009, para tratamento de doença degenerativa, tiveram seus prontuários revisados, após terem sido tratados por meio de um protocolo embasado em reparo primário da lesão, drenagem subaracnoidea fechada, subfascial e subcutânea aspirativa realizados por cirurgião experiente, associado a repouso relativo com mobilidade precoce e terapia medicamentosa. Suas anotações e exames radiológicos foram verificados com seguimento pós-operatório e direcionados para identificação de sintomas sugestivos de complicações. RESULTADOS: todos os pacientes apresentaram boa evolução, sem ocorrência de fístula liquórica ou infecção pós-operatória; três deles apresentaram cefaleia pós-operatória de leve intensidade. Não houve necessidade de reoperação em nenhum desses pacientes. CONCLUSÃO: concluiu-se que a conduta adotada é segura e de bom resultado para os pacientes quando ocorre esse tipo de lesão, independentemente da extensão da mesma.OBJETIVO: un estudio retrospectivo de pacientes con lesión de la duramadre intraoperatoria de cirugía en la columna lumbar, llevada a cabo por medio de un protocolo independiente de la extensión de la lesión, complicaciones asociadas y los resultados de seguimiento después de un mínimo de un año. MÉTODOS: 10 pacientes con durotomía accidental en la descompresión quirúrgica y artrodesis de la columna vertebral lumbar, en el período de enero de 2007 a enero de 2009, para el tratamiento de enfermedades degenerativas, tuvieron sus registros revisados después de

  17. Dihydrotestosterone stimulates proliferation and differentiation of fetal calvarial osteoblasts and dural cells and induces cranial suture fusion.

    Science.gov (United States)

    Lin, Ines C; Slemp, Alison E; Hwang, Catherine; Sena-Esteves, Miguel; Nah, Hyun-Duck; Kirschner, Richard E

    2007-10-01

    The higher prevalence of metopic and sagittal suture synostosis in male infants suggests a role for androgens in early craniofacial development. These experiments characterize the influence of androgen stimulation on growth and differentiation of fetal dural and calvarial bone cells and on cranial suture fusion. Primary murine fetal (E18) dural cells and calvarial osteoblasts were isolated and cultured. Cells were treated for 48 hours with 5alpha-dihydrotestosterone (0 to 1000 nM). Cell proliferation was examined by nonradioactive proliferation assay; mRNA expression of alkaline phosphatase, transforming growth factor (TGF)-beta1, and the bone matrix proteins osteopontin, osteocalcin, and type 1 collagen was determined by reverse-transcriptase polymerase chain reaction. In separate experiments, intact fetal calvariae were grown in tissue culture with 10 nM 5alpha-dihydrotestosterone for 7 and 14 days and then examined histologically. Androgen stimulation at 5 nM increased proliferation of fetal dural cells by 46.0 percent and of fetal calvarial osteoblasts by 20.5 percent. Dural expression of osteopontin, osteocalcin, and type 1 collagen was enhanced by 5alpha-dihydrotestosterone, as was that of TGF-beta1 and alkaline phosphatase. Androgen stimulation increased calvarial osteoblast expression of alkaline phosphatase and TGF-beta1 but induced little change in expression of osteocalcin, osteopontin, and type 1 collagen. In tissue culture, 5alpha-dihydrotestosterone stimulated osteoid formation and fusion of sagittal sutures. Androgen stimulation of dural cells and osteoblasts isolated from fetal calvaria promotes cell proliferation and osteoblastic differentiation and can induce cranial suture fusion. These results suggest that sex steroid hormone signaling may stimulate sutural osteogenesis by means of osteodifferentiation of dural cells, thus explaining the male prevalence of nonsyndromic craniosynostosis.

  18. Anesthesia considerations and intraoperative monitoring during surgery for arteriovenous malformations and dural arteriovenous fistulas.

    Science.gov (United States)

    Miller, Christina; Mirski, Marek

    2012-01-01

    The anesthetic considerations for surgical resection of arteriovenous malformations (AVMs) and dural arteriovenous fistulas (DAVFs) incorporate many principles that are common to craniotomies for other indications. However, a high-flow, low-resistance shunt results in chronic hypoperfusion of adjacent brain tissue that is vulnerable to ischemia and at high risk for hyperemia and hemorrhage as resection of the lesion redirects blood flow. A comprehensive understanding of AVM pathophysiology and rapidly titratable anesthetic and vasoactive agents allow the anesthesiologist to alter blood pressure targets as resection evolves for optimal patient outcome. Intensive management is continued post-operatively as the brain acclimatizes to new parameters.

  19. Headache in the parturient: Pathophysiology and management of post-dural puncture headache

    Directory of Open Access Journals (Sweden)

    Gita Nath

    2011-01-01

    Full Text Available Headache in the postpartum period is common and multifactorial in origin. Apart from primary causes such as tension headaches and migraine, secondary headaches such as post-dural puncture headache (PDPH are increasingly common because of increasing use of regional anaesthesia and analgesia during childbirth. Preventive measures for PDPH include the use of smaller gauge pencil-point needles for spinal blocks; epidural needles of 18 G or less; using saline rather than air for epidural space identification and the use of ultrasound guidance, especially for difficult cases such as morbid obesity and spinal deformities. In case of accidental dural puncture (ADP, the choice is between inserting the catheter in an adjacent space or intrathecal catheterization. Current evidence seems to be in favour of inserting the epidural catheter into the subarachnoid space and using the intrathecal catheter for analgesia/anaesthesia after prominently labelling it as intrathecal, to prevent misuse. It should be removed after at least 24 hours and a 10 ml bolus of saline injected before removal of catheter may be helpful. Either way, having written protocols for the management of accidental dural puncture helps to reduce the incidence of PDPH. PDPH can be disabling in severity and can mar the whole experience of childbirth. In addition, severe untreated PDPH can cause complications such as nerve palsies, subdural hematoma and cerebral venous thrombosis. Conservative methods of treatment should be tried first such as adequate hydration, paracetamol, caffeine, sumatriptan or ACTH/hydrocortisone. Epidural blood patching is the most effective treatment for PDPH. It is more effective if done 24-48 hours after dural puncture. It is an invasive procedure with its own complications as well as a failure rate of up to 30%, so that a second or even third patch may be necessary. Both these facts should be intimated to the patient beforehand. Meticulous follow-up and evaluation

  20. Isolated oculomotor nerve palsy caused by cavernous sinus dural arteriovenous fistula: Case report

    Energy Technology Data Exchange (ETDEWEB)

    Ihn, Yon Kwon; Jung, Won Sang [The Catholic Univ. of Korea, Suwon (Korea, Republic of); Kim, Bum Soo [The Catholic Univ. of Korea, Seoul (Korea, Republic of)

    2012-10-15

    Cavernous dural arteriovenous fistula (DAVF), which usually presents with conjunctival injection, proptosis, loss of visual acuity, and ophthalmoplegia, is a rare cause of ophthalmoplegia. Thus, it may be overlooked when the typical symptoms are lacking. There have been some cavernous DAVF case reports presenting with isolated oculomotor, abducens and trochlear nerve palsy. We report a patient presenting with isolated oculomotor palsy, caused by cavernous DAVF, which was treated by transvenous coil embolization. This case suggests that cavernous DAVF should be considered in the differential diagnosis of isolated oculomotor nerve palsy and for which case - selective angiography and embolization may be helpful in reaching a diagnosis and providing a guide for optimal treatment.

  1. Central action of peripherally applied botulinum toxin type A on pain and dural protein extravasation in rat model of trigeminal neuropathy.

    Directory of Open Access Journals (Sweden)

    Boris Filipović

    Full Text Available BACKGROUND: Infraorbital nerve constriction (IoNC is an experimental model of trigeminal neuropathy. We investigated if IoNC is accompanied by dural extravasation and if botulinum toxin type A (BoNT/A can reduce pain and dural extravasation in this model. METHODOLOGY/PRINCIPAL FINDINGS: Rats which developed mechanical allodynia 14 days after the IoNC were injected with BoNT/A (3.5 U/kg into vibrissal pad. Allodynia was tested by von Frey filaments and dural extravasation was measured as colorimetric absorbance of Evans blue-plasma protein complexes. Presence of dural extravasation was also examined in orofacial formalin-induced pain. Unilateral IoNC, as well as formalin injection, produced bilateral dural extravasation. Single unilateral BoNT/A injection bilaterally reduced IoNC induced dural extravasation, as well as allodynia (lasting more than 2 weeks. Similarly, BoNT/A reduced formalin-induced pain and dural extravasation. Effects of BoNT/A on pain and dural extravasation in IoNC model were dependent on axonal transport through sensory neurons, as evidenced by colchicine injections (5 mM, 2 µl into the trigeminal ganglion completely preventing BoNT/A effects. CONCLUSIONS/SIGNIFICANCE: Two different types of pain, IoNC and formalin, are accompanied by dural extravasation. The lasting effect of a unilateral injection of BoNT/A in experimental animals suggests that BoNT/A might have a long-term beneficial effect in craniofacial pain associated with dural neurogenic inflammation. Bilateral effects of BoNT/A and dependence on retrograde axonal transport suggest a central site of its action.

  2. Treatment of a cavernous sinus dural arteriovenous fistula by deep orbital puncture of the superior ophthalmic vein

    Energy Technology Data Exchange (ETDEWEB)

    Benndorf, G. [Neuroangiography, Department of Radiology, Charite, Humboldt University Berlin (Germany); Bender, A. [Neuroradiology, Department of Radiology, Charite, Humboldt University Berlin (Germany); Campi, A. [Dept. of Neuroradiology, Hospital San Raffaele, Milan (Italy); Menneking, H. [Dept. of Maxillofacial Surgery, Charite, Humboldt University Berlin (Germany); Lanksch, W.R. [Department of Neurosurgery, Charite, Humboldt University Berlin, Augustenburger Platz 1, 13 353 Berlin (Germany)

    2001-06-01

    In a patient with progressive ophthalmological problems, including uncontrolled intraocular pressure related to a cavernous sinus dural arteriovenous fistula, urgent intervention may be necessary to prevent permanent visual loss. We report a case in which inadequate transarterial embolisation and lack of access for transvenous catheterisation, including a direct approach through the superior ophthalmic vein, preceded percutaneous puncture of the superior ophthalmic vein deep within the orbit, permitting venous occlusion without complications. This case demonstrates that deep orbital puncture of the vein is feasible for occlusion of a cavernous sinus dural arteriovenous fistula. (orig.)

  3. FIBROSIS QUÍSTICA EN EL ADULTO

    Directory of Open Access Journals (Sweden)

    Joel Melo T., DR.

    2015-05-01

    Full Text Available La Fibrosis Quística (FQ es una enfermedad hereditaria autosómica recesiva. La detección precoz sumado a medidas de intervención temprana han modificado el curso de esta enfermedad con mejorías en su sobrevida, lo que ha llevado a una población creciente de pacientes de 18 años. La mutación genética determina una alteración en una Proteína Reguladora de Conductancia Transmembrana (CFTR que afecta a numerosos órganos y sistemas, pero el compromiso pulmonar es el que causa mayor morbimortalidad. El germen más frecuente que infecta a adultos es Pseudomonas aeruginosa y si bien hay una serie de medidas para el manejo de la infección crónica por Pseudomonas las terapia dirigida a la restauración de la función de la proteína CFTRhatomadorelevancia. Cuando la falla respiratoria progresa, la única alternativa disponible es el trasplante pulmonar que mejora la sobrevida y la calidad de vida en estos pacientes.

  4. Uso del colchón de agua en sala snoezelen para el tratamiento fisioterapéutico del adulto con parálisis cerebral

    OpenAIRE

    Velasco Arias, Carmen

    2013-01-01

    INTRODUCCIÓN: la parálisis cerebral comprende un grupo de alteraciones del movimiento y la postura, que en el adulto genera trastornos que varían según el tipo de patrón motor y la gravedad de la afectación. El concepto Snoezelen propone la intervención con discapacitados en la atmósfera de confianza y relajación creada en las salas de estimulación multisensorial, gracias a los elementos que encontramos en ellas. OBJETIVOS: exponer las características del colchón de agua com...

  5. Actitudes docentes y buenas prácticas con TIC del profesorado de Educación Permanente de Adultos en Andalucía

    OpenAIRE

    Fernández Batanero, José María; Torres González, José Antonio

    2015-01-01

    El presente artículo recoge los resultados de un estudio cuyo objetivo ha sido determinar las actitudes del profesorado de educación permanente de adultos de la comunidad autónoma de Andalucía, hacia el uso e integración de las Tecnologías de la Información y Comunicación (TIC) en sus respectivos centros, al mismo tiempo que identificar aquellos factores que favorecen el desarrollo de buenas prácticas. El diseño de investigación es de tipo descriptivo mixto. Las técnicas utiliz...

  6. Uso del colchón de agua en sala snoezelen para el tratamiento fisioterapéutico del adulto con parálisis cerebral

    OpenAIRE

    Velasco Arias, Carmen

    2013-01-01

    INTRODUCCIÓN: la parálisis cerebral comprende un grupo de alteraciones del movimiento y la postura, que en el adulto genera trastornos que varían según el tipo de patrón motor y la gravedad de la afectación. El concepto Snoezelen propone la intervención con discapacitados en la atmósfera de confianza y relajación creada en las salas de estimulación multisensorial, gracias a los elementos que encontramos en ellas. OBJETIVOS: exponer las características del colchón de agua com...

  7. Prevalencia de dependencia funcional y su asociación con caídas en una muestra de adultos mayores pobres en México

    OpenAIRE

    2011-01-01

    Determinar la prevalencia de la dependencia funcional (DF) de los adultos mayores (AM) que viven en condiciones de pobreza en México, y estimar la asociación entre la DF y las caídas. Material y métodos. Se realizó una encuesta con tres etapas de selección, con estratificación según tipo de localidad (rural o urbana) y con representatividad nacional del padrón de Oportunidades 2006. La población objetivo estuvo conformada por individuos de 70 años y más, beneficiarios del Programa Oportunidad...

  8. Revisión sistemática sobre el impacto de la actividad física en los trastornos de la marcha en el adulto mayor

    OpenAIRE

    Jeison Daniel Salazar Pachón; Jhon F. Ramírez Villada; David Chaparro; Henry H. León

    2014-01-01

    Objetivos. 1) realizar una revisión sistemática de los estudios que examinan el impacto de la actividad física en los trastornos de la marcha del adulto mayor entre el periodo de 2003-2013, y 2) hacer recomendaciones basadas en el nivel y la fuerza de las evidencias. Método. La revisión fue limitada a: tipo de estudio, periodo de publicación, alteraciones de marcha, actividad física, frecuencia, duración, intensidad, protocolos de evaluación. En el proceso de adquisición de la información fue...

  9. Actividad Física Vrs el Deterioro físico provocado por el envejecimiento y adicciones en hombres adultos mayores

    OpenAIRE

    Álvarez-Montoya, Berta Emilia; Araya-Medrano, Gabriela; Delgado-Serrano, María Fernanda

    2011-01-01

    Cada día son más las personas que llegan a edad avanzada, aunque ha aumentado la cantidad que realizan algún tipo de ejercicio, sigue imperando el sedentarismo. Los cambios físicos que se aprecian con el envejecimiento se aceleran por el desuso. El presente estudio evidencia los efectos de la actividad física en adultos mayores exadictos y ex indigentes después de una intervención fisioterapéutica llevada a cabo entre marzo y noviembre del 2010. Tales efectos después de realizar el análisis d...

  10. Estrés oxidativo como factor de riesgo para el desarrollo de diabetes mellitus, osteoartritis o hipertensión arterial en adultos mayores

    OpenAIRE

    Ada Saraí Beristain Pérez; Martha A. Sánchez Rodríguez; Mirna Ruiz Ramos; Víctor Manuel Mendoza Núñez

    2006-01-01

    Se ha reportado que el estrés oxidativo (EOx) es un factor de riesgo para el desarrollo de algunas enfermedades crónico- degenerativas (ECD) durante la vejez; sin embargo, las evidencias científicas no son del todo concluyentes. Por tal motivo, el objetivo del presente estudio fue determinar la influencia del EOx como factor de riesgo de diabetes mellitus tipo 2 (DM), osteoartritis (OA) o hipertensión arterial (HTA) en una población de adultos mayores (AM). Para tal efecto, se realizó un estu...

  11. Prevalencia del maltrato doméstico en adultos mayores. Policlínica "Alcides Pino". Holguín. 2009

    OpenAIRE

    Marcia Avila-Oliva; Libia Avila-Oliva; Sara Iris Rodríguez-Oliva

    2012-01-01

    Se realizó un estudio descriptivo con el objetivo de caracterizar el maltrato doméstico en adultos mayores de dos consultorios del área de salud "Alcides Pino" en el municipio de Holguín en el año 2009. De los seniles que percibieron maltrato estuvieron las edades de 60 a 74 años, predominando el sexo femenino, la escolaridad primaria y las mujeres sin vínculo conyugal, mientras que los mayoritarios estuvieron asociados a hombres casados. Otros aspectos analizados fueron, el tipo de familia o...

  12. Calidad de Arención del Adulto Mayor en la Caja Nacional de Salud Cochabamba

    Directory of Open Access Journals (Sweden)

    Wilfredo Villarroel Lafuente

    2009-06-01

    Full Text Available En Bolivia un 7% de la población es Adulta Mayor (AM, de los cuales el 61% vive en la pobreza; por ello se promulgó laley 1889 que pone en vigencia el Seguro Medico Gratuito de Vejez (SMGV, sin embargo la Caja Nacional de Salud (CNSsoporta el 88% de los afiliados al SMGV, por lo cual esta actualmente colapsada por la demanda de servicios, con la consecuenteperdida de calidad y calidez en la atención del AM. Por lo tanto desarrollamos el presente estudio de tipo transversal,descriptivo con el propósito de determinar la percepción del Adulto Mayor sobre la calidad de atención y la relaciónmédico paciente dentro del marco de las prestaciones del SMGV. Analizamos 170 muestras, 114 en la CNS policlínicoAnexo 32 y 56 en la CNS Quillacollo. Observamos que la percepción sobre la calidad de Atención del SMGV en la CNSes buena en 51% de los casos, 27% la catalogan como regular a mala y el 22% como pésima. Referente a la relación médicopaciente tenemos que 68% de los pacientes están de acuerdo con el trato que se les brinda en el SMGV. Se concluye coneste estudio que el nivel de trato y calidad de atención al paciente AM, nos falta aun mucho por avanzar, un trato cordial osolo un apretón de manos serian un buen comienzo para un tratamiento mejor del adulto mayor.

  13. Radiographic anatomy of the distal dural SAC; A myelographic investigation of dimensions and termination

    Energy Technology Data Exchange (ETDEWEB)

    Larsen, J.L.; Olsen, K.O. (Haukeland Sykehus, Bergen (Norway). Dept. of Diagnostic Radiology)

    1991-05-01

    A radio-anatomical study was performed of the distal dural sac (DS) in 121 patients subjected to myelography. In 83.4% the termination of the DS was located from the upper half of the S1-segment to the lower half of the S2-segment. In the remaining patients the dural terminations were more distally located. The average location of the DS-termination was higher than that found in a previous anatomic study. The inference is that in patients with low-back pain and sciatica, the DS tends to terminate at a higher spinal level than in a non-selected anatomic material. The caudal reduction in sagittal diameter of the DS was less than that of the frontal diameter of the sac. The linear diminution in cross-sectional area of the DS from the level of L3 towards the lumbosacral junction was not correlated with the degree of caudal extension of the DS into the sacrum. Thus the length of the DS and its transverse diameters are independent of each other. These results supported the view that the location of the termination of the DS (and hence that of the spinal cord) is not related to stenosis of the central spinal canal. (orig.).

  14. Surgical treatment of tentorial dural arteriovenous fistulae located around the tentorial incisura.

    Science.gov (United States)

    Hatano, Taketo; Bozinov, Oliver; Burkhardt, Jan-Karl; Bertalanffy, Helmut

    2013-07-01

    Tentorial dural arteriovenous fistulae (DAVF) are relatively uncommon and are the most dangerous type of DAVF. Because of a high incidence of hemorrhage and subsequent neurological deficits, treatment is mandatory. A consecutive series of nine surgically treated patients with symptomatic tentorial DAVF were analyzed in this study. All lesions were located around the tentorial incisura and were treated microsurgically using a subtemporal approach in eight cases and a supracerebellar approach in one case. The dural bases of the lesions were located adjacent to the tentorial edge in six patients and the tentorial apex in three patients. Complete obliteration was achieved in all treated tentorial DAVF. In one patient, the torcular fistula remained untreated without cortical venous reflux. Postoperative asymptomatic temporal lobe hemorrhage was diagnosed in one patient with a tentorial apex DAVF; however, no new neurological symptoms were present after surgical treatment. The subtemporal approach for unilateral tentorial DAVF is a favorable and direct approach for the highly skilled surgeon. Perimesencephalic venous dilatation or varix is an important finding on MRI to help localize tentorial DAVF in the tentorial edge or apex.

  15. Paraplegia in a chiropractic patient secondary to atraumatic dural arteriovenous fistula with perimedullary hypertension: case report.

    Science.gov (United States)

    Foreman, Stephen M; Stahl, Michael J; Schultz, Gary D

    2013-07-08

    Intracranial dural arteriovenous fistulas are abnormal communications between higher-pressure arterial circulation and lower-pressure venous circulation. This abnormal communication can result in important and frequently misdiagnosed neurological abnormalities.A case of rapid onset paraplegia following cervical chiropractic manipulation is reviewed. The patient's generalized spinal cord edema, lower extremity paraplegia and upper extremity weakness, were initially believed to be a complication of the cervical spinal manipulation that had occurred earlier on the day of admission. Subsequent diagnostic testing determined the patient suffered from impaired circulation of the cervical spinal cord produced by a Type V intracranial arteriovenous fistula and resultant venous hypertension in the pontomesencephalic and anterior spinal veins.The clinical and imaging findings of an intracranial dural arteriovenous fistula with pontomesencephalic venous congestion and paraplegia are reviewed.This case report emphasizes the importance of thorough and serial diagnostic imaging in the presence of sudden onset paraplegia and the potential for error when concluding atypical neurological presentations are the result of therapeutic misadventure.

  16. Dural sinus malformation (DSM) in fetuses. Diagnostic value of prenatal MRI and follow-up

    Energy Technology Data Exchange (ETDEWEB)

    Merzoug, Valerie; Drissi, Cyrine; Adamsbaum, Catherine [Hopital Saint Vincent de Paul, Service de Radiopediatrie, Paris (France); Flunker, Sabrina; Couture, Alain [Hopital Arnaud de Villeneuve, Service de Radiopediatrie, Montpellier cedex 5 (France); Eurin, Danielle [Hopital Charles Nicolle, Service de Radiopediatrie, Rouen (France); Grange, Gilles [Hopital Cochin, Service de Gyneco-Obstetrique, Maternite Port-Royal, Paris (France); Garel, Catherine [Hopital Armand Trousseau, Service de Radiopediatrie, Paris (France); Richter, Brigitte [Hopital Clemenceau, Service de Radiopediatrie, Caen (France); Geissler, Frederic [Centre Hospitalier Universitaire, Service de Radiopediatrie, Clermont Ferrand (France)

    2008-04-15

    Dural sinus malformations (DSM) are rare malformations mainly reported after birth. The objectives of this study are to describe their prenatal patterns and to focus on their possible favorable outcome. This multicenter retrospective study reported 13 cases of DSM prenatally diagnosed. The admission criterion was a dural mass posterior to the vermis. In 12 patients, MRI was performed after US. Follow-up in 10 born babies (mean: 8 months) and three neuropathological examinations were available. In all fetuses, DSM presented as a well-delimited round mass involving the torcular. The follow-up examinations (n = 10) revealed progressive thrombosis of the DSM marked by a heterogeneous pattern (US and MRI) with concentric rings. The volume of the mass decreased, with complete regression in seven patients (five before and two after birth). One child died at the age of 5 months in the context of major hydrocephalus and another developed atrophy of the frontal lobes. The eight other babies were doing well (5 days to 3 years) without any treatment (n = 6) or following treatment for hydrocephalus (n = 2). Prenatal DSM may have a typical MR pattern, and the prognosis might not be as bad as has previously been reported. In the absence of criterion to predict the hydrovenous cerebral imbalance, it is mandatory to check the parenchyma and the ventricles during the pregnancy. (orig.)

  17. Dural arteriovenous fistula at the foramen magnum presenting with subarachnoid hemorrhage: case reports and literature review.

    Science.gov (United States)

    Guo, L-M; Zhou, H-Y; Xu, J-W; Wang, G-S; Tian, X; Wang, Y; Qiu, Y-M; Jiang, J-Y

    2010-05-01

    Spinal dural arteriovenous fistulas (DAVFs) may arise at any level from the foramen magnum to the sacrum. Only a few case series of DAVFs at the foramen magnum have been reported, especially with patients presenting with subarachnoid hemorrhage (SAH). We performed a retrospective study of four such cases and summarize experiences in the diagnosis and surgical treatment of a DAVF at the foramen magnum. Four male patients, aged from 35 to 51 years, were admitted with severe headache. The cranial computerized tomography scans of all four patients showed SAH, with hemorrhage in the fourth ventricle with or without hemorrhage in the occipital horns of the lateral ventricles. Pre-operative digital subtraction cerebral angiography showed a DAVF at the foramen magnum draining to medullary veins and/or the straight sinus and the confluence of sinuses. Two DAVFs were fed by the vertebral artery, whilst the others were fed by dural branches of the occipital artery and/or the ascending pharyngeal artery. Three patients underwent direct microsurgical electrocoagulation and disconnection of the arteriovenous shunt via an enlargement of the foramen magnum and a hemilaminectomy at C1 by the far lateral suboccipital approach. Post-operative angiography confirmed complete obliteration of the fistula. Cerebral digital subtraction angiography is an effective and accurate method for examination of a DAVF at the foramen magnum. It can be treated effectively and with minimal surgical trauma by microsurgical electrocoagulation and disconnection of the shunt.

  18. Dural Arteriovenous Fistula Following Translabyrinthine Resection of Cerebellopontine Angle Tumors: Report of Two Cases

    Science.gov (United States)

    Li, Peter M.M.C.; Fischbein, Nancy J.; Do, Huy M.; Blevins, Nikolas H.

    2011-01-01

    We describe two cases of dural arteriovenous fistula (DAVF) developing in a delayed fashion after translabyrinthine resection of cerebellopontine angle tumors. Two patients in an academic tertiary referral center, a 46-year-old woman and a 67-year-old man, underwent translabyrinthine resection of a 2-cm left vestibular schwannoma and a 4-cm left petrous meningioma, respectively. Both patients subsequently developed DAVF, and in each case the diagnosis was delayed despite serial imaging follow-up. In one patient, cerebrospinal fluid diversion before DAVF was identified as the cause of her intracranial hypertension; the other patient was essentially asymptomatic but with a high risk of hemorrhage due to progression of cortical venous drainage. Endovascular treatment was effective but required multiple sessions due to residual or recurrent fistulas. Dural arteriovenous fistula is a rare complication of translabyrinthine skull base surgery. Diagnosis requires a high index of clinical suspicion and an understanding of subtle imaging findings that may be present on follow-up studies performed for tumor surveillance. Failure to recognize this complication may lead to misguided interventions for treatment of hydrocephalus and other complications, as well as ongoing risks related to venous hypertension and intracranial hemorrhage. As this condition is generally curable with neurointerventional and/or surgical methods, timely diagnosis and treatment are essential. PMID:23984203

  19. Endovascular treatment of sphenoid wing dural arteriovenous fistula with pure cortical venous drainage.

    Science.gov (United States)

    Fukuda, Hitoshi; Miyake, Kosuke; Kunieda, Takenobu; Murao, Kenichi

    2014-07-01

    Curative endovascular treatment of sphenoid wing dural arteriovenous fistula (dAVF) with pure cortical venous drainage is challenging because of its rarity, lack of accessible dural sinus for transvenous embolization (TVE), and proximity of skull base vital regions. Direct surgery to disconnect venous reflux has been favored. We report the curative endovascular treatment of two sphenoid wing dAVFs with pure cortical venous drainage. One patient revealed complete obliteration of dAVF by a single session of transarterial embolization (TAE). As part of strategic TAE for this complex dAVF, we used a novel approach to create a complete flow-arrest condition in which coils and an occlusion balloon were combined. A liquid agent was then injected across the pathological fistula and into the parent venous apparatus, thereby occluding the lesion. The other patient was treated with percutaneous TVE after TAE was unsuccessful. With a specific strategy and appropriate devices, the microcatheter was successfully introduced through sigmoid sinus, transverse sinus, superior sagittal sinus, and refluxing cortical vein by puncture of the jugular vein. Coils were deployed at the venous side of the fistula, resulting in successful obliteration of the dAVF. Sphenoid wing dAVF with pure cortical venous drainage could be curable by endovascular treatment with proper strategy and instruments when anatomical condition permits.

  20. [Unknown intracerebral tumour presenting as brainstem compression following unintentional dural puncture].

    Science.gov (United States)

    Castro-Castro, J; Figueiredo-González, O; Río-Gómez, A; Carballo-Loureiro, N; Castro-Bouzas, D

    2014-01-01

    A 36-year old primigravid of 41 weeks gestation was admitted to the labour ward. Her past medical history included hyperemesis gravidarum and migraine. An accidental dural puncture occurred during labour epidural analgesia. In the postpartum period she presented with continuous headache, and was treated with oral analgesics, oral caffeine, fluid therapy, and tetracosactide. She refused an epidural blood patch. On the seventh day postpartum, the patient was re-admitted to the Emergency Department with decreased level of consciousness and signs of brainstem compression. Cranial computed tomography and magnetic resonance imaging showed a posterior fossa tumour. An emergency craniotomy was performed with complete neurological recovery. This case emphasises the need to consider the differential diagnoses of post-dural puncture headache and to highlight the warning signs in patients who do not respond despite treatment with conventional therapy. Copyright © 2013 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Published by Elsevier España. All rights reserved.

  1. Improvement of depression after treatment of dural arteriovenous fistula: a case report and a review.

    Science.gov (United States)

    Nakagawa, Minoru; Sugiu, Kenji; Tokunaga, Koji; Sakamoto, Chihoko; Fujiwara, Kenjiro

    2012-01-01

    Patients with dural arteriovenous fistulas (DAVFs) in the transverse-sigmoid sinus suffer from several symptoms: bruit, headache, visual impairment, and so on. But depression is rare in patients with DAVF. The authors reported a rare case presenting the improvement of depression after the treatment of a dural arteriovenous fistula in the left transverse-sigmoid sinus. A 46-year-old male had suffered from depression and was treated with antidepressants at a local hospital for four years. The patient was temporarily laid off due to his depression. Afterwards, he had Gerstmann's syndrome and came to our hospital. A DAVF in the left transverse-sigmoid sinus was demonstrated on the angiogram. The DAVF was successfully treated with endovascular surgery, coil embolization of the isolated diseased sinus through the mastoid emissary vein which was a draining vein from the fistula. After this treatment, his depression as well as Gerstmann's syndrome was improved and the quantity of the antidepressants decreased. The patient returned to work without any antidepressant two years after the treatment. DAVFs might be one of the causes of depression. It may be necessary to evaluate cerebral vessels in patients suffering from depression by using MRA or 3D-CTA even if there are not any abnormal findings on plain CT scans.

  2. Hipnosis como complemento en la cirugía oral del adulto mayor

    Directory of Open Access Journals (Sweden)

    Elina Muñiz Manzano

    2013-03-01

    Full Text Available Introducción: el envejecimiento poblacional es un fenómeno mundial y la cirugía oral es compleja en los adultos mayores, por lo que la preparación preoperatoria es de vital importancia para una evolución satisfactoria. Este trabajo tiene como objetivo demostrar la eficacia de la hipnosis en pacientes con temor en la cirugía oral del adulto mayor. Métodos: se realizó un estudio descriptivo, transversal, con muestra de 20 pacientes de 60 años o más, atendidos en la consulta de Cirugía Maxilofacial del Hospital Universitario "Comandante Manuel Fajardo", en el año 2011, donde se analizaron las variables edad, sexo, número de sesiones de hipnosis, antecedentes patológicos, diagnósticos más frecuentes y temor. Resultados: el mayor número de pacientes se encontró entre 60-69 años de edad, (70 % y el menor en 70-79, (30 %. El sexo femenino prevaleció con 70 %. El número de sesiones fue en el grupo de 60-69 con 58, con un promedio total de 4 por pacientes. En los antecedentes patológicos más frecuentes fue la hipertensión arterial en 14 (70 % y le siguió la diabetes tipo II en 2 (10 % En los diagnósticos más frecuentes fue la caries de cuarto grado con 10 (50 % seguido por los dientes parodontósicos con 4 (20 %. El temor se midió en una escala confeccionada, en la que los pacientes con cifras de l0, 8 y 7 se redujeron a 4 y 5. Conclusiones: Se demuestra la efectividad de la terapia de hipnosis para disminuir el temor y realizar la cirugía oral en el adulto mayor.

  3. Inseguridad alimentaria en adultos mayores en 15 comunas del Gran Santiago: un tema pendiente

    Directory of Open Access Journals (Sweden)

    Vianny Vargas Puello

    2013-10-01

    Full Text Available Introducción: Experimentar inseguridad alimentaria determina consecuencias negativas en la nutrición, salud y bienestar general de los adultos mayores y sus familias. En Chile prácticamente no existe información al respecto, a pesar de ser un importante problema de salud pública en otros países de la región. Objetivos: Determinar la prevalencia de inseguridad alimentaria y su relación con factores sociodemográficos, económicos y nutricionales en Adultos Mayores residentes en comunas del nivel socioeconómico medio-bajo y bajo del Gran Santiago. Materiales y métodos: Estudio observacional transversal en 344 adultos mayores de 65 a 74 años; encuesta socioeconómica, demográfica, nutricional y de inseguridad alimentaria en el hogar (HFIAS. Se determinó prevalencia de inseguridad alimentaria y su relación con las variables independientes por modelos de regresión logística multivariados. Resultados: El 40,4% de muestra presentaba inseguridad alimentaria (95% IC 35,2-45,6%, predominantemente de tipo leve, con una proporción mayor en mujeres, en el límite de la significación estadística. La probabilidad de percibir inseguridad alimentaria se asoció significativamente con bajos ingresos familiares (OR 4,2 IC 2,1-8,6, con mayor número de personas en el hogar (OR 2,4, malnutrición por déficit o exceso (OR 2,0, no ser propietario de la vivienda (OR 2,0 y menores ingresos personales (OR 1,8. Conclusiones: Existe una alta prevalencia de inseguridad alimentaria en esta población, la que se asocia con variables sociodemográficas, económicas y nutricionales. La seguridad alimentaria es un importante tema de salud pública y nutrición en el país, que debe ser investigado en mayor profundidad.

  4. Diabetes mellitus tipo 2 y frecuencia de acciones para su prevención y control

    OpenAIRE

    Aída Jiménez-Corona; Aguilar-Salinas, Carlos A; Rosalba Rojas-Martínez; Mauricio Hernández-Ávila

    2013-01-01

    Objetivo. Estimar la frecuencia de medidas de prevención y control para diabetes tipo 2 en población mexicana. Material y métodos. La ENSANUT 2012 es una encuesta con representatividad nacional, con diseño de muestreo probabilístico, multietápico, estratificado y por conglomerados. En este análisis se utilizó la información de 46 277 adultos mayores de 20 años. El análisis se efectuó utilizando Stata 12. Resultados. La prevalencia de diabetes por diagnóstico previo fue de 9.2% (6.4 millones)...

  5. Un problema tipo bin-packing

    Directory of Open Access Journals (Sweden)

    Geovanni Figueroa Mata

    2011-09-01

    Full Text Available Se presentan dos algoritmos heurísticos para resolver un problema de tipo binpacking en el cual se quiere guardar objetos de n tipos diferentes (en donde la demanda del objeto de tipo i-ésimo está dada por d1 en m tipos de recipientes con capacidades no necesariamente iguales; todos los recipientes de tipo j =1,2,...,m deben tener la misma distribución de los objetos. El objetivo es minimizar el costo de los recipientes por utilizar, donde el costo de cada tipo de recipiente está dado por wj (j =1,2,...,m. Para cada recipiente de tipo j =1,2,...,m se deben encontrar el número de repeticiones xj del recipiente, así como el número de copias aij del objeto i-ésimo que se deben almacenar en el recipiente j-ésimo (j =1,2,...,m.

  6. Pseudotumor cerebral secundário a trombose venosa dural: relato de caso pediátrico Pseudotumor cerebri secondary to dural sinus thrombosis: pediatric case report

    Directory of Open Access Journals (Sweden)

    Adriana Rocha Brito

    2005-09-01

    Full Text Available O pseudotumor cerebral é uma síndrome neurológica relativamente comum na adolescência. Na maioria dos casos, a etiologia é idiopática, mas pode haver complicações graves, como cegueira, relacionadas com a hipertensão intracraniana. O objetivo deste artigo é enfatizar o diagnóstico diferencial do pseudotumor cerebral, com atenção especial às etiologias tratáveis. Relatamos o caso de um adolescente de 12 anos que se apresentou com diplopia e cefaléia 9 dias após otite média e mastoidite à direita. A tomografia computadorizada do crânio foi normal, mas a ressonância magnética do encéfalo detectou trombose dos seios transverso e sigmóideo ipsilaterais, a qual respondeu à anticoagulação precoce. A conclusão é que a ressonância magnética do encéfalo é essencial nos pacientes com diagnóstico clínico de pseudotumor cerebral para exclusão de causas tratáveis, como a trombose venosa dural.Pseudotumor cerebri is a relatively common neurologic syndrome in adolescence. In most cases, etiology is idiopathic, but it may have serious complications, such as blindness, that are related to increased intracranial pressure. The aim of this article is to emphasize the differential diagnosis of pseudotumor cerebri, with special attention to treatable etiologies. We report a case of an 12 year-old adolescent who presented with diplopia and headache 9 days after right-sided otitis media and mastoiditis. Head computerized tomography was normal, but brain magnetic resonance imaging demonstrated thrombosis of ipsilateral transverse and sigmoid sinuses, which responded promptly to early anticoagulation. The conclusion is that magnetic resonance imaging is essential for patients with a clinical diagnosis of pseudotumor cerebri in order to exclude treatable causes, such as dural sinus thrombosis.

  7. en unidades de cuidado intensivo de adultos

    Directory of Open Access Journals (Sweden)

    Elizabeth Romero-Massa

    2011-01-01

    Full Text Available Objetivo: determinar la relación entre la demanda de carga laboral de enfermería y la gravedad del paciente en unidades de cuidados intensivos de adultos en la ciudad de Cartagena, en el mes de julio de 2008. Método: investigación de corte longitudinal. Muestra de 42 pacientes, se obtuvieron registros TISS-28 y registros Apache II. Se realizó el cálculo de media aritmética, desviación estándar y proporciones, así como el cálculo del coeficiente de correlación de Pearson. Resultados: participaron 42 pacientes; la media para la edad fue 58,2 años (IC 95% 52,1-64,4. El 51,3% fueron mujeres. Se obtuvieron 42 calificaciones del Apache II al ingreso de los pacientes a la UCI con un promedio de 28,9, de los cuales el 66,7% (28 tienen un mal pronóstico, y 188 calificaciones de TISS-28, con un promedio de 28,7 (IC 95% 25,7-31,7. El promedio de TISS de egreso fue de 25,7 (IC 95% 22,4-28,9 por paciente. El 61,9% de los pacientes perteneció a la clase III. La razón enfermera/paciente clase IV fue de 0,57 inferior a 1:1(1. Se encontró una asociación entre el Apache II y TISS-28 de 0,55 (0,501-0,75 y un coeficiente de determinación de 0,38 (p

  8. Síntomas depresivos versus depresión en adultos mayores de una comunidad rural

    National Research Council Canada - National Science Library

    Clemente Cordero Sánchez; Guillermina García Madrid; Marcela Flores Merlo; Francisco Javier Báez Hernández; Alejandro Torres Reyes; Miguel Ángel Zenteno López

    2014-01-01

    ... la sintomatología depresiva en adultos mayores de una comunidad rural del estado de Puebla, México. Estudio descriptivo, correlacional, transversal, realizado en 155 adultos mayores a quienes...

  9. Responses of dural mast cells in concussive and blast models of mild traumatic brain injury in mice: Potential implications for post-traumatic headache.

    Science.gov (United States)

    Levy, Dan; Edut, Shahaf; Baraz-Goldstein, Renana; Rubovitch, Vardit; Defrin, Ruth; Bree, Dara; Gariepy, Helaine; Zhao, Jun; Pick, Chaim G

    2016-09-01

    Chronic post-traumatic headache (PTH) is one of the most common symptoms of mild traumatic brain injury (mTBI) but its underlying mechanisms remain unknown. Inflammatory degranulation of dural mast cells (MCs) is thought to promote headache, and may play a role in PTH. Whether mTBI is associated with persistent degranulation of dural MCs is yet to be determined. Histochemistry was used to evaluate time course changes in dural MC density and degranulation level in concussive head trauma and blast mouse models of mTBI. The effects of sumatriptan and the MC stabilizer cromolyn sodium on concussion-evoked dural MC degranulation were also investigated. Concussive head injury evoked persistent MC degranulation for at least 30 days. Blast trauma gave rise to a delayed MC degranulation response commencing at seven days that also persisted for at least 30 days. Neither sumatriptan nor cromolyn treatment reduced concussion-evoked persistent MC degranulation. mTBI evoked by closed head injury or blast exposure is associated with persistent dural MC degranulation. Such a response in mTBI patients may contribute to PTH. Amelioration of PTH by sumatriptan may not involve inhibition of dural MC degranulation. If persistent dural MC degranulation contributes to PTH, then cromolyn treatment may not be effective. © International Headache Society 2015.

  10. Autologous Vascularized Dural Wrapping for Temporalis Muscle Preservation and Reconstruction After Decompressive Craniectomy: Report of Twenty-five Cases

    Science.gov (United States)

    Di Rienzo, Alessandro; Iacoangeli, Maurizio; Alvaro, Lorenzo; Colasanti, Roberto; Nocchi, Niccolo; Di Somma, Lucia Giovanna Maria; Scerrati, Massimo

    2013-01-01

    Temporalis muscle reconstruction is a necessary step during frontotemporal cranioplasty ensuing decompressive craniectomy (DC). During this procedure, scarring between the temporalis muscle and the dural layer may lead to complicated muscle dissection, which carries an increased risk of dura and muscle damage. At time of DC, temporalis muscle wrapping by an autologous vascularized dural flap can later on facilitate dissection and rebuilding during the subsequent cranioplasty. In a span of 2 years, we performed 57 DCs for different etiologies. In 30 cases, the temporalis muscle was isolated by wrapping its inner surface using the autologous dura. At cranioplasty, the muscle could easily be dissected from the duraplasty. The inner surface was easily freed from the autologous dural envelope, and reconstruction achieved in an almost physiological position. Follow-up examinations were held at regular intervals to disclose signs of temporalis muscle depletion. Twenty-five patients survived to undergo cranioplasty. Muscle dissection could always be performed with no injury to the dural layer. No complications related to temporalis muscle wrapping were recorded. Face asymmetry developed in four cases but it was always with bone resorption. None of the patients with a good neurological recovery reported functional or aesthetic complaints. In our experience, temporalis muscle wrapping by vascularized autologous dura proved to be effective in preserving its bulk and reducing its adhesion to duraplasty, thereby improving muscle dissection and reconstruction during cranioplasty. Functional and aesthetic results were satisfying, except in cases of bone resorption. PMID:24067769

  11. In situ precise electrospinning of medical glue fibers as nonsuture dural repair with high sealing capability and flexibility

    Directory of Open Access Journals (Sweden)

    Lv FY

    2016-08-01

    Full Text Available Fu-Yan Lv,1,* Rui-Hua Dong,1,* Zhao-Jian Li,2,* Chong-Chong Qin,1 Xu Yan,1,3 Xiao-Xiao He,1 Yu Zhou,4 Shi-Ying Yan,1 Yun-Ze Long1,3 1Collaborative Innovation Center for Nanomaterials & Optoelectronic Devices, College of Physics, Qingdao University, 2Department of Neurosurgery, Affiliated Hospital of Qingdao University, 3Industrial Research Institute of Nonwovens & Technical Textiles, College of Textiles & Clothing, 4Medical College, Qingdao University, Qingdao, People’s Republic of China *These authors contributed equally to this work Purpose: In this work, we propose an in situ precise electrospinning of medical glue fibers onto dural wound for improving sealing capability, avoiding tissue adhesion, and saving time in dural repair.Methods: N-octyl-2-cyanoacrylate, a commercial tissue adhesive (medical glue, can be electrospun into ultrathin fibrous film with precise and homogeneous deposition by a gas-assisted electrospinning device.Results: The self-assembled N-octyl-2-cyanoacrylate film shows high compactness and flexibility owing to its fibrous structure. Simulation experiments on egg membranes and goat meninges demonstrated that this technology can repair small membrane defects quickly and efficiently.Conclusion: This method may have potential application in dural repair, for example, working as an effective supplementary technique for conventional dura suture. Keywords: cyanoacrylates, electrospun fibers, in situ repair dural, gas-assisted electrospinning apparatus

  12. The entire dural sinus tree is compressed in patients with idiopathic intracranial hypertension: a longitudinal, volumetric magnetic resonance imaging study

    Energy Technology Data Exchange (ETDEWEB)

    Rohr, Axel; Bindeballe, Jan; Riedel, Christian; Jansen, Olav [University Clinic of Schleswig-Holstein Campus Kiel, Department of Neuroradiology, Kiel (Germany); Baalen, Andreas van [University Clinic of Schleswig-Holstein Campus Kiel, Department of Neuropediatrics, Kiel (Germany); Bartsch, Thorsten [University Clinic of Schleswig-Holstein Campus Kiel, Department of Neurology, Kiel (Germany); Doerner, Lutz [University Clinic of Schleswig-Holstein Campus Kiel, Department of Neurosurgery, Kiel (Germany)

    2012-01-15

    The objective of this study was to explore the volumetric alterations of dural sinuses in patients with idiopathic intracranial hypertension (IIH). Standardized cranial magnetic resonance imaging (MRI) was used in 17 patients prior to and following treatment of IIH and in seven controls. Magnetic resonance venographies (MRV) were employed for (a) judgement of circumscript dural sinus stenoses and (b) computation of sinus volumes. Cross-sectional areas (CSA) of the superior sagittal sinuses (SSS) were measured on T2-weighted images. Results of the initial MRIs were compared to those on follow-up MRIs and to results of controls. Stenoses of the transverse sinuses (TS) resulting in cranial venous outflow obstruction (CVOO) were present in 15/17 (88%) patients, normalizing in 7/15 cases (47%) after treatment of IIH. CVOO was not detected in the control group. Segmentation of MRV revealed decreased dural sinus volumes in patients with IIH as compared to controls (P = 0.018). Sinus volumes increased significantly with normalization of intracranial pressure independent from disappearing of TS stenoses (P = 0.007). The CSA of the SSS were normal on the initial MRIs of patients with IIH and increased on follow-up after treatment (P < 0.001). However, volumetries displayed overlap in patients and controls. Patients with IIH not only exhibit bilateral stenoses of the TS as has been reported, but volume changes of their entire dural sinus system also occur. The potential etiopathological and diagnostic roles of these changes are discussed. (orig.)

  13. The accuracy and utility of contrast-enhanced MR angiography for localization of spinal dural arteriovenous fistulas : the Toronto experience

    NARCIS (Netherlands)

    Lindenholz, Arjen; TerBrugge, Karel G.; van Dijk, J. Marc C.; Farb, Richard I.

    2014-01-01

    The purpose of this study was to determine the accuracy and utility of contrast-enhanced MR angiography (CE-MRA) in spinal dural arteriovenous fistulas (SDAVF). A retrospective analysis from 1999-2012 identified 70 patients clinically suspected of harboring a SDAVF. Each patient underwent consecutiv

  14. Sandwich technique using fibrin-coated collagen fleece for sellar reconstruction in large dural defects during transsphenoidal surgery.

    Science.gov (United States)

    So, Jaeyoung; Park, Hunho; Sung, Kyeong-Soo; Lee, Kyu Sung; Hong, Chang-Ki

    2017-09-01

    Various surgical methods to prevent intraoperative and postoperative cerebrospinal fluid (CSF) leaks during transsphenoidal approach (TSA) surgeries have been reported, but surgical techniques to address large dural defects have been less thoroughly investigated in the literature. The authors retrospectively evaluated the usefulness of the sandwich technique using fibrin-coated collagen fleece (TachoSil) to prevent intraoperative CSF leakage from large dural defects in TSA surgery. In total, 101 cases of intraoperative CSF leaks were observed among 465 patients who underwent TSA surgery at a single university hospital between 2002 and 2014. Among them, cases with Grade 3 intraoperative CSF leakages and large diaphragmatic/dural defects were reconstructed via the sandwich technique using TachoSil or via the conventional technique using simple intrasellar packing with fat or synthetic materials, and these cases were enrolled in this study. A total of 28 cases with Grade 3 intraoperative CSF leakages were identified and analyzed. The sandwich technique using TachoSil was applied in 13 cases, and the conventional technique was applied in 15 cases. The postoperative CSF leakage was significantly decreased by the sandwich technique as compared to the conventional technique (retrospectively, 0 cases vs. 4 cases (30.8%); P=0.044). The sandwich technique using TachoSil can effectively prevent CSF leakage in cases with large dural defects during TSA surgery. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. Hepatoblastoma del adulto: presentación de un caso

    Directory of Open Access Journals (Sweden)

    A. Goikoetxea Urdiain

    Full Text Available El hepatoblastoma del adulto es una patología inusual, de patogenia no bien conocida y de muy mal pronóstico. Presentamos un caso de hepatoblastoma del adulto tratado en nuestro centro. Varón de 65 años, sin hepatopatía previa, que consulta por dolor en hipocondrio derecho de evolución subaguda. El diagnóstico anatomopatológico fue hepatoblastoma epitelial del adulto, con bordes quirúrgicos libres. Fue reintervenido 5 meses después por recidiva precoz y falleció 10 meses después del diagnóstico por nueva recidiva masiva. Su diagnóstico definitivo es histológico. La cirugía radical ofrece el único tratamiento que aumente la supervivencia, pero frecuentemente recidiva. No existen pautas bien definidas de quimioterapia adyuvante, ni experiencia en trasplante.

  16. Las alteraciones del lenguaje en el adulto

    OpenAIRE

    Pérez Restrepo, Ángela María; Fundación Valle de Lili

    2006-01-01

    ¿Qué partes del cuerpo se encargan del lenguaje?/¿Qué es afasia?/¿Quién puede presentar una afasia?/¿Cómo se alteran los diferentes niveles del lenguaje?/¿Qué tipos de afasia existen?/¿Cuáles son las manifestaciones de las afasias motoras?/¿Cuáles son las manifestaciones de las afasias de comprensión?/¿Qué es una afasia mixta?/¿Puede encontrarse dificultad en otra función psicológica superior en casos de afasia?/¿A quién consultar en estos casos?/¿Qué tratamientos se le pueden ofrecer a estos...

  17. Intervenciones musicales para la ansiedad odontológica en pacientes pediátricos y adultos

    Directory of Open Access Journals (Sweden)

    Marta Sanjuán Navais

    2016-02-01

    Full Text Available La ansiedad odontológica ha sido identificada como un problema común tanto en niños como en adultos. La ansiedad odontológica se refiere a un estado de aprensión de que algo terrible va a suceder en relación con el tratamiento dental y se combina con una sensación de pérdida de control. Se informa que uno de cada seis adultos sufren algún tipo de ansiedad y en los niños entre un 5,7% y el 19,5%. Los pacientes con ansiedad odontológica tienden a descuidar el cuidado dental, lo cual plantea un problema, tanto para los pacientes como para los dentistas. Una relación dentista-paciente dominada por la ansiedad grave puede conducir a un mal diagnóstico y tratamiento inadecuado. Existen diferentes opciones de tratamiento para la ansiedad odontológica que pueden ir desde la explicación del proceso de tratamiento, estrategias farmacológicas, biofeedback, hipnosis e intervenciones conductuales. Se cree que la música reduce la ansiedad gracias a un efecto relajante o de distracción, que a su vez disminuye la actividad de los sistemas neuro-endocrino y sistema nervioso simpático.

  18. Diabetes tipo 2, obesidad y cetoacidosis diabética en niños.: Reporte de caso

    Directory of Open Access Journals (Sweden)

    Helard Manrique

    2011-07-01

    Full Text Available Se reporta el caso de una niña con obesidad que acudió a nuestro hospital por presentar cetoacidosis diabética. El manejo inicial incluyó hidratación enérgica e insulina endovenosa. El análisis de anticuerpos anti-GAD fue negativo y el péptido C fue normal. El control metabólico a largo plazo fue con metformina, dieta y ejercicio.Tradicionalmente, la diabetes tipo 2 ha sido considerada una enfermedad de adultos. Sin embargo, a medida que aumenta la prevalencia de obesidad en niños, aumenta el número de casos de diabetes tipo 2 en este grupo etáreo. La hiperglicemia sostenida puede deteriorar la secreción de insulina por parte de las células beta del páncreas. Este fenómeno, llamado glucotoxicidad, puede explicar porque algunos pacientes con diabetes tipo 2 presentan cetoacidosis diabética. No todos los niños que debutan con cetoacidosis diabética tienen diabetes tipo 1.(Rev Med Hered 2011;22:139-142.

  19. A novel impermeable adhesive membrane to reinforce dural closure: a preliminary retrospective study on 119 consecutive high-risk patients.

    Science.gov (United States)

    Ferroli, Paolo; Acerbi, Francesco; Broggi, Morgan; Schiariti, Marco; Albanese, Erminia; Tringali, Giovanni; Franzini, Angelo; Broggi, Giovanni

    2013-01-01

    Postoperative cerebrospinal fluid (CSF) leak in neurosurgery remains a significant source of morbidity. TissuePatchDural (TPD), a novel impermeable adhesive membrane, can be used to reinforce dural closure in cases considered at high risk to develop postoperative CSF leak. A retrospective, single-center, clinical investigation was conducted on 119 patients who underwent elective neurosurgical procedures between January and June 2010. Inclusion criteria included adult patients undergoing clean elective surgeries where a primary watertight closure was not possible. Three groups of patients were considered: 1) infratentorial, 67 cases; 2) supratentorial, 34 cases; and 3) spinal, 18 cases. All these patients received TPD to reinforce dural closure. Preoperative (long-term corticosteroid therapy, previous surgery and radiotherapy), intraoperative (site of procedures and size of dural gap), and postoperative (early and late hydrocephalus) conditions were analyzed as possible risk factors associated with CSF leakage. The mean follow-up was 7.14 months (range 6-12 months). CSF leak was detected in 11 of 119 cases (9.2%). The presence of pre- and postoperative risk factors was associated with a higher percentage of CSF leakage: 8 of 22 cases (36.3%) vs. 3 of 97 cases (3.1%) (P < 0.0001). All leaks could be conservatively treated and no patient required readmission or second surgery. No TPD-related adverse or allergic effects were observed. TPD seems to be a safe tool to be used to reinforce dural closure in patients with a high risk of developing CSF leaks. Copyright © 2013 Elsevier Inc. All rights reserved.

  20. Dural metastases from disseminated prostate cancer clinically mimicking a benign reactive condition of the dura: case report and review of the literature.

    Science.gov (United States)

    Gunia, S; Ecke, T; Wohlfarth, B; Koch, S; Erbersdobler, A

    2011-01-01

    Dural spread from prostate cancer (PC) is exceedingly uncommon. We report on a 62-year-old man suffering from disseminated PC with osseous metastases who presented with a parietal skull metastasis along with a circumscribed nodular thickening of the adjacent dura. Magnetic resonance imaging findings suggested a benign reactive condition of the dura which, however, histologically turned out to be a dural metastasis. Therefore, the present case report stresses the notion that very rarely, disseminated PC might present with clinically unsuspected dural metastases radiologically mimicking a benign condition.

  1. Prevalencia de obesidad en adultos mexicanos, ENSANUT 2012

    OpenAIRE

    Simón Barquera; Ismael Campos-Nonato; Lucía Hernández-Barrera; Andrea Pedroza-Tobías; Juan A Rivera-Dommarco

    2013-01-01

    Objetivo. Describir la prevalencia de sobrepeso y obesidad (SyO) en adultos mexicanos de 20 años o más, así como detallar su tendencia en las últimas tres encuestas. Material y métodos. Se consideró una muestra de 38 208 adultos con antropometría. La clasificación para categorizar índice de masa corporal (IMC) fue la de la Organización Mundial de la Salud (OMS). Para obesidad abdominal, se utilizó la clasificación de la Federación Internacional de Diabetes (IDF). Resultados. La prevalencia de...

  2. Prevalencia de Hipercolesterolemia en adultos mayores de Costa Rica

    OpenAIRE

    Eduardo Aguilar Fernández; Ana Maricela Carballo Alfaro

    2012-01-01

    Este artículo tiene como objetivo el estudio de la prevalencia de la hipercolesterolemia (con y sin diagnóstico previo) en adultos mayores de Costa Rica e identificar los factores asociados con el control de la hipercolesterolemia dado que se tiene un diagnóstico previo. Los datos sometidos a estudio provienen de una muestra nacional del proyecto CRELES: “Costa Rica. Estudio de Longevidad y Envejecimiento Saludable” La prevalencia de hipercolesterolemia es de 59,5%. Dentro de los 890 adultos ...

  3. Farmacovigilancia intensiva en pacientes adultos y pediátricos

    OpenAIRE

    Isis B Bermúdez Camps; Nailet Real Bestard; José R Acosta Torres; Aurelio Rodríguez Fernández

    1999-01-01

    Se estudiaron 600 pacientes, 320 niños y 280 adultos seleccionados aleatoriamente a partir de los 2 368 casos ingresados en las unidades de cuidados intensivos e intermedios de los hospitales Infantil Norte "Juan de la Cruz Martínez Maceira" y Provincial Clinicoquirúrgico Docente "Saturnino Lora". Se detectaron 511 reacciones adversas a medicamentos en 261 pacientes, 187 adultos y 74 niños, con un índice de aparición de este fenómeno del 61 y 20 % respectivamente. Los resultados obtenidos fue...

  4. Prevalencia de Hipercolesterolemia en adultos mayores de Costa Rica

    OpenAIRE

    Eduardo Aguilar Fernández; Ana Maricela Carballo Alfaro

    2012-01-01

    Este artículo tiene como objetivo el estudio de la prevalencia de la hipercolesterolemia (con y sin diagnóstico previo) en adultos mayores de Costa Rica e identificar los factores asociados con el control de la hipercolesterolemia dado que se tiene un diagnóstico previo. Los datos sometidos a estudio provienen de una muestra nacional del proyecto CRELES: “Costa Rica. Estudio de Longevidad y Envejecimiento Saludable” La prevalencia de hipercolesterolemia es de 59,5%. Dentro de los 890 adultos ...

  5. Especificidad de la educación de adultos. b a s e s psicopedagógicas y señas de identidad

    Directory of Open Access Journals (Sweden)

    Óscar Medina Fernández

    2000-01-01

    Full Text Available Se plantean en este trabajo las bases psicopedagógicas de la educación de adultos y, a partir de ahí, se aborda el problema del carácter específico de este sector educativo. El autor trata de defender que, basándonos en la investigación psicológica que actualmente tenemos disponible, y haciendo uso de determinados conocimientos pedagógicos, existe base para fundamentar algunos aspectos del carácter específico de la educación de adultos como un tipo de educación propia que se diferencia de lo que habitualmente se realiza en las escuelas para niños y adolescentes. En la medida en que las señas de identidad de esa educación de adultos específica son eminentemente sociales, podemos afirmar que estamos ante un campo de la educación cuyo marco teórico más amplio es el de la Pedagogía Social

  6. Las estrategias de afrontamiento frente a la percepción de apoyo social: Estudio Descriptivo-Comparativo con adultos mayores institucionalizados y no institucionalizados de la Región Metropolitana, considerando la variable género

    Directory of Open Access Journals (Sweden)

    Carolina Reyes Rasse

    2013-07-01

    Full Text Available La presente investigación estudió las estrategias de afrontamiento frente a la percepción de apoyo social en adultos mayores institucionalizados y no institucionalizados, considerando la variable género. Se utilizó una metodología de tipo descriptivo-comparativo de carácter cuantitativo. La muestra comprendió 100 adultos mayores, 25 hombres institucionalizados y no institucionalizados, 25mujeres institucionalizadas y no institucionalizadas. Los resultados señalan que las mujeres adultas mayores perciben mayor apoyo social familiar y de las amistades que los hombres; de igual manera, los no institucionalizados perciben mayor apoyo social que los institucionalizados. Comparando ambas escalas de apoyo social, los adultos mayores perciben mayor apoyo familiar que de las amistades. Con respecto a las estrategias de afrontamiento, entre hombres y mujeres adultos mayores existen diferencias significativas en la utilización de las estrategias: reinterpretación positiva y crecimiento, focalización y ventilación de emociones, siendo las mujeres quienes las despliegan más. Los hombres utilizan más las estrategias: afrontamiento activo, aceptación de responsabilidad y autocontrol, y las mujeres reinterpretación positiva y crecimiento, aceptación de responsabilidad y autocontrol. Los adultos mayores institucionalizados despliegan menos estrategias de afrontamiento que los no institucionalizados, existiendo diferencias significativas en las estrategias: planificación, búsqueda de apoyo social por motivos instrumentales, búsqueda de apoyo social por motivos afectivos y reinterpretación positiva y crecimiento. Las principales estrategias utilizadas por los adultos mayores institucionalizados son: afrontamiento activo, aceptación de la responsabilidad y autocontrol. Los no institucionalizados utilizan más las estrategias: afrontamiento activo, planificación, reinterpretación positiva y crecimiento y de autocontrol.

  7. Prevalencia de las prácticas religiosas, disfunción familiar, soporte social y síntomas depresivos en adultos mayores. Cali, Colombia 2001

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    José Mauricio Ocampo

    2006-06-01

    Full Text Available Objetivo: Determinar la prevalencia de las prácticas religiosas, el soporte social y la disfunción familiar en adultos mayores con síntomas depresivos. Materiales y métodos: Se realizó un estudio descriptivo en el Centro de Atención Ambulatoria La Selva del Instituto de los Seguros Sociales de Cali, Colombia en el 2001. Se aplicaron la escala de religiosidad intrínseca/extrínseca (Gorsuch-McPherson, la prueba de APGAR Familiar y la escala de depresión geriátrica (EDG-Yesavage, se evaluaron la frecuencia de la oración personal, grupal o comunitaria y la lectura de los Libros Sagrados de acuerdo con su religión. Resultados: Se estudiaron 136 adultos mayores, con una edad promedio de 69.2±6.4 años, 78 (57% hombres, 82 (60% eran casados y 21 (15% viudos. De ellos 133 (97.8% afirmaron tener algún tipo de religión, 90% eran católicos; 126 (93% oraban por lo menos una vez al día, 60 (44.4% tenían orientación hacia religiosidad intrínseca, 46 (33.8% hacia religiosidad extrínseca y 16 (11.8% hacia religiosidad mixta. En 40 (29.4% hubo algún tipo de disfunción familiar; 69 (50.7% carecían de un adecuado soporte social. Los síntomas depresivos se vieron en 10 (7.3% (EDG>5/15 y sólo 5 (3.7% presentaban síntomas severos (EDG>10/15. El género masculino, la viudez y padecer una enfermedad crónica, fueron más frecuentes en adultos mayores con síntomas depresivos (p<0.05. Se observó que en la mayoría de adultos mayores con síntomas depresivos la oración no hacía parte de su vida diaria (p=0.03. Conclusiones: El género masculino, ser viudo y las enfermedades crónicas fueron más frecuentes en adultos mayores con síntomas depresivos.

  8. Factores de riesgo suicida en adultos

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    Sergio Pérez Barrero

    1997-02-01

    Full Text Available Se realiza un estudio descriptivo y poblacional en 833 adultos mayores de 15 años pertenecientes al Consultorio No. 3 del Policlínico "Bayamo Oeste", en Bayamo, Granma, entre noviembre de 1991 y octubre de 1992, para detectar la presencia de los siguientes factores de riesgo suicida: enfermedad médica crónica, enfermedad psiquiátrica, antecedentes de tratamiento e ingresos en salas de psiquiatría, ideación suicida, intento suicida previo, antecedentes familiares de conducta suicida y conflictos actuales. Se concluyó que el 39,1 % de la población estudiada poseía algún factor de riesgo suicida. La diabetes mellitus, la hipertensión arterial, el alcoholismo y la esquizofrenia, los antecedentes de tratamiento psiquiátrico, los antecedentes familiares de conducta suicida, la ideación suicida y el intento suicida previo fueron los factores de riesgo más frecuentes entre los individuos. Los conflictos de pareja y familiares, y la mala comunicación entre los miembros de las familias, fueron áreas conflictivas predominantes. Se recomienda realizar acciones de salud que disminuyan dichos factores de riesgo encontrados.A descriptive population study is carried out in 833 adults more than 15 years old, from the No.3 office of the "West Bayamo" policlinic at Bayamo, Granma province, between November 1991 and October 1992, in order to detect the appearance of the following suicidal risk factors: chronic medical disease, psychiatric disease, backgrounds of treatment and entrance in psychiatry rooms, suicidal ideation, previous suicidal attempt, family backgrounds of suiciddal behaviour, and current conflicts. It is concluded that 39,1 % of the studied population had some suicidal risk factor. The most frequent suicidal risk factors among individuals were diabetes mellitus, arterial hypertension. alcohol drinking, schizophrenia, backgrounds of psychiatric treatment, family backgrounds of suicidal behaviour, suicidal ideation, and previous

  9. Dural carotid cavernous sinus fistula presenting as isolated oculomotor nerve palsy: Case report

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    Şehnaz Arıcı

    2015-04-01

    Full Text Available Indirect (dural carotid cavernous fistula is formed by the connection between meningeal branches of the internal carotid artery and the cavernous sinüs, and low flow circulation with low pressure is occured. Proptosis, ophtalmoplegia, headache, scleral and conjuctival hyperemia expanding around the eyeball can be observed. A forty-eight year old female patient with a background of diabetes mellitus and hypertension was admitted with complaints of double vision. Isolated oculomotor nerve palsy was found in neurological examination and an indirect carotid cavernous fistula was revealed by digital subtraction angiography. Our case with carotid cavernous fistula as a rare cause of isolated oculomotor nerve palsy is worth to be reported.

  10. The suprameatal dural flap for superior petrosal vein protection during the retrosigmoid intradural suprameatal approach.

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    Mortini, Pietro; Gagliardi, Filippo; Boari, Nicola; Spina, Alfio; Bailo, Michele; Franzin, Alberto

    2014-01-01

    The drilling of the suprameatal bone during the retrosigmoid intradural suprameatal approach (RISA) puts the superior petrosal vein complex at risk of heating and mechanical injury, which may lead to cerebellar swelling and infarction. We present a new technique to protect the superior petrosal venous complex during suprameatal bone drilling. A microanatomical laboratory investigation on cadaver was conducted. The surgical technique is described and intraoperative schematic pictures are provided. The surgical steps of this technique and the related intraoperative images are reported. One case illustration regarding the removal of a large petrous apex meningioma with Meckel cave extension is described to demonstrate the application of the technique in a clinical setting. Reflecting a dural flap onto the posterior trigeminal nerve root and the superior petrosal vein complex can be a simple way to protect the nerve and the vein during the suprameatal bone drilling during the RISA. Georg Thieme Verlag KG Stuttgart · New York.

  11. Transvenous embolization of a dural carotid-cavernous sinus fistula via the inferior ophthalmic vein.

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    Michels, Kevin S; Ng, John D; Falardeau, Julie; Roberts, Warren G; Petersen, Bryan; Nesbit, Gary M; Barnwell, Stanley L

    2007-01-01

    A 76-year-old woman presented with an acute onset of right periocular pain, diplopia, ocular injection, progressive proptosis, and periocular swelling. She had an unremarkable past medical history, and the erythrocyte sedimentation rate and complete blood count were normal. A carotid-cavernous sinus fistula was suspected, and an MRI demonstrated enlargement of the superior ophthalmic vein posterior to the globe and enlargement of the inferior ophthalmic vein throughout its entire course. Cerebral arteriography demonstrated a dural cavernous sinus fistula. The inferior ophthalmic vein was accessed via the inferonasal orbital space and was catheterized for delivery of multiple platinum coils to the cavernous sinus fistula. Follow-up venograms demonstrated occlusion of the fistula. At 2-month follow-up, there was a residual sixth nerve palsy and resolution of symptoms, including proptosis and periocular swelling.

  12. A dural arteriovenous fistula in cavernous sinus developed from viral meningitis.

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    Hai, Jian; Zhang, Lin; Wan, Jue-Feng; Su, Shao-Hua; Wang, Fei; Zhang, Gui-Yun

    2011-06-01

    Although hormonal influences, inflammation, trauma, sinus thrombosis, venous hypertension, and congenital origin have been proposed as sources of dural arteriovenous fistulas (DAVFs) in cavernous and sigmoid sinuses, the etiology of these lesions remains controversial. We present a case with a cavernous sinus DAVF developed from viral meningitis which has not been previously described. A 24-year-old male was admitted to our institute because of periorbital pain, decreased vision, pulsatile tinnitus, chemosis, and exophthalmos on the right side after he had suffered viral meningitis four months before. Cerebral angiography demonstrated a cavernous sinus DAVF, which was successfully obliterated with several platinum coils using a transvenous approach. The viral meningitis most likely caused the inflammation, that may be responsible for the occurrence of the cavernous sinus DAVF. Prompt treatment for inflammation may help to prevent the development of DAVFs.

  13. Grade 4 spondylolisthesis of the L5 vertebra associated with dural ectasia in neurofibromatosis.

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    Modi, H N; Srinivasalu, S; Suh, S W; Yang, J H

    2009-08-01

    Spondylolisthesis associated with neurofibromatosis is rare, and only 12 cases have been reported so far. However, only one report of grade 4 spondylolisthesis with neurofibromatosis has been reported in the literature. A 15-year-old boy with neurofibromatosis was admitted for back pain and neurological claudication. Radiograph showed grade 4 spondylolisthesis of the L5 vertebra with scalloping of the L4-L5 vertebrae. L4-L5 laminectomy, reduction, L3-S1 posterior instrumentation and fusion were performed. The reduction of the spondylisthesis was done entirely from the posterior approach using pedicle screws. Radiography at four months showed a broken S1 screw with a loss of reduction. The patient was re-operated on, to provide additional stability with pelvic fixation. He was pain-free with a good fusion at the two-year follow-up. Adequate posterior stabilisation with fusion gives good results in grade 4 spondylolisthesis associated with neurofibromatosis and dural ectasia.

  14. Therapeutic embolization of cavernous sinus dural arteriovenous fistulas via transvenous approach

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    侯凯; 罗祺; 陈强; 王宏磊; 罗毅男; 王长坤

    2003-01-01

    Objective To describe the transvenous catheterization technique for the treatment of cavernous sinus dural arteriovenous fistulas (CSdAVFs), including its indications, complications and efficacy.Methods Eight patients with symptomatic CSdAVFs were treated by endovascular embolization with platinum coils, via the inferior petrosal sinus (IPS) in 6 patients, and via the Sylvian vein after surgical exposure in other 2 patients.Results Complete angiographic resolution of the fistula was obtained in six patients immediately after the procedures, and a complete resolution of symptoms and signs was achieved in all patients. The residual fistulas in two patients disappeared completely in the follow-up angiography.Conclusion Transvenous embolization is a useful and safe approach in the management of CSdAVFs.

  15. Endovascular management of sigmoid sinus dural arteriovenous fistula associated with sinus stenosis in an infant.

    Science.gov (United States)

    Cohen, José E; Gomori, John M; Benifla, Moni; Itshayek, Eyal; Moscovici, Samuel

    2013-01-01

    A 4-month-old female presented with a dural arteriovenous fistula (DAVF), which was successfully managed using endovascular techniques. There are very few case series reporting DAVF in infants younger than 12 months and, to our knowledge, only 60 pediatric patients with DAVF have been reported to date. Although most DAVF have a benign course, they can result in life-threatening hemorrhage. Endovascular therapies are usually indicated in the management of these neurosurgical vascular malformations. Endovascular therapy of DAVF in neonatal patients presents some major issues. Gaining arterial access may be problematic in femoral arteries too small for the introduction of a sizeable guiding catheter. The volumes of contrast and infused fluids must be carefully monitored to prevent fluid overload. Radiation exposure should be restricted as far as possible. This report contributes to the limited body of evidence on neonatal DAVF and its endovascular management. Copyright © 2012 Elsevier Ltd. All rights reserved.

  16. Prevalencia de anemia y factores asociados en adultos mayores peruanos

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    Carolina Tarqui-Mamani

    2015-10-01

    Full Text Available Objetivos. Determinar la prevalencia de anemia y factores asociados en los adultos mayores del Perú. Materiales y métodos. Se realizó un estudio transversal durante el año 2011. El muestreo fue probabilístico, estratificado y multietápico. La muestra de viviendas fue 5792 y se incluyó 2172 adultos mayores. Se definió anemia como hemoglobina 23 a 80 años (OR 2,1; IC 95%: 1,4-3,0 y la delgadez (OR 1,7; IC 95%:1,2-2,3 se asociaron con la anemia. Los departamentos con mayor prevalencia de anemia fueron Ayacucho (57,6%, Ancash (40,1%, Lambayeque (37,7% y Apurímac (36,9%. Conclusiones. Aproximadamente la cuarta parte de los adultos mayores tuvieron anemia, siendo más predominante en los analfabetos, procedentes de áreas rurales y pobres. La mayor edad y la delgadez se asocian con la presencia de anemia en los adultos mayores peruanos

  17. Prevalencia de anemia y factores asociados en adultos mayores peruanos

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    Carolina Tarqui-Mamani

    Full Text Available Objetivos. Determinar la prevalencia de anemia y factores asociados en los adultos mayores del Perú. Materiales y métodos. Se realizó un estudio transversal durante el año 2011. El muestreo fue probabilístico, estratificado y multietápico. La muestra de viviendas fue 5792 y se incluyó 2172 adultos mayores. Se definió anemia como hemoglobina 23 a 80 años (OR 2,1; IC 95%: 1,4-3,0 y la delgadez (OR 1,7; IC 95%:1,2-2,3 se asociaron con la anemia. Los departamentos con mayor prevalencia de anemia fueron Ayacucho (57,6%, Ancash (40,1%, Lambayeque (37,7% y Apurímac (36,9%. Conclusiones. Aproximadamente la cuarta parte de los adultos mayores tuvieron anemia, siendo más predominante en los analfabetos, procedentes de áreas rurales y pobres. La mayor edad y la delgadez se asocian con la presencia de anemia en los adultos mayores peruanos

  18. ¿Crisis de adolescentes o crisis de adultos?

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    Norman Darío Moreno Carmona

    2012-01-01

    Full Text Available Este artículo tiene como propósito la divulgación de una investigación cuyo objetivo fue caracterizar el significado contemporáneo del adulto en dos grupos etarios de la ciudad de Medellín (Colombia. Los tópicos centrales sobre los que se funda tal caracterización son la percepción sobre los adultos referentes, la manera como han vivido esa relación con sus adultos cercanos y la propia actitud frente a la adultez y su papel como referentes de las generaciones más jóvenes. La metodología del estudio fue cualitativa, las estrategias para la recolección de información fueron 20 entrevistas semiestructuradas y la aplicación de un test proyectivo. Los resultados muestran que hay un desdibujamiento de la adultez en la contemporaneidad, pues sus características cada vez resultan menos evidentes en los adultos.

  19. Instrumentos de avaliação de leitura em adultos: um estudo psicométrico

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    Natália Martins Dias

    Full Text Available RESUMO Objetivo: investigar as propriedades psicométricas de um teste de desempenho para avaliação de reconhecimento de palavras e de um checklist de autorrelato de dificuldades de leitura/indicadores de dislexia, em uma amostra de adultos. Métodos: foram avaliados 54 sujeitos, idades entre 18 e 57 anos (M=24,16; DP = 7,34, com Ensino Médio completo ou cursando a graduação. As avaliações foram realizadas utilizando o Teste Computadorizado de Competência de Leitura de Palavras para Adultos (TCLP-2 e o questionário de autorrelato Adult Dyslexia Checklist (ADC. Resultados: não foram observadas diferenças de desempenho em função da escolaridade e do gênero. O tempo de resposta foi menor no julgamento dos itens Corretos do TCLP-2 em relação aos itens incorretos (inversão, troca fonológica, erro ortográfico e pseudopalavra homófona. 18,5% dos participantes relataram dificuldades mais severas no ADC. Análise de grupos extremos mostrou que participantes com maiores pontuações/dificuldades no ADC tiveram pior desempenho nos itens Corretos do TCLP-2. Análise fatorial retornou solução com fator único para tipos de itens do TCLP-2. Dados de precisão se mostraram adequados para ambos os instrumentos, com valores de Spearman-Brown e alfa de Cronbach maiores que 0,70. Relações de baixa a moderadas foram observadas entre os dois instrumentos, provendo evidências de validade a ambos. Conclusão: o estudo apresentou dados psicométricos de dois instrumentos para avaliação de leitura em adultos. Ambos mostraram índices satisfatórios de precisão e evidências de validade por relação com outras variáveis. Frente à carência de instrumentos padronizados para avaliação de leitura em adultos no contexto nacional, o estudo estende sua contribuição à futura instrumentalização desta área.

  20. Carcinoma secretor da mama no adulto: existem parâmetros bem definidos para decisão terapêutica?

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    Gouveia António Manuel Ferreira

    2002-01-01

    Full Text Available O carcinoma secretor (CS da mama é uma neoplasia muito rara. O CS da mama foi inicialmente descrito em crianças e adolescentes, mas a maioria dos casos é descrito em doentes adultos. É muitas vezes associado a um prognóstico particularmente favorável, mas em doentes adultos com tumores de maiores dimensões pode apresentar um comportamento mais agressivo. Apresenta-se um caso de uma doente com 62 anos de idade, que apresentava uma volumosa tumefacção da mama com 16 anos de evolução. O exame objetivo revelou extensa fixação da lesão à pele, com sinais inflamatórios acentuados e áreas de necrose cutânea. O tratamento inicial consistiu numa mastectomia simples, com intenção paliativa. O diagnóstico anatomopatológico de carcinoma secretor (3,5 cm, sem invasão cutânea, motivou a posterior realização de esvaziamento ganglionar axilar, que revelou metástases em 2 dos 13 gânglios isolados. A doente faleceu 24 meses depois, por disseminação da doença, comprovando a maior agressividade do CS em doentes adultos com tumores de maiores dimensões (T2 e com metastização ganglionar (N1. Os autores revêem a literatura com particular ênfase nos factores de prognóstico importantes para decisão terapêutica deste tipo raro de carcinoma da mama, em doentes adultos.

  1. EVALUACIÓN DEL APEGO EN ADULTOS: CONSTRUCCIÓN DE UNA ESCALA CON MEDIDAS INDEPENDIENTES

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    Joaquín Alberto Padilla Bautista

    2016-01-01

    Full Text Available En la medición del apego se utilizan las entrevistas que asignan a un individuo un estilo determinado de apego a partir de una descripción cualitativa; las viñetas de autorreporte, en las que una persona puede indicar su estilo de apego y, por último, los instrumentos de medición con opción de respuesta tipo Likert, los cuales permiten análisis y perfiles diferenciados. Empero, en el modelo de ansiedad e intimidad es necesario tomar cuartiles basados en medianas, que ubican a las personas en una tipología particular. El presente estudio describe el proceso de validación de una escala que mide el apego en adultos, que hace posible obtener medidas independientes de los estilos seguro, preocupado, temeroso y evitante. La escala final muestra la existencia de cuatro factores independientes que explican 59.99 % de la varianza. Los ítems muestran cargas factoriales superiores a .50, comunalidades mayores a .40 y un coeficiente alfa total de .72.

  2. Inmunodeficiencias primarias por déficit de anticuerpos en adultos

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    María Mercedes Bello Rodríguez

    2014-10-01

    Full Text Available Se realizó una investigación sobre los pacientes con inmunodeficiencias primarias por déficit de anticuerpos, atendidos en el servicio de inmunología del Hospital General “Dr. Ernesto Guevara” de Las Tunas, con el objetivo de caracterizar las inmunodeficiencias por déficit de anticuerpos en pacientes adultos, atendiendo al tipo de inmunoglobulina afectada, el sexo y la edad, así como las principales manifestaciones clínicas. Se evaluaron un total de diez pacientes tratados por esta causa entre los años 2005 y 2013. Para la evaluación de los resultados se utilizó el análisis de frecuencias simple. Las inmunodeficiencias diagnosticadas se correspondieron en un 50% con el déficit de las tres clases de inmunoglobulinas. Predominó el sexo masculino en un 70% y las edades más afectadas se correspondieron con la cuarta y quinta décadas de la vida. Las infecciones respiratorias y digestivas fueron las más frecuentes (80%, tanto por gérmenes bacterianos como virales, la infección por Giardia lamblia también apareció muy frecuentemente en los pacientes estudiados

  3. Miopericarditis en enfermedad de Still del adulto: Reporte de un caso

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    Carmen Eliana Peralta Vargas

    2008-10-01

    Full Text Available Varón de 22 años, admitido en el Hospital Nacional Cayetano Heredia, con un tiempo de enfermedad de diez días, manifestando fiebre, malestar general y diaforesis nocturna; se añade astenia, disnea a moderados esfuerzos y tos productiva. No tenía antecedentes personales ni familiares de enfermedad previa. En el Hospital, desarrolla Insuficiencia Cardiaca Aguda y efusión pericárdica, el estudio del líquido y la biopsia del pericardio fueron de tipo inflamatorio inespecífico. El paciente, inicialmente recibió antibióticos, sin mejoría de cuadro clínico; desarrolló rash dérmico y oligoartritis, con estudio de líquido articular no inflamatorio, con cultivos negativos. Se solicita ferritina sérica, resultado 95 873 ng/mL. Se obtuvo mejoría en el estado general y caída de la fiebre con prednisona 60mg/d. Al excluirse otras enfermedades, se sugiere el diagnóstico de enfermedad de Still de inicio del adulto, con miopericarditis como manifestación inicial. (Rev Med Hered 2008; 19:167-170.

  4. EVALUACIÓN DE EXPERIENCIAS TRAUMÁTICAS TEMPRANAS EN ADULTOS

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    Nuria Ordóñez-Camblor

    2016-01-01

    Full Text Available La presencia de experiencias traumáticas tempranas se ha asociado con una gran variedad de alteraciones psicopatológicas en la edad adulta. Esto hace que en la práctica clínica sea importante la evaluación y el abordaje de eventos traumáticos previos en los pacientes con diferentes trastornos mentales. El objetivo fundamental de este trabajo fue realizar una breve descripción y aproximación a los principales instrumentos de medida para la evaluación de las experiencias traumáticas tempranas, preferentemente en adultos; y presentar un nuevo instrumento de medida para la evaluación de las experiencias traumáticas tempranas en pacientes con trastorno mental grave. Los resultados mostraron que la mayoría de los instrumentos existentes proporcionan escaso o ningún apoyo psicométrico y se centran en evaluar un solo tipo de experiencia traumática, lo que reduce su aplicabilidad en la práctica clínica. Del mismo modo, son escasos los instrumentos que han sido adaptados y validados en población española. Futuros estudios deberían seguir examinando las propiedades psicométricas de este conjunto de autoinformes, con la finalidad de mejorar la evaluación de las experiencias traumáticas en la edad adulta.

  5. Nivel de autotrascendencia en un grupo de adultos mayores mexicanos

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    Raúl Fernando Guerrero Castañeda

    2017-01-01

    Full Text Available Introducción: La autotrascendencia es una expansión multidimensional personal, una conexión con los demás, el entorno y/o una entidad superior, está relacionada con el bienestar personal del adulto mayor. Objetivo: Determinar el nivel de autotrascendencia de un grupo de adultos mayores mexicanos. Materiales y Métodos: Estudio descriptivo de corte transversal; realizado en tres centros gerontológicos de Celaya, Guanajuato, México, muestra probabilística aleatoria n=118. Se incluyeron adultos mayores que acudían a los centros gerontológicos, hombres y mujeres, ≥ 60 años. Se utilizó la Escala de Autotrascendencia en español con valor resultante entre 15 y 60 (mayor puntaje = mayor autotrascendencia. Se realizó prueba piloto con 40 adultos mayores con Alpha de Cronbach de 0.80. Análisis estadístico descriptivo para variables categóricas (frecuencias y porcentajes, para variables numéricas: medidas de tendencia central y dispersión. Resultados: Media de Autotrascendencia fue 51.36. Se identificaron con “Encontrando significado en mis creencias espirituales” (85.6% y “Disfrutando mi ritmo de vida” (81.4%; hubo diferencia estadísticamente significativa en la media de Autotrascendencia (p˂0.05 por sexo, siendo mayor el nivel en las mujeres. No hubo diferencia entre grupos de edad. Discusión y Conclusiones: La media de autotrascendencia refleja un nivel alto, en comparación con otros estudios y se reportó entre 75-84 años una media mayor. Los adultos mayores se identifican con características como la religión y el disfrute de la vida. La Escala de Autotrascendencia se puede usar en adultos mayores mexicanos ya que demostró un buen nivel de consistencia interna. Cómo citar este artículo: Guerrero RF, Lara R. Nivel de autotrascendencia en un grupo de adultos mayores mexicanos. Rev Cuid. 2017; 8(1: 1476-87. http://dx.doi.org/10.15649/cuidarte.v8i1.354

  6. La calidad de vida del adulto mayor con Artritis Reumatoidea

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    Clara Gallardo

    2017-05-01

    Full Text Available Objetivo determinar la atención de Enfermería y su incidencia en la calidad de vida del adulto mayor con artritis reumatoidea atendidos en el subcentro de salud de Ambatillo en el período Julio – Diciembre 2013. Métodos y materiales: Estudio no experimental de diseño descriptivo aplicando técnicas de observación y cuestionario cuya población fue de 30 adultos mayores en los que se detectó la necesidad de investigar la problemática, cuyos resultados indican que los principales problemas que presentan los pacientes son: dolor e inflamación articular, incapacidad músculo esquelética, discapacidad etc. Re- sultados: La problemática que se aborda es la calidad de vida del adulto mayor con esta patología pues muchas veces no se da una atención basada en el estado emocional, respuesta fisiológica, aspecto físico al que se enfrenta tanto el paciente como su núcleo familiar.es asì que el 69% de adultos mayores con artritis reumatoidea , la misma manera el 75% del personal de enfermería que labora en el Subcentro de salud de Ambatillo Conclusiones: Una vez evidenciada la problemática de estudio se presenta como propuesta la elaboración de una Guía de Atención de Enfermería el mismo que permitirá valorar en forma integral, priorizar las necesidades de atención y brindar cuidados específicos en el adulto mayor con artritis reumatoidea.

  7. A tomada de decisão em adultos jovens e em adultos idosos: um estudo comparativo

    Directory of Open Access Journals (Sweden)

    Daniela Schneider Bakos

    Full Text Available O presente estudo comparou adultos jovens e adultos idosos em seu desempenho na IGT. A amostra foi constituída por de 72 indivíduos, distribuídos em dois grupos etários: 36 adultos jovens (M = 29,86, DP = 4,63 e 36 adultos idosos (M = 66,89, DP = 5,19. Não houve diferença entre os grupos quanto às escolhas de cartas (p= 0,60, considerando o escore com base no cálculo (mental. Observaram-se, contudo, diferenças significativas no processo de aprendizagem (p = 0,026. considerando o escore com base na frequência (punição, não foram observadas diferenças significativas nas escolhas das cartas (p = 0,48 bem como no processo de aprendizagem (p = 0,076. Os resultados corroboram estudos anteriores, que minimizam a influência da idade na IGT. Sugerese que a forma de analisar os escores pode estar influenciando o entendimento do comportamento de escolha, juntamente a aspectos referentes à constituição da amostra.

  8. Morbilidad cardiovascular en el adulto mayor

    Directory of Open Access Journals (Sweden)

    Rita Campillo Motilva

    2001-12-01

    Full Text Available Se realizó un estudio transversal y descriptivo, con el objetivo de definir la morbilidad por enfermedad cardiovascular en pacientes de 60 años y más, en un consultorio médico perteneciente al Policlínico Docente "Dr. Mario Escalona Reguera" del municipio Habana del Este, en el período entre marzo y diciembre del año 2000. Fueron incluidos 69 pacientes, 52 de los cuales (75,3 % presentó algún tipo de enfermedad cardiovascular, y fue el sexo femenino el más afectado (51,9 %. La enfermedad que se encontró con mayor frecuencia fue la hipertensión arterial (43 pacientes para un 62,3 %, observamos que la sistodiastólica (86,1 % y el estadio II (53,5 % fue donde se incluyeron mayor número de individuos. Otras enfermedades encontradas fueron los trastornos electrocardiográficos (33 pacientes para un 47,8 % y valvulopatías (18 pacientes para un 26 %.A cross-sectional and descriptive study was conducted in order to define morbidity due to cardiovascular disease in patients aged 60 and over in a family physician’s office of "Dr. Mario Escalona Reguera" Teaching Polyclinic, in Habana del Este municipality, from March to December, 2000. 69 patients were included. 52 of them (75.3 % had some type of cardiovascular disease and females were the most affected (51.9 %. Arterial hypertension was the most commonly found disease (43 patients for 62.3 %. Most of the individuals were included in the systodiastolic (86.1 % and in stage II (53.5 %. Electrocardiographic disorders (33 patients for 47.8 % and valvulopathies (18 patients for 26 % were other of the diseases detected.

  9. Estrutura temporal dos tipos de xuro

    OpenAIRE

    Reboredo Nogueira, Juan Carlos

    2013-01-01

    Esta unidade didáctica forma parte do curso de Análise Económica dos Mercados Financeiros I que se imparte no primeiro cuadrimestre do Máster en Economía: Organización Industrial e Mercados Financeiros. Esta unidade ten como obxectivo analizar a estrutura temporal dos tipos de xuro, é dicir a relación existente entre os tipos de xuro a diferentes prazos. En particular, estudarase a curva cupón cero, a súa utilidade no proceso de valoración dos activos financeiros e os diferentes mé...

  10. Algunos tipos de preferencias no transitivas

    OpenAIRE

    Carmen Vázquez

    2010-01-01

    Este trabajo ofrece una visión sobre la modelación de las relaciones de preferencias del consumidor diferente a la clásica, pues prescindimos de la hipótesis de transitividad. Concretamente, analizamos dos tipos de relaciones de preferencias no transitivas, las acíclicas y las asimétricas, que bajo ciertas condiciones, admiten tipos de representación numérica distintos. Justificamos la aceptación de las mismas mediante ejemplos prácticos y vemos también resultados que garantizan la existencia...

  11. TIPOS DE OPORTUNIDADES NO EMPREENDEDORISMO INTERNACIONAL

    OpenAIRE

    Leite, Yákara Vasconcelos Pereira; Moraes,Walter Fernando Araújo de; Salazar, Viviane Santos

    2015-01-01

    Esta pesquisa teve o objetivo de analisar os tipos de oportunidades no empreendedorismo internacional. Para alcançá-lo, um estudo de múltiplos casos qualitativo foi desenvolvido. A entrevista semiestruturada foi a principal via para coletar dados com 30 gestores e consultores. O software ATLAS.ti apoiou a análise de conteúdo dos dados. Foram identificados dois tipos de oportunidades, a internacional e nacional. Tal resultado complementa o que vem sendo investigado sobre oportunidades no empre...

  12. Symptomatic Pneumocephalus Associated with Lumbar Dural Tear and Reverse Trendelenburg Positioning: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Stephen M. Pirris

    2013-01-01

    Full Text Available Symptomatic pneumocephalus is a rare complication of degenerative lumbar spine surgery. This is a case report of a patient who developed transient diplopia associated with pneumocephalus following lumbar spine surgery complicated by a dural tear. The diplopia improved as the pneumocephalus resolved. Factors involved in the development of pneumocephalus include an unintended durotomy and intraoperative reverse Trendelenburg positioning that was utilized to decrease the risk of postoperative vision loss. When encountering cerebrospinal fluid (CSF leakage intraoperatively, spine surgeons should level the operating table until closure of the dural defect to prevent potential complications associated with pneumocephalus. If postoperative patients complain of severe headaches or display a focal cranial neurologic deficit, then a computed tomography (CT scan of the brain should be ordered and evaluated. Consulting neurologists should be aware of the circumstances surrounding this rare complication.

  13. Variación de la actividad cognitiva en diferentes tipos de pruebas de fluidez verbal.

    Directory of Open Access Journals (Sweden)

    Julián C. Marino

    2009-12-01

    Full Text Available En esta investigación se aplicaron diez pruebas de fluidez verbal del tipo fonológico, categorial, gramatical y combinadas a 259 adultos argentinos (15 a 70 años con el fin de conocer su correlación con la actividad ejecutiva, semántica y atencional. Se indagó sobre la estructura teórica de cada prueba de fluidez verbal, a fines de determinar la lógica de sus variaciones. El objetivo final de la investigación fue aportar al desarrollo de un explorador neuropsicológico en fluidez verbal, que sea útil para hacer evaluaciones breves y sencillas, incluyendo situaciones difíciles como pacientes hospitalizados, y tratando de extraer la máxima información posible de la actividad cognitiva. RESULTADOS: se realizaron análisis descriptivos sobre las pruebas de fluidez verbal, análisis factorial sobre las variables de la actividad cognitiva y análisis de regresión múltiples, ingresando como variables independientes las variables cognitivas y como dependientes cada una de las pruebas de fluidez verbal. CONCLUSIONES: los modelos predictivos hallados indican variaciones sistemáticas en relación al compromiso cognitivo entre los tipos de pruebas de fluidez verbal. También se hallaron variaciones dentro de cada tipo. Esto indica que el explorador en fluidez verbal puede ser una herramienta útil para evaluar diferentes capacidades y funciones cognitivas.

  14. Closing the dura: dural hitching versus surgicel and tisseel overlay graft in craniocervicaldecompression for Chiari 1 malformation.

    Science.gov (United States)

    Tonkins, Michael; Farooqi, Naeem; Ahmed, Rohan; Sinha, Saurabh; Bhattacharyya, Debapriya

    2017-03-02

    This study compares dural hitching to surgicel and tisseel overlay graft following craniocervical decompression and C1 laminectomy with simple durotomy for Chiari I malformation. Outcome measures were syrinx decompression, headache resolution and complication rates. A retrospective analysis of case notes was conducted. Patients who had undergone craniocervical decompression (CCD) were grouped by method of dural closure. Outcomes compared were rates of syrinx decompression, headache resolution, and post-operative complications. Statistical analysis was conducted using SPSS v20. We identified 32 adult patients for inclusion in this study. 53.1% (n = 17) had asyrinx, and 78.1% (n = 25) had a pre-operative headache. All were treated with suboccipital craniectomy, C1 laminectomy (with or without C2 laminectomy), and durotomy. The dura was either left open by dural hitching (n = 23) or closed with surgicel and tisseel overlay graft (n = 9). We found a statistically significant association between the method of dural closure and the rate of syrinx resolution. Resolution occurred in 91.7% (n = 11) of the hitching group, compared to 20.0% (n = 1) of the overlay graft group: Χ(2)(1) = 5.6, p = .018. There were no statistically significant differences between the two groups in the rates of headache resolution or other complications. In patients with symptomatic Chiari I malformation and associated syringomyelia, syrinx resolution is more likely if the dura is hitched open rather than closed bysurgicel and tisseel overlay graft after durotomy.

  15. Does preoperative gabapentin affects the characteristics of post-dural puncture headache in parturients undergoing cesarean section with spinal anesthesia?

    OpenAIRE

    Walid Hamed Nofal; Mohamed Sidky Mahmoud; Azza Atef Abd Al Alim

    2014-01-01

    Background: Gabapentin is effective for treating different types of headache including post-dural puncture headache (PDPH), also used for prophylaxis against migraine. We studied the effect of pre-operative administration of gabapentin on the characteristics of PDPH in parturients undergoing cesarean section (CS) under spinal anesthesia. Materials and Methods: Women undergoing elective cesarean section under spinal anesthesia were randomized to receive preoperative gabapentin 600 mg or placeb...

  16. Tentorial dural arteriovenous fistula successfully treated with surgical interruption of leptomeningeal venous drainage:a case report

    Institute of Scientific and Technical Information of China (English)

    LI Mei-hua; XU Geng-sheng; LI Yi-yun

    2005-01-01

    @@ Tentorial dural arteriovenous fistula (DAVF) is a rare disease, accounting for some 4% of all cases of intracranial DAVF.1 Because of a high risk of intracranial hemorrhage, patients with DAVF need aggressive treatment. Despite recent advances in endovascular technology, many researchers2-4 advocate open surgery for the treatment of tentorial DAVF. In this report, we present a case of tentorial DAVF with pure leptomeningeal venous drainage successfully treated by interruption of the draining vein.

  17. Dural Tail Sign in the Resection of Ventral Foramen Magnum Meningiomas via a Far Lateral Approach: Surgical Implications.

    Science.gov (United States)

    Wu, Bo; Shen, Shang-Hang; Chen, Long-Yi; Liu, Wei-Dong

    2015-11-01

    To investigate the implications of dural tail sign (DTS) in the tailored far lateral approach for resection of ventral foramen magnum meningiomas (FMMs). Clinical data for 16 patients treated surgically for ventral FMMs over 5 years were reviewed retrospectively. The DTS was positive in 11 cases (68.8%) and negative in 5 cases (31.2%). The most frequent form was a single cranial tail (7 of 11), followed by multiple tails consisting of a cranial tail and a caudal tail (3 of 11), and multiple tails composed of a cranial tail and a contralateral tail (1 of 11). The retrocondylar approach was carried out in 5 cases without DTS characterized by a narrow dural attachment and a partial transcondylar approach in 11 cases with DTS featuring a broad and hypervascular dural attachment. Drilling ranged from approximately one fifth to one third of the condyle with reference to the DTS form and tumor size. Total tumor removal was achieved in 16 patients. Postoperative complications were encountered in 25% of patients, predominantly associated with cranial nerve impairment. Follow-up ranging from 8 to 56 months (mean 24.4 months) showed no tumor recurrence. In addition to tumor dural attachment and tumor size, we propose that DTS should be considered as another factor in planning the surgical approach for ventral FMMs. Differentiation between a positive and negative DTS plays a role in the neurosurgical planning of ventral FMMs. Bone removal is warranted in tumors with DTS, particularly the multiple form with contralateral tails, to facilitate the surgical procedure and achieve a more radical resection. Copyright © 2015 Elsevier Inc. All rights reserved.

  18. Endocannabinoids in the brainstem modulate dural trigeminovascular nociceptive traffic via CB1 and "triptan" receptors: implications in migraine.

    Science.gov (United States)

    Akerman, Simon; Holland, Philip R; Lasalandra, Michele P; Goadsby, Peter J

    2013-09-11

    Activation and sensitization of trigeminovascular nociceptive pathways is believed to contribute to the neural substrate of the severe and throbbing nature of pain in migraine. Endocannabinoids, as well as being physiologically analgesic, are known to inhibit dural trigeminovascular nociceptive responses. They are also involved in the descending modulation of cutaneous-evoked C-fiber spinal nociceptive responses from the brainstem. The purpose of this study was to determine whether endocannabinoids are involved in the descending modulation of dural and/or cutaneous facial trigeminovascular nociceptive responses, from the brainstem ventrolateral periaqueductal gray (vlPAG). CB1 receptor activation in the vlPAG attenuated dural-evoked Aδ-fiber neurons (maximally by 19%) and basal spontaneous activity (maximally by 33%) in the rat trigeminocervical complex, but there was no effect on cutaneous facial receptive field responses. This inhibitory vlPAG-mediated modulation was inhibited by specific CB1 receptor antagonism, given via the vlPAG, and with a 5-HT1B/1D receptor antagonist, given either locally in the vlPAG or systemically. These findings demonstrate for the first time that brainstem endocannabinoids provide descending modulation of both basal trigeminovascular neuronal tone and Aδ-fiber dural-nociceptive responses, which differs from the way the brainstem modulates spinal nociceptive transmission. Furthermore, our data demonstrate a novel interaction between serotonergic and endocannabinoid systems in the processing of somatosensory nociceptive information, suggesting that some of the therapeutic action of triptans may be via endocannabinoid containing neurons in the vlPAG.

  19. Optic pathway glioma associated with orbital rhabdomyosarcoma and bilateral optic nerve sheath dural ectasia in a child with neurofibromatosis-1

    Energy Technology Data Exchange (ETDEWEB)

    Nikas, Ioannis; Theofanopoulou, Maria; Lampropoulou, Penelope; Hadjigeorgi, Christiana [Aghia Sophia Children' s Hospital, Imaging Department, Athens (Greece); Pourtsidis, Apostolos; Kosmidis, Helen [Children' s Hospital, A. Kyriakou, Department of Oncology, Athens (Greece)

    2006-11-15

    Neurofibromatosis-1 (NF-1) is a multisystem disorder presenting with a variety of clinical and imaging manifestations. Neural and non-neural tumours, and unusual benign miscellaneous conditions, separately or combined, are encountered in variable locations. We present a 21/2-year-old boy with NF-1 who demonstrated coexisting optic pathway glioma with involvement of the chiasm and optic nerve, orbital alveolar rhabdomyosarcoma and bilateral optic nerve sheath dural ectasia. (orig.)

  20. The role of CT in evaluation of the effectiveness of embolisation of spinal dural arteriovenous fistulae with N -butyl cyanoacrylate

    Energy Technology Data Exchange (ETDEWEB)

    Cognard, C. [Service de Neuroradiologie Charcot, Hopital de la Salpetriere, Paris (France); Miaux, Y. [Service de Neuroradiologie Charcot, Hopital de la Salpetriere, Paris (France); Pierot, L. [Service de Neuroradiologie Charcot, Hopital de la Salpetriere, Paris (France); Weill, A. [Service de Neuroradiologie Charcot, Hopital de la Salpetriere, Paris (France); Martin, N. [Service de Neuroradiologie Charcot, Hopital de la Salpetriere, Paris (France); Chiras, J. [Service de Neuroradiologie Charcot, Hopital de la Salpetriere, Paris (France)

    1996-10-01

    A failed embolisation of a spinal dural arteriovenous fistula (AVF), because a pedicular injection has not reached the initial venous compartment, must be identified immediately, to allow prompt surgery and thus avoid clinical deterioration. The purpose of our study was to determine the role of CT in confirming a complete cure just after embolisation with N -butyl cyanoacrylate (NBCA). Seven patients embolised for spinal dural AVFs with perimedullary venous drainage had an immediate postembolisation CT scan. In six patients a complete cure was achieved, with a normal postembolisation angiogram in five cases. Just after injection of NBCA, we were unable to determine on plain films whether or not the glue had reached the draining vein in six of seven cases. The postembolisation CT showed various patterns: in two cured patients, the glue was visible in the inner surface of the dura mater and therefore on the venous side. In five cases, the glue was approaching the dura mater around the cord or seemed to reach its surface: in the four patients cured, the glue column was 7-18 mm high, whereas it was less than 2 mm high in the patient with angiographic proof of recurrent fistula. The follow-up angiogram remains the only way to confirm a durable cure. We suggest that immediate postembolisation CT may help in assessing endovascular treatment of spinal dural AVFs. (orig.). With 4 figs., 2 tabs.

  1. FACTORES BIOPSICOSOCIALES ASOCIADOS A LAS ACTIVIDADES DE LA VIDA COTIDIANA DEL ADULTO MAYOR. CENTRO DE SALUD SAN JUAN DEL DISTRITO DE PAUCARPATA.AREQUIPA, 2012

    OpenAIRE

    MACEDO VALENCIA, HILDA EMILIANA

    2013-01-01

    EL ADULTO MAYOR ETAPA EVOLUTIVA DEL ADULTO MAYOR CARACTERÍSTICAS DEL ADULTO MAYOR QUE TIENEN UN ENVEJECIMIENTO SALUDABLE IMPACTO DE LAS CONDICIONES PSICOSOCIALES EN EL ADULTO MAYOR FACTORES BIO-PSICO-SOCIALES FACTORES BIOLÓGICOS FACTORES PSICOLÓGICOS FACTORES SOCIALES ACTIVIDADES DE LA VIDA COTIDIANA DEL ADULTO MAYOR

  2. FACTORES BIOPSICOSOCIALES ASOCIADOS A LAS ACTIVIDADES DE LA VIDA COTIDIANA DEL ADULTO MAYOR. CENTRO DE SALUD SAN JUAN DEL DISTRITO DE PAUCARPATA.AREQUIPA, 2012

    OpenAIRE

    MACEDO VALENCIA, HILDA EMILIANA

    2013-01-01

    EL ADULTO MAYOR ETAPA EVOLUTIVA DEL ADULTO MAYOR CARACTERÍSTICAS DEL ADULTO MAYOR QUE TIENEN UN ENVEJECIMIENTO SALUDABLE IMPACTO DE LAS CONDICIONES PSICOSOCIALES EN EL ADULTO MAYOR FACTORES BIO-PSICO-SOCIALES FACTORES BIOLÓGICOS FACTORES PSICOLÓGICOS FACTORES SOCIALES ACTIVIDADES DE LA VIDA COTIDIANA DEL ADULTO MAYOR

  3. CLINICAL MANIFESTATIONS, RADIOLOGICAL FINDINGS AND OUTCOME IN CEREBRAL VEIN AND DURAL SINUS THROMBOSIS: A PROSPECTIVE STUDY

    Directory of Open Access Journals (Sweden)

    Thota

    2015-09-01

    Full Text Available Cerebral vein and dural sinus thrombosis (CVT is a type of cerebrovascular disease marked by thrombosis of blood in cerebral veins, or dural sinuses, and, in rare cases, cortical veins. CVT is now a days a disease that is easy to diagnose with MRI provide d the clinician suspect CVT in patients. Before CT and MRI evolution, CVT was considered as a disorder of infectious origin. Between November 2012 and December 2013, 50 patients with CVT in the neurology at the Sri Venkateswara Institute of Medical Science s (SVIMS, Tirupati, confirmed with radioimaging, were included and studied. The mean age of the patients was 27.67±9.1 years. Most of the patients were in the third decade of life; majority were women (70%. CVT. Procoagulant state is found to be major ri sk factor with majority belonging to postpartum state (32% followed by dehydration (30%. Postpartum in combination with dehydration constituted the major risk factor because of local ritual belief that water should not be taken by the postpartum mother f or initial few days after delivery, found to be a modifiable risk factor. Superior sagittal sinus is the commonest sinus involved (58% with transverse sinus being the second most common sinus involved and most (64% of the patients with CVT had involvemen t of more than 1 venous sinus and site of thrombosis didn’t show any correlation with presenting features. MRV brain detected CVT in all the 50 patients in the study but in 28% of the patients no evidence of CVT was found on CT brain plain and contrast sug gesting the sensitivity of MRV over the CT. 70% of the patients had complete functional recovery at the end of hospital stay where as 6% of the patients died. Early diagnosis and prompt institution of anticoagulation irrespective, antioedema measures and a ntiepileptic drugs brings down the mortality and morbidity in patients with CVT. Decompressive craniectomy is an effective procedure decreasing morbidity and mortality and should be

  4. Dural sinus obstruction following head injury: a diagnostic and clinical study.

    Science.gov (United States)

    Benifla, Mony; Yoel, Uri; Melamed, Israel; Merkin, Vladimir; Cohen, Avi; Shelef, Ilan

    2016-09-01

    OBJECTIVE The aim of this study is to describe the clinical characteristics of patients with skull fracture adjacent to a dural venous sinus (DVS) and evaluate the role of CT venography (CTV) in the diagnosis of the effect of this fracture on the involved DVS. METHODS The study comprised patients with vault or skull base fracture adjacent to a DVS who were admitted to 1 medical center during a 2-year period. The medical records were reviewed for the clinical and radiographic characteristics. All patients had undergone CTV to evaluate potential DVS pathology. The clinical and radiological findings of the patients with DVS pathology were compared with those of the patients with normal DVS. The groups were compared using the chi-square and t-tests for categorical and continuous data, respectively. The potential risk for poor outcome among the patients with DVS pathology was also investigated. RESULTS Of 434 patients with skull fractures, 41 (9.4%) had fractures adjacent to a DVS. DVS pathology was detected in 51% of patients (21 of 41 patients). For 9 (43%) patients, obstruction was extraluminal without thrombosis, and 12 (57%) patients had dural sinus thrombosis (DST). In patients with a positive-CTV scan, the severity of injury according to the Glasgow Coma Scale score at presentation was correlated with the presence of DST (p = 0.007). The sensitivity of noncontrast CT (NCCT) for DVS involvement was 38% among the patients with positive-CTV scans. For patients with DVS pathology, poor outcome was correlated with DST (intraluminal), rather than extraluminal obstruction without thrombosis (p = 0.02), and superior sagittal sinus (SSS) involvement (p = 0.05). CONCLUSIONS NCCT is not sensitive enough to detect DVS obstruction in patients with skull fracture adjacent to a DVS, and CTV should be performed in order to rule it out. A correlation was found between the severity of injury and the presence of DST, rather than extraluminal obstruction. The authors' findings

  5. Timing of neuraxial pain interventions following blood patch for post dural puncture headache.

    Science.gov (United States)

    Shaparin, Naum; Gritsenko, Karina; Shapiro, David; Kosharskyy, Boleslav; Kaye, Alan D; Smith, Howard S

    2014-01-01

    Post dural puncture headache (PDPH) is a common complication of interventional neuraxial procedures. Larger needle gauge, younger patients, low body mass index, women (especially pregnant women), and "traumatic" needle types are all associated with a higher incidence of PDPH. Currently, an epidural blood patch is the gold-standard treatment for this complication. However, despite the high PDPH cure rate through the use of this therapy, little is known about the physiology behind the success of the epidural blood patch, specifically, the time course of patch formation within the epidural space or how long it takes for the blood patch volume to be resorbed by the body. Of the many unanswered and debated topics related to PDPH and epidural blood patches, one additional specific question that may alter clinical management is when it is safe for patients who have experienced a disruption of the thecal space and have undergone this procedure to have a subsequent epidural or spinal procedure, such as a neuraxial anesthetic (i.e. a spinal anesthetic for an elective outpatient procedure) or an interventional pain procedure for chronic pain management. This question becomes more unclear if the new procedure includes a steroid medication. As an example, an older patient presents with a history of lumbar disc disease and during lumbar epidural steroid injection, an inadvertent wet tap occurs leading to PDPH. Following management with fluids, caffeine, medications, and a successful epidural blood patch, it remains unclear as to when would be the best time frame to consider a second lumbar epidural steroid injection. We identified the 3 main risk factors of subsequent interventional neuraxial procedures as (1) disruption of the epidural blood patch and ongoing reparative processes, (2) epidural procedure failure, and (3) infection. We looked at the literature, and summarized the existing literature in order to enable health care professionals to understand the time course of

  6. Funcionalidad familiar y ansiedad en pacientes adultos con enfermedad crónica

    Directory of Open Access Journals (Sweden)

    Ma. del Refugio Zavala-Rodríguez

    2009-01-01

    Full Text Available Objetivo. Describir el grado de relación entre la funcionalidad familiar y el nivel de ansiedad en pacientes adultos con enfermedad crónica de una institución de salud de segundo nivel. Metodología. El diseño del estudio fue descriptivo, transversal, correlacional, se efectuó en una muestra de 97 pacientes y una misma cantidad de familiares; los primeros se seleccionaron mediante un análisis de potencia, cubriendo los siguientes criterios de inclusión: pacientes adultos, orientados, de los servicios de hospitalización y consulta externa de una institución de segundo nivel de atención. Se utilizó una cédula sociodemográfica, la Escala de Efectividad en el Funcionamiento Familiar de Friedemann (E-EFF, y la escala de ansiedad-rasgo de Spielberger, estos últimos con una consistencia interna de ,83 y ,75 respectivamente, determinada por el alpha de Cronbach. Los datos se analizaron a través de estadística descriptiva e inferencial. Resultados. El grupo de edad que predominó en los familiares fue de 33 a 47 años, con una media de 45,73, y en los pacientes predominó el grupo de 60 a 70 años, con una media de 65,05; en ambos grupos se destacó el género femenino. El 56% de los pacientes presenta diabetes mellitus tipo 2. En cuanto a los índices, la ansiedad-rasgo obtuvo una media de 51 (DE 10,7, en la E-EFF fue de 84 (DE 11,5. Por tanto, se detectó nivel moderado de ansiedad en el 92% de los pacientes, y el 91% integra una familia funcional. La correlación de Spearman no arrojó una asociación significativa entre las dos variables del estudio (rho= -,094, p= ,362. Conclusión. Las cuatro subescalas de la E-EFF obtuvieron una media significativa, con valores que fluctúan entre 77,0 a 92,0. Este último valor equivale a la subescala de coherencia que, de acuerdo con Friedemann, guía a la unidad y pertenencia familiar, y permite vínculos emocionales positivos.

  7. Medio ambiente, comportamento y aprendizaje en ratones adultos

    Directory of Open Access Journals (Sweden)

    Luis Miguel Garcia-Segura

    1977-03-01

    Full Text Available Se analiza el efecto que tiene sobre el ratón adulto el ser sometido a diferentes situaciones ambientales. Para ello se colocan ratones adultos en grupos de 12 en cajas que contienen rampas, pasarelas, pasadizos y objetos diversos, que se cambiaban de posición relativa varias veces por semana. Otros ratones se colocaron en grupos de 4 en cajas más pequenas y sin ninguno de estos objetos. Despues de estar 60 dias en estas condiciones se estúdio el comportamiento explorador de los ratones y su capacidad de aprendizaje de un laberinto complejo. Se observó una diferencia significativa entre los dos grupos de ratones ,tanto en su comportamiento explorador como en el tiempo empleado en resolver el laberinto y el número de ratones que lo resolvian en cada una de 10 pruebas sucesivas.

  8. Estilo de vida. Adultos mayores de Santa Marta

    OpenAIRE

    Marín Monroy, Cristina

    2013-01-01

    Introducción: se describe el estilo de vida saludable de 394 adultos mayores no pensionados y pensionados de la ciudad de Santa Marta. Metodología: estudio descriptivo, transversal. Resultados: el 74% de los adultos mayores tienen una alimentación no balanceada, ya que el consumo diario de proteínas, frutas y verduras es bajo, y predomina el consumo de arroz y carbohidratos como pan, galletas, arepa y plátano. En cuanto a hábitos de sueño, sólo el 29% duerme 8 horas o más. Los resultados con ...

  9. propiedades psicométricas en adultos mayores

    Directory of Open Access Journals (Sweden)

    Armando Rivera-Ledesma

    2013-01-01

    Full Text Available La presente investigación propone la adaptación al español y validación de la Escala de Soporte Social (ESS-AM de Tagaya, Okuno, Tamura y Davis (2000, conducida en cuatro muestras independientes de adultos mayores de la Ciudad de México. La escala, de ocho reactivos, mide la percepción de apoyo social mediante un solo factor que explica el 60,7% de la varianza, con una consistencia interna a de 0,84 y correlaciones negativas significativas con la variable soledad. Con base en ello, se concluye que la ESS-AM es un instrumento confiable, útil y sencillo en funciones de tamizaje para evaluar si el adulto mayor cuenta con adecuados niveles de apoyo social percibido.

  10. A reinserção do estilete não afeta a incidência de cefaleia pós-punção dural (CPPD após raquianestesia

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    Nadir S. Sinikoglu

    2013-04-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: Este estudo foi conduzido para investigar os efeitos da reinserção do estilete em cefaleia pós-punção dural (CPPD após raquianestesia. MÉTODOS: Foram selecionados para este estudo 630 pacientes submetidos a cirurgia eletiva com raquianestesia. Os pacientes foram randomicamente designados para dois grupos: Grupo A (reinserção do estilete antes da retirada da agulha e Grupo B (retirada da agulha sem reinserção do estilete. Os pacientes foram observados durante 24 horas no hospital e avaliados quanto à CPPD no terceiro e sétimo dias do estudo. RESULTADOS: No geral, a incidência da CPPD foi de 10,8% (68 pacientes. Trinta e três desses pacientes (10,5% que estavam no Grupo A e 35 (11,1% no grupo B tiveram CPPD. Não houve diferença significativa entre os dois grupos em relação à CPPD. CONCLUSÕES: Ao contrário da punção lombar diagnóstica, a reinserção do estilete após raquianestesia com agulhas tipo Quincke de calibre 25 não reduz a incidência de CPPD.

  11. Intervención de trabajo social con adultos mayores

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    Yesica Rodríguez Montañez

    2003-01-01

    Full Text Available El artículo presenta las metodologías de intervención del Trabajo Social con adultos mayores realizando un recorrido por los términos envejecimiento y vejez, haciendo énfasis en la importancia de la pérdida en la concepción de la misma . Se realiza un aná

  12. Plano de amostragem do biótipo B de Bemisia tabaci na cultura do pepino

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    Moura Marcelo Fialho de

    2003-01-01

    Full Text Available A adoção de programas de manejo integrado de pragas permite reduzir a aplicação de inseticidas e os planos convencionais de amostragem representam o ponto inicial na geração desses programas. Assim, o objetivo deste trabalho foi determinar plano de amostragem convencional para o biótipo B da mosca-branca Bemisia tabaci Genn. (Hemiptera: Aleyrodidae na cultura do pepino. Foram avaliadas as densidades de ninfas e de adultos em dez lavouras comerciais de pepino, Tocantins, MG, estudando nove sistemas amostrais formados pela combinação de três técnicas (batida de folha em bandeja de plástico branco, contagem direta dos insetos na face inferior da folha e coleta de folha em sacola de plástico e três unidades amostrais (folha do terço apical, mediano ou basal do espaldeiramento. A contagem direta em folha do terço basal foi o sistema com maior precisão econômica na amostragem de ninfas, mas não possibilitou a geração de plano de amostragem praticável. As batidas, em bandeja, de folha dos terços apicais, medianos ou basais do espaldeiramento foram os sistemas economicamente mais precisos na amostragem de adultos. Desses, apenas a batida de folha do terço mediano em bandeja gerou plano de amostragem praticável, sendo que este plano é composto de 196 amostras/lavoura.

  13. Recovery of opthalmoplegia associated with cavernous sinus dural arteriovenous fistulas after transvenous cavernous sinus packing

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    Lv Xianli; Jiang Chuhan; Li Youxiang; Yang Xinjian [Beijing Neurosurgical institute, Beijing Tiantan Hospital, Capital Medical University, 6, Tiantan Xili, Chongwen, Beijing (China); Wu Zhongxue, E-mail: ttyyzjb@sina.co [Beijing Neurosurgical institute, Beijing Tiantan Hospital, Capital Medical University, 6, Tiantan Xili, Chongwen, Beijing (China)

    2010-08-15

    Background: We report the recovery of ophthalmoplegia in 11 patients with cavernous sinus dural arteriovenous fistula (CSDAVF) after sinus packing at follow-up. Methods: Of 18 patients with CSDAVF treated with transvenous cavernous sinus packing between August 2002 and December 2007 at Beijing Tiantan Hospital, there were 9 patients with initial CNIII or CNVI dysfunction and 2 patients with CNVI dysfunction immediately after cavernous sinus packing selected and reevaluated. Results: Of 11 patients with CNIII or CNVI palsy, recovery was complete in 10. In 1 patient, complete CNVI palsy was unchanged because the CSDAVF was not cured. There were 6 men and 5 women with a mean age of 52.9 years. In 5 patients, CNVI palsy was associated with chemosis, proptosis and pulsatile tinnitus. Timing of treatment after onset of symptoms was from 4 to 35 days in 9 patients. All CSDAVFs were Barrow type D. Mean follow-up after treatment was 17.7 months (range, 2-54 months). Conclusion: CSDAVF-induced CNIII or CNVI palsies can be cured after cavernous sinus packing transvenously in most patients.

  14. Coil embolization of cavernous sinus in patients with direct and dural arteriovenous fistula

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    Bink, Andrea; Berkefeld, Joachim; Zanella, Friedhelm; Mesnil de Rochemont, Richard du [Goethe University, Department of Neuroradiology, Frankfurt am Main (Germany); Luechtenberg, Marc [Goethe University, Department of Ophthalmology, Frankfurt/Main (Germany); Gerlach, Ruediger [Goethe University, Department of Neurosurgery, Frankfurt/Main (Germany); Neumann-Haefelin, Tobias [Goethe University, Department of Neurology, Frankfurt/Main (Germany)

    2009-06-15

    To determine technical success and acute complication rates after endovascular coil packing of the cavernous sinus. Nineteen patients presented with either direct (13) or dural (6) arteriovenous fistula (AVF) and were treated by means of coil embolization of the cavernous sinus. The aim of treatment was complete obliteration of the fistula. In a retrospective study, the degree of obliteration, regression of symptoms as well as complication rates were evaluated. Initial complete obliteration was achieved in 12 patients, subtotal occlusion of the sinus in 6 and incomplete packing with major residual fistula in 1 of the patients. Retreatment was successfully performed in two patients with early recurrence of AVF. Follow-up showed complete occlusion rates in 16 and subtotal obliteration in 3 patients. Chemosis and exophthalmus regressed rapidly in all affected patients. Persistence of cranial nerve deficits was observed in 11 cases. Postinterventional thrombosis of the ophthalmic vein was the only major acute complication (n = 2). Coil embolization of the cavernous sinus in cases with AVF is a complex procedure that is technically feasible and safe in the majority of cases. Adequate anticoagulation is recommended to avoid thrombembolic complications. Long-term outcome has to be determined by further studies. (orig.)

  15. Medullary Venous Hypertension Secondary to a Petrous Apex Dural Arteriovenous Fistula: A Case Report

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    Meghan Murphy

    2012-11-01

    Full Text Available Background: Dural arteriovenous fistulae (dAVF are common intracranial vascular lesions typically becoming symptomatic with cortical venous hypertension and possible hemorrhage. Here, we present a case illustration of a petrous apex dAVF with marked medullary venous hypertension and a unique clinical presentation. Methods: Case report. Results: A 72-year-old female, whose clinical progression was significant for altered mental status and progressive weakness, presented with diplopia, right leg paresis, and ataxia. Magnetic resonance imaging revealed edema involving the medulla. On digital subtraction cerebral angiogram, the patient was found to have a petrous apex dAVF, Cognard type IV. Following treatment with Onyx embolization, her symptoms rapidly improved, with complete resolution of diplopia and drastic improvement of her ataxia. Conclusion: The importance of this case is in the presentation and deterioration of the clinical exam, resembling an acute ischemic event. Further, this case illustrates that dAVF may cause venous hypertension with rapid onset of focal neurologic symptoms not exclusive to cortical locations.

  16. Unusual MRI findings of dural arteriovenous fistula: Isolated perfusion lesions mimicking TIA

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    Kim Yong-Won

    2012-08-01

    Full Text Available Abstract Background The diagnosis of transient ischemic attack (TIA based on clinical history and objective findings, even including multiparametric MRI, can be misleading. We report two patients who presented with TIA-like deficits with isolated perfusion lesions in corresponding areas but were finally diagnosed as transient neurological symptoms associated with dural arteriovenous fistula (dAVF. Case presentation Two patients presented with transient focal neurological symptoms lasting less than one hour. An isolated perfusion deficit with no diffusion change in the clinically relevant area was shown on brain MRI, indicating transient ischemia as the most plausible cause of neurological symptoms. However, cerebral angiography let to diagnosis of dAVF in both cases. Intracerebral hemorrhage occurred after the initial diagnosis of TIA in one patient, and the small area of perfusion abnormality accompanied by the enlarged cortical vein in the other case helped to identify the dAVF through the further investigation. The pattern of perfusion-weighted imaging in both cases revealed increase of mean transit time and relative cerebral blood volume denoting the venous congestion in a clinically corresponding area. Conclusion Reported cases are uncommon clinical presentation of a dAVF, which can be misdiagnosed as TIA on clinical grounds. In rare cases, the isolated perfusion deficits could be attributable to venous congestion, despite the similar pattern of clinical presentation, such as with TIA.

  17. Comparison of dural grafts in Chiari decompression surgery: Review of the literature

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    A A Abla

    2010-01-01

    Full Text Available Background: Decompression of Chiari malformation is a common procedure in both pediatric and adult neurosurgery. Although the necessity for some bony removal is universally accepted, other aspects of Chiari surgery are the subject of debate. The most controversial points include the optimal amount of bony removal, the use of duraplasty (and the type of material, the need for subarachnoid dissection, and the need for tonsillar shrinkage. Material and Methods: We critically reviewed the literature to elucidate the risks and benefits of different graft types and to clarify optimal treatment options therein. Based on our search results, 108 relevant articles were identified. With specific inclusion and exclusion criteria, we noted three studies that directly compared two tlpes of dural substitutes in Chiari malformation surgery. Results: Our review did not support the superiority of either autologous or nonautologous grafts when duraplasty is employed. Our institutional experience, however, dictates that when the pericranium is available and of good quality, it should be utilized for duraplasty. It is non-immunogenic, inexpensive, and capable of creating a watertight closure with the dura. Conclusions: Discrepancies between the three comparative studies analyzed are likely attributable to increases in pericranial quality and thickness with maturity. Future randomized studies with large numbers and the power to resolve differences in the relatively low rates of complications in Chiari surgery are warranted.

  18. Determining the Level of the Dural Sac Tip: Magnetic Resonance Imaging in an Adult Population

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    Binokay, F.; Akgul, E.; Bicakci, K.; Soyupak, S.; Aksungur, E.; Sertdemir, Y. [Cukurova Univ., Balcali Hospital, Adana (Turkey). Dept. of Radiology and Dept. of Biostatistics

    2006-07-15

    Purpose: To determine the variation in the location of the dural sac (DS) in a living adult population and to correlate this position with age and sex. Material and Methods: T2-weighted, midline, sagittal, spin-echo magnetic resonance imaging (MRI) studies of 743 patients were assessed to identify the tip of the DS. This location was recorded in relation to the upper, middle, or lower third of the adjacent vertebral body or the adjacent intervertebral disk. Results: Frequency distribution for levels of termination of the DS on MRI demonstrated that the end of the DS was usually located at the upper one-third of S2 (25.2%). The mean level in females was also the upper one-third of S2 (26.5%) and in males the lower one-third of S2 (24.1%). The overall mean DS position was mostly at the upper one-third of S2. No significant differences in DS position were seen between male and female patients or with increasing age. Conclusion: It is important to know the possible range for the termination level of the DS when performing caudal anesthesia and craniospinal irradiation in some clinical situations. The distribution of DS location in a large adult population was shown to range from the L5-S1 intervertebral disk to the upper third of S3 vertebrae.

  19. Post Dural Puncture Headache after Cesarean Section, a Teaching Hospital Experience

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    Farhad Etezadi

    2012-03-01

    Full Text Available Objective: This prospective study examined the frequency of Post-Dural Puncture Headache (PDPH in361 parturient women undergoing spinal anesthesia for cesarean section in a teaching hospital ofTehran University of Medical Sciences.Materials and methods: Spinal anesthesia was performed using 25 gauge Quincke needles in allwomen. Patients were followed up to determine incidence of PDPH and then tried to compare those withor without PDPH using statistical methods to determine risk factors of PDPH.Results: The overall incidence of PDPH was 10.8 percent in this study. In terms of probable risk factorswhich were compared between the two groups of patients, no statistically significant differences werefound.Conclusion: The incidence of PDPH in our study was higher than studies which used pencil - tippedneedles and we determined that the occurrence of PDPH is not associated to some factors like theprevious history of nonspecific headache, Body Mass Index, age, type of local anesthetic, previoushistory of PDPH, experience of operator, history of habitual tea and coffee drinking.

  20. Superior cerebellar artery infarction in endovascular treatment for tentorial dural arteriovenous fistulas

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    Zhang Jingbo; Lv Xianli; Jiang Chuhan; Li Youxiang [Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, 6, Tiantan, Xili, Chongwen, 100050, Beijing (China); Wu Zhongxue, E-mail: ttyyzjb@sina.co [Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, 6, Tiantan, Xili, Chongwen, 100050, Beijing (China)

    2010-06-15

    Background: Superior cerebellar artery (SCA) syndrome shows ipsilateral cerebellar ataxia and Horner's syndrome, contralateral superficial sensory disturbance, as well as nystagmus toward the impaired side, vertigo, and nausea. Occasionally, unilateral lesions may produce bilateral hypogeusia and contralateral hypoacusia. Objective: To report 2 patients with unilateral lower midbrain ischemic lesions of the inferior colliculus level caused by transarterial embolization for tentorial dural arteriovenous fistulas (TDAVFs). Methods: Hospital records for 21 patients with TDAVFs mainly treated by endovascular techniques between 2005 and 2008 were reviewed. Two patients with MRI evidence of unilateral SCA territory infarction were investigated. Results: Of 21 patients, 2 treated transarterially with Onyx-18 (a nonahesive liquid embolic agent) developed infarctions in the territory of SCA. One patient had lateral SCA infarction characterized by ipsilateral gait ataxia, contralateral hemihypoesthesia, with additional ipsilateral ocular motor palsy and bilateral gustatory loss. And the other patient had medial SCA infarction characterized by ipsilateral ataxia contralateral hemihypoesthesia with additional contralateral hypoacusia. Conclusion: SCA infarction can be caused by transarterial injection of Onyx-18 via SCA or the posterior cerebral artery (PCA) for TDAVFs and additionally presented with gustatory loss and deafness, which is generally not a feature of the SCA syndrome.

  1. Primary Dural Spinal Lymphoma Presentation of a Rare Spinal Tumor Case

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    Dilber Ayçiçek Çeçen

    2015-01-01

    Full Text Available Background. Primary spinal dural lymphomas (PSDL are tumors with characteristic histopathology of a lymphoma, which are completely in the spinal epidural space without any other systemic involvement. Extranodal primary lymphoma involving nervous system prefers thalamus/basal ganglia, periventricular region, cerebellum, eyes, meninges/dura, and cranial nerves or spinal cord. Rare spinal localization with acute spinal cord compression is worth attention. Case Presentation. A 48-year-old male presented with a several-month-long history of upper back pain. Lately, he had numbness and weakness at both lower extremities and was unable to walk for one week. A spinal MRI showed a thoracic lesion with cord compression at T2–T4 levels. The patient underwent surgical decompression, with his final histopathology showing diffuse large B-cell lymphoma. Systemic work-up was negative for nodal disease. Following surgery, he received radiotherapy combined with chemotherapy. He experienced a good outcome after four years. Conclusion. The upper thoracic cord is a rare location for primary spinal lesions/metastases, both of which prefer the lower thoracic and upper lumbar regions. In cases of progressive paraparesis, there should be immediate surgical intervention in the case of denovo disease, followed by combined radiotherapy and chemotherapy procedures.

  2. Dural reconstruction by fascia using a temperature-controlled CO2 laser soldering system

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    Forer, Boaz; Vasilyev, Tamar; Brosh, Tamar; Kariv, Naam; Gil, Ziv; Fliss, Dan M.; Katzir, Abraham

    2005-04-01

    Conventional methods for dura repair are normally based on sutures or stitches. These methods have several disadvantages: (1) The dura is often brittle, and the standard procedures are difficult and time consuming. (2) The seal is leaky. (3) The introduction of a foreign body (e.g. sutures) may cause an inflammatory response. In order to overcome these difficulties we used a temperature controlled fiber optic based CO2 laser soldering system. In a set of in vitro experiments we generated a hole of diameter 10 mm in the dura of a pig corpse, covered the hole with a segment of fascia, and soldered the fascia to the edges of the hole, using 47% bovine albumin as a solder. The soldering was carried out spot by spot, and each spot was heated to 65° C for 3-6 seconds. The soldered dura was removed and the burst pressure of the soldered patch was measured. The average value for microscopic muscular side soldering was 194 mm Hg. This is much higher than the maximal physiological pressure of the CSF fluid in the brain, which is 15 mm Hg. In a set of in vivo experiments, fascia patches were soldered on holes in five farm pigs. The long term results of these experiments were very promising. In conclusion, we have developed an advanced technique for dural reconstruction, which will find important clinical applications.

  3. Endovascular management of dural arteriovenous fistulas of the transverse and sigmoid sinus in 150 patients

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    Kirsch, M. [Ernst-Moritz-Arndt-Universitaet Greifswald, Institut fuer Diagnostische Radiologie und Neuroradiologie, Greifswald (Germany); Liebig, T. [TU Muenchen, Institut fuer Neuroradiologie, Klinikum Rechts der Isar, Munich (Germany); Kuehne, D. [Klinik fuer Radiologie und Neuroradiologie, Alfried-Krupp-Krankenhaus, Essen (Germany); Henkes, H. [Katharinenhospital-Klinikum Stuttgart, Klinik fuer Neuroradiologie, Stuttgart (Germany)

    2009-07-15

    This study aimed to evaluate the safety and efficiency of the endovascular treatment of transverse-sigmoid sinus dural arteriovenous fistulas (TS{sub d}AVF). A total of 150 consecutive patients and 348 procedures were evaluated. Pulsatile tinnitus (81%), headache (15%), and intracranial hemorrhage (10%) were the most frequent manifestations of the TS{sub d}AVFs. More than half of the affected sinuses were partially or completely thrombosed. Access-wise treatment was performed transarterial (n = 33), transvenous (n = 21), or a combination thereof (n = 96). A mean of 2.4 procedures per patient was required. Immediate postprocedural occlusion rate after transarterial embolization was 30% only. Transvenous treatment alone resulted in an early occlusion rate of 81%, with delayed complete obliteration of half of the remaining fistulas. After combined transarterial/transvenous treatment, the angiographic cure rate was 54%. At follow-up, 88% of patients with residual shunt after the treatment showed complete occlusion. The cumulative complication rate was 9% (n = 13), with minor adverse events in ten patients (7%) and major complications in three patients (2%). Transvenous coil occlusion of the sinus segment with the adjacent dAVF site, eventually combined with transarterial occlusion of supplying arteries, is a very effective and well-tolerated treatment method. In selected patients, variations of these methods (e.g., sinus stenting, compartmental sinus occlusion) can be useful. (orig.)

  4. Benign spinal meningioma without dural attachment presenting delayed CSF dissemination and malignant transformation.

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    Tsuda, Kyoji; Akutsu, Hiroyoshi; Yamamoto, Tetsuya; Ishikawa, Eiichi; Saito, Atsushi; Nakai, Kei; Takano, Shingo; Matsumura, Akira

    2013-07-01

    Benign spinal meningiomas have good prognoses, with low rates of recurrence and no cerebrospinal fluid (CSF) dissemination. However, we experienced an extremely rare case of initially benign non-dura-based spinal meningioma that showed multiple CSF disseminated lesions, which progressed for 14 years. A 29-year-old woman without neurofibromatosis presented with progressing dysesthesia in her lower limbs, low back pain, and intermittent claudication. Magnetic resonance imaging (MRI) showed an intradural extramedullary mass lesion at the Th10/11 level. The patient underwent a tumor resection. Intraoperative findings indicated that the tumor had no dural attachment. Histopathological diagnosis after gross total removal was microcystic meningioma (grade I, WHO 2007). Seven years after the first operation, other lesions appeared at the levels of Th11/12, L1, and L2/3 in MRI. These tumors were slow growing and became symptomatic; thus, a second surgery was performed 14 years after the first operation. The histopathological diagnosis was atypical meningioma (grade II, WHO 2007). Benign spinal meningiomas show CSF dissemination extremely rarely, although some authors have reported non-dura-based intraspinal clear-cell meningiomas showing CSF dissemination. However, even in cases of WHO grade I, neurosurgeons should pay attention to late CSF dissemination and malignant transformation after surgical removal of non-dura-based intraspinal meningiomas.

  5. Needle gauge and tip designs for preventing post-dural puncture headache (PDPH).

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    Arevalo-Rodriguez, Ingrid; Muñoz, Luis; Godoy-Casasbuenas, Natalia; Ciapponi, Agustín; Arevalo, Jimmy J; Boogaard, Sabine; Roqué I Figuls, Marta

    2017-04-07

    Post-dural puncture headache (PDPH) is one of the most common complications of diagnostic and therapeutic lumbar punctures. PDPH is defined as any headache occurring after a lumbar puncture that worsens within 15 minutes of sitting or standing and is relieved within 15 minutes of the patient lying down. Researchers have suggested many types of interventions to help prevent PDPH. It has been suggested that aspects such as needle tip and gauge can be modified to decrease the incidence of PDPH. To assess the effects of needle tip design (traumatic versus atraumatic) and diameter (gauge) on the prevention of PDPH in participants who have undergone dural puncture for diagnostic or therapeutic causes. We searched CENTRAL, MEDLINE, Embase, CINAHL and LILACS, as well as trial registries via the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) search portal in September 2016. We adopted the MEDLINE strategy for searching the other databases. The search terms we used were a combination of thesaurus-based and free-text terms for both interventions (lumbar puncture in neurological, anaesthesia or myelography settings) and headache. We included randomized controlled trials (RCTs) conducted in any clinical/research setting where dural puncture had been used in participants of all ages and both genders, which compared different tip designs or diameters for prevention of PDPH DATA COLLECTION AND ANALYSIS: We used the standard methodological procedures expected by Cochrane. We included 70 studies in the review; 66 studies with 17,067 participants were included in the quantitative analysis. An additional 18 studies are awaiting classification and 12 are ongoing. Fifteen of the 18 studies awaiting classification mainly correspond to congress summaries published before 2010, in which the available information does not allow the complete evaluation of all their risks of bias and characteristics. Our main outcome was prevention of PDPH, but we also

  6. Dural arteriovenous fistula-induced thalamic dementia: report of 4 cases.

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    Holekamp, Terrence F; Mollman, Matthew E; Murphy, Rory K J; Kolar, Grant R; Kramer, Neha M; Derdeyn, Colin P; Moran, Christopher J; Perrin, Richard J; Rich, Keith M; Lanzino, Giuseppe; Zipfel, Gregory J

    2016-06-01

    Nonhemorrhagic neurological deficits are underrecognized symptoms of intracranial dural arteriovenous fistulas (dAVFs) having cortical venous drainage. These symptoms are the consequence of cortical venous hypertension and portend a clinical course with increased risk of neurological morbidity and mortality. One rarely documented and easily misinterpreted type of nonhemorrhagic neurological deficit is progressive dementia, which can result from venous hypertension in the cortex or in bilateral thalami. The latter, which is due to dAVF drainage into the deep venous system, is the less common of these 2 dementia syndromes. Herein, the authors report 4 cases of dAVF with venous drainage into the vein of Galen causing bithalamic edema and rapidly progressive dementia. Two patients were treated successfully with endovascular embolization, and the other 2 patients were treated successfully with endovascular embolization followed by surgery. The radiographic abnormalities and presenting symptoms rapidly resolved after dAVF obliteration in all 4 cases. Detailed descriptions of these 4 cases are presented along with a critical review of 15 previously reported cases. In our analysis of these 19 published cases, the following were emphasized: 1) the clinical and radiographic differences between dAVF-induced thalamic versus cortical dementia syndromes; 2) the differential diagnosis and necessary radiographic workup for patients presenting with a rapidly progressive thalamic dementia syndrome; 3) the frequency at which delays in diagnosis occurred and potentially dangerous and avoidable diagnostic procedures were used; and 4) the rapidity and completeness of symptom resolution following dAVF treatment.

  7. Brain herniations into the dural venous sinus or calvarium: MRI findings, possible causes and clinical significance

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    Battal, Bilal; Hamcan, Salih; Akgun, Veysel; Sari, Sebahattin; Tasar, Mustafa [Gulhane Military Medical School, Department of Radiology, Ankara (Turkey); Oz, Oguzhan [Gulhane Military Medical School, Department of Neurology, Ankara (Turkey); Castillo, Mauricio [University of North Carolina School of Medicine, Division of Neuroradiology, Department of Radiology, Chapel Hill, NC (United States)

    2016-06-15

    To determine frequency, imaging features and clinical significance of herniations of brain parenchyma into dural venous sinuses (DVS) and/or calvarium found on MRI. A total of 6160 brain MRI examinations containing at least one high-resolution T1- or T2-weighted sequence were retrospectively evaluated to determine the presence of incidental brain herniations into the DVS or calvarium. MRI sequences available for review were evaluated according to their capability to demonstrate these herniations. Patients' symptoms and clinical findings were recorded. Twenty-one (0.32 %) brain parenchyma herniations into the DVS (n = 18) or calvarium (n = 3) in 20 patients were detected. The most common locations of the herniations were the transverse sinuses (n = 13) and those involving inferior gyrus of the temporal lobe (n = 9). High-resolution T1- and T2-weighted sequences were equally useful in the detection of these brain herniations. According to clinical symptoms, brain herniations were considered to be incidental but headaches were present in nine patients. Brain herniations with surrounding cerebrospinal fluid (CSF) into the DVS and/or calvarium are incidental findings and not proven to be associated with any symptoms. Although rare, these herniations are more common than previously recognized and should not be confused with arachnoid granulations, clots or tumours. (orig.)

  8. Case report: management of persistent dural anastomotic dehiscence in a patient treated with bevacizumab.

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    Elstner, Kristen E; Clarke, Frederick K; Turner, Scott J

    2013-12-01

    A 55-year-old woman with recurrent glioblastoma multiforme on palliative chemotherapy including Avastin, an angiogenesis inhibitor, presents with several episodes of bacterial meningitis secondary to a persistent cerebrospinal fluid (CSF) leak. Anastomotic dehiscence of the dura mater in the region of the previous craniotomy sites was evident. Attempts to repair the cranial CSF leak with external ventricular drain and ventriculoperitoneal shunt were unsuccessful. This patient underwent repair of the dural defects with a radial forearm free fascial flap, with consequent resolution of the CSF leak.A literature search was performed, and the available data on angiogenesis inhibitors and anastomotic dehiscence was reviewed, specifically focusing on delayed anastomotic dehiscence in patients receiving Avastin (bevacizumab). Although the potential complications of anastomotic dehiscence in patients receiving angiogenesis inhibitors are well documented, there is comparatively little documentation in the literature regarding delayed wound or anastomotic dehiscence. Twenty such cases were found cited in the literature; however, only one study was found which specifically considered angiogenesis inhibitors within the context of central nervous system malignancies.

  9. Thyroid carcinoma presenting as a dural metastasis mimicking a meningioma: A case report

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    El Mehdi Tazi

    2011-01-01

    Full Text Available Context: Follicular thyroid cancer rarely manifests itself as a distant metastatic lesion. Case Report: We report a case of a 41-year old man presented with a solid mass located in the left temporo-occipital region. The 3D computed tomography showed a large solid mass with high vascularity, skull erosion and supra-infratentorial epidural mass effect. After magnetic resonance imaging (MRI a suspect diagnosis of meningioma was made. The patient underwent surgery where a soft mass with transverse sinus invasion was encountered; the tumour was successfully resected employing microsurgical techniques. Histological examination revealed a thyroid follicular neoplasm with positive staining for follicular carcinoma in immunohistochemical analysis. Postoperatively levels of thyroid hormones were normal. Treatment was planned for the thyroid gland, patient receiving 6 courses of chemotherapy including paclitaxel. Conclusions: The present case emphasizes that although they are uncommon, dural metastasis can be mistaken for meningiomas. The definitive diagnosis of a meningioma should be established only after the histopathological analysis. Thyroid follicular carcinoma should be included in the differential diagnosis in cases of extrinsic tumoral lesions.

  10. Cognard Type V intracranial dural arteriovenous fistula presenting in a pediatric patient with rapid, progressive myelopathy.

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    Jermakowicz, Walter J; Weil, Alexander G; Vlasenko, Artyom; Bhatia, Sanjiv; Niazi, Toba N

    2017-08-01

    Cognard Type V dural arteriovenous fistulas (dAVFs) are a unique type of cranial vascular malformation characterized by congestion of the perimedullary venous system that may lead to devastating spinal cord pathology if left untreated. The authors present the first known case of a pediatric patient diagnosed with a Type V dAVF. A 14-year-old girl presented with a 3-week history of slowly progressive unilateral leg weakness that quickly progressed to bilateral leg paralysis, sphincter dysfunction, and complete sensory loss the day of her presentation. MRI revealed an extensive T2 signal change in the cervical spine and tortuous perimedullary veins along the entire length of the cord. An emergency cranial angiogram showed a Type V dAVF fed by the posterior meningeal artery with drainage into the perimedullary veins of the cervical spine. The fistula was not amenable to embolization because vascular access was difficult; therefore, the patient underwent urgent suboccipital craniotomy and ligation of the arterialized venous drainage from the fistula. The patient's clinical course immediately reversed; she had a complete recovery over the course of a year, and she remains asymptomatic at the 2-year follow-up. This report adds to a growing body of evidence that describes the diverse and unpredictable nature of Type V dAVFs and highlights the need to obtain a cranial angiogram in pediatric patients with unexplained myelopathy and cervical cord T2 signal change on MRI.

  11. The advantages of balloon assistance in endovascular embolization of spinal dural arteriovenous fistulas.

    Science.gov (United States)

    Cohen, José E; Moscovici, Samuel; Itshayek, Eyal

    2013-01-01

    Endovascular embolization is accepted as an alternative to surgical management of spinal dural arteriovenous fistulas (DAVF) in most patients; however, when the feeder vessel arises from the trunk vessel with an acutely angled origin, microcatheter navigation may be difficult, hazardous, and sometimes impossible. We propose a technique that eases microguidewire engagement and microcatheterization of arteries that arise at very acute angles with the assistance of a parallel compliant balloon that acts as supporter, guider, and protector. This technique was successfully applied in three consecutive patients with spinal DAVF with unfavorable vascular anatomy that limited selective microcatheterization. The balloon supports and guides the microguidewire along the feeder (supportive role). The balloon can then be placed at the origin of the feeder vessel and inflated during embolization to prevent liquid agent reflux (protective role). Use of this technique as a first option reduces procedure time and radiation exposure. A limiting factor is the need for a relatively large working channel to allow the combined use of a balloon and a microcatheter. Copyright © 2012 Elsevier Ltd. All rights reserved.

  12. Improvement of Depression after Treatment of Dural Arteriovenous Fistula: A Case Report and a Review

    Directory of Open Access Journals (Sweden)

    Minoru Nakagawa

    2012-01-01

    the treatment of a dural arteriovenous fistula in the left transverse-sigmoid sinus. A 46-year-old male had suffered from depression and was treated with antidepressants at a local hospital for four years. The patient was temporarily laid off due to his depression. Afterwards, he had Gerstmann's syndrome and came to our hospital. A DAVF in the left transverse-sigmoid sinus was demonstrated on the angiogram. The DAVF was successfully treated with endovascular surgery, coil embolization of the isolated diseased sinus through the mastoid emissary vein which was a draining vein from the fistula. After this treatment, his depression as well as Gerstmann's syndrome was improved and the quantity of the antidepressants decreased. The patient returned to work without any antidepressant two years after the treatment. DAVFs might be one of the causes of depression. It may be necessary to evaluate cerebral vessels in patients suffering from depression by using MRA or 3D-CTA even if there are not any abnormal findings on plain CT scans.

  13. MANEJO DEL ESTRÉS PARA EL CONTROL METABÓLICO DE PERSONAS CON DIABETES MELLITUS TIPO 2

    OpenAIRE

    Roberto Montes Delgado; Roberto Oropeza Tena; Francisco Javier Pedroza Cabrera; Julio César Verdugo Lucero; José Filiberto Enríquez Bielma

    2013-01-01

    El objetivo del estudio fue enseñar a adultos el uso de técnicas para el manejo del estrés, para lograr una respuesta de relajación y mejorar el control meta- bólico de su diabetes mellitus tipo 2 (dm2). Participaron ocho personas adultas, 25% mujeres y 75% hombres (con un rango de edad de 43 a 69 años). Se utilizó un muestreo no probabilístico por conveniencia. La investigación tuvo tres fases: línea base retrospectiva (90 días), tratamiento (56 días) y seguimiento (90 días). Para conocer s...

  14. Diabetes melito do tipo 2 na infância e adolescência: revisão da literatura

    OpenAIRE

    Gabbay Monica; Cesarini Paulo R.; Dib Sergio A.

    2003-01-01

    OBJETIVO: análise crítica dos estudos sobre a epidemiologia, fisiopatologia, diagnóstico e tratamento do DM2 no jovem. MÉTODOS: revisão da literatura nos últimos 10 anos, através de pesquisa no banco de dados Medline, utilizando os termos "diabetes do tipo 2 no jovem". RESULTADOS: a fisiopatologia do DM2 no jovem é semelhante à do adulto, e compreende tanto a resistência à ação da insulina como uma alteração na função da célula beta-pancreática. O antecedente familiar para DM2, a presença de ...

  15. Cirurgia metabólica: cura para diabete tipo 2 Metabolic surgery: cure for type 2 diabetes

    OpenAIRE

    Jorge Luiz de Mattos Zeve; Carlos Alberto Bezerra Tomaz

    2011-01-01

    INTRODUÇÃO: O diabete melito tipo 2 é doença metabólica caracterizada por hiperglicemia crônica que está associada com dano e insuficiência de vários órgãos. A evolução da doença é a causa mais comum de cegueira, amputações e insuficiência renal em adultos no ocidente, além de aumentar a incidência de infarto agudo do miocárdio e acidente vascular cerebral, com maior mortalidade dos pacientes. A associação dele com obesidade é relevante. Os pacientes obesos diabéticos quando submetidos ao tra...

  16. Prevalencia de dependencia funcional y su asociación con caídas en una muestra de adultos mayores pobres en México Functional dependency and falls in elderly living in poverty in Mexico

    OpenAIRE

    2011-01-01

    OBJETIVO: Determinar la prevalencia de la dependencia funcional (DF) de los adultos mayores (AM) que viven en condiciones de pobreza en México, y estimar la asociación entre la DF y las caídas. MATERIAL Y MÉTODOS: Se realizó una encuesta con tres etapas de selección, con estratificación según tipo de localidad (rural o urbana) y con representatividad nacional del padrón de Oportunidades 2006. La población objetivo estuvo conformada por individuos de 70 años y más, beneficiarios del Programa O...

  17. Neodesarrollismo y el tipo de cambio competitivo

    Directory of Open Access Journals (Sweden)

    Alejandro Fiorito

    2015-01-01

    Full Text Available En este trabajo se intenta mostrar que las modificaciones en los tipos de cambio tienen efectos limitados en el aumento del producto, mientras que, inversamente, esos cambios impactan especialmente en la distribución del ingreso al incidir en los precios domésticos. Se analizan y muestran múltiples referencias de la literatura internacional que cuestionan este "consenso de tipos de cambio competitivos". Se realizan correlaciones que muestran resultados distintos de los obtenidos en Rodrik (2008 con los mismos datos utilizados, aunque simplemente cambiando la metodología de datos de panel y usando en cambio una más convencional de series de tiempo.

  18. Educación emocional y satisfacción con la vida percibida en un grupo de adultos mayores

    Directory of Open Access Journals (Sweden)

    Adriana del Pilar Perugache Rodríguez

    2016-07-01

    Full Text Available La investigación tuvo como objetivo determinar el efecto de un Programa en Educación Emocional sobre la percepción de la satisfacción con la vida en un grupo de Adultos Mayores. Materiales y método: el trabajo realizado fue de tipo explicativo y empleó un diseño experimental. Se evaluó inicialmente el nivel de la variable dependiente, en los grupos experimental y control a través de la prueba Índice de Satisfacción Vital (ISV –A adaptación de la escala original validada por Zegers, Rojas y Förstein (2009; con una consistencia interna de 0, 80, y una validez de 0.84. Posteriormente se implementó el Programa de Educación Emocional en el grupo experimental y finalmente, se aplicó el pos-test en los dos grupos. El análisis de los datos se realizó con el paquete estadístico SPSS versión 0.20. Debido a que no se cumplió con el supuesto de normalidad se aplicó la prueba de Wilcoxon para muestras relacionadas y la U de Mann Whitney para las muestras independientes. Resultados: el programa mejoró los niveles de satisfacción con la vida percibida en el grupo experimental, obteniendo un p0,05. Conclusiones: El programa incrementa los niveles de satisfacción con la vida percibida en adultos mayores.

  19. Tipos e mitos do pensamento brasileiro

    Directory of Open Access Journals (Sweden)

    Ianni Octavio

    2002-01-01

    Full Text Available No pensamento brasileiro são freqüentes os "tipos ideais" elaborados por diferentes autores e que se tornam emblemáticos, notáveis ou mesmo definitivos, podendo, às vezes, figurar como mitos. Esse é o caso do bandeirante, do gaúcho, do Jeca Tatu, do Macunaíma, do homem cordial e outros. Vale a pena refletir sobre este aspecto da cultura e do pensamento brasileiros.

  20. A questão do consenso nas representações sociais: um estudo do medo entre adultos

    Directory of Open Access Journals (Sweden)

    Antonio Roazzi

    Full Text Available O presente estudo aborda a questão metodológica que caracteriza a pesquisa na área das representações sociais. Em particular, aprofunda o problema da verificação empírica do consenso que uma representação possui para um determinado grupo social. Esta preocupação metodológica foi abordada neste estudo cujo objetivo foi compreender a organização estrutural da representação social do medo em adultos de ambos os sexos. O interesse foi também analisar o papel do gênero na construção deste tipo de representação. Primeiramente, com um grupo de 60 indivíduos adultos, foi desenvolvida a abordagem da livre associação de idéias, como meio de acesso ao campo semântico das representações, (pedia-se que os sujeitos expressassem livremente o que pensavam com a evocação da palavra medo. A partir deste levantamento, foram selecionadas 20 palavras entre as mais evocadas. Depois, com um grupo de 72 sujeitos, foi investigado o nível de consenso da representação social do medo através da técnica não-verbal de classificação. Para tal investigação, os sujeitos foram submetidos a duas tarefas: uma de classificação livre, em que foram convidados a agrupar as 20 palavras inscritas nos cartões, mais a palavra "medo", em grupos diferentes de acordo com a similaridade de significados, ou de função, entre elas; a outra tarefa foi a de classificação dirigida: os sujeitos foram solicitados a pensar sobre as 20 palavras e ordená-las em função de estarem mais ou menos associadas com a emoção medo. Os dados foram analisados por métodos estatísticos multidimensionais (SSA, MSA. Considerados em seu conjunto os resultados das projeções MSA dos dois grupos de adultos - homens e mulheres - apresentam as mesmas regionalizações dos itens e um mesmo tipo de polarização entre as regiões. As várias regiões - Saúde, Abandono, Entidades Sobrenaturais e Violência Social - apresentam elementos e caracter

  1. Ataxia espinocerebelar tipo 6: relato de caso

    Directory of Open Access Journals (Sweden)

    Bianca Simone Zeigelboim

    2014-10-01

    Full Text Available O objetivo deste estudo foi verificar as alterações vestibulococleares observadas em um caso de ataxia espinocerebelar tipo 6. O caso foi encaminhado do Hospital de Clínicas para o Laboratório de Otoneurologia de uma Instituição de Ensino e foi submetido aos seguintes procedimentos: anamnese, inspeção otológica, avaliações audiológica e vestibular. O caso retrata uma paciente com diagnóstico genético de ataxia espinocerebelar tipo 6, do sexo feminino, com 57 anos de idade, que referiu desequilíbrio à marcha com tendência a queda para a esquerda, disartria e disfonia. Na avaliação audiológica apresentou configuração audiométrica descendente a partir da frequência de 4kHz e curva timpanométrica do tipo "A" com presença dos reflexos estapedianos bilateralmente. No exame vestibular observou-se na pesquisa da vertigem posicional presença de nistagmo vertical inferior e oblíquo, espontâneo e semiespontâneo múltiplo com características centrais (ausência de latência, paroxismo, fatigabilidade e vertigem, nistagmooptocinético abolido e hiporreflexia à prova calórica. Constataram-se alterações labirínticas que indicaram afecção do sistema vestibular central evidenciando-se a importância dessa avaliação. A existência da possível relação entre os achados com os sintomas vestibulares apresentados pela paciente apontou a relevância do exame labiríntico neste tipo de ataxia uma vez que a presença do nistagmo vertical inferior demonstrou ser frequente neste tipo de patologia.

  2. Intervención educativa en adultos mayores con diabetes mellitus en Guatemala

    Directory of Open Access Journals (Sweden)

    José Manuel Contreras Tejeda

    2014-08-01

    Full Text Available Se realizó un estudio de intervención comunitaria, con el objetivo de incrementar los conocimientos en pacientes diabéticos adultos mayores, pertenecientes al Departamento Alta Verapaz, Cobán, Guatemala; en el período comprendido desde junio de 2011 hasta junio de 2012. El universo de estudio estuvo constituido por los pacientes diabéticos dispensarizados por el médico y la enfermera en el área periférica, conformándose la muestra con 46 de ellos, a los cuales se les evaluó el grado de conocimientos previo y posterior a la aplicación de la intervención para modificar estilos de vida, empleando para ello técnicas participativas. Para obtener la información se revisaron las historias clínicas individuales, se realizaron entrevistas y se aplicaron cuestionarios a los pacientes, antes y después de aplicadas las técnicas educativas. Los resultados fueron procesados por métodos estadísticos. En la muestra predominaron los pacientes con diabetes mellitus tipo II. Después de la intervención hubo un incremento en las respuestas correctas en un 63.04%, haciéndose más marcado a medida que aumenta el nivel de escolaridad y en los que tienen más de diez años de evolución de la enfermedad. El estado nutricional se mejoró en un 50%. Se logró un mejor control de las complicaciones crónicas, así como del control metabólico en un 78.26%. Las charlas educativas en la comunidad resultaron efectivas para la incorporación de elementos educativos que incidieron en el mejor autocuidado de los pacientes diabéticos

  3. Consumo de carnes por adultos do sul do Brasil: um estudo de base populacional

    Directory of Open Access Journals (Sweden)

    Bruna Celestino Schneider

    2014-08-01

    Full Text Available Estudo transversal de base populacional que avaliou indivíduos com 20 anos ou mais, residentes na zona urbana de Pelotas, Rio Grande do Sul, que objetivou descrever a frequência do consumo de carnes e o hábito de consumi-las com excesso de gordura. Foi avaliado, no último ano, o consumo de carnes vermelhas (com osso, bife e carne moída, brancas (frango e peixes, vísceras e embutidos. Dos 2,730 entrevistados, 99,1% (IC95%, 98,7 - 99,5 consumiu algum tipo de carne no último ano, sendo que, em torno de 32% referiu consumo diário. A prevalência do consumo de carnes vermelhas (99,3%, IC95%, 98,9 - 99,6 e brancas (99,4% IC95%, 99,1 - 99,7 foi semelhante. A carne de frango foi a mais consumida (98,0%, IC95%, 97,4 - 98,5, enquanto que as vísceras, as menos (59,1% IC95% 56,4 - 61,7. Os embutidos, consumidos por 85,5% (IC95%, 83,7 - 87,2 das pessoas, apresentaram a maior prevalência de consumo diário (16,6%. As carnes com excesso de gordura foram consumidas por 52,3% (IC95%, 49,8 - 54,8 dos adultos, principalmente homens, e pessoas de menor escolaridade e nível econômico.

  4. Comportamento de Aedes albopictus e de Ae. scapularis adultos (Diptera: Culicidae no Sudeste do Brasil

    Directory of Open Access Journals (Sweden)

    Oswaldo Paulo Forattini

    2000-10-01

    Full Text Available OBJETIVO: Observar e comparar o comportamento das espécies de Aedes albopictus e de Ae. scapularis, na localidade de Pedrinhas, litoral sul do Estado de São Paulo, Brasil. MÉTODOS: As observações foram feitas de outubro de 1996 a janeiro de 2000. Foram realizadas coletas sistemáticas de formas adultas mediante a utilização de isca humana, aspirações ambientais e armadilha tipo Shannon. A domiciliação foi estimada pelo índice de Nuorteva e pela razão de sinantropia. RESULTADOS: Foram feitas 87 coletas diurnas, com a obtenção de 872 adultos fêmeas. As médias de Williams', multiplicadas por 100, foram de 118 e 21 para Ae. albopictus nos horários de 7h às 18h e de 18h às 20h, respectivamente. Quanto a Ae. scapularis, foram de 100 e 106 nos mesmos períodos. Esse último revelou pico de atividade crepuscular vespertina. Na aspiração de abrigos, obteve-se o total de 1.124 espécimens, dos quais 226 Ae. albopictus e 898 Ae. scapularis. O período de janeiro a maio correspondeu ao de maior rendimento para ambos os mosquitos. Quanto à armadilha de Shannon, as coletas realizadas na mata revelaram a ausência de Ae. albopictus. No que concerne à domiciliação, esse último mostrou os maiores valores de índices, enquanto Ae. scapularis revelou comportamento de tipo ubiquista. CONCLUSÕES: Os resultados confirmam outras observações, permitindo levantar hipóteses. Em relação a Ae. scapularis, sugere-se que possa existir fenômeno de diapausa das fêmeas no período verão-outono, a qual cessaria no inverno-primavera quando então a atividade seria retomada. Quanto a Ae. albopictus, os dados sugerem que se trata de população em processo adaptativo ao novo ambiente.

  5. Resistência de clones de batata a Bemisia tabaci biótipo B Resistance of potato clones to Bemisia tabaci biotype B

    Directory of Open Access Journals (Sweden)

    Artur BO Rocha

    2012-03-01

    Full Text Available Avaliou-se a resistência de 30 genótipos de batata a B. tabaci (Genn. biótipo B (Hemiptera: Aleyrodidae em casa de vegetação, por meio de três experimentos. No primeiro com chance de escolha, foi em blocos ao acaso, 30 tratamentos e três repetições. Avaliou-se a atratividade para adultos, a preferência para oviposição e a densidade de tricomas simples e glandulares. Os sete genótipos com menor oviposição, juntamente com o padrão de resistência 'Achat', e o mais ovipositado foram selecionados para os experimentos seguintes, nos quais se avaliou a preferência para oviposição sem chance de escolha e para o acompanhamento do período de desenvolvimento ovo-adulto, ambos em blocos ao acaso, nove tratamentos e cinco repetições. Na avaliação de atratividade, após 72 horas, HPC 5B e BAP 82 tiveram o menor número de adultos, enquanto que NYL 235-4 e MAC 2 foram os mais atrativos. Neste mesmo experimento, os genótipos HPC 6R, BACH 4, Clone APTA 2135, HPC 9B, BAP 82, 'Baraka' e HPC 5B foram os menos ovipositados. O genótipo NYL 235-4 mostrou alta densidade de tricomas simples (TS e glandulares (TG, enquanto os genótipos CH 2, 'Santé' e 'Caesar' tiveram alta densidade de TS, e HPC 9B, 'Radosa', 'Cupido', 'Caesar', 'Saginaw Gold', BACH 3 e HPC 1B para TG revelaram menor pilosidade. Houve correlação significativa entre atratividade para adultos e preferência para oviposição. No experimento sem chance de escolha, os genótipos BACH 4, HPC 9B, 'Baraka' e 'Achat' foram menos ovipositados, caracterizando-se como portadores de resistência do tipo não-preferência para oviposição. Quanto ao período de desenvolvimento ovo-adulto, as médias não diferiram entre os genótipos, variando de 34,4 a 36,6 dias. Observou-se para os genótipos BAP 82, 'Baraka' e BACH 4 o menor número de adultos emergidos, sugerindo a presença de antibiose. Com base nos três experimentos, os clones 'Baraka' e BACH 4 destacaram-se como os mais

  6. Estrategias de cortesia verbal utilizadas en debates semipautados de jovenes y adultos mayores de Santiago de Chile

    National Research Council Canada - National Science Library

    Aguilar Pena, Paula

    2015-01-01

    ...: adultos mayores y jovenes. De forma general, los resultados expresan diferencias en la descripcion de estrategias corteses usadas por jovenes y adultos en el contexto comunicativo de intercambio de ideas...

  7. ESTUDIO MORFOLÓGICO DEL PTERION Y ASTERION EN CRÁNEOS ADULTOS MEXICANOS. Estudio morfológico del pterion y asterion en cráneos adultos mexicanos

    Directory of Open Access Journals (Sweden)

    Rodolfo Morales Ávalos

    2016-03-01

    Full Text Available Introducción. El pterion y asterion son puntos craneométricos de confluencia sutural observables en una vista lateral del cráneo, ambos representan puntos de referencia y/o acceso dentro del campo de la neurocirugía así como puntos de importancia dentro de la antropología física y medicina legal por sus diferencias morfológicas entre las diferentes poblaciones. Materiales y Métodos. Se examinaron ochenta y cinco cráneos secos de adultos mexicanos bilateralmente, se obtuvieron las distancias promedio entre el centro del pterion y el borde posterior de la sutura frontocigomática, borde superior del arco cigomático, base de la fosa mandibular, vértice de la apófisis mastoides y el centro del asterion. Resultados. Se identificaron cuatro tipos de pterion: esfenoparietal (90%, estellar (4.12%, epiptérico (3.53% y frontotemporal (2.35%. Se identificaron dos tipos de asterion: tipo 1 (7.06% y  tipo 2 (92.94%. Conclu-siones. Los resultados obtenidos en la morfología sutural de ambos puntos y los resultados de las mediciones son de importancia para el abordaje neuroquirúrgico del cráneo, patólogos forenses y antropólogos.  Introduction. Pterion and asterion are craniometrical landmarks of sutural confluence observable in a lateral view of the skull. Both represent points of reference and/or access in the field of neurosurgery, and are aspects of importance in disciplines such as physical anthropology and legal medicine for the morphological differences between the different populations. Materials and Methods. Examinations were conducted bilaterally in 85 (eighty five dry skulls from Mexican adults. The average distances were obtained from the center of the pterion to the following landmarks: posterior edge of the frontozygomatic suture, superior edge of the zygomatic arch, base of the mandibular fossa, vertex of the mastoid process and the center of the asterion. Results. Four types of pterion were identified: sphenoparietal (90

  8. Pediatric intracranial dural arteriovenous fistulas: age-related differences in clinical features, angioarchitecture, and treatment outcomes.

    Science.gov (United States)

    Hetts, Steven W; Moftakhar, Parham; Maluste, Neil; Fullerton, Heather J; Cooke, Daniel L; Amans, Matthew R; Dowd, Christopher F; Higashida, Randall T; Halbach, Van V

    2016-11-01

    OBJECTIVE Intracranial dural arteriovenous fistulas (DAVFs) are rare in children. This study sought to better characterize DAVF presentation, angioarchitecture, and treatment outcomes. METHODS Children with intracranial DAVFs between 1986 and 2013 were retrospectively identified from the neurointerventional database at the authors' institution. Demographics, clinical presentation, lesion angioarchitecture, treatment approaches, angiographic outcomes, and clinical outcomes were assessed. RESULTS DAVFs constituted 5.7% (22/423) of pediatric intracranial arteriovenous shunting lesions. Twelve boys and 10 girls presented between 1 day and 18 years of age; boys presented at a median of 1.3 years and girls presented at a median of 4.9 years. Four of 8 patients ≤ 1 year of age presented with congestive heart failure compared with 0/14 patients > 1 year of age (p = 0.01). Five of 8 patients ≤ 1 year old presented with respiratory distress compared with 0/14 patients > 1 year old (p = 0.0021). Ten of 14 patients > 1 year old presented with focal neurological deficits compared with 0/8 patients ≤ 1 year old (p = 0.0017). At initial angiography, 16 patients harbored a single intracranial DAVF and 6 patients had 2-6 DAVFs. Eight patients (38%) experienced DAVF obliteration by the end of treatment. Good clinical outcome (modified Rankin Scale score 0-2) was documented in 77% of patients > 1 year old at presentation compared with 57% of patients ≤ 1 year old at presentation. Six patients (27%) died. CONCLUSIONS Young children with DAVFs presented predominantly with cardiopulmonary symptoms, while older children presented with focal neurological deficits. Compared with other pediatric vascular shunts, DAVFs had lower rates of angiographic obliteration and poorer clinical outcomes.

  9. Therapeutic clues in spinal dural arteriovenous fistulas - a 30 year experience of 156 cases.

    Science.gov (United States)

    Hessler, C; Regelsberger, J; Grzyska, U; Illies, T; Zeumer, H; Westphal, M

    2010-02-01

    Spinal dural arteriovenous fistulae (SDAVF) are rare but remain the most common type of spinal vascular malformations. Treatment options for SDAVF include endovascular embolization, microsurgical dissection or a combination of both. But the optimal treatment paradigm has yet to be defined and may well be an individualized interdisciplinary combinatorial approach. From 1980 to 2008, 156 patients with the diagnosis of SDAVF were treated by neuroradiological and neurosurgical means. Based on the procedure-related complications we retrospectively analyzed our data to elucidate the reasons for endovascular failure and the evolution of the surgical technique. 156 patients were included in this study. There were 31 (19.9%) female and 125 (80.1%) male patients. Average age at the time of diagnosis was 60.8 years. 102 out of 156 (65.4%) underwent endovascular obliteration, 54 (34.6%) patients were treated primarily by surgery. 134 (85.9%) underwent follow-up examination. A total of 29 (18.6%) out of 156 patients could not be treated successfully by endovascular (9.4%) or surgical (4.1%) means. Microsurgery can be recommended as the first choice treatment when the fistula's point is unmistakably identified intradurally. Endovascular obliteration may be justifiable in cases with an easy access to a monoradicular feeding artery during diagnostic angiography. Surgery is a definitive treatment with stable long-term results in which procedure-related morbidity is low. During evolution of the combined approach, endovascular coil placement for correct localization of the fistula and the use of intraoperative micro-Doppler was found to be very helpful in increasing the safety of the surgical procedure and minimizing surgical exposure. Georg Thieme Verlag KG Stuttgart * New York.

  10. Characteristics, diagnosis and treatment of hypoglossal canal dural arteriovenous fistula: report of nine cases

    Energy Technology Data Exchange (ETDEWEB)

    Manabe, Shinji; Satoh, Koichi; Matsubara, Shunji; Satomi, Junichiro; Hanaoka, Mami; Nagahiro, Shinji [University of Tokushima, Department of Neurosurgery, Tokushima (Japan)

    2008-08-15

    We report the characteristics, diagnosis and treatment of dural arteriovenous fistula (DAVF) of the hypoglossal canal in nine patients with this relatively rare vascular disorder. Of 248 patients with intracranial DAVFs managed at our institution, nine patients (3.6%; four men, five women; mean age 62 years) were diagnosed with hypoglossal canal DAVF. We investigated patient characteristics with respect to clinical symptoms, neuroradiological findings, efficacy and complications related to endovascular treatment. Seven patients had experienced head injury. All patients presented with pulsatile tinnitus. One patient displayed ipsilateral hypoglossal nerve palsy before treatment. MR angiography showed a 'magic wand' appearance between the affected hypoglossal canal and the internal jugular vein in four patients. Angiography demonstrated an AV fistula on the medial aspect of the superior jugular bulb, mostly arising from the bilateral occipital, ascending pharyngeal and vertebral arteries with drainage to the internal jugular vein via the anterior condylar vein. Contralateral carotid injection accurately clarified the shunting point. Five patients underwent endovascular treatment: transarterial embolization (TAE; n=2), transvenous embolization (TVE; n=2), and TAE/TVE (n=1). Complete shunt obliteration was achieved in four patients and shunt reduction in one. The remaining four patients were treated conservatively and the shunt had disappeared at follow-up. Postoperative hypoglossal nerve palsy occurred in one patient after TVE, possibly due to coil overpacking. The incidence of hypoglossal canal DAVF was not very low in our series. Contralateral carotid injection is an essential examination to provide an accurate diagnosis. TVE should be considered when access is available, although TAE is also appropriate for shunt reduction. (orig.)

  11. THE IMPACT OF ANXIETY ON POST - DURAL PUNCTURE HEADACHE IN ROUTINE NEUROLOGY PRACTICE

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    Stefka Mantarova

    2015-09-01

    Full Text Available Background: The post-dural puncture headache (PDPH is the most common complication of lumbar puncture in neurological practice. Although the comorbidity of headache and psychiatric symptoms is well-recognized, the data about the relationship between PDPH and symptoms of anxiety and depression are limited. The aim of the present study was to determine the influence of anxiety symptoms on the risk for PDPH. Methods: Diagnostic lumbar puncture was performed to thirty-nine neurological patients, presented by 26 women and 13 men. All subjects completed the Hospital Anxiety and Depression Scale (HADS before the procedure. Information about the clinical characteristic of the headache - quality, location, severity, postural nature, duration and associated symptoms (nausea, vomiting, and tinnitus was collected. Results: Fifteen of the patients (38,5% developed PDPH. According to the presence of PDPH the patients were divided into two groups – with (group 1 and without headache (group 2. Women with headache were significantly younger (mean age 34,00±11,22 years compared to females in group 2 (mean age 45,07±12,36 years (p=0,028. Patients in group 1 had significantly higher levels of reported anxiety symptoms compared to group 2 (p= 0,045. A significant positive correlation was observed between anxiety and PDPH (Spearman’s rho = 0,412, p=0,009. Conclusion: Younger female patients with anxiety had a considerably increased rate of PDPH. This could be of practical benefit in devising an additional treatment strategy for patients with PDPH.

  12. Cranial Nerve Dysfunction Associated with Cavernous Dural Arteriovenous Fistulas After Transvenous Embolization with Onyx

    Energy Technology Data Exchange (ETDEWEB)

    Li, Chuanhui; Wang, Yang; Li, Youxiang; Jiang, Chuhan; Wu, Zhongxue; Yang, Xinjian, E-mail: yang-xj@163.net [Capital Medical University, Beijing Neurosurgical Institute and Beijing Tiantan Hospital (China)

    2015-10-15

    PurposeCranial nerve dysfunction (CND) is not uncommon in patients with cavernous dural arteriovenous fistulas (cDAVFs), and may represent an initial manifestation or a complication after endovascular treatment. This study evaluated the outcome of CND associated with cDAVFs after transvenous embolization (TVE) using Onyx.Materials and MethodsForty-one patients with cDAVFs were treated with TVE in our department between April 2009 and October 2013. For each patient, clinical and radiologic records were retrospectively reviewed and evaluated, with an emphasis placed on evaluating the outcomes of the pre-existing cDAVF-induced CND and the TVE-induced CND.ResultsOf the 41 cases, 25 had a history of preoperative CND. Postoperatively, gradual remission to complete recovery (CR) within 8 months was observed in 17 of these cases, transient aggravation in 7, and significant improvement to be better than preoperative function but no CR in 1. All aggravation of CND occurred immediately or within 1 day after TVE and resolved completely within 5 months. Nine patients developed new CND after TVE. New CND occurred during the perioperative period in 8 cases, but all cases resolved completely within 15 days–6 months. Delayed CND was observed in 3 cases with a time lag of 3–25 months after TVE. Two of these completely resolved within 20 days–1 month and the remaining case significantly improved.ConclusionBoth the pre-existing cDAVF-induced CND and the TVE-induced new or aggravated CND completely resolved in almost all cases after embolization with Onyx.

  13. Gamma Knife surgery for clival epidural-osseous dural arteriovenous fistulas.

    Science.gov (United States)

    Lee, Cheng-Chia; Chen, Ching-Jen; Chen, Shao-Ching; Yang, Huai-Che; Lin, Chung Jung; Wu, Chih-Chun; Chung, Wen-Yuh; Guo, Wan-Yuo; Hung-Chi Pan, David; Shiau, Cheng-Ying; Wu, Hsiu-Mei

    2017-06-16

    OBJECTIVE Clival epidural-osseous dural arteriovenous fistula (DAVF) is often associated with a large nidus, multiple arterial feeders, and complex venous drainage. In this study the authors report the outcomes of clival epidural-osseous DAVFs treated using Gamma Knife surgery (GKS). METHODS Thirteen patients with 13 clival epidural-osseous DAVFs were treated with GKS at the authors' institution between 1993 and 2015. Patient age at the time of GKS ranged from 38 to 76 years (median 55 years). Eight DAVFs were classified as Cognard Type I, 4 as Type IIa, and 1 as Type IIa+b. The median treatment volume was 17.6 cm(3) (range 6.2-40.3 cm(3)). The median prescribed margin dose was 16.5 Gy (range 15-18 Gy). Clinical and radiological follow-ups were performed at 6-month intervals. Patient outcomes after GKS were categorized as 1) complete improvement, 2) partial improvement, 3) stationary, and 4) progression. RESULTS All 13 patients demonstrated symptomatic improvement, and on catheter angiography 12 of the 13 patients had complete obliteration and 1 patient had partial obliteration. The median follow-up period was 26 months (range 14-186 months). The median latency period from GKS to obliteration was 21 months (range 8-186 months). There was no intracranial hemorrhage during the follow-up period, and no deaths occurred. Two adverse events were observed following treatment, and 2 patients required repeat GKS treatment with eventual complete obliteration. CONCLUSIONS Gamma Knife surgery offers a safe and effective primary or adjuvant treatment modality for complex clival epidural-osseous DAVFs. All patients in this case series demonstrated symptomatic improvement, and almost all patients attained complete obliteration.

  14. Health-related quality of life in patients with spinal dural arteriovenous fistulae.

    Science.gov (United States)

    Sasamori, Toru; Hida, Kazutoshi; Osanai, Toshiya; Yano, Shunsuke; Seki, Toshitaka; Houkin, Kiyohiro

    2017-01-01

    Neurological improvement in patients with spinal dural arteriovenous fistulae (SDAVF) is often partial even after adequate treatment. While treatment outcomes have been evaluated primarily on the basis of the postoperative changes in neurological deficits, outcome measures should also reflect the patient-reported outcome (PRO). We conducted a health-related quality of life (HRQOL) survey in 52 SDAVF patients; 33 (63.5%) completed the short-form 36 Health Survey (SF-36) questionnaire. They were 25 males and 8 females ranging in age from 47 to 85 years (mean age 70.0 years). The mean follow-up period was 95.6 months. We analyzed the completed questionnaires and examined the clinical factors associated with their HRQOL. After treatment, gait- and micturition disturbances persisted in 31 (93.9%) and 31 (93.9%) of our patients; 26 (78.8%) reported chronic leg pain. The SF-36 scores of treated SDAVF patients were significantly lower than the national average of 50 for all 8 sub-items in the questionnaire. The scores for physical functioning (PF) and role-physical (RP) were particularly low. With the exception of bodily pain (BP), there was a significant negative correlation between the Aminoff-Logue scale (ALS) scores for gait- and micturition and the sub-item scores. The score for BP showed a significant positive correlation with the scores for the 7 other SF-36 sub-items. The HRQOL of treated SDAVF patients was lower than the national average with respect to both physical and mental aspects. Persistent post-treatment pain and gait- and micturition disturbances were responsible for their lower HRQOL.

  15. [Intracranial dural arteriovenous fistulae. Experience after 81 cases and literature review].

    Science.gov (United States)

    Paredes, Igor; Martinez-Perez, Rafael; Munarriz, Pablo M; Castaño-Leon, Ana María; Campollo, Jorge; Alén, Jose F; Lobato, Ramiro D; Lagares, Alfonso

    2013-01-01

    To analyse the clinical, radiological and therapeutic variables of intracranial dural arteriovenous fistulae (DAVF) treated at our institution, and to assess the validity of the Borden and Cognard classifications and their correlation with the presenting symptoms. The DAVF identified were retrospectively analysed. They were classified according to their location, drainage pattern and the Borden and Cognard classifications. We recorded the different treatments, their complications and efficacy. There were 81DAVF identified between 1975 and 2012. The cavernous sinus (CS) location was the most frequent one. The Borden and Cognard classifications showed an interobserver Kappa index of 0.72 and 0.76 respectively. The odds ratio of aggressive presentation in the presence of cortical venous drainage (CVD) was 19.3 (2.8-132.4). No location, once adjusted by venous drainage pattern, showed significant association with an aggressive presentation. Endovascular transarterial treatment of cavernous sinus DAVF achieved symptomatic improvement of 78%, with a complication rate of 5%. The DAVF of non-CS locations, with CVD, treated surgically were angiographically shown cured in 100% of the cases, with no treatment-related complications. The presence of CVD was significantly associated with aggressive presentations. The Borden and Cognard classifications showed little interobserver variability. Endovascular treatment for CS DAVF is safe and relatively effective. Surgical treatment of non-CS DAVF with CVD is safe, effective and the first choice treatment in our environment. Copyright © 2012 Sociedad Española de Neurocirugía. Published by Elsevier España. All rights reserved.

  16. Double spinal dural arteriovenous fistulas: case report and review of the literature

    Energy Technology Data Exchange (ETDEWEB)

    Krings, T. [Department of Neuroradiology, University Hospital of the University of Technology, Aachen, Pauwelsstrasse 30, 52057, Aachen (Germany); Department of Neurosurgery, University Hospital of the University of Technology, Aachen, Pauwelsstrasse 30, 52057, Aachen (Germany); Mull, M.; Thron, A. [Department of Neuroradiology, University Hospital of the University of Technology, Aachen, Pauwelsstrasse 30, 52057, Aachen (Germany); Reinges, M.H.T. [Department of Neurosurgery, University Hospital of the University of Technology, Aachen, Pauwelsstrasse 30, 52057, Aachen (Germany)

    2004-03-01

    Spinal dural arteriovenous fistula (SDAVF) is the most common spinal vascular malformation. It mainly affects men after the fifth decade and is usually an acquired lesion with an unknown etiology. We report on a patient with the unusual finding of two separate SDAVFs at the level of L1 on the right and L2 on the left side. Initial selective spinal digital subtraction angiography (DSA) was terminated with demonstration of a SDAVF at the level of L1 but incomplete demonstration of all segmental arteries. Due to a recurrent deterioration of the patient's neurological status, and persistent pathological vessels seen on MRI, a second spinal DSA was performed 6 years later, demonstrating the second fistula at the level of L2 on the left side with a separate venous drainage pattern. A retrospective analysis of the angiographic films suggested that both fistulas had already been present 6 years previously. This conclusion is justified because of a transient and faint opacification of the left L2 fistula demonstrated on the films after injection of the right L2 segmental artery. We conclude that in the case of incomplete angiography and persistent clinical and MR findings not only reopening of the treated SDAVF has to be taken into account but also the existence of a second fistula. Since this is the first case of a double fistula in our series of 129 SDAVFs, and given the few reported cases of double SDAVFs, we do not think that completion of selective spinal DSA has to be postulated routinely after a fistula has been found. However, repeat angiography should be performed in patients who continue to deteriorate, fail to improve with persisting MRI pathologies, or demonstrate delayed deterioration after a period of improvement. (orig.)

  17. Revisión sistemática sobre el impacto de la actividad física en los trastornos de la marcha en el adulto mayor

    Directory of Open Access Journals (Sweden)

    Jeison Daniel Salazar Pachón

    2014-12-01

    Full Text Available Objetivos. 1 realizar una revisión sistemática de los estudios que examinan el impacto de la actividad física en los trastornos de la marcha del adulto mayor entre el periodo de 2003-2013, y 2 hacer recomendaciones basadas en el nivel y la fuerza de las evidencias. Método. La revisión fue limitada a: tipo de estudio, periodo de publicación, alteraciones de marcha, actividad física, frecuencia, duración, intensidad, protocolos de evaluación. En el proceso de adquisición de la información fueron empleadas las palabras clave marcha, patrón de marcha, biomecánica de la marcha, autonomía, funcionalidad, actividad física, ejercicio físico, vejez, adulto mayor, lesiones, fallos, caídas. Un total de 963 artículos fueron valorados desde la metodología, los resultados, la discusión y las conclusiones. Sólo 52 documentos cumplían con los criterios inclusión y exclusión establecidos, facilitando la presentación de niveles de evidencia y fuerza de las recomendaciones. Resultados: los programas de entrenamiento físico basados en la potencia muscular, con una frecuencia no menor a dos días por semana, mínimo por 12 semanas, 150 minutos semanales de trabajo, con intensidades entre 50 % y el 80 % respecto a la variable de trabajo generan adaptaciones positivas en la marcha del adulto mayor. Hay una gran variedad de materiales y métodos empleados en la valoración de los patrones de marcha, factor que limita la validez externa de los estudios revisados.

  18. Estudio longitudinal de mortalidad de adultos costarricenses 1984-2007

    Directory of Open Access Journals (Sweden)

    Luis Rosero-Bixby

    2010-01-01

    Full Text Available Se describen los procedimientos y se presentan algunos resultados del "estudio longitudinal de mortalidad de adultos costarricenses" (ELMAC, consistente en una muestra de cerca de 20.000 costarricenses de 30 o más años de edad del censo de población de 1984 seguidos hasta fines de 2007. El Instituto Nacional de Estadística y Censos (INEC digitalizó los nombres de la boleta censal de los individuos en la muestra. Procesos informáticos depuraron los nombres y los enlazaron al número único de identificación ¿el número de cédula¿ del Registro Civil. El empate se efectuó en el 87% de la muestra. Los individuos identificados se siguieron en las bases de datos del Registro Civil para establecer su sobrevivencia. Se identificaron más de 5.000 defunciones entre el censo de 1984 y diciembre de 2007. Procesos informáticos adicionales enlazaron 92% de estas defunciones con las de las estadísticas vitales del INEC que contienen el dato de la causa de defunción. El patrón de mortalidad de la muestra, que comprende 373.000 personas-años de observación, reproduce bien las tasas de las tablas de mortalidad del país. Las gradientes socioeconómicas de la mortalidad en esta muestra no son sensibles a posibles errores en los empates o en las imputaciones efectuadas. La muestra confirma la excepcionalmente baja mortalidad de los adultos costarricenses, especialmente de los varones. Esta muestra abre la puerta para que se efectúen variedad de análisis de los determinantes socioeconómicos de la mortalidad de adultos en Costa Rica, algo rara vez intentado en un país en desarrollo.

  19. Prolongamentos na fala de adultos com e sem gagueira

    Directory of Open Access Journals (Sweden)

    Pâmila Bento da Silva

    Full Text Available RESUMO Objetivo: realizar uma análise quantitativa e qualitativa dos prolongamentos de adultos com e sem gagueira. Métodos: os participantes foram divididos em: Grupo de Pesquisa (GP, 15 adultos com gagueira e Grupo Controle (GC, 15 fluentes. Os procedimentos utilizados foram: avaliação da fluência, Instrumento de Gravidade da Gagueira e análises quantitativa e qualitativa dos prolongamentos. Resultados: GP mostrou maior número de prolongamentos não hesitativos, enquanto que GC mostrou maior ocorrência de prolongamentos hesitativos em relação ao total das disfluências. Prolongamentos não hesitativos ocorreram com maior frequência na palavra inicial e monossilábica, bem como na posição medial da frase para GP. Em relação à tensão muscular e duração, observou-se diferença apenas para a tensão muscular nos prolongamentos não hesitativos com maior média de ocorrência para GP. Conclusão: os prolongamentos não hesitativos ocorreram com maior frequência no GP, nas palavras iniciais, monossílabos e na posição medial da frase. Qualitativamente a tensão muscular foi uma característica típica dos prolongamentos não hesitativos no GP. Com relação aos prolongamentos hesitativos houve semelhança entre os adultos dos dois grupos quanto à frequência em relação ao total da fala, a posição dos prolongamentos nas palavras e nas frases e nos aspectos qualitativos, relacionados a tensão muscular e duração.

  20. Estudio longitudinal de mortalidad de adultos costarricenses 1984-2007

    Directory of Open Access Journals (Sweden)

    Rosero-Bixby, Luis

    2010-01-01

    Full Text Available Se describen los procedimientos y se presentan algunos resultados del “estudio longitudinal de mortalidad de adultos costarricenses” (ELMAC, consistente en una muestra de cerca de 20.000 costarricenses de 30 o más años de edad del censo de población de 1984 seguidos hasta fines de 2007. El Instituto Nacional de Estadística y Censos (INEC digitalizó los nombres de la boleta censal de los individuos en la muestra. Procesos informáticos depuraron los nombres y los enlazaron al número único de identificación –el número de cédula– del Registro Civil. El empate se efectuó en el 87% de la muestra. Los individuos identificados se siguieron en las bases de datos del Registro Civil para establecer su sobrevivencia. Se identificaron más de 5.000 defunciones entre el censo de 1984 y diciembre de 2007. Procesos informáticos adicionales enlazaron 92% de estas defunciones con las de las estadísticas vitales del INEC que contienen el dato de la causa de defunción. El patrón de mortalidad de la muestra, que comprende 373.000 personas-años de observación, reproduce bien las tasas de las tablas de mortalidad del país. Las gradientes socioeconómicas de la mortalidad en esta muestra no son sensibles a posibles errores en los empates o en las imputaciones efectuadas. La muestra confirma la excepcionalmente baja mortalidad de los adultos costarricenses, especialmente de los varones. Esta muestra abre la puerta para que se efectúen variedad de análisis de los determinantes socioeconómicos de la mortalidad de adultos en Costa Rica, algo rara vez intentado en un país en desarrollo.

  1. Consumo de pre-adultos de mosquitos por peces ornamentales

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    Marco Polo Franco Archundia

    2015-01-01

    Full Text Available La investigación sobre alternativas de alimento para especies acuáticas con alto potencial económico, es uno de los principales temas de estudio en la acuicultura. En la presente investigación se evaluó el consumo de pre-adultos de mosquito por cuatro especies ícticas ornamentales: Carassius auratus, Pterophyllum scalare, Danio rerio y Xiphophorus helleri. El diseño experimental consistió en cuatro tratamientos, con tres réplicas. Cada ensayo se realizó de manera independiente entre especies. En cada acuario (1 l se colocaron dos peces juveniles, con peso húmedo y longitud total (promedio ± desviación estándar conocidos. Se suministraron en un tratamiento 100 larvas y en otro 100 pupas de mosquito. La tasa diaria de consumo de larvas y pupas se registró a un intervalo de tres horas durante un ciclo de 24 horas por especie. El peso húmedo de pre-adultos de mosquito difirió 5.20% y el seco 37.69%; en ambos casos, superior en las pupas (p < 0.001. Los peces fueron más activos durante la fase luminosa, 09:00-18:00 h, evidenciado por una mayor tasa de consumo de larvas y pupas de mosquito. Carassius auratus presentó el mayor consumo de larvas/pez/24 horas 131.33 ± 4.16 y de pupas/pez/24 horas 86.16 ± 3.20. Lo anterior difirió significativamente con respecto a P. scalare, D. rerio y X. helleri (p < 0.001. Finalmente, Carassius auratus presentó la mayor capacidad de consumo de pre-adultos de mosquitos.

  2. Comparison of dynamic contrast-enhanced 3T MR and 64-row multidetector CT angiography for the localization of spinal dural arteriovenous fistulas.

    Science.gov (United States)

    Oda, S; Utsunomiya, D; Hirai, T; Kai, Y; Ohmori, Y; Shigematsu, Y; Iryo, Y; Uetani, H; Azuma, M; Yamashita, Y

    2014-02-01

    For the localization of spinal dural arteriovenous fistulas, it is not determined whether dynamic contrast-enhanced MRA is more reliable than multidetector CTA. The aim of this study was to compare the agreement between intra-arterial DSA, dynamic contrast-enhanced MRA at 3T, and 64-row multidetector CTA for the localization of spinal dural arteriovenous fistulas. We enrolled 12 consecutive patients (11 men, 1 woman; age range, 46-83 years; mean, 65 years) who underwent preoperative dynamic contrast-enhanced MRA at 3T and 64-row multidetector CTA. The spinal dural arteriovenous fistula location was confirmed by intra-arterial DSA as the reference standard. Two reviewers independently evaluated the level of the artery feeding the spinal dural arteriovenous fistula on the basis of continuity between the feeder and abnormal spinal vessels on 3T dynamic contrast-enhanced MRA and 64-row multidetector CTA images. Interobserver and intermodality agreement was determined by calculation of the κ coefficient. On DSA, the vessel feeding the spinal dural arteriovenous fistula was the intercostal artery (7 cases), the lumbar artery (3 cases), and the internal iliac artery or the ascending pharyngeal artery (1 case each). For the fistula level, interobserver agreement was excellent for 3T dynamic contrast-enhanced MRA (κ = 0.97; 95% CI, 0.92-1.00) and very good for 64-row multidetector CTA (κ = 0.84; 95% CI, 0.72-0.96). Intermodality agreement with DSA was good for 3T dynamic contrast-enhanced MRA (κ = 0.78; 95% CI, 0.49-1.00) and moderate for 64-row multidetector CTA (κ = 0.41; 95% CI, 0.020-0.84). For the localization of spinal dural arteriovenous fistulas, 3T dynamic contrast-enhanced MRA may be more reliable than 64-row multidetector CTA.

  3. Early dural metastasis from a case of glioblastoma with primitive neuroectodermal differentiation: A case report and literature review.

    Science.gov (United States)

    Konar, Subhas K; Bir, Shyamal C; Maiti, Tanmoy K; Patra, Devi Prasad; DiPoto Brahmbhatt, Angela C; Jacobsohn, Jamie A; Nanda, Anil

    2017-01-01

    Glioblastoma with a primitive neuroectodermal (PNET) variant is a rare primary parenchymal tumor. Only a few cases of extraparenchymal metastasis are reported in world literature. Although the overall survival duration of glioblastoma multiforme (GBM) with primitive neuroectodermal tumor (PNET) variety may be prolonged in comparison to classical glioblastoma, the metastatic trend is completely different, and the prognosis is worse. We report an early dural metastasis of pure PNET component appearing in a case of primary glioblastoma with PNET variant. The lesson learned from this case is to look for early craniospinal metastasis in GBM patient with PNET component, even after completion of adjuvant radiochemotherapy.

  4. Cefalea postpunción dural: correlación clínico-radiológica.

    OpenAIRE

    2015-01-01

    El síndrome de hipotensión intracraneal ha sido ampliamente estudiado por parte de los profesionales de Neurología, de lo que se derivan gran cantidad de publicaciones en las que se describen sus manifestaciones clínicas, radiológicas y anatomopatológicas, así como diferentes teorías para explicar su fisiopatología. Por otro lado, se considera a la cefalea postpunción dural (CPPD) como síntoma del síndrome de hipotensión intracraneal de causa conocida, no habiendo sido estudiado como pat...

  5. Multimodality evaluation of dural arteriovenous fistula with CT angiography, MR with arterial spin labeling, and digital subtraction angiography: case report.

    Science.gov (United States)

    Alexander, Matthew; McTaggart, Ryan; Santarelli, Justin; Fischbein, Nancy; Marks, Michael; Zaharchuk, Greg; Do, Huy

    2014-01-01

    Dural arteriovenous fistulae (DAVF) are cerebrovascular lesions with pathologic shunting into the venous system from arterial feeders. Digital subtraction angiography (DSA) has long been considered the gold standard for diagnosis, but advances in noninvasive imaging techniques now play a role in the diagnosis of these complex lesions. Herein, we describe the case of a patient with right-side pulsatile tinnitus and DAVF diagnosed using computed tomography angiography, magnetic resonance with arterial spin labeling, and DSA. Implications for imaging analysis of DAVFs and further research are discussed.

  6. Error de tipo y el conocimiento del hecho

    OpenAIRE

    Palacios Riquetti, Damián Patricio

    2013-01-01

    Lo que busco es establecer la diferencia entre el error de tipo y el error de prohibición, para luego tratar sobre el conocimiento que debe tener el autor, sobre los elementos del tipo legal, para que se configure un error de tipo, y determinar si el error de tipo es evitable o inevitable, lo que en cada caso llevará a la gradación y a la imposición o no de una pena; trataré sobre el error de los elementos normativos integrados en el tipo penal, comentaré del error sobre el curso causa...

  7. O sofrimento espiritual do doente adulto com leucemia aguda internado

    OpenAIRE

    2010-01-01

    Tese de mestrado, Ciências da Dor, Faculdade de Medicina, Universidade de Lisboa, 2011 O presente estudo teve como objectivo saber quais os factores que influenciam o sofrimento espiritual no doente adulto (faixa etária dos 30 aos 65 anos) com leucemia aguda internado. A amostra foi de 30 doentes, 14 homens e 16 mulheres e o estudo teve a duração de 6 meses, decorrendo no Serviço de Hematologia do CHLC-EPE (Hospital de Santo António dos Capuchos). O instrumento de colheita de dados apli...

  8. Actitudes en la ingesta de bebidas saludables en adultos mayores

    OpenAIRE

    Saldaña Ibarra, Sandra Areli; Universidad Veracruzana; Hernández Guerson, Enrique; Universidad Veracruzana

    2013-01-01

    A partir de una escala elaborada ex profeso, se evaluaron las actitudes favorables o no favorables de la ingesta de líquidos en una población de adultos mayores residentes en un asilo, a quienes se impartió un programa educativo, comparada con otra de usuarios de una estancia con servicios de día, sin intervención. Se consideró una actitud favorable cuando los puntos obtenidos grupalmente, en la evaluación de diversos temas relacionados, mostraran incremento después del programa. Los resultad...

  9. Recomendaciones para el manejo de la faringoamigdalitis aguda del adulto

    OpenAIRE

    Cots, Josep M; Juan-Ignacio Alós; Mario Bárcena; Xavier Boleda; José L. Cañada; Niceto Gómez; Ana Mendoza; Isabel Vilaseca; Carles Llor

    2015-01-01

    La faringoamigdalitis aguda (FAA) en el adulto es una de las enfermedades infecciosas más comunes en la consulta del médico de familia. La etiología más frecuente es viral. Dentro de la etiología bacteriana, el principal agente responsable es Streptococcus pyogenes o estreptococo β-hemolítico del grupo A (EBHGA), causante del 5-30% de los casos. En el manejo diagnóstico, las escalas de valoración clínica para predecir la posible etiología bacteriana, son una buena ayuda para seleccionar a qué...

  10. Prevalencia de alteraciones del medio interno en pacientes adultos hospitalizados.

    OpenAIRE

    CIEZA, Javier; Velasquez, Silvia; Miyahira, Juan; ESTREMADOYRO, Luis

    2013-01-01

    Objetivo: Determinar la prevalencia de punto de los disturbios electrolíticos y ácidobase en adultos internados en el Hospital Nacional Cayetano Heredia, que estuvieran recibiendo fluídos endovenosos el día del estudio. Material y métodos: El estudio fue de corte transversal, descriptivo y analítico. Se recolectaron datos clínicos de las  historias respectivas y se buscó la existencia de asociación con los disturbios encontrados. Resultados: Hubo 34/280 pacientes hospitalizados que recibían f...

  11. Fracturas radiculares en pacientes adultos: propuesta de tratamiento actual

    OpenAIRE

    Francisco Javier Verdugo-Avello; Edgardo González; Christian Pedemonte; Ilich Vargas

    2014-01-01

    Objetivo: El objetivo de este estudio fue ver la prevalencia y la evolución del tratamiento en las fracturas radiculares en pacientes adultos laboralmente activos que sufrieron un trauma dentoalveolar y presentar un protocolo de tratamiento distinto basándose en el pronóstico a largo plazo según nuestros porcentajes de éxito. Materiales y métodos: Se realizó una revisión retrospectiva de los casos de trauma dentoalveolar y específicamente de fracturas radiculares que acudieron a la Unidad ...

  12. Kinefilaxia en actividad física en adultos mayores

    OpenAIRE

    Figueroa, Aixa Nahir

    2013-01-01

    Considerando que los kinesiólogos, en su rol de agentes de la salud, deben desempeñarse en áreas filácticas, realizando tareas de prevención de lesiones y/o patologías, y de rehabilitación terapéutica aplicando y desarrollando sus conocimientos, el siguiente trabajo de investigación se centró en conocer cómo influye la Kinesiología durante la actividad física en los adultos mayores de acuerdo a grupos etarios y patologías preexistentes. Los objetivos planteados permiten conocer...

  13. Beneficios percibidos por adultos mayores incorporados al ejercicio

    OpenAIRE

    René Barrios Duarte; Rolando Borges Mojaiber; Laura del Carmen Cardoso Pérez

    2003-01-01

    El propósito del trabajo es conocer los beneficios que perciben los adultos mayores del sexo femenino, con larga permanencia en el ejercicio, y las relaciones que se establecen entre estos y las variables edad, nivel cultural, tiempo de permanencia y ocupación anterior. Se tomó una muestra de 75 personas pertenecientes a 5 círculos de abuelos de Ciudad de La Habana, con edades entre 56 y 90 años, a los cuales se les aplicó un cuestionario de datos sociodemográficos y una entrevista. Los benef...

  14. Fisioterapia motora em pacientes adultos em terapia intensiva

    OpenAIRE

    Borges,Vanessa Marcos; Oliveira,Luiz Rogério Carvalho de; Peixoto,Elzo; Carvalho, Nilza Aparecida de Almeida

    2009-01-01

    O objetivo desse estudo é realizar uma revisão da literatura abordando o tema fisioterapia motora para pacientes adultos em unidade de terapia intensiva. A busca de artigos científicos foi realizada nas bases de dados PubMed, MedLine (Literatura Internacional em Ciências e Saúde), LILACS (Literatura Latino Americana e do Caribe em Ciências e Saúde) e Cochrane entre 1995 e dezembro de 2008 utilizando as palavras-chaves: physical therapy, mobilization and intensive care unit. Para efeito de com...

  15. Fracturas radiculares en pacientes adultos: propuesta de tratamiento actual

    OpenAIRE

    Francisco Javier Verdugo-Avello; Edgardo González; Christian Pedemonte; Ilich Vargas

    2014-01-01

    Objetivo: El objetivo de este estudio fue ver la prevalencia y la evolución del tratamiento en las fracturas radiculares en pacientes adultos laboralmente activos que sufrieron un trauma dentoalveolar y presentar un protocolo de tratamiento distinto basándose en el pronóstico a largo plazo según nuestros porcentajes de éxito. Materiales y métodos: Se realizó una revisión retrospectiva de los casos de trauma dentoalveolar y específicamente de fracturas radiculares que acudieron a la Unidad ...

  16. Tipos de resistência a Alabama argillacea (Huebner, 1818 (Lepidoptera: Noctuidae envolvidos em genótipos de algodoeiro: II. Antibiose Evaluation of cotton genotypes resistance to Alabama argillacea (Huebner, 1818 (Lepidoptera: Noctuidae: II. Antibiosis

    Directory of Open Access Journals (Sweden)

    ALVEMAR FERREIRA

    1999-01-01

    Full Text Available Objetivou-se verificar a ocorrência do tipo de resistência antibiose em genótipos de algodoeiro (Gossypium hirsutum L. em relação a Alabama argillacea (Huebner, 1818, em experimentos de laboratório (27 ± 2oC, 70 ± 10% de U.R. e fotofase de 14 horas. Folhas dos genótipos T 1122-13-1, STO 285 N, JPM 157, T 953-13-4-2, CNPA 9211-21 e CNPA 9211-31 foram fornecidas às larvas, diariamente, verificando-se a duração de cada fase do inseto, avaliando-se a massa de larvas aos 3 e aos 8 dias de idade, a massa de pupas e as porcentagens de mortalidade larval, pré-pupal e pupal. O delineamento utilizado foi inteiramente casualizado, com dez repetições, cada uma com dez larvas/genótipo. Em comparação com STO 285 N, todos os genótipos provocaram períodos mais longos de larva a adulto em A. argillacea; entretanto, os menores valores de massa de larvas com 3 dias e de massa média de pupas, e os maiores valores de duração do período larval e de mortalidade de larva a adulto foram verificados em CNPA 9211-31 e CNPA 9211-21, evidenciando que antibiose é um dos tipos de resistência presentes em ambos os genótipos.Cotton genotypes resistance to Alabama argillacea (Huebner, 1818 due to antibiosis has been evaluated in laboratory trials (at 27 ± 2oC, 70 ± 10% relative humidity and 14 hours photoperiod. Six different genetic materials (T 1122-13-1, STO 285 N, JPM 157, T 953-13-4-2, CNPA 9211-21, and CNPA 9211-31 have been tested in a completely randomized experimental design, with ten replications, each one with ten larvae/genotype. Larvae have been supplied with leaves daily. The following variables have been scored: time length of several insect stages (from larvae to adult, average mass of larvae and pupae as well as average larval, pre-pupal and pupal mortality rates. All genotypes have revealed longer overall average time length of stage duration from larvae to adult, as compared to STO 285 N; however, CNPA 9211-31 and CNPA 9211-21 have

  17. Seguridad social para adultos mayores en Venezuela: caracteristicas, bondades y limitaciones del Regimen Prestacional de Servicios Sociales al Adulto Mayor y Otras Categorias de Personas

    National Research Council Canada - National Science Library

    Arraga Barrios, Marisela Virginia

    2011-01-01

    .... Esto se materializo en la Ley de Servicios Sociales aprobada en el ano 2005, constituyendose en la primera en el pais que reconoce al adulto mayor como actor social con derechos naturales, legales...

  18. Criando falsas memórias em adultos por meio de imagens faciais - doi: 10.5102/ucs.v3i1.544

    Directory of Open Access Journals (Sweden)

    Verônica Souza Caixeta

    2008-04-01

    Full Text Available O presente estudo baseia-se em verificar se é possível criar falsas memórias em adultos de ambos os sexos por meio de imagens faciais. Para tanto, realizou-se pesquisa com funcionários de uma empresa de transporte coletivo em Brasília. O método consistiu em apresentar imagens faciais na tela do computador fazendo com que acreditassem ter visualizado uma face que, na verdade, não foi apresentada entre as outras. Na parte introdutória, apresentam-se aspectos gerais e específicos da memória, entre eles, os tipos, estágios e distúrbios. Foram comparados os dados obtidos de homens e mulheres e por meio de tabelas, gráficos e com base em teorias de Fisiologia, os resultados encontrados para tal amostra de sujeitos permitiram chegar a conclusões.

  19. Prevalencia del maltrato doméstico en adultos mayores. Policlínica "Alcides Pino". Holguín. 2009

    Directory of Open Access Journals (Sweden)

    Marcia Avila-Oliva

    2012-01-01

    Full Text Available Se realizó un estudio descriptivo con el objetivo de caracterizar el maltrato doméstico en adultos mayores de dos consultorios del área de salud "Alcides Pino" en el municipio de Holguín en el año 2009. De los seniles que percibieron maltrato estuvieron las edades de 60 a 74 años, predominando el sexo femenino, la escolaridad primaria y las mujeres sin vínculo conyugal, mientras que los mayoritarios estuvieron asociados a hombres casados. Otros aspectos analizados fueron, el tipo de familia obteniéndose las extensas y ampliadas; en los perfiles de maltrato, el físico se destacó en la mujer y en lo económico/Financiero y psicológico estuvieron presente en ambos sexos. Se recomienda extender el estudio a otros consultorios para la posterior toma de decisiones encaminadas a su tratamiento.

  20. Apoptosis neuronal: la diversidad de señales y de tipos celulares

    Directory of Open Access Journals (Sweden)

    Lina Vanessa Becerra

    2009-03-01

    Full Text Available La muerte celular programada es un evento fisiológico durante el desarrollo. En el encéfalo y la médula espinal, este proceso determina el número y la localización de los diferentes tipos celulares. En el sistema nervioso del adulto, la muerte celular programada o apoptosis está más restringida, pero puede jugar un papel determinante en enfermedades crónicas o agudas. Al contrario de otros tejidos en los cuales la apoptosis está documentada ampliamente desde el punto de vista morfológico, en el sistema nervioso central la evidencia en este sentido es escasa. A pesar de esto, existe consenso acerca de la activación de diferentes sistemas de señalización apoptótica. En el presente artículo se intenta resumir las principales vías de señalización apoptótica identificadas en el tejido nervioso. Considerando que las vías apoptóticas son múltiples, los tipos neuronales diversos y especializados y que la respuesta neuronal a la lesión y la supervivencia dependen del contexto de la célula en el tejido (preservación de la conectividad, integridad glial y matriz extracelular, flujo sanguíneo y disponibilidad de factores tróficos, lo que es relevante en el proceso apoptótico en un sector del cerebro puede no serlo en otro.

  1. O oraloma da diabetes melitos tipo 1 vs diabetes melitos tipo 2 - um estudo comparativo

    OpenAIRE

    2013-01-01

    A Diabetes Melitos é uma doença de grande prevalência a nível mundial e os seus mecanismos fisiopatológicos não são ainda totalmente conhecidos. Actualmente, a terapêutica seguida em casos de Diabetes Melitos é eminentemente sintomática consistindo na administração de insulina nos casos de Diabetes Melitos tipo 1 ou quando se verifica a falência das células beta do pâncreas de pacientes com Diabetes Melitos tipo 2, ou no controlo da glicemia nos casos de Diabetes Melitos ...

  2. ALGUNOS ASPECTOS A CONSIDERAR SOBRE LA SEXUALIDAD DEL ADULTO MAYOR

    Directory of Open Access Journals (Sweden)

    Zoila Edith Hernández Zamora

    2008-12-01

    Full Text Available La presente investigación expone, a partir de una serie de entrevistas realizadas a una muestra de adultos mayores, aspectos relativos a la satisfacción general en la vida, así como las actitudes, conocimientos y prácticas de la sexualidad de un grupo de adultos mayores que asisten regularmente a una estancia diurna de la ciudad de Xalapa, Veracruz, México, misma que fue diseñada especialmente para este grupo etario. Se encontraron diferencias estadísticamente significativas entre la actitud hacia el ejercicio de la sexualidad de las personas mayores entre los hombres y las mujeres de la muestra, y entre .las personas que tienen pareja con relación a las que no tienen; así como que hay una diferencia estadísticamente significativa entre aquellas personas que tiene una o ninguna enfermedad y las que tienen dos o más enfermedades con respecto a su frecuencia de actividad sexual. Es de resaltar la escasez de conocimientos sobre aspectos básicos de la sexualidad que poseen estas personas mayores, lo que hace necesario el establecimiento de programas educativos que incluyan al personal de salud y a los mismos senectos.

  3. Prevalencia de Hipercolesterolemia en adultos mayores de Costa Rica

    Directory of Open Access Journals (Sweden)

    Eduardo Aguilar Fernández

    2012-01-01

    Full Text Available Este artículo tiene como objetivo el estudio de la prevalencia de la hipercolesterolemia (con y sin diagnóstico previo en adultos mayores de Costa Rica e identificar los factores asociados con el control de la hipercolesterolemia dado que se tiene un diagnóstico previo. Los datos sometidos a estudio provienen de una muestra nacional del proyecto CRELES: "Costa Rica. Estudio de Longevidad y Envejecimiento Saludable" La prevalencia de hipercolesterolemia es de 59,5%. Dentro de los 890 adultos mayores que poseen un diagnóstico previo de hipercolesterolemia, el 68% resultó con niveles de colesterol total de 200 mg/dl o más en las mediciones del estudio. La prevalencia es mayor en las mujeres que en los hombres. La diferencia resultó significativa. Los factores asociados con el control de la hipercolesterolemia son el ser hombre, el tener diagnóstico de diabetes e hipertensión, la actividad física y tomar medicamentos para controlar el nivel lipídico. La interacción entremedicamentos no resultó significativa en el estudio.

  4. Relacionamentos de amizade íntima entre jovens adultos

    Directory of Open Access Journals (Sweden)

    Diogo Araújo DeSousa

    2012-12-01

    Full Text Available A literatura é consensual quanto ao importante papel dos amigos no ciclo vital, na maior parte do tempo, para melhorias na qualidade de vida. Este estudo teve como objetivo investigar e descrever características dos relacionamentos íntimos de amizade de jovens adultos. Participaram 98 jovens adultos com idade entre 18 e 30 anos. Os procedimentos de amostragem foram baseados na técnica do Respondent Driven Sampling. Foram utilizados três questionários autoaplicados e os dados foram submetidos a tratamento quantitativo. Os resultados demonstraram uma homogeneidade de características entre amigos íntimos, especialmente para o gênero. O companheirismo despontou como aspecto mais marcante na amizade. Todas as funções da amizade apresentaram correlações positivas entre si. Conclui-se que parece haver um filtro de similaridades entre amigos na adultez jovem e que amizades de boa qualidade em uma determinada função costumam ser de boa qualidade em seu total.

  5. Relacionamentos de amizade e coping entre jovens adultos

    Directory of Open Access Journals (Sweden)

    Diogo Araújo DeSousa

    Full Text Available Este artigo descreve um estudo de relações que existem entre características dos relacionamentos de amizade de jovens adultos e suas estratégias e recursos de coping. Participaram 98 jovens adultos, com idades entre 18 e 30 anos (M=23,01; DP=6,57, 45,9% homens. A amostragem se baseou na técnica do Respondent Driven Sampling. Foram aplicados um questionário sociodemográfico e três escalas autoaplicáveis (abordando relacionamentos de amizade, estratégias de coping e percepção de suporte social. Estratégias de coping por confronto e reavaliação positiva se associaram às amizades com mulheres, enquanto que o autocontrole se correlacionou positivamente a amigos homens. Qualidades da amizade se correlacionaram positivamente à percepção de suporte social. Quanto melhores as qualidades das amizades, mais os amigos provêm recursos de coping.

  6. O significado da morte para adolescentes, adultos e idosos

    Directory of Open Access Journals (Sweden)

    Caroline Garpelli Barbosa

    2011-08-01

    Full Text Available Apesar do aumento na quantidade de trabalhos que visam a abordar a morte como tema de investigação, observa-se que ainda prevalece a interdição do assunto morte, dificultando que ela seja abordada e discutida. Este estudo buscou ampliar a compreensão de como pessoas, em diferentes etapas desenvolvimentais, lidam com perdas e com a própria finitude. Para isso, 7 adolescentes, 14 adultos de meia-idade e 10 idosos foram entrevistados, e os dados foram compreendidos mediante análise de conteúdo. Entre os participantes, os adultos foram os que mostraram mais aflição e inquietação, ao falarem sobre a própria finitude e sobre a possibilidade da morte de pessoas queridas. Os adolescentes abordaram-na como um acontecimento distante e impessoal, enquanto os idosos se referiram a ela com maior proximidade e aceitação. Sugere-se a realização de estudos que aprofundem tais compreensões, relacionando-as às diferentes religiões, classes sociais e experiências com perdas.

  7. Prevalencia de Hipercolesterolemia en adultos mayores de Costa Rica

    Directory of Open Access Journals (Sweden)

    Eduardo Aguilar Fernández

    2012-01-01

    Full Text Available Este artículo tiene como objetivo el estudio de la prevalencia de la hipercolesterolemia (con y sin diagnóstico previo en adultos mayores de Costa Rica e identificar los factores asociados con el control de la hipercolesterolemia dado que se tiene un diagnóstico previo. Los datos sometidos a estudio provienen de una muestra nacional del proyecto CRELES: “Costa Rica. Estudio de Longevidad y Envejecimiento Saludable” La prevalencia de hipercolesterolemia es de 59,5%. Dentro de los 890 adultos mayores que poseen un diagnóstico previo de hipercolesterolemia, el 68% resultó con niveles de colesterol total de 200 mg/dl o más en las mediciones del estudio. La prevalencia es mayor en las mujeres que en los hombres. La diferencia resultó significativa. Los factores asociados con el control de la hipercolesterolemia son el ser hombre, el tener diagnóstico de diabetes e hipertensión, la actividad física y tomar medicamentos para controlar el nivel lipídico. La interacción entre medicamentos no resultó significativa en el estudio.

  8. Farmacovigilancia intensiva en pacientes adultos y pediátricos

    Directory of Open Access Journals (Sweden)

    Isis B Bermúdez Camps

    1999-08-01

    Full Text Available Se estudiaron 600 pacientes, 320 niños y 280 adultos seleccionados aleatoriamente a partir de los 2 368 casos ingresados en las unidades de cuidados intensivos e intermedios de los hospitales Infantil Norte "Juan de la Cruz Martínez Maceira" y Provincial Clinicoquirúrgico Docente "Saturnino Lora". Se detectaron 511 reacciones adversas a medicamentos en 261 pacientes, 187 adultos y 74 niños, con un índice de aparición de este fenómeno del 61 y 20 % respectivamente. Los resultados obtenidos fueron procesados y evaluados mediante pruebas estadísticas, la aplicación del algoritmo de Naranjo y el cálculo del beneficio-riesgo de los tratamientos aplicados.600 patients (320 children and 280 adults were studied, who had been ramdonly selected from 2 368 cases admitted to the intensive and intermidiate care units in "Juan de la Cruz-Martínez Maceira" Northern Pediatric Hospital and "Saturnino Lora" Provincial Teaching Clinicosurgical Hospital. 511 adverse reactions to drugs were detected in 201 patients 187 adults and 74 children- with an occurrence index of 61 % and 20 % respectively. The result were processed and asseased through statistical tests, Naranjo’s algoritthm and benefit- risk analysis of used treatments.

  9. Glaucoma secundario a neurofibromatosis tipo-1

    Directory of Open Access Journals (Sweden)

    Anay Martínez Díaz

    2012-02-01

    Full Text Available Paciente de 59 años de edad, con antecedentes de neurofibromatosis tipo 1 y trauma contuso del ojo derecho desde hace años. Acudió a consulta de oftalmología refiriendo disminución lenta de la visión; al examen físico se constató una agudeza visual de 0.6 en ambos ojos, así como disminución concéntrica del campo visual en la perimetría por confrontación. El examen objetivo mostró en los anexos una pingüécula en ojo derecho y pterigion grado II en ojo izquierdo; en segmento anterior, múltiples nódulos de Lisch en el iris de ambos ojos, y en el ojo derecho, pupila ligeramente midriática, pero reactiva. Se le realizó gonoscopia, oftalmoscopia y perimetría Humphry; en esta última se halló un escotoma arqueado en ojo derecho, y un defecto superior arqueado en el ojo izquierdo. Se concluyó el caso con los diagnósticos de catarata presenil incipiente y glaucoma secundario a neurofibromatosis tipo 1.

  10. The effect of intravenous propofol on the incidence of post-dural puncture headache following spinal anesthesia in cesarean section

    Directory of Open Access Journals (Sweden)

    Parisa Golfam

    2016-09-01

    Full Text Available Introduction: Post Dural puncture headache is still a common complication among young women undergone cesarean section, although use of small size spinal needles reduced its prevalence. Several methods have been suggested for prevention and treatment of this side effect; such as complete bed rest, hydration, non-opioid analgesics, caffeine, codeine, which none of them proved to be totally effective. The last option would be epidural blood patch, if headache persist. The aim of this study was evaluation the efficacy of intravenous propofol on post dural puncture headache incidence after cesarean section. Methods: In a randomized clinical trial 120 patients aged 18-45 years old in American Society of Anesthesiologist (ASA class I or II, who had no history of headache, analgesic consumption, substance abuse and drug addiction, candidate for elective cesarean section, were randomly assigned into intervention (propofol and control groups. The anesthesia method for both groups was precisely the same. After spinal anesthesia in the first group 30µg/kg/min of intravenous propofol have been infused slowly. Then at 1, 6, 18, 24 hours and 2nd to 7th days after surgery, anesthesiologist asked groups for presence or absence of headache. The data analyzed with SPSS 16.0 software. Results: Headache incidence rate in the group who receiving propofol was significantly reduced (P.V=0.001. Conclusion: This study showed that 30µg/kg/min of intravenous propofol caused reduced the incidence of post spinal headache in young women undergone elective cesarean section.

  11. Intracranial arteriovenous malformation and dural arteriovenous fistula embedded in a meningioma—case report and review of the literature

    Directory of Open Access Journals (Sweden)

    Moujahed Labidi

    2015-12-01

    Full Text Available The association between a vascular malformation and a meningioma is a rare occurrence intracranially. We document the case of a 59-year-old man who presented with a right parietal extra-axial mass with headaches and seizures. Hemangiopericytoma was initially suspected on the basis of an unusual vascular pattern and rapid lesion progression. Angiography revealed abnormal vessels and an early draining vein associated with the mass. Arterial feeders were primarily from the middle cerebral artery with discrete contribution from both middle meningeal arteries. Craniotomy and Simpson 0 resection of the lesion were undertaken and revealed the coexistence of a dural based tumor with an AVM and a dural arteriovenous fistula (dAVF. Histology and immunohistochemistry were consistent with the diagnosis of meningioma and associated AVM. This case represents the eleventh report of an AVM associated with a meningioma, among which only 6 were contiguous. Such cases illustrate the pathogenic roles of angiogenesis and inflammation that is common to AVMs, dAVF and meningiomas.

  12. Widening of the spinal canal and dural ectasia in Marfan's syndrome: assessment by CT

    Energy Technology Data Exchange (ETDEWEB)

    Villeirs, G.M.; Verstraete, K.L.; Kunnen, M.F. [Dept. of Radiology, Univ. Hospital, Gent (Belgium); Tongerloo, A.J. van; Paepe, A.M. de [Dept. of Medical Genetics, Univ. Hospital, Gent (Belgium)

    1999-11-01

    We describe a method for diagnosing dural ectasia (DE) and spinal canal widening (SCW) using CT. We examined 23 patients with Marfan's syndrome (MFS), 17 with Ehlers-Danlos syndrome (EDS) and 29 normal subjects, using six axial slices at the level of the L1-S1 pedicles. Transverse diameters of the vertebral bodies, spinal canal and dural sac were measured and indices were defined to differentiate patients with DE and SCW from normal. Statistical significance was assessed using Student's t -test, {chi} {sup 2}-test and Pearson's correlation coefficient. DE and SCW occurred in 69.6 % and 60.9 % of cases of MFS and in 23.5 % and 35.3 % of EDS respectively. In MFS, prevalence was significantly higher than in the control group. DE was significantly more frequent in MFS than in EDS. A strong correlation existed between DE and SCW in MFS and the control group, but not in EDS. Our system enables quantitative assessment of SCW and DE. The latter is particularly important in subjects suspected of having MFS, in whom it is a common and characteristic sign. (orig.)

  13. CT and MR imaging of non-cavernous cranial dural arteriovenous fistulas: Findings associated with cortical venous reflux

    Energy Technology Data Exchange (ETDEWEB)

    Letourneau-Guillon, Laurent; Cruz, Juan Pablo; Krings, Timo, E-mail: Timo.Krings@uhn.ca

    2015-08-15

    Highlights: • The conventional neuroimaging manifestations of dural arteriovenous fistulas are highly variable. • Identification of cortical venous reflux is important to prevent complications. • Tortuous and dilated vessels without a nidus are associated with cortical venous reflux. • Digital subtraction angiography remains the gold standard for DAVF diagnosis. - Abstract: Purpose: To compare the conventional CT and MR findings of DAVFs in relation to the venous drainage pattern on digital subtraction angiography (DSA). Materials and Methods: Cross-sectional imaging findings (CT and/or MR) in 92 patients were compared to the presence of cortical venous reflux (CVR) on DSA. Results: Imaging features significantly more prevalent in patients with CVR included: abnormally dilated and tortuous leptomeningeal vessels (92% vs. 4%, p < 0.001) or medullary vessels (69% vs. 0%, p < 0.001), venous ectasias (45% vs. 0%, p < 0.001) and focal vasogenic edema (38% vs. 0%, p < 0.001). The following findings trended towards association but did not reach the p value established following Bonferroni correction: dilated external carotid artery branches (71% vs. 38%, p = 0.005), cluster of vessels surrounding dural venous sinus (50% vs. 19%, p = 0.009), presence of hemorrhage (33 vs. 12%, p = 0.040), and parenchymal enhancement (21% vs. 0%, p = 0.030). Conclusion: In the appropriate clinical setting, recognition of ancillary signs presumably related to venous arterialization and congestion as well as arterial feeder hypertrophy should prompt DSA confirmation to identify DAVFs associated with CVR.

  14. Efectos terapéuticos del ejercicio con sobrecarga en el perfil lipídico de adultos sedentarios

    Directory of Open Access Journals (Sweden)

    Felipe Caamaño-Navarrete

    2015-10-01

    Full Text Available Antecedentes. Actualmente, el sedentarismo en Chile, más que un tema de moda, es un grave problema para la salud que, además, se asocia con el desarrollo de enfermedades crónicas no transmisibles. Objetivo. Determinar los efectos de un programa de ejercicio físico de sobrecarga de dos meses de duración, hasta el fallo muscular, sobre el perfil lipídico de adultos sedentarios. Materiales y métodos. Estudio de tipo experimental, con pre-prueba y pos-prueba, en una muestra de 16 sujetos que fueron divididos en dos grupos: adherente (GA, n=8, edad=34.88+6.89 años y no adherente (GNA, n=8, edad=35.13+6.64años. La muestra es de tipo no probabilística, con sujetos elegidos de manera no aleatoria por conveniencia. Los participantes del GA fueron sometidos a ejercicio físico de sobrecarga hasta el fallo muscular dos veces por semana durante dos meses. Antes y 72 horas después de la última sesión de intervención, se evaluó, en ambos grupos (en ayuno ≥12 horas, colesterol total (Col-total, colesterol HDL (C-HDL, colesterol LDL (C-LDL y triglicéridos (TG. Resultados. Posterior a la intervención no se encontraron diferencias significativas (p>0.05 en Col-total, C-HDL, C-LDL y TG. Conclusiones. Si bien se observa una tendencia a la baja en el perfil lipídico, una mayor duración y/o frecuencia de intervención podría ser necesaria para modificar significativamente las variables plasmáticas.

  15. Total dural irradiation: RapidArc versus static-field IMRT: A case study

    Energy Technology Data Exchange (ETDEWEB)

    Kelly, Paul J., E-mail: paulj.kelly@hse.ie [Department of Radiation Oncology, Dana Farber/Brigham and Women' s Cancer Center, Harvard Medical School, Boston, MA (United States); Mannarino, Edward; Lewis, John Henry; Baldini, Elizabeth H.; Hacker, Fred L. [Department of Radiation Oncology, Dana Farber/Brigham and Women' s Cancer Center, Harvard Medical School, Boston, MA (United States)

    2012-07-01

    The purpose of this study was to compare conventional fixed-gantry angle intensity-modulated radiation therapy (IMRT) with RapidArc for total dural irradiation. We also hypothesize that target volume-individualized collimator angles may produce substantial normal tissue sparing when planning with RapidArc. Five-, 7-, and 9-field fixed-gantry angle sliding-window IMRT plans were generated for comparison with RapidArc plans. Optimization and normal tissue constraints were constant for all plans. All plans were normalized so that 95% of the planning target volume (PTV) received at least 100% of the dose. RapidArc was delivered using 350 Degree-Sign clockwise and counterclockwise arcs. Conventional collimator angles of 45 Degree-Sign and 315 Degree-Sign were compared with 90 Degree-Sign on both arcs. Dose prescription was 59.4 Gy in 33 fractions. PTV metrics used for comparison were coverage, V{sub 107}%, D1%, conformality index (CI{sub 95}%), and heterogeneity index (D{sub 5}%-D{sub 95}%). Brain dose, the main challenge of this case, was compared using D{sub 1}%, Dmean, and V{sub 5} Gy. Dose to optic chiasm, optic nerves, globes, and lenses was also compared. The use of unconventional collimator angles (90 Degree-Sign on both arcs) substantially reduced dose to normal brain. All plans achieved acceptable target coverage. Homogeneity was similar for RapidArc and 9-field IMRT plans. However, heterogeneity increased with decreasing number of IMRT fields, resulting in unacceptable hotspots within the brain. Conformality was marginally better with RapidArc relative to IMRT. Low dose to brain, as indicated by V5Gy, was comparable in all plans. Doses to organs at risk (OARs) showed no clinically meaningful differences. The number of monitor units was lower and delivery time was reduced with RapidArc. The case-individualized RapidArc plan compared favorably with the 9-field conventional IMRT plan. In view of lower monitor unit requirements and shorter delivery time, Rapid

  16. A microcontroller-based simulation of dural venous sinus injury for neurosurgical training.

    Science.gov (United States)

    Cleary, Daniel R; Siler, Dominic A; Whitney, Nathaniel; Selden, Nathan R

    2017-06-02

    OBJECTIVE Surgical simulation has the potential to supplement and enhance traditional resident training. However, the high cost of equipment and limited number of available scenarios have inhibited wider integration of simulation in neurosurgical education. In this study the authors provide initial validation of a novel, low-cost simulation platform that recreates the stress of surgery using a combination of hands-on, model-based, and computer elements. Trainee skill was quantified using multiple time and performance measures. The simulation was initially validated using trainees at the start of their intern year. METHODS The simulation recreates intraoperative superior sagittal sinus injury complicated by air embolism. The simulator model consists of 2 components: a reusable base and a disposable craniotomy pack. The simulator software is flexible and modular to allow adjustments in difficulty or the creation of entirely new clinical scenarios. The reusable simulator base incorporates a powerful microcomputer and multiple sensors and actuators to provide continuous feedback to the software controller, which in turn adjusts both the screen output and physical elements of the model. The disposable craniotomy pack incorporates 3D-printed sections of model skull and brain, as well as artificial dura that incorporates a model sagittal sinus. RESULTS Twelve participants at the 2015 Western Region Society of Neurological Surgeons postgraduate year 1 resident course ("boot camp") provided informed consent and enrolled in a study testing the prototype device. Each trainee was required to successfully create a bilateral parasagittal craniotomy, repair a dural sinus tear, and recognize and correct an air embolus. Participant stress was measured using a heart rate wrist monitor. After participation, each resident completed a 13-question categorical survey. CONCLUSIONS All trainee participants experienced tachycardia during the simulation, although the point in the simulation

  17. Oviposição e dispersão de ninfas de Bemisia tabaci biótipo B em genótipos de tomateiro Oviposition and nymphal dispersion of Bemisia tabaci biotype B on tomato genotypes

    Directory of Open Access Journals (Sweden)

    Marilene Fancelli

    2008-12-01

    Full Text Available Diversos métodos têm sido empregados para avaliar a resistência de plantas a moscas-brancas. Todavia, poucos trabalhos têm sido realizados visando determinar a dispersão de ninfas desses insetos sobre as plantas. O objetivo do presente trabalho foi avaliar a oviposição de B. tabaci biótipo B e a dispersão de suas ninfas em folíolos com e sem exsudatos de genótipos de tomateiro. Foram utilizados sete genótipos de tomateiro: LA716, LA1739, PI134417, LA462, LA1584, 'Santa Clara' e P25 (controle suscetível. A oviposição de B. tabaci biótipo B foi avaliada em gaiolas plásticas (2,8 cm² fixadas na face abaxial dos folíolos, nas quais foram inseridos dez casais do inseto. Para avaliação da dispersão das ninfas, considerou-se o deslocamento dos insetos além do limite da área ocupada pelas gaiolas. As variáveis observadas foram: mortalidade de adultos 24 horas após a liberação, número de ovos, viabilidade da fase de ovo, período de incubação, número de ninfas e dispersão. Em folíolos com exsudato, LA716, LA1739 e PI134417 provocaram as maiores mortalidades. Adultos mortos nos folíolos desses genótipos ficaram aderidos aos tricomas glandulares, o que provocou redução na oviposição do inseto. Para dispersão, nos folíolos com exsudato, os máximos valores ocorreram nos genótipos LA716, LA462 e P25. Na condição sem exsudato, LA716 promoveu a menor dispersão das ninfas. A presença do exsudato influencia negativamente a sobrevivência e oviposição do inseto. A dispersão das ninfas também é afetada pelo exsudato, embora outros fatores possam ser importantes para o deslocamento do inseto.Several methods have been employed for evaluating plant resistance to whiteflies. Although, a few researches have been conducted aiming to determine the whitefly nymphal dispersion on crops. The objective of this work was to evaluate the oviposition of B. tabaci biotype B and nymphal dispersion in leaflets with and without

  18. Identificação das queixasde adultos separados atendidos em uma clínica-escola de Psicologia

    Directory of Open Access Journals (Sweden)

    Rita Aparecida Romaro

    Full Text Available Este estudo objetivou caracterizar as queixas dos adultos separados atendidos em uma clínica-escola da cidade de São Paulo, entre 1996 e 2000, em função do sexo, faixa etária, escolaridade, tipos de queixas, encaminhamento e adesão ao tratamento. Empregou-se uma metodologia descritiva retrospectiva documental, de consulta aos prontuários clínicos. Dos 28 pacientes separados atendidos nesse período, encontrou-se a predominância do sexo feminino (78,5%, na faixa etária de 31 a 35 anos (28,5%, 2º grau completo (25%, com encaminhamento realizado pelo psicólogo ou estudante de Psicologia (35,7%. Foram listadas 86 queixas, predominando as de ansiedade, insegurança, medo (42,8% e depressão (32,1%. A separação foi citada como parte da história clínica em 60,7% dos casos; o encaminhamento para psicoterapia breve ocorreu em 75% dos processos, e foi concluída em 63% dos casos. A principal implicação deste estudo refere-se à falta de pesquisas relacionadas que especifiquem as queixas das pessoas separadas ou divorciadas.

  19. Los adultos con discapacidad motriz y sus familiares: la organización del hogar, los afectos y el trabajo.

    Directory of Open Access Journals (Sweden)

    María Pía Venturiello

    2014-12-01

    Full Text Available El objetivo de este artículo es analizar las percepciones de los adultos con discapacidad motriz mayores de 50 años y sus familiares acerca de las principales dificultades que encuentran en su desempeño laboral, familiar y en la organización del hogar, según aspectos económicos y sociales en el Gran Buenos Aires. Para cumplir con este objetivo se desarrolló un abordaje metodológico de tipo cualitativo. Se entrevistó a 39 personas con discapacidad motriz y a 17 familiares. Los resultados indicaron que la edad en que acontece la discapacidad, el nivel socioeconómico y la situación de dependencia de las personas son determinantes para poder sortear, en mayor o menor medida, la marginación económica y el descrédito simbólico que las perjudica. Las familias brindan intercambios afectivos y apoyos materiales para la resolución de la vida diaria, mientras que la salud emocional de sus integrantes, su reproducción material y proyectos se ven modificados por las dificultades que la sociedad impone a las personas que relega al lugar de la anormalidad.

  20. Identificação das queixas de adultos separados atendidos em uma clínica-escola de Psicologia

    Directory of Open Access Journals (Sweden)

    Rita Aparecida Romaro

    Full Text Available Este estudo objetivou caracterizar as queixas dos adultos separados atendidos em uma clínica-escola da cidade de São Paulo, entre 1996 e 2000, em função do sexo, faixa etária, escolaridade, tipos de queixas, encaminhamento e adesão ao tratamento. Empregou-se uma metodologia descritiva retrospectiva documental, de consulta aos prontuários clínicos. Dos 28 pacientes separados atendidos nesse período, encontrou-se a predominância do sexo feminino (78,5%, na faixa etária de 31 a 35 anos (28,5%, 2º grau completo (25%, com encaminhamento realizado pelo psicólogo ou estudante de Psicologia (35,7%. Foram listadas 86 queixas, predominando as de ansiedade, insegurança, medo (42,8% e depressão (32,1%. A separação foi citada como parte da história clínica em 60,7% dos casos; o encaminhamento para psicoterapia breve ocorreu em 75% dos processos, e foi concluída em 63% dos casos. A principal implicação deste estudo refere-se à falta de pesquisas relacionadas que especifiquem as queixas das pessoas separadas ou divorciadas.

  1. Dural attachment of intracranial meningiomas: evaluation with contrast-enhanced three-dimensional fast imaging with steady-state acquisition (FIESTA) at 3 T

    Energy Technology Data Exchange (ETDEWEB)

    Yamamoto, Junkoh; Takahashi, Mayu; Aoyama, Yuichi; Soejima, Yoshiteru; Saito, Takeshi; Akiba, Daisuke; Nishizawa, Shigeru [University of Occupational and Environmental Health, Department of Neurosurgery, Kitakyusyu (Japan); Kakeda, Shingo; Korogi, Yukunori [University of Occupational and Environmental Health, Department of Radiology, Kitakyusyu (Japan)

    2011-06-15

    The purpose of this study was to evaluate the role of contrast-enhanced fast imaging with steady-state acquisition (CE-FIESTA) for assessing whether dural attachment in intracranial meningiomas is adhesive or not by correlation with intraoperative findings. Fourteen consecutive patients who were candidates for surgical treatment of meningiomas were prospectively analyzed with preoperative magnetic resonance imaging, including CE-FIESTA at 3 T. First, two neuroradiologists assessed several characteristics of the attachment of the meningioma to the dura mater or skull base on CE-FIESTA images. Second, the surgical findings of adhesion at the dural attachment of meningiomas were evaluated by two neurosurgeons. Finally, the CE-FIESTA findings were correlated with the surgical findings by one neurosurgeon and one neuroradiologist by consensus. CE-FIESTA clearly depicted a hypointense marginal line at the attachment site of the meningioma. When CE-FIESTA revealed smooth marginal lines or hyperintense zones along the marginal lines, tumors were detached easily from the dura mater. On the contrary, when CE-FIESTA showed an irregularity, such as partial disruption of the marginal lines, vessels, or bony hyperostosis, the tumors tended to adhere firmly to the dura mater, which was found to contain small vessels and fine fibrous tissues. There seems to be an excellent correlation between the characteristics of dural attachment of meningiomas on CE-FIESTA images and intraoperative findings. Therefore, for operative planning, CE-FIESTA may provide useful information regarding the adhesiveness of dural attachment. (orig.)

  2. Dural attachment of intracranial meningiomas: evaluation with contrast-enhanced three-dimensional fast imaging with steady-state acquisition (FIESTA) at 3 T.

    Science.gov (United States)

    Yamamoto, Junkoh; Kakeda, Shingo; Takahashi, Mayu; Aoyama, Yuichi; Soejima, Yoshiteru; Saito, Takeshi; Akiba, Daisuke; Korogi, Yukunori; Nishizawa, Shigeru

    2011-06-01

    The purpose of this study was to evaluate the role of contrast-enhanced fast imaging with steady-state acquisition (CE-FIESTA) for assessing whether dural attachment in intracranial meningiomas is adhesive or not by correlation with intraoperative findings. Fourteen consecutive patients who were candidates for surgical treatment of meningiomas were prospectively analyzed with preoperative magnetic resonance imaging, including CE-FIESTA at 3 T. First, two neuroradiologists assessed several characteristics of the attachment of the meningioma to the dura mater or skull base on CE-FIESTA images. Second, the surgical findings of adhesion at the dural attachment of meningiomas were evaluated by two neurosurgeons. Finally, the CE-FIESTA findings were correlated with the surgical findings by one neurosurgeon and one neuroradiologist by consensus. CE-FIESTA clearly depicted a hypointense marginal line at the attachment site of the meningioma. When CE-FIESTA revealed smooth marginal lines or hyperintense zones along the marginal lines, tumors were detached easily from the dura mater. On the contrary, when CE-FIESTA showed an irregularity, such as partial disruption of the marginal lines, vessels, or bony hyperostosis, the tumors tended to adhere firmly to the dura mater, which was found to contain small vessels and fine fibrous tissues. There seems to be an excellent correlation between the characteristics of dural attachment of meningiomas on CE-FIESTA images and intraoperative findings. Therefore, for operative planning, CE-FIESTA may provide useful information regarding the adhesiveness of dural attachment.

  3. Gamma Knife radiosurgery for intracranial meningiomas : Do we need to treat the dural tail? A single-center retrospective analysis and an overview of the literature

    NARCIS (Netherlands)

    Bulthuis, Vincent J; Hanssens, Patrick E J; Lie, Suan Te; van Overbeeke, Jacobus J

    2014-01-01

    BACKGROUND: The dural tail (DT) has been described as a common feature in meningiomas. There is a great variation of tumor invasion and extent of tumor cells in the DT. Therefore, the necessity to include the whole DT in Gamma Knife radiosurgery is not clear, since inclusion increases the target vol

  4. Measurement of the cross-sectional area of the dural tube in the lumbar spine on magnetic resonance imaging. Comparison between normal, pre- and post-discectomy conditions

    Energy Technology Data Exchange (ETDEWEB)

    Matsubayashi, Yasutomo [Juntendo Univ., Tokyo (Japan). School of Medicine

    1997-07-01

    This study evaluated the usefulness of pre- and postoperative magnetic resonance imaging (MRI) of lumbar disc hernia with special attention to measurement of the cross-sectional area of the dural tube. Twenty-five patients (20 men and 5 women; 25 discs) who underwent posterior lumbar discectomy and 73 normal individuals (44 men and 29 women; 219 discs) of a similar age distribution were studied. Axial MRI was mainly used for the measurement of the dural tube. In the patient group, MRI examination was performed 1, 3, 6, and 12 months postoperatively. Assessment of the clinical symptoms was also included and used for comparison with the MRI evaluation. The cross-sectional area was significantly reduced to about 50% of the normal preoperatively. One month postoperatively, there was no significant increase in the size of the area, but after three months, the area increased significantly and progressed to the normal size within a year. One-month postoperatively, MRI examination was not considered useful because of postoperative hematoma and/or edema at the surgical site. The increase in the size of the cross-sectional area of the dural tube correlated well with the improvement in clinical symptoms. Three-months postoperatively, MRI evaluation of the lumbar disc seemed useful and measurement of the cross-sectional area of the dural tube appeared to serve as an indicator of the effectiveness of the surgery. (author)

  5. Gamma Knife radiosurgery for intracranial meningiomas : Do we need to treat the dural tail? A single-center retrospective analysis and an overview of the literature

    NARCIS (Netherlands)

    Bulthuis, Vincent J; Hanssens, Patrick E J; Lie, Suan Te; van Overbeeke, Jacobus J

    2014-01-01

    BACKGROUND: The dural tail (DT) has been described as a common feature in meningiomas. There is a great variation of tumor invasion and extent of tumor cells in the DT. Therefore, the necessity to include the whole DT in Gamma Knife radiosurgery is not clear, since inclusion increases the target

  6. Projeto, construção e teste de protótipo de maca para transporte de crianças de um até dez anos de idades

    OpenAIRE

    Alan Ferreira Pinheiro Tavares

    2015-01-01

    Resumo: No transporte, por ambulâncias, as crianças estão expostas a riscos fatais ao serem transportadas em macas de adultos as quais não atendem a antropometria infantil. A situação é agravada ao considerar o fato das ambulâncias se locomoverem em altas velocidades e necessitarem frequentemente reduzi-las de modo abrupto. Neste cenário, buscou-se projetar, construir e testar um protótipo de maca com um sistema de retenção eficaz para transportes emergenciais de crianças. O diferencial do pr...

  7. Ejemplares tipo de Asteraceae (= Compositae de A. L. Cabrera

    Directory of Open Access Journals (Sweden)

    Susana E. Freire

    2000-01-01

    Full Text Available Freire, S. E. & Iharlegui, L. 2000. Ejemplares tipo de Asteraceae (= Compositae de A. L.Cabrera. Darwiniana 38(3-4: 307-364.El presente trabajo representa un catálogo de los ejemplares tipo de 426 especies y 82 variedades deAsteraceae descriptas por A. L. Cabrera entre los años 1931 y 1999. Los taxones se presentan en ordenalfabético. Para cada taxón se indica: diagnosis original, tipo nomenclatural, categoría del tipo, herbario,etiqueta original y nombre actualizado

  8. Estereótipos e mulheres na cultura marroquina

    OpenAIRE

    Sadiqi,Fatima

    2008-01-01

    Estereótipos sobre as mulheres no Marrocos podem ser caracterizados como crenças culturais incompletas e inexatas mantidas por algumas pessoas e que se encontram inscritos em expressões lingüísticas ou em discursos subliminares. A cultura popular marroquina emprega representações poderosas para transmitir e sustentar tais estereótipos. Embora existam alguns estereótipos positivos, a maioria dos estereótipos sobre as mulheres no Marrocos é negativa e reflete ditames patriarcais subliminares qu...

  9. Dural tears secondary to operations on the lumbar spine. Management and results after a two-year-minimum follow-up of eighty-eight patients.

    Science.gov (United States)

    Wang, J C; Bohlman, H H; Riew, K D

    1998-12-01

    We reviewed the results of acute management of patients who had sustained a dural tear during an operation on the lumbar spine, and we attempted to determine the long-term sequelae of this complication. In the five years from July 1989 to July 1994, 641 consecutive patients had a decompression of the lumbar spine, performed by the senior one of us; of these patients, eighty-eight (14 percent) sustained a dural tear, which was repaired during the operation. The duration of follow-up ranged from two to eight years (average, 4.3 years). Postoperative management consisted of closed suction wound drainage for an average of 2.1 days and bed rest for an average of 2.9 days. Of the eighty-eight procedures that resulted in a dural tear, forty-five were revisions; these revisions were performed after an average of 2.2 previous operations on the lumbar spine, all of which resulted in a scar adherent to the dura. Only eight patients had headaches related to the spinal procedure and photophobia in the postoperative period; these symptoms resolved in all but two patients, both of whom had had a revision operation. Each of the two patients had symptoms of a persistent leak of spinal fluid and needed a reoperation for repair. Overall, seventy-six patients had a good or excellent result and twelve had a poor or satisfactory result with some residual back pain. One patient had arachnoiditis, and another had symptoms of viral meningitis one month postoperatively. A dural tear that occurs during an operation on the lumbar spine can be treated successfully with primary repair followed by bed rest. Such a tear does not appear to have any long-term deleterious effects or to increase the risk of postoperative infection, neural damage, or arachnoiditis. Closed suction wound drainage does not seem to aggravate the leak and can be used safely in the presence of a dural repair.

  10. Apicoformación en un paciente adulto

    OpenAIRE

    1992-01-01

    Dada la rareza del caso clínico que tratamos, creímos que sería de interés su conocimiento. Se llevó a cabo tratamiento de apicoformación en el diente número 21 en paciente adulto de 27 años de edad con antecedente de traumatismo a los siete años en el citado diente. Se realizaron curas periódicas con pasta de hidróxido de calcio durante dos años. El resultado del tratamiento tres años más tarde de su inicio mostró la evolución favorable del proceso.

  11. Tratamento da deficiência de somatropina no adulto

    OpenAIRE

    Marques, Cristina Mariana Almendra da

    2016-01-01

    Trabalho de revisão do 6º ano médico com vista à atribuição do grau de mestre (área científica de endocrinologia) no âmbito do ciclo de estudos de Mestrado Integrado em Medicina. A somatropina (vulgarmente designada hormona do crescimento) é uma hormona hipofisária conhecida pela sua importância na infância e puberdade devido ao seu envolvimento no crescimento e maturação. No entanto, esta hormona está presente durante toda a vida. No adulto, são as suas funções metabólicas que se destacam...

  12. Meningitis y artritis por Haemophilus influenzae en un adulto

    Directory of Open Access Journals (Sweden)

    Javier Molina

    1988-02-01

    Full Text Available Tradicionalmente el Haemophilus influenzae ha sido considerado un germen causante de infecciones en niños; en adultos se lo ha relacionado con Infecciones respiratorias, pero en los últimos tiempos se han descrito en ellos infecciones severas cuando hay algunos factores predisponentes. Se describe un paciente drogadicto de 30 años con cuadro de meningitis y artritis y prueba de látex y cultivo de LCR positivos para HaemophiIus influenzae, quien recibió tratamiento con ampicilina, 2 gramos Intravenosos cada 4 horas y evolucionó a la mejoría sin secuelas. Se plantea la necesidad de tener en cuenta al Haemophilus influenzae como patógeno del adulto y más en aquellas personas con factores predisponentes.

    Haemophilus influenzae has traditionally been considered as an infectious agent that predominantly affects children; instead, in adults It has been Linked either to respiratory infections or to gevere infections occurring when predisposing factors are present. We describe a 30 year-old drug adict patient that presented with meningitis and arthritis; both latex test and cerebrospinal fluid culture were positive for Haemophilus influenzae. He was treated with ampicilin 2 gm, I. V. every four hours and improved without sequelae. This microorganism must be considered among those affecting adult patients specially when predisposing factors for infection are present.

  13. Actitud y miedo ante la muerte en adultos mayores

    Directory of Open Access Journals (Sweden)

    Ana Fernanda Uribe Rodríguez

    2007-01-01

    Full Text Available A través de los años el tema de la muerte se ha conceptualizado de diversas maneras. En la actualidad las personas evitan hablar del tema y se observa conductas evitativas, de miedo y ansiedad. El presente artículo tiene como objetivo evaluar la actitud y miedo ante la muerte en una muestra de 170 adultos mayores ( X :71,02; DT=5,946 de la ciudad de Cali-Colombia por medio del Perfil Revisado de Actitudes hacia la Muerte (PAM-R y la Escala de Collet-Lester (1969; se tuvo en cuenta las variables sexo, religión y estrato socioeconómico. Los resultados muestran diferencias significativas en función del sexo en las escalas de miedo a la propia muerte, evitación de la muerte, aceptación de acercamiento. Con relación al estrato socioeconómico se encontraron diferencias significativas en las escalas de miedo a la muerte y aceptación de acercamiento y en función de la religión sólo hay diferencias significativas en la evitación a la muerte. Se concluye la importancia de contribuir desde la psicología, al mejoramiento en los procesos de adaptación a los duelos y disminuir la presencia de duelos patológicos que se generan ante situaciones inesperadas y mal elaboradas en este caso, en los adultos mayores.

  14. Enfermedad arterial periférica en adultos mayores

    Directory of Open Access Journals (Sweden)

    Julio César Fernández Travieso

    2013-01-01

    Full Text Available La enfermedad arterial periférica junto con la enfermedad coronaria y la cerebrovascular son el resultado del desarrollo de la enfermedad aterotrombótica, por lo cual constituye un importante problema de salud a nivel mundial, y constituye una de las principales causas de morbimortalidad y discapacidad en los adultos mayores. La claudicación intermitente de los miembros inferiores es la forma más frecuente de su presentación clínica. Dado que muchos pacientes se encuentran asintomáticos, esta enfermedad se encuentra frecuentemente infra-diagnosticada y secundariamente, infratratada. Es importante su diagnóstico y tratamiento, ya que la enfermedad arterial periférica se asocia con un incremento de la mortalidad. En este contexto, la medición del índice tobillo-brazo es especialmente útil, ya que permite un diagnóstico precoz de ella. Los Lineamientos de expertos consideran a los antiagregantes plaquetarios como los agentes de primera línea y se mantiene como primera opción la aspirina, mientras que en aquellos casos intolerantes, alérgicos o resistentes a esta se indica clopidogrel. En la presente revisión se aborda brevemente la enfermedad arterial periférica, su fisiopatología, sintomatología y clasificación clínica. Además, se discuten sus factores de riesgo, se enfatiza su control como medida clave en las estrategias de prevención, así como se aborda el adecuado diagnóstico y tratamiento para su manejo. Se concluye que la mejor manera de reducir la morbilidad y mortalidad por enfermedad arterial periférica en los adultos mayores radica en su prevención, control de los factores de riesgo, estilo de vida saludable y su adecuado manejo terapéutico.

  15. Prevalencia de alteraciones del medio interno en pacientes adultos hospitalizados

    Directory of Open Access Journals (Sweden)

    Javier Cieza

    1996-10-01

    Full Text Available Objetivo: Determinar la prevalencia de punto de los disturbios electrolíticos y ácido-base en adultos internados en el Hospital Nacional Cayetano Heredia, que estuvieran recibiendo fluídos endovenosos el día del estudio. Material y métodos: El estudio fue de corte transversal, descriptivo y analítico. Se recolectaron datos clínicos de las historias respectivas y se buscó la existencia de asociación con los disturbios encontrados. Resultados: Hubo 34/280 pacientes hospitalizados que recibían fluídos endovenosos, 27/34 pacientes fueron adultos menores de 60 años, (promedio 38.17 años. El 44% fueron varones y el 56% mujeres. El disturbio electrolítico más frecuente fue hiponatremia (23.52%, seguido de hipokalemia (20.5%, hiperkalemia (3.88% e hipernatremia (2.9%. La hiponatremia fue leve en la mayoría (75%. El uso de diuréticos y el tiempo de hospitalización mayor de cinco días, estuvieron asociados al desarrollo de hiponatremia (p<0.05. La hipokalemia fue leve en el 71% y severa en un 14%. La mayoría de las alteraciones electrolíticas se generaron intrahospitalariamente. Las alteraciones ácido-base fueron: alcalosis respiratoria (85%, acidosis metabólica (33%, alcalosis metabólica (9% y acidosis respiratoria (3%. Conclusiones: La hiponatremia fue el disturbio electrolítico más prevalente y se generó intrahospitalariamente, mientras la alcalosis respiratoria fue el disturbio ácido-base más prevalente y generalmente se encontró asociada a otras alteraciones. (Rev Med Hered 1996; 7: 154-161.

  16. Condicoes dentarias entre adultos brasileiros de 1986 a 2010

    Directory of Open Access Journals (Sweden)

    Sergio do Nascimento

    2013-12-01

    Full Text Available OBJETIVO: Identificar tendências do padrão da cárie dentária em adultos brasileiros. MÉTODOS: Foram utilizados dados provenientes de levantamentos epidemiológicos realizados pelo Ministério da Saúde nos anos de 1986, 2003 e 2010. A experiência de cárie, expressa pelo índice CPOD (dentes permanentes cariados, perdidos e obturados, e a saúde dentária, expressa pelo índice OH-D (dentes hígidos + obturados relativo ao número de dentes funcionais, foram comparadas em amostras aleatórias de residentes de 35 a 44 anos de idade em cada região brasileira. As diferenças nas condições dentárias entre os anos foram estimadas por meio da razão dos valores dos índices, empregando-se análise de regressão de Poisson ajustada pela idade. RESULTADOS: Houve reduções no índice CPOD e aumento no índice OH-D em todas as regiões no período de 1986 a 2010. A região Norte, que tinha o pior padrão em 1986, apresentou o maior ganho em termos de dentição funcional. CONCLUSÕES: Tem ocorrido uma transição da saúde bucal para melhor nos adultos brasileiros. É plausível que a adição de flúor à água e ao creme dental, maior incorporação de serviços restauradores e a melhoria nos indicadores de desenvolvimento humano decorrentes de políticas públicas estejam relacionados a essa melhora.

  17. 铁定千元机 索尼Xperia Tipo/Tipo Dual

    Institute of Scientific and Technical Information of China (English)

    2012-01-01

    除了XperiaMiro,还有另外一对因为疯狂点击而早产的双胞胎——XperiaTipo和XperiaTipoDual。两机外观上一摸一样。前者共有白、黑、蓝、红四色可选,后者仅有银、黑两色。Tipoi两兄弟都内置800MHz高通处理器、512MBRAM以及320万像素摄像头,屏幕再度缩减为3.2英寸HVGA级别。具备抗刮划的能力。其中,TipoDual还是一部支持双卡双待的产品.非常符合国内运营商千元机的定制标准。

  18. Fetal MR imaging of posterior intracranial dural sinus thrombosis: a report of three cases with variable outcomes

    Energy Technology Data Exchange (ETDEWEB)

    Byrd, Sharon E.; Elias, Dean [Rush Medical College and Rush University Medical Center, Department of Diagnostic Radiology and Nuclear Medicine Section of Neuroradiology, Chicago, IL (United States); Abramowicz, Jacques S. [Rush Medical College and Rush University Medical Center, Department of Obstetrics and Gynecology, Rush Fetal and Neonatal Medicine Center, Chicago, IL (United States); Kent, Paul [Rush Medical College and Rush University Medical Center, Department of Pediatrics, Division of Hematology and Oncology, Chicago, IL (United States); Kimura, Robert E. [Rush Medical College and Rush University Medical Center, Department of Pediatrics, Division of Neonatology, Chicago, IL (United States); Heydeman, Peter T. [Rush Medical College and Rush University Medical Center, Department of Pediatrics, Division of Pediatric Neurology, Chicago, IL (United States)

    2012-05-15

    Thrombosis of fetal intracranial dural sinuses is a rare entity. A specific type of midline dural sinus thrombosis (DST) at the torcular Herophili with extension into the superior sagittal sinus (SSS) was initially seen on fetal US and was referred to fetal MRI for definite diagnosis and better delineation. Retrospective comparison to medical literature of three cases, diagnosed at our institution, of midline fetal DST with MR imaging findings and clinical outcomes. We reviewed MRI findings on T2-weighted images of our three cases of fetal midline DST and clinical outcomes of these fetuses and compared our findings to medical literature. The MR imaging and clinical findings of our cases extend over 6 years. They consist of three pregnant women, 31-39 years of age each with a single fetus, with fetal MR imaging performed at different gestational ages (GA). Case 1 the MR imaging was performed at 21 5/7 weeks' GA, case 2 at 24 and 33 4/7 weeks' GA, and case 3 at 22 and 25 weeks' GA. Postnatal MRI was performed in case 2 at 6 months of life and case 3 at 1 day of life. Clinical follow-up occurred during the last 6 years. In all of our cases, T2-W MR imaging demonstrated ballooned midline torcular Herophili with iso- to hypointense mass with or without focal eccentric area of greater hypointensity occupying the torcular Herophili with extension into the SSS. Case 3 had associated leptomeningeal dural vascular malformation overlying the left cerebral hemisphere with development of migrational disorder in the left cerebral hemisphere. Clinical outcome consisted of fetal demise in case 1, normal postnatal outcome in case 2 and severe brain damage with poor postnatal outcome in case 3. Our findings of large iso-hypointense thrombus with or without a focal eccentric area more hypointense to thrombus in a dilated torcular Herophili with extension into the SSS on T2-W images corresponds to the majority of cases of this rare type of DST in the medical literature

  19. Sensitization of dural afferents underlies migraine-related behavior following meningeal application of interleukin-6 (IL-6

    Directory of Open Access Journals (Sweden)

    Yan Jin

    2012-01-01

    Full Text Available Abstract Background Migraine headache is one of the most common neurological disorders, but the pathophysiology contributing to migraine is poorly understood. Intracranial interleukin-6 (IL-6 levels have been shown to be elevated during migraine attacks, suggesting that this cytokine may facilitate pain signaling from the meninges and contribute to the development of headache. Methods Cutaneous allodynia was measured in rats following stimulation of the dura with IL-6 alone or in combination with the MEK inhibitor, U0126. The number of action potentials and latency to the first action potential peak in response to a ramp current stimulus as well as current threshold were measured in retrogradely-labeled dural afferents using patch-clamp electrophysiology. These recordings were performed in the presence of IL-6 alone or in combination with U0126. Association between ERK1 and Nav1.7 following IL-6 treatment was also measured by co-immunoprecipitation. Results Here we report that in awake animals, direct application of IL-6 to the dura produced dose-dependent facial and hindpaw allodynia. The MEK inhibitor U0126 blocked IL-6-induced allodynia indicating that IL-6 produced this behavioral effect through the MAP kinase pathway. In trigeminal neurons retrogradely labeled from the dura, IL-6 application decreased the current threshold for action potential firing. In response to a ramp current stimulus, cells treated with IL-6 showed an increase in the numbers of action potentials and a decrease in latency to the first spike, an effect consistent with phosphorylation of the sodium channel Nav1.7. Pretreatment with U0126 reversed hyperexcitability following IL-6 treatment. Moreover, co-immunoprecipitation experiments demonstrated an increased association between ERK1 and Nav1.7 following IL-6 treatment. Conclusions Our results indicate that IL-6 enhances the excitability of dural afferents likely via ERK-mediated modulation of Nav1.7 and these responses

  20. Incidencia de la diabetes tipo 1 en Navarra, 2009-2012

    Directory of Open Access Journals (Sweden)

    L. Forga

    2014-08-01

    Full Text Available Fundamento: En Europa se ha descrito un gradiente norte-sur en la incidencia de diabetes tipo 1 (DM1, con mayor incidencia en los países del norte. El objetivo del presente trabajo consiste en conocer los datos de incidencia de DM1 en Navarra, sin límite de edad al diagnóstico, durante el período 2009-2012, su distribución geográfica y sus características en cuanto a edad y sexo. Pacientes y métodos: Estudio prospectivo, con una fuente primaria y tres secundarias. La exhaustividad del registro se evaluó mediante el método captura-recaptura y fue del 98,42%. La comparación de la incidencia entre los diferentes grupos de género y edad, se ha realizado estimando la razón de incidencia a partir de métodos de regresión de Poisson. Para comparar las incidencias entre las distintas áreas, se ajustaron los valores obtenidos por el método de estandarización indirecta. Resultados: Se detectaron 216 casos (incidencia: 8,4/100.000 habitantes-año; IC 95%: 7,3-9,5. La incidencia en niños fue mayor que en adultos, aunque el número de debuts fue mayor en mayores de 15 años. El grupo de edad con mayor incidencia fue el de 10 a 14 años; en cambio, el mayor porcentaje de pacientes pertenece al grupo de 15 a 29 años. La incidencia en varones fue mayor que en mujeres. Los valores de incidencia en las 3 regiones del sur tienden a superar la media de la Comunidad. Conclusiones: Navarra presenta una incidencia muy alta de DM1 en niños y adultos de 15 a 29 años. La DM1 predomina en varones y muestra cierta variabilidad geográfica.

  1. Absence of abnormal vessels in the subarachnoid space on conventional magnetic resonance imaging in patients with spinal dural arteriovenous fistulas.

    Science.gov (United States)

    Miller, Timothy R; Eskey, Clifford J; Mamourian, Alexander C

    2012-05-01

    Spinal dural arteriovenous fistula (DAVF) is an uncommon condition that can be difficult to diagnose. This often results in misdiagnosis and treatment delay. Although conventional MRI plays an important role in the initial screening for the disease, the typical MRI findings may be absent. In this article, the authors present a series of 4 cases involving patients with angiographically proven spinal DAVFs who demonstrated cord T2 prolongation on conventional MRI but without abnormal subarachnoid flow voids or enhancement. These cases suggest that spinal DAVF cannot be excluded in symptomatic patients with cord edema based on conventional MRI findings alone. Dynamic Gd-enhanced MR angiography (MRA) was successful in demonstrating abnormal spinal vasculature in all 4 cases. This limited experience provides support for the role of spinal MRA in patients with abnormal cord signal and symptoms suggestive of DAVF even when typical MRI findings of a DAVF are absent.

  2. Transvenous embolization with a combination of detachable coils and Onyx for a complicated cavernous dural arteriovenous fistula

    Institute of Scientific and Technical Information of China (English)

    HE Hong-wei; JIANG Chu-han; WU Zhong-xue; LI You-xiang; LU Xian-li; WANG Zhong-cheng

    2008-01-01

    Background Treatment of cavemous dural arteriovenous fistulas (DAVF) is usually made by a transartedal approach.However,in many complicated patients,treatments via transarterial approaches can not be achieved,and only an operation via a transvenous approach is feasible.We aimed to study the feasibility of transarterial embolJzation of cavernous dural arteriovenous fistulas with a combination detachable coils and Onyx to embolize a complicated cavemous DAVF via a transvenous approach.Methods From August 2006 to August 2007,six cases of complicated cavernous DAVF were embolized with a combination of detachable coils and Onyx via a transvenous approach.Three cases were male and the other three were female.Their ages ranged from 36 to 69 years old.The fistula was in the right lateral cavernous sinus in one case,in the left lateral cavernous sinus in another,and in the bilateral cavernous sinus in 4 cases.One fistula was fed by the right internal carotid artery and its meningohypophyseal trunk;one was fed by the branches of the left internal carotid artery and left extemal carotid artery;four were fed by the branches of the bilateral internal carotid artery and/or the bilateral external carotid artery.One case was drained via one lateral inferior petrosal sinus;three were drained via bilateral inferior petrosal sinuses;one was drained via one lateral ophthalmic and facial veins;one was drained via the infedor petrosal sinus and the ophthalmic and facial veins.Four were embolized via the inferior petrosal sinus,and two were embolized via the ophthalmic and facial veins.Results Among six cases of complicated cavernous DAVF,four were fully embolized with Onyx by a single operation,and two cases were fully embolized with Onyx following two operations.Transient headache was found after operation in all patients,but was cured after several days by the symptomatic treatments.In one case,the first operation via the inferior petrosal sinus was a failure;the feeding branches of

  3. A rare association of cerebral dural arteriovenous fistula with venous aneurysm and contralateral flow-related middle cerebral artery aneurysm.

    Science.gov (United States)

    Onu, David O; Hunn, Andrew W; Harle, Robin A

    2013-09-19

    The association of cerebral dural arteriovenous fistula (DAVF) and ipsilateral flow related aneurysm has infrequently been reported. We describe a male patient who presented with an acute haemorrhagic stroke and was found to have a large right fronto-parietal intra-parenchymal haemorrhage from the ruptured Borden type II DAVF in addition to a large venous aneurysm and a flow related intraosseous aneurysm of the contralateral middle meningeal artery (MMA) all clearly delineated by CT and DSA. He underwent emergency stereotactic evacuation of the intraparenchymal haemorrhage and successful surgical treatment of all the vascular lesions at the same time with residual neurological deficit. To our knowledge, this is the first such reported case. We discuss the challenging surgical treatment, emphasising the role of CT/DSA in management, and provide a literature review.

  4. Efectos del entrenamiento en superficies inestables sobre el equilibrio y funcionalidad en adultos mayores

    National Research Council Canada - National Science Library

    Juan C. López S; Elkin F. Arango V

    2015-01-01

    Objetivo: determinar los efectos de un programa de ocho semanas de entrenamiento en superficies inestables con y sin trabajo de fuerza, sobre el equilibrio y la capacidad funcional en adultos mayores de 60...

  5. Percepcion del ambiente y niveles de actividad fisica en adultos de un barrio de Cartagena

    National Research Council Canada - National Science Library

    Herazo-Beltran, Yaneth; Dominguez-Anaya, Regina

    2010-01-01

    Metodos Estudio transversal en 350 adultos de 18 a 65 anos residentes en el barrio Ternera, ubicado en el area urbana de la ciudad de Cartagena de Indias, Colombia y con predomino del estrato socioeconomico 2...

  6. Perfil clínico del adulto mayor atendido ambulatoriamente en un hospital general

    Directory of Open Access Journals (Sweden)

    Paola Casas

    2012-10-01

    Full Text Available Objetivo: Describir el perfil clínico del adulto mayor atendido ambulatoriamente en un hospital general. Material y métodos: Estudio descriptivo, transversal, realizado a través de encuestas aplicadas a pacientes en la consulta ambulatoria de geriatría del Hospital Nacional Cayetano Heredia (HNCH, entre agosto de 2011 y enero 2012. Resultados: Se evaluaron 290 pacientes, el 69,3% fueron mujeres; el 65,5% tenía entre 60 y 79 años. La hipertensión arterial fue el diagnóstico más frecuente (55,5%. El 83,1% consumía algún tipo de medicamento y el 45% más de 3 fármacos. En la valoración por esferas: el 83,5% era autónomo, el 18,1% tenía deterioro cognitivo, el 7,7% depresión, el 79,3% riesgo social, el 23,8% disfunción familiar, el 31,4% riesgo de malnutrición, el 23,4% obesidad, el 96% mala higiene del sueño y el 4,9% riesgo de caídas. El síndrome geriátrico más frecuente fue caídas en 23,8% y de los problemas geriátricos, el edentulismo en 77,6%; 17,4% eran frágiles según la velocidad de la marcha; se encontró asociación entre fragilidad y edad avanzada, género femenino y la presencia de riesgo social. Conclusión: Los pacientes que acuden a la consulta externa de Geriatría fueron mayoritariamente mujeres, funcionalmente autónomos, sin deterioro cognitivo, con riesgo social y adecuada funcionalidad familiar, prefrágiles y con enfermedades crónicas no transmisibles principalmente.

  7. Miocardiopatía tipo Takotsubo

    Directory of Open Access Journals (Sweden)

    Juan José Ramírez Chaves

    2014-06-01

    Full Text Available La miocardiopatía adquirida de tipo Takotsubo ha sido descrita desde 1991 en pacientes principalmente del género feme­nino, post menopáusicas, quienes posterior a un evento estresante físico o psicológico asocian clínica de dolor precordial, con cambios electrocardiográficos, alteraciones transitorias de contractilidad de predominio anteroapical del ventrículo izquierdo (VI y elevación de los biomarcadores cardiacos, en ausencia de una enfermedad arterial coronaria (EAC aguda como mecanismo desencadenante del cuadro. La fisiopatología no ha sido completamente dilucidada pero existe con­senso sobre la acción tóxica de las catecolaminas sobre el miocardio. El pronóstico es variable y va desde dolor, insuficien­cia cardiaca, choque cardiogénico hasta, la muerte; por lo tanto, constituye un desafío en el diagnóstico diferencial de las causas no ateroescleróticas generadoras de un síndrome coronario agudo (SCA.

  8. Resistência de meloeiro a Bemisia Tabaci biótipo B Resistance of melon to Bemisia Tabaci biotype B

    Directory of Open Access Journals (Sweden)

    Sérgio Alexandre Mottola Pereira Coelho

    2009-01-01

    Full Text Available Em âmbito mundial, a mosca-branca Bemisia tabaci (Genn. biótipo B é praga-chave em diversas culturas. O uso de resistência varietal se destaca entre os métodos de controle, sendo considerado o método ideal. O objetivo do presente trabalho foi avaliar, em casa de vegetação, a resistência de 32 cultivares de meloeiro em relação a essa mosca-branca. Para atratividade, em 'Neve' observou-se o menor número de adultos na face abaxial das folhas (0,6 adulto/10 cm², enquanto 'Nilo' foi a mais preferida (5,6 adultos/10 cm². A oviposição foi avaliada em testes com e sem chance de escolha; em ambos, 'Neve' proporcionou o menor número de ovos, contrastando com 'Nilo', a cultivar com a maior média. A colonização da mosca-branca durante o ciclo das plantas foi avaliada por meio de uma escala de notas variando de 0 (ausência de colonização até 6 (folha totalmente colonizada; 'Neve' destacou-se por sua reduzida colonização, sendo as mais altas médias obtidas em 'Imperial', 'Jangada', 'Vereda', 'Deneb' e 'Nilo'. Na duração do ciclo ovo-adulto da mosca-branca, que variou de 24,0 ('Neve' a 25,4 dias ('Jangada', as cultivares não diferiram entre si. Quanto à emergência de adultos, as menores médias foram induzidas por Vereda' (68,2% e 'Nilo' (69,3%, indicando a possível ocorrência de resistência do tipo antibiose nessas duas cultivares, enquanto as maiores médias ocorreram em 'Imperial' (90,9 % e 'Deneb' (89,6%. Considerando-se os parâmetros avaliados, infere-se que 'Neve' é a cultivar mais resistente a B. tabaci biótipo B, podendo ser indicada para plantio em regiões onde essa praga ocorra de forma acentuada ou para uso em programas de melhoramento.Silverleaf whitefly B. tabaci biotype B is an important worldwide pest of many crops. Use of resistant cultivars is considered the ideal method of control. In this research, 32 cultivars of melon were evaluated under greenhouse conditions reganding resistance to silverleaf

  9. EDUCAÇÃO DE ADULTOS: DE ONDE VIEMOS E PARA ONDE VAMOS?

    Directory of Open Access Journals (Sweden)

    Carine Schenekenberg Guedes

    2016-02-01

    Full Text Available Este artigo tem como escopo apresentar uma abordagem histórica da educação dando destaque às iniciativas da UNESCO diante da realização das Conferências Internacionais de Educação de Adultos, as CONFINTEAS. Partindo do princípio de que para entendermos a história da educação de adultos faz-se necessário refletir sobre o conceito que lhe é atribuído, o texto que ora apresentamos está organizado da seguinte forma: de início procuramos refletir sobre o conceito de educação de adultos e as dimensões que esse abarca. Na sequência abordamos a história da educação de adultos desde a antiguidade até o período que antecede a Segunda Guerra Mundial. Em seguida, abordamos os diferentes contornos que a educação de adultos assume dentro dos documentos resultantes as CONFINTEAS. Encerramos não com uma conclusão, mas com algumas indagações no sentido de provocar reflexões sobre as perspectivas da educação de adultos neste início do século XXI.

  10. La educación de los adultos mayores en TICs

    Directory of Open Access Journals (Sweden)

    Boarini, Mauricio Nazareno

    2006-01-01

    Full Text Available El siguiente trabajo pretende mostrar una propuesta de educación destinada a la capacitación de Adultos Mayores en TICs, teniendo en cuenta el contexto sociocultural actual que originan estas prácticas, su adecuación a los destinatarios y el reconocimiento que las mismas tienen por parte de los Adultos Mayores, quienes enfrentan el desafío de llevar adelante nuevos aprendizajes para sentirse integrados al grupo social con el que conviven. Atendiendo a este propósito, el trabajo se divide en tres partes; en primer lugar se incluyen diferentes proyecciones poblacionales que muestran el crecimiento de la población de Adultos Mayores a nivel mundial, y se caracteriza a la sociedad, donde la integración de las Tecnologías de la Información y la Comunicación cambia las formas de vida. En segundo lugar, se caracteriza al Adulto Mayor como sujeto destinatario de los diferentes cambios que se deben proponer desde el sistema educativo. Por último se describe la propuesta de educación de Adultos Mayores en TICs del Programa Educativo de Adultos Mayores de la Universidad Nacional de Río Cuarto y la valoración de la misma por parte de los alumnos y sociedad en general.

  11. Prevalencia de los trastornos del sueño en el adulto mayor Prevalence of sleep disorders in the elderly

    Directory of Open Access Journals (Sweden)

    Manuel Pando-Moreno

    2001-02-01

    Full Text Available El presente es un estudio realizado con adultos mayores de la Ciudad de Guadalajara, México, que viven en domicilios particulares. De ellos, el 58% de los hombres y el 76% de las mujeres presentaron al menos un síntoma de trastornos del sueño, según el "Cuestionario General de Salud de Goldberg"; el 8,5% registró positivo en el total de los reactivos. Conforme a los criterios del DSM IV, un 33,3% podría ser considerado "caso" de trastorno del sueño. Estos posibles casos estarían asociados al género, al grado de estudio y con la presencia de depresión; pero no con el estado civil ni la edad. Ante la gran cantidad de "posibles casos" encontrados, que no han sido previamente detectados ni se encuentran en ningún tipo de tratamiento ad hoc, se recomienda promover cursos de actualización en esta materia para los profesionales de la salud (principalmente médicos y enfermeras, de manera que se facilite la detección oportuna de los casos, así como incrementar y mejorar la accesibilidad de los servicios de salud mental para la población de la tercera edad, e incrementar las actividades de educación para la salud para el adulto mayor y los cuidadores de éstos.This study was performed with senior citizens in Greater Metropolitan Guadalajara, Mexico, who live in private homes, alone, or with family. Of these, 58% of men and 76% of women showed at least one symptom of sleep disorder according to the Goldberg General Health Questionnaire, while 8.5% were positive for all survey items. According to DSM IV criteria, 33.3% could be considered "cases" of sleep disorder, and none were under any type of treatment at the time of the study. These possible cases were apparently associated with gender and educational level, but not with marital status or age. In addition, no strong association was detected with the presence of depression, established according to Brink's Geriatric Depression Scale. Given the large amount of "possible cases" found that

  12. DIAGNÓSTICO ENFERMERO EN LOS ADULTOS MAYORES ATENDIDOS EN EL PROGRAMA ADULTO MAYOR DE UN CENTRO DE SALUD, CHICLAYO 2014

    OpenAIRE

    2014-01-01

     Los diagnósticos enfermeros, son esenciales para brindar un cuidado holístico y humanizado, por ello, esta investigación cuantitativa descriptiva tuvo como objetivo identificar los diagnósticos de enfermería en las personas atendidas en el Programa Adulto Mayor del Centro de Salud Túpac Amaru, en los meses de enero a marzo. La población muestral fueron 61 adultos mayores, aplicándoseles tres técnicas: entrevista, observación y examen físico, datos que se registraron en la guía de valoración ...

  13. Estabilidad de supositorios de naproxeno para uso infantil y adulto

    Directory of Open Access Journals (Sweden)

    Yania Suárez Pérez

    Full Text Available Introducción : el naproxeno en supositorios para uso infantil y adulto constituye una de las líneas de investigación en desarrollo de la Empresa "Roberto Escudero Díaz". Los estudios de estabilidad son una parte indispensable para el registro de una nueva formulación. Objetivo: determinar la estabilidad de los supositorios de naproxeno para uso infantil y adulto, teniendo en cuenta la estabilidad física y química del analito en las nuevas formulaciones. Métodos: se realizó el estudio de estabilidad para formulaciones en fase de desarrollo de supositorios de naproxeno para uso infantil y adulto, teniendo en cuenta la metodología propuesta por el Centro para el Control Estatal de la Calidad de los Medicamentos (CECMED. Se emplearon para cada dosis evaluada, supositorios de tres lotes pilotos envasados en tiras de aluminio termosellables. Se almacenaron los supositorios a temperatura de refrigeración (2-8 °C y ambiente (30 ± 2 °C durante un año, y se les realizaron muestreos a los 0, 1, 3, 6 y 12 meses de elaborados. Para el análisis de la estabilidad química, se consideraron los resultados del contenido de naproxeno obtenidos por volumetría de neutralización y por cromatografía líquida de alta resolución, así como la determinación de los posibles productos de degradación por cromatografía en capa delgada. Resultados: se demostró la adecuada estabilidad física de los supositorios de ambas dosis, independientemente de la temperatura de almacenamiento durante 12 meses, ya que se mantuvieron inalteradas las características organolépticas y el peso. Aunque el tiempo de liquefacción disminuyó durante el almacenamiento, siempre fue inferior al límite establecido. Con el método por cromatografía líquida de alta resolución, se detectaron pequeños cambios en la concentración de analito, por lo que este método fue superior para el seguimiento de la estabilidad química que la volumetría de neutralización. No se

  14. Desigualdades na autoavaliacao da saude bucal em adultos

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    Carla Antoni Luchi

    2013-08-01

    Full Text Available OBJETIVO Analisar a associação entre autoavaliação da saúde bucal em adultos e desigualdades sociodemográficas. MÉTODOS Estudo transversal com 2.016 adultos de 20 a 59 anos de idade, de Florianópolis, SC, em 2009. A amostra foi obtida por duplo estágio (setores censitários e domicílios. Os dados foram coletados por entrevistas domiciliares face a face. O desfecho foi autoavaliação da saúde bucal. As variáveis exploratórias foram caracterizadas em blocos demográficos, socioeconômicos, de utilização de serviços e de condições bucais autorreferidas. Foi realizada análise de regressão multivariável de Poisson e estimadas as razões de prevalências e respectivos intervalos de 95% de confiança. RESULTADOS A prevalência de autoavaliação negativa da saúde bucal foi de 33,2% (IC95% 29,8;36,6. Idade avançada, referir-se como pardo, possuir menor escolaridade, ter consultado o dentista há três anos ou mais, ter realizado a última consulta em consultório público, possuir menos de dez dentes naturais presentes em pelo menos um arco, perceber necessidade de tratamento odontológico, apresentar sensação de boca seca e dificuldade de alimentação em virtude dos dentes foram associados à autoavaliação negativa da saúde bucal na análise ajustada. CONCLUSÕES A autoavaliação da saúde bucal reflete as desigualdades em saúde e está relacionada às piores condições socioeconômicas, menor uso de serviços de saúde e pior condição bucal autorreferida.

  15. Fatores associados as dificuldades de adultos na mastigacao

    Directory of Open Access Journals (Sweden)

    Daniela de Rossi Figueiredo

    2013-12-01

    Full Text Available OBJETIVO : Estimar a prevalência de dificuldade de adultos na mastigação, segundo sexo, e analisar os fatores associados. MÉTODOS : Estudo transversal de base populacional com adultos de 20 a 59 anos de idade (n = 2.016, de Florianópolis, SC, em 2009, por meio de amostragem em dois estágios, setores censitários e domicílios. A dificuldade na mastigação foi investigada por meio de pergunta sobre dificuldade de mastigação devida a problemas com os dentes ou dentadura. Analisaram-se os fatores  demográficos, socioeconômicos, utilização dos serviços de saúde para consulta odontológica e condição bucal autorreferida. Foi realizada regressão logística multivariável, estratificada por sexo. RESULTADOS : A taxa de resposta foi de 85,3% (n = 1.720. A prevalência de dificuldade na mastigação foi de 13,0% (IC95% 10,3;15,8 e 18,0% (IC95% 14,6;21,3 em homens e em mulheres, respectivamente. Mulheres e homens com 50 anos ou mais, aqueles com dez dentes naturais ou menos e os que manifestaram dor dentária tiveram mais chance de apresentar dificuldade na mastigação. O efeito conjunto da perda e da dor na dificuldade na mastigação foi cerca de quatro vezes maior entre as mulheres. CONCLUSÕES : A magnitude das associações entre variáveis socioeconômicas, demográficas e de condição bucal autorreferidas foi diferente para homens e mulheres, em geral maiores para as mulheres, destacando-se a dor dentária. Os resultados sugerem que o impacto das condições bucais varia segundo o sexo.

  16. Beneficios percibidos por adultos mayores incorporados al ejercicio

    Directory of Open Access Journals (Sweden)

    René Barrios Duarte

    2003-04-01

    Full Text Available El propósito del trabajo es conocer los beneficios que perciben los adultos mayores del sexo femenino, con larga permanencia en el ejercicio, y las relaciones que se establecen entre estos y las variables edad, nivel cultural, tiempo de permanencia y ocupación anterior. Se tomó una muestra de 75 personas pertenecientes a 5 círculos de abuelos de Ciudad de La Habana, con edades entre 56 y 90 años, a los cuales se les aplicó un cuestionario de datos sociodemográficos y una entrevista. Los beneficios percibidos se agruparon en 4 categorías principales: salud, aptitud, psicológicos y sociales. No se encontró relación de dependencia con ninguna de las variables analizadas, aunque sí se encontraron diferencias en categorías específicas. El estudio detalla los beneficios que se pueden percibir con la práctica sistemática en programas destinados al adulto mayor, así como su carácter multidimensional, físico, psicológico y social. Se confirma la importancia del ejercicio y se ofrecen razones para su fomento.The objective of the paper is to find out the benefits that older females receive from practicing exercises for a long time and the relations that are established between these benefits and the variables age, educational level, length of practice and former occupation. A sample of 75 persons from 5 grandfather´s clubs in the City of Havana, aged 56-60 years was administered a socio-demographic questionnaire and an interview. Received benefits were grouped into 4 main categories: health, aptitude, psychological and social. There was no dependence relation with any of the analyzed variables, although differences were found in specific categories. The study detailed the benefits that may be received from systematic physical exercising in programs devoted to older people as well as their multidimensional, physical, psychological and social character. The paper confirmed the importance of exercising and provided reasons for encouraging

  17. Novos acessos de tomateiro resistentes à mosca-branca biótipo B New accessions of tomato resistant to whitefly biotype B

    Directory of Open Access Journals (Sweden)

    Maria Elisa de Sena Fernandes

    2009-11-01

    Full Text Available O objetivo deste trabalho foi selecionar novas fontes de resistência a Bemisia tabaci biótipo B, entre 34 acessos de tomateiro (Lycopersicon esculentum, do Banco de Germoplasma de Hortaliças da UFV. Avaliaram-se os números de adultos, ovos e ninfas por planta, além da densidade de tricomas. Detectaram-se diferenças entre os acessos nas variáveis avaliadas. Os acessos BGH-166, BGH-616, BGH-850, BGH-990, BGH-2102 e BGH-2125 apresentaram menor número de adultos, ovos e ninfas por planta e tiveram menor densidade de tricomas. A resistência dos acessos de tomate à mosca-branca foi associada a uma menor densidade de tricomas.The objective of this work was to evaluate resistance to Bemisia tabaci biotype B in 34 tomato (Lycopersicon esculentum accessions from the Banco de Germoplasma de Hortaliças of UFV. The number of adults, eggs and nymphs per plant besides of trichome density were evaluated. Differences between accessions were found for the evaluated variables. Accessions BGH-166, BGH-616, BGH-850, BGH-990, BGH-2102 and BGH-2125 presented less infestation of adults, eggs and nymphs per plant and showed lower trichome density. The resistance of these tomato accessions to whitefly was associated to a lower trichome density.

  18. Doença cerebrovascular tipo "moyamoya"

    Directory of Open Access Journals (Sweden)

    Reynaldo A. Brandt

    1976-09-01

    Full Text Available É relatado o caso de um paciente masculino, branco, 34 anos, que apresentou hemorragia meníngea sem sinais de comprometimento cerebral. A carotidoangiografia direita mostrou as alterações típicas do "moyamoya", com estenose da artéria carótida interna ao nível do sifão, acima da origem da artéria comunicante posterior; há uma rede vascular angiomatosa anormal projetando-se na base do cérebro, da qual nascem as artérias cerebrais anterior e média, sendo as artérias comunicante e cerebral posterior hipertrofiadas e de trajeto tortuoso; há anastomoses meningo-corticiais, sendo as artérias meníngeas hipertrofiadas. A carotidoangiografia esquerda mostrou hipertrofia das artérias carótidas comum e interna, com contrastação de ambas as artérias cerebrais anteriores e médias a partir deste lado; a artéria comunicante anterior é do tipo fetal e há a presença anômala da artéria cerebral anterior mediana do corpo caloso. Estes dados apoiam a teoria segundo a qual a doença constitui anomalia do desenvolvimento vascular encefálico, não tendo sido encontrado outro caso na literatura com hipertrofia vicariante da artéria carótida interna contralateral à da lesão típica do "moyamoya".

  19. Rendimiento en pruebas cognitivas breves, de adultos mayores con demencia en estadios avanzados, residentes de una comunidad urbana de Lima, Perú

    Directory of Open Access Journals (Sweden)

    Nilton Custodio

    Full Text Available Objetivos. Evaluar el rendimiento de la prueba de dibujo de reloj en versión de Manos (PDR-M y Mini Mental State Examination (MMSE en su versión peruana, para detectar demencia de cualquier tipo en adultos mayores residentes de una comunidad urbana de Lima, Perú. Materiales y métodos. Análisis secundario de base de datos, de tipo observacional, analítico y transversal; con diseño de prueba diagnóstica, teniendo como prueba estándar a las evaluaciones clínica y neuropsicológica en conjunto. Se evaluó el rendimiento de las pruebas individualmente, así como de forma combinada. Resultados. El rendimiento de MMSE para la evaluación de pacientes con demencia de cualquier tipo presentó sensibilidad de 64,1%, especificidad de 84,1%, VPP de 24,4%, VPN de 96,7%, LR (+ de 4,03 y LR (- de 0,43. La PDR-M presentó sensibilidad de 89,3%, especificidad de 98,1%, VPP de 79,3%, VPN de 99,1%, LR (+ de 47,79 y LR (- de 0,11. Cuando se aplicaron ambas pruebas, y al menos una de ellas fue positiva, presentaron sensibilidad de 98,1%, especificidad de 84,1%, VPP de 33,1%, VPN de 99,8%, LR (+ de 6,17 y LR (- de 0,02. Al realizar el análisis, por separado, de demencia tipo alzhéimer y no alzhéimer, los valores de los parámetros no se diferencian sustancialmente de los obtenidos para demencias de cualquier tipo. Conclusiones. La combinación de MMSE y PDR-M demuestran un buen rendimiento para detectar demencia en estadios moderado y severo en población residente de una comunidad urbana de Lima.

  20. Tipos de interés de los productos bancarios

    OpenAIRE

    Gonzalo Aguado, David

    2016-01-01

    EI trabajo analiza los tipos de interes que las entidades financieras establecen en sus productos. Se configura en tres bloques: Operaciones de Activo, Operaciones de Pasivo y Otras Operaciones. Se puede comprobar que tienen dos opciones : Aplicar un tipo de interés fijo, con el que desde el primer momento conocemos la totalidad de lo que vamos a pagar. La otra opción es aplicar un tipo de interés variable, normalmente aplicando el Euribor más una parte fija. Dentro de cada producto bancario,...

  1. Genética de la diabetes mellitus tipo 2

    OpenAIRE

    Carmen Carrillo; Arturo Panduro Cerda

    2001-01-01

    Factores genéticos predisponen a la diabetesmellitus (DM) tipo 2 y el desarrollo de la enfermedad depende en gran parte de la alimentación y actividad física (factores ambientales).Existen familias cuyos miembros presentan DMtipo 2 solamente o bien diferentes tipos de diabetes. En general se presenta un patrón de herencia multifactorial, rara vez autosómico dominante o mitocondrial. El riesgo que tienen losfamiliares de pacientes con DM tipo 2 se establece con el valor lambda el cual depende ...

  2. Primeiro caso de botulismo tipo F, em Portugal

    OpenAIRE

    Saraiva, Margarida; Lopes, Teresa Teixeira; Militão, André; Ribeiro, Rosa Santos; Coelho, Adelaide; Moura, Isabel Bastos; Pena, Cláudia; Bonito, Conceição Costa; Cunha, Isabel Campos; Sousa, Isabel; Toscano, Maria Manuel; Gomes, Carlos Orta; Soares, Elsa; Tavares, António; Calhau, Maria Antónia

    2016-01-01

    A nível mundial, estão descritos poucos casos de botulismo tipo F em humanos. Em julho de 2016 foi identificado o primeiro caso de botulismo tipo F, em Portugal. Foi detetada toxina botulínica tipo F (BoNT/F) nas fezes de um doente com quadro clínico típico de botulismo e isolada a estirpe de Clostridium botulinum produtora de BoNT/F. Worldwide few cases of type F botulism are described in humans. In July 2016 the first case of type F botulism in Portugal was identified. ...

  3. Fenótipo Rett em paciente com cariótipo XXY: relato de caso

    Directory of Open Access Journals (Sweden)

    SCHWARTZMAN JOSÉ SALOMÃO

    1998-01-01

    Full Text Available Relatamos o caso de um menino com cariótipo XXY que apresenta desordem neurológica progressiva com início por volta dos 11 meses de idade, com estagnação do desenvolvimento seguida de regressão. A criança apresenta, ainda, movimentos estereotipados de mãos, apraxia manual e microcefalia. Investigações não constataram presença de qualquer condição neurológica ou sistêmica definida que pudesse ser apontada como possível etiologia para o quadro descrito. Trata-se de menino com alterações fenotípicas muito similares àquelas consideradas típicas para a síndrome de Rett que, associadas com a alteração cromossômica constatada (cariótipo XXY, constituem quadro de evidente interesse científico.

  4. Envejecimiento activo. Las TIC en la vida del adulto mayor.

    Directory of Open Access Journals (Sweden)

    Maricela Sevilla Caro

    2015-02-01

    Full Text Available La Organización Mundial de la Salud informa que la cantidad de población de la tercera edad crece en todo el mundo, produciéndose un envejecimiento acelerado de la población y un aumento en la expectativa de vida. El envejecimiento activo trata de ampliar la esperanza de vida en salud y la calidad de vida para todas las personas a medida que envejecen, el término activo hace referencia a la participación continua en las cuestiones sociales, económicas, culturales, espirituales y cívicas. Este artículo tiene como propósito dar a conocer el impacto que tiene el uso de las computadoras en la vida cotidiana de los adultos mayores que han participado en un curso-taller de computación y conocer los cambios en el estado de ánimo y forma de pensar al incorporarlos a la sociedad tecnológica, información que se obtuvo mediante un proyecto de investigación cualitativa, mediante la modalidad de estudio de caso

  5. Calidad de vida de cuidadores de adultos con accidente cerebrovascular

    Directory of Open Access Journals (Sweden)

    INNA ELIDA FLÓREZ TORRES

    2010-10-01

    Full Text Available Objetivo: describir la calidad de vida de los cuidadores familiares de adultos con secuelas de accidente cerebrovascular, en Cartagena, Colombia. Método: estudio descriptivo cuantitativo realizado durante el segundo semestre de 2008. Muestra no probabilística por conveniencia de 97 cuidadores. Se empleó el instrumento propuesto por Ferrell et ál. Para valorar cada uno de los bienestares que integran la calidad de vida se utilizaron medidas de tendencia central y coeficiente de variación. Resultados: el grupo de cuidadores presentó en el bienestar físico un promedio de 11,1 con relación al máximo puntaje, lo que indica el peor estado de salud; los bienestares psicológico y social tuvieron promedios de 48,8 y 21,9, respectivamente, con menor afectación. El mejor estado se halló en el bienestar espiritual, con promedio de 22,6. Conclusiones: la experiencia de ser cuidador modifica de manera importante la calidad de vida de las personas; los cuidadores, como fuente importante de cuidado informal, requieren apoyo de los sistemas de salud y, como parte de este, de los profesionales de enfermería.

  6. Recrutamento de participantes no Estudo Longitudinal de Saude do Adulto

    Directory of Open Access Journals (Sweden)

    Estela M L Aquino

    2013-06-01

    Full Text Available OBJETIVO: Apresentar as estratégias de comunicação e recrutamento no Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil e discutir os resultados alcançados na constituição da coorte. MÉTODOS: As estratégias foram voltadas à divulgação, à institucionalização e ao recrutamento propriamente dito. As ações de comunicação pretenderam promover o fortalecimento de imagem institucional positiva para o estudo, a gestão de conhecimentos e o diálogo eficaz com seu público-alvo. Foi criado web site oficial visando dialogar com diferentes públicos, funcionar como difusor científico e contribuir para a consolidação da imagem do estudo perante a sociedade. RESULTADOS: Foram recrutados 16.435 mulheres e homens, servidores ativos e aposentados de seis instituições públicas de ensino e pesquisa para constituir a coorte de 15.105 participantes. As metas de recrutamento foram plenamente alcançadas nos seis centros, com leve predomínio de mulheres e daqueles mais jovens, e um pouco menos de servidores com menor escolarização. CONCLUSÕES: As estratégias utilizadas se mostraram adequadas e essenciais para o sucesso da captação e participação dos servidores.

  7. AUTOPERCEPCIÓN DE LOS ADULTOS MAYORES SOBRE SU VEJEZ*

    Directory of Open Access Journals (Sweden)

    Sagrario Garay Villegas

    2010-03-01

    Full Text Available El objetivo de este artículo es aproximarse a los significados y percepciones que tienen los adultos mayores sobre esta etapa de su vida. Para ello utilizaremos herramientas de carácter cualitativo y cuantitativo. Nuestra pretensión de usar ambos métodos es contar con la visión de la población con 60 años o más, sobre aspectos relacionados con su salud física y mental, pero también indagar el los factores que podrían estar influyendo en dicha percepción. Los resultados encontrados nos revelan que existe una asociación muy cercana entre la percepción sobre la salud física y el estado mental de las personas adultas mayores. Palabras clave: vejez; significados; salud mental; salud física y felicidad. * Agradecemos los valiosos comentarios a versiones preeliminares de este documento realizados por la Dra. Verónica Montes de Oca.

  8. Surdez e Diagnóstico: narrativas de surdos adultos

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    Rosa Monteiro

    Full Text Available RESUMO Investigamos neste artigo o que os surdos narram sobre a descoberta de sua própria condição a partir do diagnóstico da surdez. Partimos de uma metodologia qualitativa, estruturada em forma de grupo focal composto por cinco surdos adultos pobres e conduzida por uma equipe multidisciplinar (pedagoga, psicóloga e intérprete de língua de sinais ao longo de 2013 (Brasília, Brasil. Nos resultados, identificamos fragmentos narrativos reveladores de dois aspectos interdependentes sobre o impacto do diagnóstico da surdez na constituição do surdo: a o efeito iatrogênico e b o reposicionamento dramático das relações parentais após o diagnóstico. A conclusão aponta que, após a da descoberta da surdez, os participantes passam a ser vistos a partir do lugar da deficiência indesejada.

  9. Líquen estriado no adulto Lichen striatus on adult

    Directory of Open Access Journals (Sweden)

    Leticia Fogagnolo

    2011-02-01

    Full Text Available Líquen estriado é uma erupção inflamatória incomum, de etiologia desconhecida. Raramente acomete adultos, e é caracterizada pelo surgimento abrupto de pápulas coalescentes, em arranjo linear, usualmente em extremidades. A histopatologia mostra reação liquenóide envolvendo folículos e glândulas. Ocasionalmente há sobreposição com líquen plano linear e "blaschkitis", seus principais diagnósticos diferenciais. Relata-se um caso de mulher adulta com pápulas eritematovioláceas em região cervical e hemiface direitas, cuja correlação clínico-histopatológica permitiu o diagnóstico de líquen estriado. Os achados atípicos e a dificuldade diagnóstica são discutidos.Lichen Striatus is an uncommon inflammatory skin eruption of unknown etiology. It rarely affects adults, and it is characterized by abrupt onset of coalescent papules, in a linear disposition, usually on the extremities. Histopathology shows lichenoid reaction involving follicles and glands. Occasionally, there is overlap with linear lichen planus and "blaschkitis", the main differential diagnoses. It is reported here the case of an adult woman with erythematous violaceous papules on the right side of the neck and face, diagnosed with lichen striatus by clinical and histopathological correlation. The atypical findings and the diagnostic difficulty are discussed.

  10. Estructura narrativa en el discurso oral de adultos mayores

    OpenAIRE

    Wittig,Fernando

    2004-01-01

    El envejecimiento implica cambios cognitivos que se traducen en distintos problemas en la producción de discurso narrativo (Kemper, 1992; Craik, Andreson, Kerr & Li, 1995; Juncos, 1998). Juncos y Pereiro (1998) sostienen que el nivel educacional es un factor que incide positivamente en el manejo de la estructura de este tipo de discurso. Para evaluar lo anterior se analizan 167 narraciones orales de 24 sujetos con distinto nivel educacional (básico y universitario) y se clasifican según l...

  11. Efectividad del programa educativo “Cuidando con amor” en los conocimientos, actitudes y prácticas sobre prevención de úlceras por presión de los cuidadores de pacientes adultos mayores del Hospital San Isidro Labrador – EsSalud, Lima, Perú

    OpenAIRE

    Arpasi Quispe, Orfelina

    2015-01-01

    Objetivo: Determinar la efectividad del programa educativo “Cuidando con amor” en los conocimientos, actitudes y prácticas sobre prevención de úlceras por presión de los cuidadores de pacientes adultos mayores del Hospital San Isidro Labrador – EsSalud. Material y Métodos: El estudio fue de diseño preexperimental, de tipo cuantitativo con un solo grupo a quien se aplicó una preprueba y posprueba. Se utilizó el muestreo no probabilístico, a conveniencia del investigador, basado en criterios de...

  12. Relación entre el conocimiento y la práctica del autocuidado e hipertensión arterial en los adultos mayores de 35 años del distrito misionero de Chaclacayo de la Iglesia Adventista del Séptimo Día, 2011.

    OpenAIRE

    Condori Meza, Deisy; Sánchez Rivera, Eima; Miranda Limachi, Keila

    2015-01-01

    Objetivo: El objetivo del estudio fue determinar la relación entre nivel de conocimiento y práctica de autocuidado de la hiper- tensión arterial en los adultos mayores de 35 años del distrito misionero de Chaclacayo de la Iglesia Adventista del Séptimo Día, 2011. Metodología: El estudio fue de tipo cuantitativo, diseño no experimental, descriptivo, correlacional – causal de corte transversal en el distrito misionero de Chaclacayo, mediante un muestreo probabilístico, sobre 123 participantes. ...

  13. Efectividad del programa educativo “Cuidando con amor” en los conocimientos, actitudes y prácticas sobre prevención de úlceras por presión de los cuidadores de pacientes adultos mayores del Hospital San Isidro Labrador – EsSalud, Lima, Perú

    OpenAIRE

    Arpasi Quispe, Orfelina

    2015-01-01

    Objetivo: Determinar la efectividad del programa educativo “Cuidando con amor” en los conocimientos, actitudes y prácticas sobre prevención de úlceras por presión de los cuidadores de pacientes adultos mayores del Hospital San Isidro Labrador – EsSalud. Material y Métodos: El estudio fue de diseño preexperimental, de tipo cuantitativo con un solo grupo a quien se aplicó una preprueba y posprueba. Se utilizó el muestreo no probabilístico, a conveniencia del investigador, basado en criterios de...

  14. Ansiedad ante la muerte y factores de vulnerabilidad asociados en ofensores sexuales recluidos en el Centro de Atención Institucional Adulto Mayor/Death anxiety and vulnerability factors associated in sex offenders held at the Elderly Prison, Costa Rica

    OpenAIRE

    Blanco Álvarez, Tatiana María

    2015-01-01

    Objetivo: Establecer la relación entre los factores de vulnerabilización y la ansiedad ante la muerte en ofensores sexuales, recluidos en el Centro de Atención Institucional Adulto Mayor. Metodología: Estudio de tipo mixto, con un alcance correlacional y transversal. Instrumentos: Escala de Ansiedad ante la Muerte de Templer, Cuestionario de Ansiedad Estado-Rasgo, la Escala Geriátrica de Ansiedad. Muestra: 103 personas adultas mayores de la Asociación Gerontológica Costarricense y 80 privados...

  15. Relación entre el conocimiento y la práctica del autocuidado e hipertensión arterial en los adultos mayores de 35 años del distrito misionero de Chaclacayo de la Iglesia Adventista del Séptimo Día, 2011.

    OpenAIRE

    Condori Meza, Deisy; Sánchez Rivera, Eima; Miranda Limachi, Keila

    2015-01-01

    Objetivo: El objetivo del estudio fue determinar la relación entre nivel de conocimiento y práctica de autocuidado de la hiper- tensión arterial en los adultos mayores de 35 años del distrito misionero de Chaclacayo de la Iglesia Adventista del Séptimo Día, 2011. Metodología: El estudio fue de tipo cuantitativo, diseño no experimental, descriptivo, correlacional – causal de corte transversal en el distrito misionero de Chaclacayo, mediante un muestreo probabilístico, sobre 123 participantes. ...

  16. Diagnósticos de enfermagem em adultos em tratamento de hemodiálise Diagnósticos enfermería en adultos en tratamiento de hemodiálisis Nursing diagnosis in adults on hemodialysis

    Directory of Open Access Journals (Sweden)

    Aline Gozzi Braga Lata

    2008-01-01

    Full Text Available OBJETIVO: Analisar a distribuição dos diagnósticos de enfermagem presentes em adultos de uma clínica de hemodiálise de Petrópolis - Rio de Janeiro. MÉTODOS: Estudo quantitativo do tipo transversal, de caráter exploratório e descritivo. Foram avaliados 20 pacientes nos meses de abril e maio de 2006. Os instrumentos de coleta de dados foram: roteiro de entrevista e exame físico. RESULTADOS: Verificou-se que metade eram mulheres, sendo a maioria casada, com média de 2 filhos. Foram identificados 16 diagnósticos de enfermagem, quatro desses acima do percentil 75, são eles: Risco de infecção; Perfusão tissular ineficaz: renal; Padrão de sono perturbado e Intolerância à atividade. CONCLUSÃO: O estudo proporcionou maior conhecimento da realidade desses pacientes, contribuindo para uma possível implementação de ações de enfermagem mais eficientes para a solução dos problemas identificados.OBJETIVO: Analizar la distribución de los diagnósticos de enfermería presentes en adultos de una clínica de hemodiálisis de Petrópolis - Rio de Janeiro. MÉTODOS: Se trata de un estudio cuantitativo de tipo transversal, de carácter exploratorio y descriptivo. Fueron evaluados 20 pacientes en los meses de abril y mayo del 2006. Los instrumentos de recolección de datos fueron: una guía de entrevista y examen físico. RESULTADOS: Se verificó que la mitad eran mujeres, siendo la mayoría casadas, con un promedio de 2 hijos. Se identificaron 16 diagnósticos de enfermería, cuatro de ellos encima del percentil 75, que son: Riesgo de infección; Perfusión tisular ineficaz: renal; Patrón de sueño perturbado e Intolerancia a la actividad. CONCLUSIÓN: El estudio proporcionó mayor conocimiento de la realidad de esos pacientes, contribuyendo a una posible implementación de acciones de enfermería más eficientes para la solución de los problemas identificados.OBECTIVE: to analyze the nursing diagnoses present in adults from a

  17. Bilateral Carotid and Vertebral Rete Mirabile Presenting with a Prominent Anterior Spinal Artery Mimicking a Spinal Dural AV Fistula at MRI

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Seung Young; Cha, Sang Hoon [Chungbuk National University College of Medicine, Iksan (Korea, Republic of)

    2011-11-15

    Bilateral carotid and vertebral rete mirabile (CVRM) is a very rare condition. We report a new case of CVRM initially detected by magnetic resonance imaging (MRI) of the cervical spine. MRI demonstrated tortuous vascular signal voids limited to the anterior cerebrospinal fluid space mimicking spinal dural arteriovenous fistula. A diagnosis of CVRM was confirmed on the basis of angiographic findings of rete formation associated with bilateral aplasia of the cavernous internal carotid and vertebral arteries without abnormal arteriovenous connection.

  18. A traumatic dural arteriovenous fistula between the inferolateral trunk of the internal carotid artery and the ophthalmic vein: A case of transvenous coil embolization via the facial vein

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jun Young; Hong, Chang Ki; Suh, Sang Hyun [Dept. of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of); Kim, Dong Ik [Dept. of of Radiology, CHA Bundang Medical Center, CHA University, Seongnam (Korea, Republic of)

    2017-05-15

    A 31-year-old man was admitted with exophthalmos. He suffered from progressive exophthalmos, bruit and conjunctival chemosis 7 days after head trauma caused by falling down. Cerebral angiography showed a dural arteriovenous fistula (DAVF) draining into the ophthalmic vein caused by tear in the inferolateral trunk, which is a rare presentation of traumatic DAVF. Selective transvenous coil embolization was performed via the facial vein without neurologic complications.

  19. Direct orbital puncture of the cavernous sinus for the treatment of a carotid-cavernous dural AV fistula with a concomitant venous/lymphatic malformation.

    Science.gov (United States)

    Coumou, Adriaan D; van den Berg, René; Bot, Joost C; Beetsma, Daan B; Saeed, Peerooz

    2014-02-01

    A 37- year old male with a long history of a left orbital venous/lympathic malformation presented with ocular injection, increased proptosis and reduced left vision. Angiography demonstrated a carotid cavernous dural AV fistula combined with a concomitant venous/lymphatic malformation. After attempts at transvenous embolization, a direct uncomplicated transorbital puncture of the cavernous sinus via a lateral orbitotomy was performed with complete resolution of ocular symptoms.

  20. 颅内静脉寞血栓形成循证病例报告%Case-report of evidenced-based treatment of dural sinus thrombosis

    Institute of Scientific and Technical Information of China (English)

    孟强; 董曼丽; 林岚; 钟静玫; 翟明; 武绍远; 张金章

    2003-01-01

    @@ INTRODUCTION Dural sinus thrombosis(DST) is a seldom and special cerebrovas-cular disease in clinic, which can cause severe results such asblindness, coma and even death. Now there is no unitary treatmentplan for this special cerebrovascular disease. On the basis of re-trieving domestic and abroad documents about this disease, 3 pa-tients were given evidence-based treatment which adopted throm-bolytic therapy with urokinase continuous perfusion by artery, whichwas reported as following.

  1. Anesthetic management of a patient with Weaver syndrome undergoing emergency evacuation of extra-dural hematoma: A case report and review of the literature.

    Science.gov (United States)

    Khokhar, R S; Hajnour, Msm; Aqil, M; Al-Saeed, A H; Qureshi, S

    2016-01-01

    Weaver syndrome is a rare disorder of unknown etiology characterized by skeletal overgrowth, distinctive craniofacial and digital abnormalities and advanced bone age. In general, craniofacial abnormalities that cause difficulty with tracheal intubation may improve, worsen, or remain unchanged as craniofacial structures mature. Furthermore, there is an estimated risk in these children of ≤1.09% of rhabdomyolysis or malignant hyperpyrexia. We report a case of a boy with Weaver syndrome who underwent emergency evacuation of extra-dural hematoma under general anesthesia.

  2. Transvenous treatment of a complex cavernous sinus dural arteriovenous fistula secondary to balloon embolization of a traumatic carotid-cavernous fistula

    Institute of Scientific and Technical Information of China (English)

    HAI Jian; CHEN Zuo-quan; DENG Dong-feng; PAN Qing-gang; LING Feng

    2006-01-01

    @@ AIthough recurrent traumatic carotid-cavernous fistula (CCF) and its treatment have been reported sporadically,1 a complex cavernous sinus dural arteriovenous fistula (DAVF) secondary to balloon embolization of a direct traumatic CCF is rare. In 2005, we treated such a case via transvenous approach using coils and N-buty-2-cyanoacrylate (NBCA). The causes of recurrent cavernous sinus DAVF and its endovascular approach are discussed.

  3. Malrotación intestinal en adultos: causa infrecuente de abdomen agudo oclusivo Intestinal malrotation in adults: infrecuent cause of acute oclusive syndrome

    Directory of Open Access Journals (Sweden)

    Josefina Etchevers

    2008-12-01

    Full Text Available El 90 % de los casos de obstrucción por malrotación intestinal ocurre en niños menores de 1 año de edad, siendo altamente infrecuente en adultos. Un paciente de sexo masculino, de 31 años de edad, con antecedente de episodios de dolor abdominal, vómitos y constipación que alternaban con períodos de normalidad desde la niñez es admitido en el hospital por sintomatología similar, la que no cede. Luego de estudios radiológicos y de laboratorio se decide su intervención quirúrgica con el diagnóstico de obstrucción intestinal. El diagnóstico intraoperatorio realizado fue de malrotación intestinal tipo I, practicándose la operación de Ladd. La evolución del paciente es favorable. La infrecuente presentación de esta patología en adultos es lo que motiva la presentación del caso.The 90 % of the bowel obstruction caused by intestinal malrotation occurred in children younger than 1 year, this type of obstruction is very uncommon in adults. This is a male of 31 years old, with history of abdominal pain, vomits and constipation since he was a child. These symptoms were sporadical, he didn't need any surgical treatment. Recently he was admitted in our institution presenting similar symptoms, without remission of them. After imaging and laboratory studies, was performed a surgery, and the intraoperatoty diagnosis was intestinal malrotation type I. The surgical treatment was the Ladd Operation. The postsurgery evolution was good. Discharged 4 days after the surgery. The aim of this article is to present a rare case of intestinal obstruction in adults caused for an intestinal malrotation.

  4. Oraciones producidas por adultos mayores y adultos jóvenes en una situación controlada (Sentence production by elder and young adults under a controlled situation

    Directory of Open Access Journals (Sweden)

    Mónica Véliz

    2013-12-01

    Full Text Available Se realizó un experimento en el que se compara un grupo de jóvenes y uno de adultos mayores en una tarea que consiste en producir una oración a partir de palabras-estímulo. Las variables lingüísticas que se contrastan son el tipo de verbo (transitivo, intransitivo, transitivo que admite objeto directo oracional y el número de estímulos (2, 3. Los resultados no muestran diferencias significativas entre ambos grupos ni en la complejidad sintáctica y densidad proposicional de las oraciones producidas ni en los tiempos de planificación y producción. Solo el porcentaje de errores que cometen los participantes permite diferenciar a los mayores de los jóvenes. Los resultados se discuten en la perspectiva teórica del envejecimiento cognitivo y su efecto sobre los procesos de producción lingüística. (We present an experiment that compares young and older adults in a sentence production task based on stimulus-words. Type of verb (transitive, intransitive, transitive with direct object and the number of stimuli (2, 3 are tested. Data shows no significant difference between age groups both in the syntactic complexity and propositional density of the sentences produced, nor on the planning and production time periods. Only response errors were different for older and younger participants. Results are discussed in the light of theoretical cognitive aging and its effect on language production processes.

  5. Direct percutaneous transorbital puncture under fluoroscopic guidance with a 3D skull reconstruction overlay for embolisation of intraorbital and cavernous sinus dural arteriovenous fistulas.

    Science.gov (United States)

    Lv, Ming; Jiang, Chuhan; Liu, Dong; Ning, Zhiguang; Yang, Jun; Wu, Zhongxue

    2015-06-01

    To describe the direct percutaneous transorbital puncture technique for embolisation of the selected intraorbital and cavernous sinus dural arteriovenous fistula, which failed to be treated by conventional endovascular techniques. One case of intraorbital and five cases of cavernous sinus dural arteriovenous fistula were embolised through direct percutaneous transorbital puncture in 2012, and the clinical data were reviewed. Under fluoroscopic guidance with a three-dimensional (3D) skull reconstruction overlay, the cavernous sinus or ophthalmic vein was punctured via the superior orbital fissure. Then a microcatheter was inserted via the needle, and Onyx was injected to embolise the fistula with or without a combination of coils. Complete obliteration of the fistula was achieved in all six patients. After operation all the patients experienced transient swelling of the punctured orbit persisting for three to five days. No other complications occurred. Follow-up of six patients at three to six months showed resolution of their initial neuro-ophthalmological symptoms in five and left visual loss in one did not recover. Six months follow-up angiogram showed no recurrence of these fistulas. Direct percutaneous transorbital puncture provides an option for the intraorbital and cavernous sinus dural arteriovenous fistulas, particularly when the conventional transvenous routes are inaccessible. Overlay of the 3D skull reconstruction can facilitate the precise puncture of the superior orbital fissure. © The Author(s) 2015.

  6. Parâmetros de desempenho e carcaça de genótipos de frangos tipo caipira

    OpenAIRE

    Veloso,R.C.; PIRES, A. V.; R.A. Torres Filho; Pinheiro,S.R.F.; Winkelstroter,L.K.; Alcântara,D.C.; Cruz,C.C.D.C.S.

    2014-01-01

    Objetivou-se com este trabalho avaliar as características de desempenho e de carcaça de sete genótipos de frangos tipo caipira da linhagem Redbro. Foram utilizados 840 pintos de um dia, machos, distribuídos em delineamento inteiramente ao acaso, dos seguintes genótipos: Caboclo, Carijó, Colorpak, Gigante Negro, Pesadão Vermelho, Pescoço Pelado e Tricolor. Os frangos foram alojados em 28 boxes, sendo 30 frangos por boxe, em galpão de alvenaria com a...

  7. Tipo de alimentación en pacientes con diabetes mellitus tipo 2: una muestra de Monterrey (México)

    OpenAIRE

    Samaniego Garay, Rafael Armando; Universidad Autónoma de Zacatecas; Álvarez Bermúdez, Javier; Universidad Autónoma de Nuevo León

    2013-01-01

    El presente trabajo tuvo el propósito de realizar un análisis descriptivo de la frecuencia y tipo de alimentos que se consumen en un grupo de personas con este padecimiento. Se describen los resultados obtenidos en 94 pacientes con diabetes tipo 2 que asistían a un hospital universitario, encontrándose que el tipo de dieta que realizan no es la apropiada, que este recurso es menos utilizado que otras actividades de tratamiento para el control de la diabetes y que el nivel de glucemia en ayuna...

  8. Algunos swaps de tipos de interés

    OpenAIRE

    Fernández, Pablo

    2013-01-01

    Empresa A firmó, el 27 de febrero de 2008, un contrato de crédito de 800.000 euros por el que pagaría a Banco B el tipo euríbor más un 1% anual (véase la Figura 1 del caso). La empresa A invertía en plantas de energía solar fotovoltaica. Con este crédito, Empresa A tiene lo que se denomina "riesgo de tipo de interés", que es incertidumbre en el tipo de interés que pagará. El tipo de interés a pagar será alto (grande) si el euríbor sube, y bajo (pequeño) si el euríbor desciende.

  9. Lesoes organofuncionais do tipo nodulos, polipos e edema de reinke

    National Research Council Canada - National Science Library

    Aparecida Cielo, Carla; Finger, Leila Susana; de Caldas Rosa, Juliana; Brancalioni, Ana Rita

    2011-01-01

    ...: nodulos, polipos vocais e edema de Reinke. Objetivo: realizar um estudo comparativo dos dados descritos na literatura sobre prega vocal normal e afeccoes organofuncionais do tipo nodulos, polipos e edema de Reinke...

  10. Representaciones mentales sobre los tipos de agresion en escolares

    National Research Council Canada - National Science Library

    Fang Alandette, Yuly; Lucia Hoyos, Olga

    2009-01-01

    Este articulo presenta un estudio descriptivo comparativo de corte transversal acerca de las representaciones mentales de los tipos de agresion en una muestra de 60 ninos escolarizados, de 8 a 11 anos de edad...

  11. Adult T-cell leukemia/lymphoma: report of two cases Leucemia/linfoma de células T do adulto: relato de dois casos

    Directory of Open Access Journals (Sweden)

    Ricardo Aparecido Olivo

    2008-06-01

    Full Text Available Adult T-cell leukemia/lymphoma is a lymphoproliferative disorder of mature T lymphocytes associated with infection with human T-cell lymphotrophic virus type I (HTLV-I. Adult T-cell leukemia/lymphoma is characterized by clinical and laboratory polymorphism that allows it to be classified into four distinct subgroups: smoldering, chronic, acute and lymphomatous types. We present here two cases of adult T-cell leukemia/lymphoma, respectively in the acute and lymphomatous forms of the disease. Case 1 was a 35-year-old woman who presented abdominal distension accompanied by hepatosplenomegaly, adenomegaly, skin lesions, positivity for anti-HTLV-I antibodies and leukocytosis with the presence of flower cells. Case 2 was a 38-year-old man who was admitted with generalized lymphadenomegaly, positivity for anti-HTLV-I antibodies, hypercalcemia and osteolytic lesions. In this paper, we correlate the clinical-laboratory findings of these two cases with data in the literature.A leucemia/linfoma de células T do adulto é um distúrbio linfoproliferativo de linfócitos T maduros associado à infecção pelo vírus linfotrópico de células T humanas tipo I (HTLV-I. A leucemia/linfoma de células T do adulto tem polimorfismo clínico e laboratorial, que a classifica em quatro subgrupos distintos entre si: smoldering, crônica, aguda e linfomatosa. Apresentamos neste artigo, dois casos de leucemia/linfoma de células T do adulto, respectivamente, nas formas aguda e linfomatosa da doença. O caso 1: uma paciente de 35 anos apresentava distensão abdominal com hepato-esplenomegalia, adenomegalia, lesões cutâneas, anticorpos anti-HTLV-I positivo e leucocitose com presença de flower cell. O caso 2: homem de 38 anos, internado com linfadenomegalia generalizada, anticorpos anti-HTLV-I positivo, hipercalcemia e lesões osteolíticas. Neste artigo correlacionamos os achados clínicos e laboratoriais destes dois casos com dados da literatura.

  12. Preparación de los adultos mayores en los Estados Unidos para hacer frente a los desastres naturales: encuesta a escala nacional*

    Science.gov (United States)

    Al-rousan, Tala M.; Rubenstein, Linda M.; Wallace, Robert B.

    2015-01-01

    Objetivos. Nos propusimos determinar el grado de preparación frente a los desastres naturales de los adultos mayores en los Estados Unidos y evaluar los factores que pueden afectar negativamente la salud y la seguridad durante este tipo de incidentes. Métodos. Obtuvimos una muestra de adultos de 50 años en adelante (n = 1 304) de la encuesta del 2010 del Estudio de la Salud y la Jubilación (HRS por su sigla en inglés). La encuesta recogió datos sobre las características demográficas generales, el estado de discapacidad o las limitaciones funcionales, y también sobre factores y comportamientos relacionados con la preparación frente a los desastres. Calculamos una puntuación global de preparación mediante indicadores individuales a fin de evaluar el grado de preparación general. Resultados. La media de la edad de los participantes (n = 1 304) fue de 70 años (desviación estándar [DE] = 9,3). Solo 34,3% informaron que habían participado en un programa formativo o que habían leído materiales sobre la preparación para los desastres. Casi 15% indicaron que usaban dispositivos médicos eléctricos que podían correr riesgo de no funcionar si se interrumpiera el suministro eléctrico. La puntuación de preparación indicó que la edad más avanzada, la discapacidad física y el menor nivel de escolaridad y de ingresos se asociaban independiente y significativamente a un grado de preparación general inferior. Conclusiones. A pesar de la mayor vulnerabilidad ante los desastres y del número cada vez mayor de adultos mayores en los Estados Unidos, muchos de los problemas sustanciales que encontramos son remediables y requieren atención en los sectores de la sociedad dedicados a la atención clínica, a la salud pública y al manejo de situaciones de emergencia.

  13. Especificidades de la reacción emocional en adolescentes y adultos jóvenes: un estudio psicofisiológico

    Directory of Open Access Journals (Sweden)

    Perla Veronica Flores Hernández

    2013-01-01

    Full Text Available El paso de una edad a otra depende de múltiples cambios en el desarrollo de procesos cognitivos y neurológicos; en el caso de habilidades afectivas y sociales, se ha demostrado que la adolescencia es una edad crítica para tomar decisiones, auto-monitorearse y realizar análisis social afectivo-emocional. El objetivo del estudio fue comparar la reacción emocional entre adolescentes y adultos jóvenes. El estudio se llevó a cabo en dos muestras, constituidas de un grupo control de adultos jóvenes y un grupo experimental de adolescentes, a los que se les solicitó responder el Manikí de Auto-Evaluación (SAM, en cinco opciones, medidas en escala Likert. Se les solicitó elegir entre tres pares de variables: agradable vs desagradable, activado vs anhedónico y controlado vs en-control. Se midió la reactividad autónoma en derivaciones: frecuencia cardiaca, conductancia de la piel, temperatura y la respuesta muscular abdominal. No se observaron diferencias estadísticamente significativas en la reacción autonómica entre grupos de edad. El análisis del Modelo Lineal General de Respuesta Conductual (GLM mostró diferencias significativas en las respuestas entre los diferentes tipos de estímulos, observadas en la reactividad autónoma y las respuestas asignadas; sin embargo, no se encontraron diferencias significativas. Los datos indican un nivel similar en la reacción de reconocimiento y respuesta autónoma de valencia emocional entre adolescentes y adultos jóvenes. Estos hallazgos pueden indicar la misma reacción de autónoma para ambos grupos estudiados, lo cual conduce a la hipótesis sobre el desarrollo posterior en el procesamiento de afectividad en las estructuras principales nerviosas superiores, pero no en la reacción de dispositivo periférico.

  14. OTROS TIPOS ESPECÍFICOS DE DIABETES MELLITUS

    Directory of Open Access Journals (Sweden)

    DRA. M. Gabriela Sanzana G.

    2016-03-01

    En las “Diabetes Atípicas” (no incluidas en la clasificación ADA, se mencionan la DM tipo 2 en niños y adolescentes, favorecida por el aumento de la obesidad y del sedentarismo; la diabetes propensa a la cetosis, que debutan en cetoacidosis, con etiopatogenia y evolución de DM2; los Latent Autoinmune Diabetes of Adults (LADA, DM tipo 1 de lenta aparición y la diabetes postrasplante.

  15. Teorías de la educación de adultos que subyacen en el uso de videojuegos

    Directory of Open Access Journals (Sweden)

    Laura ALONSO DÍAZ

    2015-01-01

    Full Text Available La sociedad actual crece en edad y en tecnología, requiriendo de investigaciones en las que la educación permanente se convierta en su principal objeto de estudio. En este contexto comienzan a surgir tendencias en las que se promueve el uso de tecnologías lúdicas con objetivos pedagógicos y formativos a través de los videojuegos, pero los esfuerzos se están centrando en una etapa muy concreta de la vida, la infantil y la juvenil, habiendo apenas estudios en la edad adulta. En este artículo presentamos el proceso de validación de un cuestionario que nos permitirá conocer los rasgos propios de las teorías de educación de adultos que subyacen a los videojuegos a los que juegan las personas adultas, concretamente principios andragógicos, heutagógicos, del modelo social del aprendizaje y del modelo de formación basado en competencias. Se realizaron tres tipos de validaciones: de contenido, a través de juicio de expertos; de criterio, a través de entrevistas abiertas; y de constructo, mediante una prueba piloto. En total participaron doce expertos internacionales y 93 personas mayores de 16 años. Finalmente, hemos obtenido una prueba consistente y fiable que se estructura en seis dimensiones y 50 ítems, las dimensiones de la prueba son: datos del jugador, datos del videojuego, tecnológico-descriptiva, personal y contextual, interacción social, y desarrollo de competencias.

  16. Cansancio, cuidados y repercusiones en cuidadores informales de adultos mayores con enfermedades crónico degenerativas

    Directory of Open Access Journals (Sweden)

    María Asunción Vicente Ruiz

    2016-08-01

    Full Text Available Las enfermedades crónicas como diabetes, hipertensión, enfermedad cardiovascular, cáncer, pueden limitar la habilidad de los adultos mayores para ejecutar actividades de la vida diaria, generando cansancio o sobrecarga en los cuidadores. Objetivo: Determinar la relación que existe entre el cansancio, el cuidado y los efectos a la salud del cuidador. Metodología: Estudio cuantitativo y analítico. La muestra se conformó con 123 cuidadores familiares y 123 personas adultas con enfermedad crónico degenerativa. El tipo de muestreo fue no probabilístico. Resultados y Discusión: Se encontró asociación entre el cansancio y las repercusiones del cuidado (r=.438, p<.01, lo que sugiere que mayor cansancio en los cuidadores, mayores serán las repercusiones en la salud. Además correlación de los cuidados que presta el cuidador con las repercusiones en la salud del cuidador (r=.546, p<.01, así a mayor cantidad y complejidad de los cuidados, mayores serán las repercusiones que afecten el bienestar del cuidador. Los cuidados se relacionaron con el cansancio, se afirma que a mayor cantidad y complejidad del cuidado mayor cansancio percibe el cuidador (r=.109, p<.01. Conclusión: El cansancio en los cuidadores es elevado, está asociado a la sobrecarga del cuidado con serias repercusiones en la salud o bienestar y fundamenta las intervenciones interdisciplinarias futuras.

  17. Significado de la calidad de vida del adulto mayor para sí mismo y para su familia

    Directory of Open Access Journals (Sweden)

    Martha Vera

    2007-09-01

    Full Text Available Objetivo: Comprender el significado que la expresión lingüística ‘calidad de vida del adulto mayor’ tiene para el adulto mayor y para su familia. Diseño: Estudio cualitativo, descriptivo, interpretativo - comprensivo, fundamentado en la Teoría de las Representaciones Sociales. Lugar: Asentamiento Humano Laura Caller, en Los Olivos. Participantes: Adultos mayores y sus respectivos grupos familiares. Métodos: Las técnicas e instrumentos utilizados fueron la observación, entrevista a profundidad y grupos focales; guía de observación y dos cuestionarios con ocho preguntas norteadoras, previamente validados. Principales medidas de resultados: Significado de calidad de vida para el adulto mayor y para la familia. Resultados: Participaron dieciséis adultos mayores con sus respectivos grupos familiares, entre 2004 y 2006. Los discursos a través de la ‘objetivación’ y el ‘anclaje’ y los análisis general, ideográfico-axial y nomotético-selectivo permitieron la emergencia de cuatro representaciones sociales: a conocimiento sobre la vejez y ser un adulto mayor; b elementos principales y secundarios del significado de calidad de vida del adulto mayor; c valores y actitudes del adulto mayor y familia sobre la calidad de vida; y, d necesidades del adulto mayor como ser social y la calidad de vida. Conclusiones: Para el adulto mayor, calidad de vida significa tener paz y tranquilidad, ser cuidado y protegido por la familia con dignidad, amor y respeto, y tener satisfechas como ser social sus necesidades de libre expresión, decisión, comunicación e información. Para la familia, que el adulto mayor satisfaga sus necesidades de alimentación, vestido, higiene y vivienda.

  18. Atratividade e preferência para oviposição de Trialeurodes vaporariorum em genótipos de aboboreira Attractiveness and oviposition preference of Trialeurodes vaporariorum in squash genotypes

    Directory of Open Access Journals (Sweden)

    André C Alves

    2006-12-01

    Full Text Available O comportamento de 13 genótipos de aboboreira foi avaliado em relação à atratividade para adultos e à preferência para oviposição da mosca-branca Trialeurodes vaporariorum (West. (Hemiptera: Aleyrodidae em testes com e sem chance de escolha, em campo e em casa de vegetação. Os experimentos foram conduzidos com plantas de aboboreira em fase vegetativa, infestadas naturalmente no campo (atratividade para adultos e oviposição com chance de escolha e artificialmente em casa de vegetação (oviposição sem chance de escolha. Dentre as aboboreiras tipo moita, o híbrido Arlika apresentou a menor atratividade para adultos e, entre os genótipos de crescimento rasteiro, não houve diferença em relação à atratividade. Quanto à preferência para oviposição em teste de livre escolha, 'Arlika', no grupo de moita, e 'Atlas', 'Sandy', 'Bárbara', 'Baianinha' e 'Caravela', no grupo das rasteiras, apresentaram os menores índices de oviposição, que se confirmaram no teste sem chance de escolha, indicando que a menor preferência para oviposição de T. vaporariorum nesses genótipos é estável.Thirteen squash genotypes were evaluated in relation to attractiveness and oviposition preference of Trialeurodes vaporariorum (West. (Hemiptera: Aleyrodidae under field and greenhouse conditions. In the field, two experiments were carried out, one being with bush squash and the other with summer squash genotypes. Plant infestation occurs naturally after seedling transplanting. By counting adults on the abaxial surfaces of the leaves, in the bush squash experiment, the hybrid 'Arlika' showed the lowest attractiveness; in the summer squash experiment, no difference was observed among genotypes. Regarding eggs counting, 'Arlika' (bush squash experiment, 'Atlas', 'Sandy', 'Barbara', 'Baianinha' and 'Caravela' (summer squash experiment presented nonpreference for oviposition. Oviposition was also evaluated in two no-choice experiments, with artificial

  19. Fibrilación atrial en los adultos mayores

    Directory of Open Access Journals (Sweden)

    Jorge Brizuela-Torres

    2009-09-01

    Full Text Available La fibrilación atrial es la taquiarritmia más prevalente en los adultos mayores. La frecuencia de dicha arritmia aumenta con la edad, presentándose en un 1.5% de los 50 a 59 años a 10% de los 80 a 89 años. La fibrilación atrial no valvular incrementa el riesgo de sufrir un evento cerebrovascular isquémico cardioembólico en 5 veces y causa el 15% de todos los accidentes cerebrovasculares isquémicos en Estados Unidos de América. El manejo de la fibrilación atrial se enfoca, principalmente, en la prevención de los fenómenos tromboembólicos y en el control de la frecuencia y ritmo cardiaco. La anticoagulación, cuando está indicada, ha demostrado ser la principal herramienta en la prevención de dichos eventos. Sin embargo, aunque las complicaciones hemorrágicas son más frecuentes, en esta población, y aumentan con la edad, sobrepasa por mucho, el beneficio al riesgo. El control de la frecuencia cardiaca ha demostrado ser igual o mejor que el control del ritmo en cuanto a prevención de eventos cerebrovasculares y mortalidad en estos pacientes. La edad cronológica por sí sola, no es contraindicación alguna para ofrecer una terapia óptima. Debe tomarse en cuenta el estado funcional, cognitivo y social, así como aspectos fisiológicos del envejecimiento con respecto a la prescripción de medicamentos. Cuando, a pesar del tratamiento adecuado, la sintomatología persiste, las estrategias invasivas han demostrado ser beneficiosas, pero faltan estudios que involucren a individuos mayores.

  20. Optimizando la funcionalidad del adulto mayor a través de una estrategia de autocuidado Otimizando a funcionalidade do adulto maior através duma estratégia de autocuidado Optimizing older adults' functionality through a self-care strategy

    Directory of Open Access Journals (Sweden)

    Marcela Isabel del Pilar Sanhueza Parra

    2012-01-01

    Full Text Available Objetivo: evaluar el efecto de un programa de autocuidado en la funcionalidad de adultos mayores, pertenecientes a un Centro de Salud Familiar del sur de Chile. Metodología: estudio de tipo experimental puro que intervino un grupo de adultos mayores entre 65 y 79 años, durante julio y agosto de 2002, en la que se midió la funcionalidad de acuerdo con las necesidades funcionales básicas, funciones mentales y autopercepción de salud. Resultados: fuerte asociación entre la participación en el programa de autocuidado y ausencia de dependencia para necesidades funcionales básicas valor p=0,0001; funciones mentales intactas valor p= 0,01 y buena autopercepción de salud valor p=0,0002. Discusión: los resultados se correlacionan con los obtenidos por Domínguez O, Albala C y cols., Mella R; Gordillo Y; y Lara R, Mardones M (1, 2, 3, 4, 5 quienes describen altos porcentajes de adultos mayores funcionalmente independientes, difriendo con Sequeira D; y Muñoz, M. y cols. (6, 7, quienes presentan altos porcentajes de dependencia. Las funciones cognitivas se evalúan como normales al igual que el estudio de Lara R y Mardones M (5. La autopercepción de salud inicial al igual que para Albala C y cols., y la réplica del estudio realizada por Gordillo Y (1, 4, es evaluada como regular. Conclusión: el programa de autocuidado constituiría un entorno estimulante declarado por Lehr y Orem, necesario para mantener o corregir el declive funcional natural del adulto mayor (8, 9, favoreciendo su independencia en necesidades básicas de la vida diaria, mejorando sus funciones mentales y autopercepción de salud.Objetivo: avaliar o efeito de um programa de autocuidado na funcionalidade de adultos maiores, pertencentes a um Centro de Saúde Familiar do sul de Chile. Metodologia: estudo de tipo experimental puro que en-volveu a participação de um grupo de adultos maiores entre 65 e 79 anos, durante julho e agosto de 2002, no intuito de medir a funcionalidade