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Sample records for intragasseriano para neuralgia

  1. Neuralgia

    Science.gov (United States)

    ... Prevention Strict control of blood sugar may prevent nerve damage in people with diabetes. In the case of shingles, antiviral drugs and the herpes zoster virus vaccine may prevent neuralgia. Alternative Names Nerve pain; Painful neuropathy; Neuropathic pain Images Central nervous ...

  2. Glossopharyngeal Neuralgia

    Science.gov (United States)

    ... the mouth. GN can be caused by compression of the glossopharyngeal nerve, but in some cases, no cause is evident. Like trigeminal neuralgia, it is associated with multiple sclerosis. GN primarily affects the elderly. × Definition Glossopharyngeal neuralgia (GN) is a rare pain syndrome ...

  3. Modeling and commissioner of a set of cones brain lab for trigeminal neuralgia; Modelado y comisionado de un sistema de conos brainlab para la neuralgia de trigemino

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2013-07-01

    Radiosurgery is an effective treatment for trigeminal neuralgia. The use of LINAC with cone system is an alternative front other procedures. As the fields to measure are very small we prefer not to use camera type pinpoint due to lack of lateral balance and the use of diodes implies fixes to correct the over-estimation of his reading. (Author)

  4. Postherpetic Neuralgia

    Science.gov (United States)

    ... Postherpetic neuralgia Symptoms & causes Diagnosis & treatment Doctors & departments Advertisement Mayo Clinic does not endorse companies or products. ... a Job Site Map About This Site Twitter Facebook Google YouTube Pinterest Mayo Clinic is a not- ...

  5. Trigeminal Neuralgia

    Science.gov (United States)

    ... such as touching the face, chewing, speaking or brushing teeth Bouts of pain lasting from a few seconds ... neuralgia, including: Shaving Touching your face Eating Drinking Brushing your teeth Talking Putting on makeup Encountering a breeze Smiling ...

  6. Trigeminal neuralgia

    DEFF Research Database (Denmark)

    Maarbjerg, Stine; Di Stefano, Giulia; Bendtsen, Lars

    2017-01-01

    Introduction Trigeminal neuralgia (TN) is characterized by touch-evoked unilateral brief shock-like paroxysmal pain in one or more divisions of the trigeminal nerve. In addition to the paroxysmal pain, some patients also have continuous pain. TN is divided into classical TN (CTN) and secondary TN...

  7. Infratrochlear neuralgia.

    Science.gov (United States)

    Pareja, Juan A; Casanova, Ignacio; Arbex, Andrea; Cuadrado, María L

    2015-11-01

    The infratrochlear nerve supplies the medial aspect of the upper eyelid, the superolateral aspect of the nose and the lacrimal caruncle. This nerve may contribute to the pain stemming from the trochlea, but infratrochlear neuralgia has not been identified as a specific cause of pain. Over a 10-year period we have been recruiting patients with pain in the internal angle of the orbit that did not show features of trochlear pain. Seven patients (six female, one male; mean age, 46.1 ± 18.9) presented with pain in the territory of the infratrochlear nerve. The pain appeared in the internal angle of the orbit and upper eyelid (n = 3), the superolateral aspect of the nose (n = 3), or the lacrimal caruncle (n = 1). All patients had a paroxysmal pain, with the attacks lasting five to 30 seconds. Pain attacks were mostly spontaneous, but two patients had triggers. Between attacks, all patients had local allodynia. Pain did not increase with vertical eye movements. Six patients were treated with gabapentin with complete response, and one patient experienced long-lasting relief with an anesthetic blockade of the infratrochlear nerve. Infratrochlear neuralgia should be considered as a possible cause of pain in the internal angle of the orbit. © International Headache Society 2015.

  8. Triggering trigeminal neuralgia

    DEFF Research Database (Denmark)

    Di Stefano, Giulia; Maarbjerg, Stine; Nurmikko, Turo

    2018-01-01

    Introduction Although it is widely accepted that facial pain paroxysms triggered by innocuous stimuli constitute a hallmark sign of trigeminal neuralgia, very few studies to date have systematically investigated the role of the triggers involved. In the recently published diagnostic classification...

  9. Management of pudendal neuralgia.

    Science.gov (United States)

    Pérez-López, F R; Hita-Contreras, F

    2014-12-01

    Pelvic pain is a frequent complaint in women during both reproductive and post-reproductive years. Vulvodynia includes different manifestations of chronic vulvar pain with no known cause. Many women do not receive a diagnosis and appropriate treatment. Pudendal neuralgia is a painful condition caused by inflammation, compression or entrapment of the pudendal nerve; it may be related to or be secondary to childbirth, pelvic surgery, intense cycling, sacroiliac skeletal abnormalities or age-related changes. Clinical characteristics include pelvic pain with sitting which increases throughout the day and decreases with standing or lying down, sexual dysfunction and difficult with urination and/or defecation. To confirm pudendal neuralgia, the Nantes criteria are recommended. Treatment includes behavioral modifications, physiotherapy, analgesics and nerve block, surgical pudendal nerve decompression, radiofrequency and spinal cord stimulation.

  10. IMAGING EVALUATION OF TRIGEMINAL NEURALGIA

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    Marinos KONTZIALIS

    2017-12-01

    Full Text Available Trigeminal neuralgia is a debilitating pain syndrome in the sensory distribution of the trigeminal nerve. Compression of the cisternal segment of the trigeminal nerve by a vessel, usually an artery, is considered the most common cause of trigeminal neuralgia. A number of additional lesions may affect the trigeminal nerve anywhere along its course from the trigeminal nuclei to the most peripheral branches to cause facial pain. Relevant differential considerations are reviewed starting proximally at the level of the brainstem.

  11. MRI EVALUATION OF TRIGEMINAL NEURALGIA

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    Sama Surya Sravani

    2017-04-01

    Full Text Available BACKGROUND Neuralgia is the set of symptoms associated with nerve dysfunction. The most common of these symptoms is pain, which can occur intermittently in one area of the body or can radiate along the length of a damaged nerve. The most common type of neuralgia is trigeminal neuralgia. This study focuses on the effectiveness of MRI in visualising the entire course of trigeminal nerve and to diagnose the exact location, aetiology responsible for trigeminal neuralgia and possible pretreatment evaluation. MATERIALS AND METHODS Clinical records and imaging studies of 30 patients between the ages of 18-60 years who presented to the Department of Radiodiagnosis, KIMS, for brain magnetic resonance imaging with (Philips 1.5T machine during June 2015 to December 2016 were analysed retrospectively. RESULTS  The entire course of trigeminal nerve is evaluated in these patients.  There are different causes of trigeminal neuralgia, but in our study, most frequent cause is mechanical irritation of nerve is due to neurovascular contact (24 cases. The other causes identified are cerebellopontine angle lesions, brainstem tumours, demyelinating disease involving brainstem.  The cisternal portion of the nerve is the most common site of involvement. CONCLUSION Trigeminal nerve is the largest cranial nerve. MRI is unique as it produces images of entire course of the nerve. Of the many causes of trigeminal neuralgia, neurovascular conflict is the most common cause. The exact location and degree of neurovascular compression is graded on MRI.

  12. Lacrimal neuralgia: so far, a missing cranial neuralgia.

    Science.gov (United States)

    Pareja, Juan A; Cuadrado, María-Luz

    2013-10-01

    The lacrimal nerve supplies the lacrimal gland, the lateral upper eyelid, and a small cutaneous area adjacent to the external CANTHUS . First division trigeminal neuralgia, supraorbital/supratrochlear neuralgia, and infraorbital neuralgia have been acknowledged as neuralgic causes of pain in the forehead and periorbit. However, the lacrimal nerve has never been identified as a source of facial pain. Here we report two cases of lacrimal neuralgia. A 66-year-old woman had continuous pain in the lateral aspect of her left superior eyelid and an adjacent area of the temple since age 64. A 33-year-old woman suffered from continuous pain in a small area next to the lateral CANTHUS of her left eye since age 25. In both patients the superoexternal edge of the orbit was tender. In addition, sensory dysfunction could be demonstrated within the painful area. Anaesthetic blockades of the lacrimal nerve with lidocaine 2% resulted in complete but short-lasting relief. Pregabalin provided a complete response in the first patient. The second patient was refractory to various oral and topical drugs and different radiofrequency procedures, but she eventually obtained partial relief with pregabalin. Lacrimal neuralgia should be considered among the neuralgic causes of orbital and periorbital pain.

  13. Post-scurfy sciatic neuralgia: case report

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    Evaristo Febles Piñar

    2012-05-01

    Full Text Available Introduction: Post scurfy neuralgia is a frequent cause of chronic intractable pain and constitutes the most feared complication of Herpetic Neuralgia. It can last for many years leading the patient to despair, depression, social isolation, and suicidal ideas. Ojectives: To present the clinical course of an elderly patient with post herpetic sciatic neuralgia treated at the Pain Clinic of Ameijeiras Brothers Hospital in January of 2011. Conclusions: Success in treating post scurfy neuralgia is related to early detection and intervention.

  14. Accommodation to Diagnosis of Trigeminal Neuralgia

    OpenAIRE

    Bašić Kes, Vanja; Zadro Matovina, Lucija

    2017-01-01

    Trigeminal neuralgia is one of the most common causes of facial pain. It implies short lasting episodes of unilateral electric shock-like pain with abrupt onset and termination, in the distribution of one or more divisions of the trigeminal nerve that are triggered by innocuous stimuli. Most cases of trigeminal neuralgia are caused by compression of the trigeminal nerve root. Depending on the etiology, trigeminal neuralgia can be classified as classic trigeminal neuralgia or painful trigemina...

  15. Accommodation to Diagnosis of Trigeminal Neuralgia

    Science.gov (United States)

    Bašić Kes, Vanja; Zadro Matovina, Lucija

    2017-03-01

    Trigeminal neuralgia is one of the most common causes of facial pain. It implies short lasting episodes of unilateral electric shock-like pain with abrupt onset and termination, in the distribution of one or more divisions of the trigeminal nerve that are triggered by innocuous stimuli. Most cases of trigeminal neuralgia are caused by compression of the trigeminal nerve root. Depending on the etiology, trigeminal neuralgia can be classified as classic trigeminal neuralgia or painful trigeminal neuropathy. It may be precipitated by some actions at trigger zones. The diagnosis of trigeminal neuralgia is based on diagnostic criteria for classic trigeminal neuralgia, neuroimaging and electrophysiologic trigeminal reflex testing. Treatment of classic trigeminal neuralgia for most patients is pharmacological therapy, while surgical approach is reserved for patients that are refractory to medical therapy and in cases of painful trigeminal neuropathy.

  16. Historical characterization of trigeminal neuralgia.

    Science.gov (United States)

    Eboli, Paula; Stone, James L; Aydin, Sabri; Slavin, Konstantin V

    2009-06-01

    TRIGEMINAL NEURALGIA IS a well known clinical entity characterized by agonizing, paroxysmal, and lancinating facial pain, often triggered by movements of the mouth or eating. Historical reviews of facial pain have attempted to describe this severe pain over the past 2.5 millennia. The ancient Greek physicians Hippocrates, Aretaeus, and Galen, described kephalalgias, but their accounts were vague and did not clearly correspond with what we now term trigeminal neuralgia. The first adequate description of trigeminal neuralgia was given in 1671, followed by a fuller description by physician John Locke in 1677. André described the convulsive-like condition in 1756, and named it tic douloureux; in 1773, Fothergill described it as "a painful affection of the face;" and in 1779, John Hunter more clearly characterized the entity as a form of "nervous disorder" with reference to pain of the teeth, gums, or tongue where the disease "does not reside." One hundred fifty years later, the neurological surgeon Walter Dandy equated neurovascular compression of the trigeminal nerve with trigeminal neuralgia.

  17. Stereotactic Radiosurgery for Classical Trigeminal Neuralgia

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    Henry Kodrat

    2016-04-01

    Full Text Available Trigeminal neuralgia is a debilitating pain syndrome with a distinct symptom mainly excruciating facial pain that tends to come and go unpredictably in sudden shock-like attacks. Medical management remains the primary treatment for classical trigeminal neuralgia. When medical therapy failed, surgery with microvascular decompression can be performed. Radiosurgery can be offered for classical trigeminal neuralgia patients who are not surgical candidate or surgery refusal and they should not in acute pain condition. Radiosurgery is widely used because of good therapeutic result and low complication rate. Weakness of this technique is a latency period, which is time required for pain relief. It usually ranges from 1 to 2 months. This review enlightens the important role of radiosurgery in the treatment of classical trigeminal neuralgia.

  18. Atypical Trigeminal Neuralgia Secondary to Meningioma

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    Premeshwar Niwant

    2015-01-01

    Full Text Available Trigeminal neuralgia is a disorder of the fifth cranial nerve that causes episodes of intense, stabbing, electric shock-like pain that lasts from few seconds to few minutes in the areas of the face where the branches of the nerve are distributed. More than one nerve branch can be affected by the disorder. We report an unusual case of trigeminal neuralgia affecting right side of face presenting atypical features of neuralgia and not responding to the usual course of treatment. The magnetic resonance imaging study of brain revealed a large extra-axial mass involving right cerebellopontine angle region causing moderate pressure effect on trigeminal nerve and brain stem. The aim of this case report is to show a tumor of cerebellopontine angle, presenting clinically as atypical trigeminal neuralgia.

  19. Treatment of trigeminal neuralgia with low doses of topiramate Tratamento da neuralgia do trigêmeo com baixas doses de topiramato

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    Renan Barros Domingues

    2007-09-01

    Full Text Available Topiramate was administered to eight patients with classical trigeminal neuralgia with or without previous symptomatic therapy with other antiepileptic drugs. The topiramate doses ranged from 50 to 100 mg a day, according to the clinical response and the reported side effects. Three patients had complete symptoms remission, three reported moderate improvement, and the treatment was not effective in two. The most frequently registered side effects were dizziness, somnolence and weight loss. Topiramate can be considered an alternative treatment for patients with trigeminal neuralgia.Oito pacientes com neuralgia do trigêmeo, com ou sem tratamentos prévios com anticonvulsivantes, foram submetidos a tratamento com topiramato. As doses de topiramato variaram de 50 a 100 mg ao dia, de acordo com a resposta clínica e com os efeitos colaterais relatados. Três pacientes obtiveram remissão completa, três relataram melhora parcial e o tratamento com topiramato foi ineficaz em dois pacientes. Os efeitos colaterais mais frequentemente citados foram tontura, sonolência e perda de peso. O topiramato pode ser considerado uma alternativa potencialmente eficaz para o tratamento de pacientes com neuralgia do trigêmeo.

  20. Neuralgia do trigêmeo bilateral: relato de caso Neuralgia del trigémino bilateral: relato de caso Bilateral trigeminal neuralgia: case report

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    Caio Marcio Barros de Oliveira

    2009-08-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: A neuralgia do nervo trigêmeo é uma condição intensamente dolorosa, caracterizada por surtos de dor lancinante e súbita, tipo choque, com duração de poucos segundos a dois minutos e geralmente unilateral. Sua incidência anual é de cerca de 4,3 em 100.000 na população geral, tendo manifestação bilateral em apenas 3% desses casos. O objetivo deste artigo foi descrever um caso raro de neuralgia do trigêmeo primário bilateral. RELATO DO CASO: Paciente de 61 anos, maranhense, casada, do lar, com antecedente de hipertensão arterial e há seis anos com queixa de dor intensa em V2-V3 à esquerda, com duração de 5 a 10 segundos, em região lateral do nariz e mandibular, com piora ao falar, mastigar e com diminuição da temperatura. Já havia utilizado clorpromazina (3 mg a cada oito horas e carbamazepina (200 mg a cada oito horas durante seis meses sem alívio da dor. Ao exame físico apresentava alodinia térmica e mecânica em regiões de V2-V3. Estava em uso de gabapentina (1.200 mg ao dia com alívio parcial da dor. Foi então aumentada a gabapentina para 1500 mg ao dia e introduzida amitriptilina 12,5 mg à noite. Evoluiu com dor leve e esporádica com diminuição da intensidade da dor ao longo de 10 meses de tratamento, sendo reduzida progressivamente a gabapentina para 600 mg ao dia e mantida a amitriptilina 12,5 mg ao dia. Após um ano, começou a apresentar dor de característica semelhante em região mandibular à direita, tendo melhorado com aumento de gabapentina para 900 mg ao dia. Não apresentava exames alterados de tomografia ou ressonância magnética de encéfalo. CONCLUSÕES: A carbamazepina é o fármaco de primeira escolha para tratamento de neuralgia trigeminal, porém a gabapentina tem sido cada vez mais utilizada como primeira medida farmacológica ou em casos refratários à terapia convencional.JUSTIFICATIVA Y OBJETIVOS: La neuralgia del nervio trigémino es una condici

  1. Comparison of Trigeminal and Postherpetic Neuralgia

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    C Peter N Watson

    1996-01-01

    Full Text Available Although postherpetic neuralgia and trigeminal neuralgia (tic douloureux are common causes of facial pain, they have very little in common aside from lancinating pain (other qualities of pain in each disorder are different. Each disorder affects different areas of the face and the treatment of each is quite dissimilar. The pathogenesis of these two disorders quite likely involves different mechanisms. This report reviews aspects of these two difficult pain problems, particularly with reference to the work of the late Gerhard Fromm, to whom this is dedicated.

  2. Management of Trigeminal Neuralgia using Amitriptyline and ...

    African Journals Online (AJOL)

    Trigeminal neuralgia (TN) is a clinical condition presenting with severe, paroxysmal facial pain, often described by patients also known as tic douloureux. Carbamazepine (CBZ) is the drug of choice, but some patients develop adverse effects and some others may become unresponsive to CBZ. We present three cases of TN ...

  3. Treatment of trigeminal neuralgia with radiosurgery

    International Nuclear Information System (INIS)

    Latorzeff, I.; Redon, A.; Debono, B.; Sol, J.C.; Menegalli, D.; Mertens, P.; Muracciole, X.

    2012-01-01

    Idiopathic trigeminal neuralgia is defined as brief paroxysms of pain limited to the facial distribution of the trigeminal nerve. Drug therapy is considered to be the first-line of treatment for trigeminal neuralgia. Unfortunately, medical treatment does not always provide satisfactory pain relief for 25% of the patients. Moreover, the relief provided by drug therapy generally decreases over time, and increased dosages of these medications are limited because of side effects. In this case, patients can be offered several surgical approaches, such as percutaneous techniques (thermo-coagulation, micro-compression, glycerol injection) or microvascular decompression in the cerebello-pontine angle (Gardner-Jannetta's technique). In this indication, stereotactic radiosurgery, driven by teams using Gamma Knife R , has shown promising efficacy and tolerance to allow this treatment being truly part of trigeminal neuralgia treatment. Technological progresses now allow performing radiosurgery with ballistic and dosimetric processes optimized with stereotactic radiosurgery dedicated linear accelerators. This procedure supports frame implantation to guarantee targeting accuracy in accordance of elevated dose distribution. This article on trigeminal neuralgia treatment will review the different medical and surgical therapeutic options and specify the contemporary place of stereotactic radiosurgery in the light of its clinical results and tolerance aspects. (authors)

  4. Management of trigeminal neuralgia by radiofrequency ...

    African Journals Online (AJOL)

    Wael Fouad

    2011-06-24

    Jun 24, 2011 ... Abstract Introduction: The trigeminal neuralgia (TN) which is resistant to medical treatment has been benefited from many surgical techniques. Opinions differ regarding the best surgical treatment. Objective: This study was done to evaluate the functional results of percutaneous radiofre-.

  5. Microvascular decompression for trigeminal neuralgia

    International Nuclear Information System (INIS)

    Khan, S.A.; Khan, B.; Khan, A.A.; Afridi, E.A.A.; Mehmood, S.; Muhammad, G.; Hussain, I.; Zadran, K.K.; Bhatti, S.N.

    2015-01-01

    Background: Trigeminal Neuralgia (TGN) is the most frequently diagnosed type of facial pain. In idiopathic type of TGN it is caused by the neuro-vascular conflict involving trigeminal nerve. Microvascular decompression (MVD) aims at addressing this basic pathology in the idiopathic type of TGN. This study was conducted to determine the outcome and complications of patients with idiopathic TGN undergoing MVD. Method: In a descriptive case series patients with idiopathic TGN undergoing MVD were included in consecutive manner. Patients were diagnosed on the basis of detailed history and clinical examination. Retromastoid approach with craniectomy was used to access cerebellopontine angle (CP-angle) and microsurgical decompression was done. Patients were followed up for 6 months. Results: A total of 53 patients underwent MVD with mean age of 51.6±4.2 years and male predominance. In majority of cases (58.4 percentage) both Maxillary and Mandibular divisions were involved. Per-operatively superior cerebellar artery (SCA) was causing the neuro-vascular conflict in 33 (62.2 percentage) of the cases, anterior inferior cerebellar artery (AICA) in 6 (11.3 percentage) cases, both CSA and AICA in 3 (5.6 percentage) cases, venous compressions in only 1 (1.8percentage) patient and thick arachnoid adhesions were seen in 10 (18.9 percentage) patients. Postoperatively, 33 (68 percentage) patients were pain free, in 14 (26.45 percentage) patients pain was significantly improved whereas in 3 (5.6 percentage) patients there was mild improvement in symptoms. Three (5.6 percentage) patients did not improve after the primary surgery. Cerebrospinal fluid (CSF) leak was encountered in 7 (13.2 percentage) patients post-operatively, 4 (7.5 percentage) patients developed wound infection and 1 (1.8 percentage) patient developed aseptic meningitis. Three (5.6 percentage) patients had transient VII nerve palsy while one patient developed permanent VII nerve palsy. Conclusion: MVD is a safe and

  6. Gamma knife treatment of trigeminal neuralgia

    International Nuclear Information System (INIS)

    Hirai, Tatsuo; Yoshida, Mamoru; Watanabe, Shinichi; Takihana, Toshiki; Shouzuhara, Hidetaka; Yamamoto, Yoshisuke

    2003-01-01

    Effectiveness and limitations of Gamma Knife treatment for various kinds of trigeminal neuralgia (typical, atypical and mixed types) were analyzed from the data of 54 cases treated over the past 4 years. The mean patient age was 74 years (range 50 to 101 years). Forty five patients with typical trigeminal neuralgia, four patients with atypical facial pain and five patients with mixed type trigeminal neuralgia were evaluated. Isodose distribution determined with a 4 mm collimator was centered on the root entry zone of the trigeminal nerve in 35 cases and centered on the retro-Gasserian trigeminal nerve in 19 cases. The maximum dose range used was 70 to 80 Gy. Median follow-up after radiosurgery was 21.4 months (range 3 to 54 months). Typical trigeminal neuralgia treated at the root entry zone became pain free without medication in 53.6% (15/28), 78.6% (22/28) and 78.6% (22/28) of the patients after 3, 6 and 12 months, respectively, while, that treated at the retro-Gasserian nerve became pain free in 29.4% (5/17), 53.8% (7/13) and 70.0% (7/10) of the patients after 3, 6 and 8 months. No matter whether the target was the root entry zone or the retro-Gasserian nerve, 70 to 78% of patients became pain free without medication when examined at 8 to 12 months after radiosurgery. Facial hypesthesia including localized slight hypesthesia occurred in 13 to 20% of the patients at 12 to 24 months after radiosurgery, but no patients developed any other new neurological deficits or systemic complications. Patients with atypical trigeminal neuralgia did not respond well to this treatment. Further study is required to determine the optimal target and dose. Because of its noninvasive nature, radiosurgery is an attractive option for treatment of typical and mixed typed trigeminal pain, particularly in elderly patients and patients not amenable to the various surgical methods available for treatment of trigeminal neuralgia. (author)

  7. Delayed Mental Nerve Neuralgia following Chin Augmentation

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    Ineke Wever

    2013-01-01

    Full Text Available This paper describes a case of mental nerve neuralgia following a traumatic dislodgement of a chin implant ten months after surgery. Our case is unusual, both in the specific complication and the patients' atypical representation—delayed and initially without mention of trauma. To the authors' knowledge, this case has not been reported previously in the literature. We review the complications of chin augmentation and the techniques for fixation and discuss implications for the preoperative disclosure with patients.

  8. Psychological assessment of a case of trigeminal neuralgia | Osawe ...

    African Journals Online (AJOL)

    Objective: Recent report links trigeminal neuralgia as a trigger for psychiatric crisis. This article reports the findings from psychological assessment of a case of trigeminal neuralgia, to highlight the associated psychological problems of this condition. Method: A 58 years old male trader, who presented with one year history of ...

  9. Occipital Neuralgia With Atypic Symptoms: A Case Report

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    Gökçen Gözübatık-çelik

    2014-12-01

    Full Text Available Cranial neuralgia is a rare form of headache disorders characterized with transient and unilateral attacks. Inflamatuar diseases and cervical compression are amongst the most common etiological factors even so idiopathic forms might be observed. International Classification of Headache Disorders (ICHD-2made the classification of cranial neuralgias in 18 different groups. Occipital neuralgia, being a subgroup of cranial neuralgies, is a headache that involves anatomically at major, minor or third occipital nerve areas sometimes accompanying with sensory deficits or dysesthesia. Occipital neuralgia includes aching burning or throbbing headache that is often unilateral and continuous with intermittent shocking and shooting pain on the occipital nerve area. Patients with occipital neuralgia can be divided into those with structural causes and those with idiopathic causes. Structural lesions are cervical disc diseases, trauma, compression of the cervical discs. Tumors rarely metastasize to the paravertebral region and compression of the cervical nerve roots may result in occipital neuralgia. Our aim is to present a case with late onset medical refractory occipital neuralgia due to metastatic prostate cancer, emphasizing that relevant medical history should alert clinicans to the possibility of metastasis causing occipital neuralgia.

  10. Tratamento famacológico da neuralgia do trigêmeo: revisão sistemática e metanálise Tratamiento famacológico de la neuralgia del trigémino: revisión sistemática y metanálisis Pharmacological treatment of trigeminal neuralgia: systematic review and metanalysis

    Directory of Open Access Journals (Sweden)

    Túlio César Azevedo Alves

    2004-12-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: A neuralgia do trigêmeo é uma síndrome de dor crônica, caracterizada por paroxismos de dor excruciante que afeta de maneira dramática a qualidade de vida dos pacientes acometidos. A terapia medicamentosa sistêmica é considerada o tratamento de primeira linha para esta doença. Este estudo teve como objetivo avaliar a eficácia, a segurança e a tolerabilidade dos diversos tratamentos farmacológicos oferecidos aos pacientes com neuralgia do trigêmeo, visando fornecer evidências para as recomendações da prática clínica e identificar as necessidades de pesquisas adicionais. MÉTODO: Foram analisados ensaios clínicos aleatórios e controlados, publicados até julho de 2003, sobre o efeito analgésico das drogas prescritas no tratamento da neuralgia do trigêmeo. A análise estatística foi realizada com o auxilio do programa Review Manager 4.2.2 (Colaboração Cochrane, 2003. RESULTADOS: Os resultados da metanálise sugerem que a carbamazepina é mais eficaz que o placebo. Em três estudos controlados comparando a lamotrigina, o topiramato e o cloridrato de proparacaína ao placebo, somente a lamotrigina mostrou-se superior a ele. O dextrometafano foi comparado ao lorazepam em baixas doses, havendo aumento da dor com o uso daquele fármaco. Três estudos compararam a carbamazepina com a tizanidina, a tocainida e a pimozida, mostrando-se apenas a pimozida superior à carbamazepina. CONCLUSÕES: A carbamazepina continua como droga de escolha para o tratamento da neuralgia do trigêmeo, estando a lamotrigina e a pimozida indicadas em casos refratários à terapia convencional. Além disso, estudos adicionais são necessários para o estabelecimento de futuras opções terapêuticas.JUSTIFICATIVA Y OBJETIVOS: La neuralgia del trigémino es una síndrome de dolor crónico, caracterizada por paroxismos de dolor excruciante que afecta de manera dramática la calidad de vida de los pacientes acometidos. La terapia

  11. Postherpetic neuralgia: epidemiology, pathophysiology, and pain management pharmacology

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    Mallick-Searle T

    2016-09-01

    Full Text Available Theresa Mallick-Searle,1 Brett Snodgrass,2 Jeannine M Brant,3 1Pain Management Center, Stanford Health Care, Redwood City, CA, 2LifeLinc Pain Centers, Cordova, TN, 3Billings Clinic, Billings, MT, USA Abstract: Herpes zoster, also known as shingles, is a distinctive clinical condition caused by the reactivation of latent varicella zoster (chickenpox virus following an initial infection. Approximately 1 million cases of herpes zoster occur annually in the US, and one in every three people develops herpes zoster during their lifetime. Postherpetic neuralgia is a neuropathic pain syndrome characterized by pain that persists for months to years after resolution of the herpes zoster rash. It stems from damage to peripheral and central neurons that may be a byproduct of the immune/inflammatory response accompanying varicella zoster virus reactivation. Patients with postherpetic neuralgia report decreased quality of life and interference with activities of daily living. Approaches to management of postherpetic neuralgia include preventing herpes zoster through vaccination and/or antiviral treatment, and administering specific medications to treat pain. Current guidelines recommend treatment of postherpetic neuralgia in a hierarchical manner, with calcium channel α2-δ ligands (gabapentin and pregabalin, tricyclic antidepressants (amitriptyline, nortriptyline, or desipramine, or topical lidocaine patches as first-line drugs. The safety and tolerability of pharmacologic therapies for pain are important issues to consider as postherpetic neuralgia affects primarily an older population. Patients should be educated on appropriate dosing, titration if applicable, the importance of adherence to treatment for optimal effectiveness, and possible side effects. Health-care professionals play a key role in helping to ameliorate the pain caused by postherpetic neuralgia through early recognition and diligent assessment of the problem; recommending evidence

  12. Atypic geniculate neuralgia: atypic anatomic correlation of cranial nerve roots and AICA.

    Science.gov (United States)

    Ozer, Füsun Demirçivi; Duransoy, Yusuf Kurtuluş; Camlar, Mahmut

    2009-08-01

    Geniculate neuralgia is a rare cause of craniofacial pains. The anterior inferior cerebellar artery is the offending vessel which compress nervus intermedius in the patients with typical geniculate neuralgia. We report a patient whose pain was atypical for either geniculate neuralgia and trigeminal neuralgia. At operation the anterior inferior cerebellar artery was coursing with the nerves and was separated. After the decompression the pain resolved immediately.

  13. Treatment of refractory idiopathic supraorbital neuralgia using percutaneous pulsed radiofrequency.

    Science.gov (United States)

    Luo, Fang; Lu, Jingjing; Ji, Nan

    2018-02-26

    No ideal therapeutic method currently exists for refractory idiopathic supraorbital neuralgia patients who don't respond to conservative therapy, including medications and nerve blocks. Pulsed radiofrequency is a neuromodulation technique that does not produce sequelae of nerve damage after treatment. However, the efficacy of percutaneous pulsed radiofrequency for the treatment of refractory idiopathic supraorbital neuralgia is still not clear. The purpose of our study was to evaluate the efficacy and safety of pulsed radiofrequency treatment of the supraorbital nerve for refractory supraorbital neuralgia patients. We prospectively investigated the long-term effects of ultrasound-guided percutaneous pulsed radiofrequency in the treatment of 22 refractory idiopathic supraorbital neuralgia patients. A reduction of verbal pain numerical rating scale score of more than 50% was used as the standard of effectiveness. The effectiveness rates at different time points within two years were calculated. After a single pulsed radiofrequency treatment, the effectiveness rate at one and three months was 77%, and the rates at six months, one year, and two years were 73%, 64%, and 50%, respectively. Except for a small portion of patients (23%) who experienced mild upper eyelid ecchymosis that gradually disappeared after approximately two weeks, no obvious complications were observed. In conclusion, the results of our study demonstrate that for patients with refractory idiopathic supraorbital neuralgia, percutaneous pulsed radiofrequency may be an effective and safe treatment choice. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  14. Gamma knife radiosurgery for trigeminal neuralgia

    International Nuclear Information System (INIS)

    Tomida, Mihoko; Hayashi, Motohiro; Kawakami, Yoriko; Ishimaru, Jun-ichi

    2009-01-01

    Gamma knife surgery (GKS) has been employed for treating intractable pain such as trigeminal neuralgia (TN) and pain relief has been gained from the treatment, however, little is understood about the side effects of other sensitivities induced from GKS. We assessed ten patients (four men and six women; mean age 67 years) with TN who were investigated by questionnaire for symptoms and visual analog scale (VAS) of pain, and their threshold of touch sensation was examined using Semmes-Weinstein monofilaments, cold sensation and allodynia before and after GKS. MR and CT images were obtained after a Leksell head frame was applied to the head parallel to the trigeminal nerve. These images were uploaded to a computer system and retro-Gasserian area planned the target was correctly marked on the images of a computer in which gamma planning software was installed. All patients were irradiated with a maximum dose of 90 Gy at retro-Gasserian using a 4 mm collimator. The mean±standard deviation (SD) of VAS of pain was 8.5±1.3 and 8 patients had facial paresthesia before GKS. All patients experienced a significant reduction in pain without side effects such as effect on the peripheral nerves without 6 month after GKS. Allodynia, facial paresthesia or cold sensation numbness occurred in the patients before GKS disappeared according to complete pain relief. These results suggest that GKS is a safe and effective treatment for TN. (author)

  15. Linear accelerator radiosurgery for trigeminal neuralgia: case report

    International Nuclear Information System (INIS)

    Yun, Hyong Geun

    2006-01-01

    Trigeminal neuralgia is defined as an episodic electrical shock-like sensation in a dermatomal distribution of the trigeminal nerve. When medications fail to control pain, various procedures are used to attempt to control refractory pain. Of available procedures, stereotactic radiosurgery is the least invasive procedure and has been demonstrated to produce significant pain relief with minimal side effects. Recently, linear accelerators were introduced as a tool for radiosurgery of trigeminal neuralgia beneath the already accepted gamma unit. Author have experienced one case with trigeminal neuralgia treated with linear accelerator. The patient was treated with 85 Gy by means of 5 mm collimator directed to trigeminal nerve root entry zone. The patient obtained pain free without medication at 20 days after the procedure and remain pain free at 6 months after the procedure. He didn't experience facial numbness or other side effects

  16. Supratrochlear Neuralgia: A Prospective Case Series of 15 Patients.

    Science.gov (United States)

    Pareja, Juan A; López-Ruiz, Pedro; Mayo, Diego; Villar-Quiles, Rocío-Nur; Cárcamo, Alba; Gutiérrez-Viedma, Álvaro; Lastarria, Carlo P; Romeral, María; Yangüela, Julio; Cuadrado, María-Luz

    2017-10-01

    The aim of this study was to describe clinical features unique to supratrochlear neuralgia. The supratrochlear nerve supplies the medial aspect of the forehead. Due to the intricate relationship between supraorbital and supratrochlear nerves, neuralgic pain in this region has been traditionally attributed to supraorbital neuralgia. No cases of supratrochlear neuralgia have been reported so far. From 2009 through 2016, we prospectively recruited patients with pain confined to the territory of the supratrochlear nerve. Fifteen patients (13 women, 2 men; mean age 51.4 years, standard deviation 14.9) presented with pain in the lower paramedian forehead, extending to the eyebrow in two patients and to the internal angle of the orbit in another. Pain was unilateral in 11 patients (six on the right, five on the left), and bilateral in four. Six patients had continuous pain and nine described intermittent pain. Palpation of the supratrochlear nerve at the medial third of the supraorbital rim resulted in hypersensitivity in all cases. All but one patient exhibited sensory disturbances within the painful area. Fourteen patients underwent anesthetic blockades of the supratrochlear nerve, with immediate relief in all cases and long-term remission in three. Six of them had received unsuccessful anesthetic blocks of the supraorbital nerve. Five patients were treated successfully with oral drugs and one patient was treated with radiofrequency. Supratrochlear neuralgia is an uncommon disorder causing pain in the medial region of the forehead. It may be differentiated from supraorbital neuralgia and other similar headaches and neuralgias based on the topography of the pain and the response to anesthetic blockade. © 2017 American Headache Society.

  17. Update on the challenges of treating trigeminal neuralgia

    Directory of Open Access Journals (Sweden)

    Obermann M

    2015-04-01

    Full Text Available Mark Obermann Department of Neurology, University of Duisburg-Essen, Essen, Germany Abstract: Despite the multitude of treatment options currently available for trigeminal neuralgia, its management remains challenging in a considerable number of patients. The response to any particular treatment can be quite variable interindividually, and personalized treatment options are both resource-consuming and time-consuming. Anticonvulsant drugs, muscle relaxants, and neuroleptic agents are the preferred medical treatment for trigeminal neuralgia. Large placebo-controlled clinical trials are scarce, and no specific established substance has been developed for the treatment of trigeminal neuralgia. Promising new treatment options currently in clinical evaluation are botulinum neurotoxin type A injections and CNV1014802, a novel sodium channel blocker that selectively blocks the Nav1.7 sodium channel. Patients who do not respond to medical therapy may be eligible for more invasive treatment options, such as percutaneous Gasserian ganglion techniques, gamma knife surgery, and microvascular decompression. Keywords: trigeminal neuralgia, treatment, current, future, options, orphan drugs 

  18. Pharmaceutical Management of Trigeminal Neuralgia in the Elderly

    NARCIS (Netherlands)

    Oomens, M.A.E.; Forouzanfar, T.

    2015-01-01

    Classical trigeminal neuralgia (CTN) is a severe neuropathic pain in the distribution of one or more branches of the trigeminal nerve, which occurs in recurrent episodes, causing deterioration in quality of life, affecting everyday habits and inducing severe disability. The aim of this review is to

  19. Pharmaceutical management of trigeminal neuralgia in the elderly

    NARCIS (Netherlands)

    Oomens, M.A.E.M.; Forouzanfar, T.

    2015-01-01

    Classical trigeminal neuralgia (CTN) is a severe neuropathic pain in the distribution of one or more branches of the trigeminal nerve, which occurs in recurrent episodes, causing deterioration in quality of life, affecting everyday habits and inducing severe disability. The aim of this review is to

  20. Comparative efficacy of phenytoin, steroid and carbamazepine in herpes zoster and post herpetic neuralgia

    Directory of Open Access Journals (Sweden)

    Agarwal S

    1991-01-01

    Full Text Available Three hundred patients of different ages were sequentially assigned three therapy groups (100 in each group viz. phenytoin, steroid (prednisolone and carbamazepine. Effect of these drugs on herpes zoster neuralgia and in prevention of post herpetic neuralgia was studied. Phenytoin was found to be superior to both steroid and carbamazepine in relieving the pain of herpes zoster and in reducing the incidence of post herpetic neuralgia. Only 16.1% of the patients in phenytoin treated group developed post herpetic neuralgia lasting for 2-4 weeks while 22.7% and 29.6% of the steroid and carbamazepine treated patients respectively developed post herpetic neuralgia and that too lasting for longer duration. No patient under 40 years developed post herpetic neuralgia.

  1. Peripheral nerve surgery for the treatment of postherpetic neuralgia.

    Science.gov (United States)

    Ducic, Ivica; Felder, John Matthew

    2013-10-01

    Postherpetic neuralgia is a chronic pain condition that develops in some patients after the resolution of herpes zoster, and has no medical cure. Medications used to treat chronic pain do not hasten resolution of the disorder and may impair function. In this brief case report, we describe our experience with excision and implantation to muscle of peripheral sensory nerves in the affected dermatomes as a novel surgical treatment to reduce pain and improve quality of life for patients with this condition. Of the 3 treated patients, all had resolution of chronic pain after surgery. It is concluded that peripheral nerve surgery offers a promising option to improve pain and quality of life in postherpetic neuralgia patients, without affecting systemic functioning.

  2. Beneficial effects of botulinum toxin type A in trigeminal neuralgia

    OpenAIRE

    Zúñiga,Carlos; Díaz,Sergio; Piedimonte,Fabián; Micheli,Federico

    2008-01-01

    Botulinum toxin has been thoroughly studied as a potential tool in the treatment of several pain syndromes. Therefore, we assessed the clinical effects of botulinum toxin type A injections in 12 patients with otherwise unresponsive idiopathic trigeminal neuralgia. Patients were infiltrated with 20-50 units of botulinum toxin in trigger zones. Those who presented with mandibular involvement were also infiltrated in the masseter muscle. The patients were assessed on a weekly basis using the Vis...

  3. Some experience of trigeminal neuralgia treatment by glycerol rhizolysis

    Directory of Open Access Journals (Sweden)

    А. В. Семенов

    2016-11-01

    Full Text Available Aim. The study was to evaluate the advantages and disadvantages of trigeminal neuralgia treatment by Hakanson S. glycerol rhizolysis method. Methods. The results of glycerol rhizolysis treatment were retrospectively evaluated in 96 patients with trigeminal neuralgia, who had been operated at Neurosurgical Department of Irkutsk City Hospital over a period from 2009 to 2016. To study the prospective follow-up, 53 patients operated during 2009 – 2014 were surveyed over the phone. The comparison of our long-term results and the results of other authors from literature sources was then performed.Results. The median of follow-up period was 43 months. The pain recurrence (III-V rate of Barrow Neurological Institute score for trigeminal neuralgia was observed in 30.2 % of patients, with the mean rate of the visual analogue scale amounting to 1.96. Complications included aseptic meningitis in 3.1 % cases, intracerebral hematoma – 1.04 %, hyperesthesia in appropriate trigeminal region – 3.8%, labial herpes – 40.7 %, temporary anesthesia in appropriate trigeminal region – 30.2%, temporary decrease of corneal reflex sensitivity – 41.5 %. There was no postoperative mortality.Conclusion. Glycerol rhizolysis is an effective method of trigeminal neuralgia treatment and its results are comparable with those of other surgical methods. Strict adherence to all surgical steps and contrast cistenography is the key to success of intervention. The method is minimally invasive, applicable for anesthesia and particularly promising for patients over 70 years old.Received 25 May 2016. Accepted 14 September 2016.Funding: The study had no sponsorship. Conflict of interest: The authors declare no conflict of interest.

  4. Arterial compression of nerve is the primary cause of trigeminal neuralgia.

    Science.gov (United States)

    Chen, Guo-Qiang; Wang, Xiao-Song; Wang, Lin; Zheng, Jia-Ping

    2014-01-01

    Whether arterial or venous compression or arachnoid adhesions are primarily responsible for compression of the trigeminal nerve in patients with trigeminal neuralgia is unclear. The aim of this study was to determine the causes of trigeminal nerve compression in patients with trigeminal neuralgia. The surgical findings in patients with trigeminal neuralgia who were treated by micro vascular decompression were compared to those in patients with hemifacial spasm without any signs or symptoms of trigeminal neuralgia who were treated with microvascular decompression. The study included 99 patients with trigeminal neuralgia (median age, 57 years) and 101 patients with hemifacial spasm (median age, 47 years). There were significant differences between the groups in the relationship of artery to nerve (p relationship of vein to nerve. After adjustment for age, gender, and other factors, patients with vein compression of nerve or with artery compression of nerve were more likely to have trigeminal neuralgia (OR = 5.21 and 42.54, p = 0.026 and p compression of the trigeminal nerve is the primary cause of trigeminal neuralgia and therefore, decompression of veins need not be a priority when performing microvascular dissection in patients with trigeminal neuralgia.

  5. Neuroimmune-Glia Interactions in the Sensory Ganglia Account for the Development of Acute Herpetic Neuralgia.

    Science.gov (United States)

    Silva, Jaqueline R; Lopes, Alexandre H; Talbot, Jhimmy; Cecilio, Nerry T; Rossato, Mateus F; Silva, Rangel L; Souza, Guilherme R; Silva, Cassia R; Lucas, Guilherme; Fonseca, Benedito A; Arruda, Eurico; Alves-Filho, Jose C; Cunha, Fernando Q; Cunha, Thiago M

    2017-07-05

    Herpetic neuralgia is the most important symptom of herpes zoster disease, which is caused by Varicella zoster Nevertheless, the pathophysiological mechanisms involved in herpetic neuralgia are not totally elucidated. Here, we examined the neuroimmune interactions at the sensory ganglia that account for the genesis of herpetic neuralgia using a murine model of Herpes Simplex Virus Type-1 (HSV-1) infection. The cutaneous HSV-1 infection of mice results in the development of a zosteriform-like skin lesion followed by a time-dependent increase in pain-like responses (mechanical allodynia). Leukocytes composed mainly of macrophages and neutrophils infiltrate infected DRGs and account for the development of herpetic neuralgia. Infiltrating leukocytes are responsible for driving the production of TNF, which in turn mediates the development of herpetic neuralgia through downregulation of the inwardly rectifying K + channel Kir4.1 in satellite glial cells. These results revealed that neuroimmune-glia interactions at the sensory ganglia play a critical role in the genesis of herpetic neuralgia. In conclusion, the present study elucidates novel mechanisms involved in the genesis of acute herpetic pain and open new avenues for its control. SIGNIFICANCE STATEMENT Acute herpetic neuralgia is the most important symptom of herpes zoster disease and it is very difficult to treat. Using a model of peripheral infection of mice with HSV-1, we have characterized for the first time the neuroimmune-glia interactions in the sensory ganglia that account for the development of acute herpetic neuralgia. Among these mechanisms, leukocytes composed mainly of macrophages and neutrophils infiltrate infected sensory ganglia and are responsible for driving the production of TNF. TNF, via TNFR1, mediates herpetic neuralgia development through downregulation of the inwardly rectifying K + channel Kir4.1 in satellite glial cells. This study elucidates novel mechanisms involved in the genesis of

  6. Trigeminal Neuralgia and Multiple Sclerosis: A Historical Perspective.

    Science.gov (United States)

    Burkholder, David B; Koehler, Peter J; Boes, Christopher J

    2017-09-01

    Trigeminal neuralgia (TN) associated with multiple sclerosis (MS) was first described in Lehrbuch der Nervenkrankheiten für Ärzte und Studirende in 1894 by Hermann Oppenheim, including a pathologic description of trigeminal root entry zone demyelination. Early English-language translations in 1900 and 1904 did not so explicitly state this association compared with the German editions. The 1911 English-language translation described a more direct association. Other later descriptions were clinical with few pathologic reports, often referencing Oppenheim but citing the 1905 German or 1911 English editions of Lehrbuch. This discrepancy in part may be due to the translation differences of the original text.

  7. Osteopetrosis presenting with paroxysmal trigeminal neuralgia. A case report.

    Science.gov (United States)

    Chindia, M L; Ocholla, T J; Imalingat, B

    1991-08-01

    Osteopetrosis is a rare disease of unknown aetiology. The relentless bone growth may progressively obliterate the various craniofacial skeletal foramina leading to nerve compression and a diversity of neurological disorders. A case is reported of a 37-year-old woman who was seen because of frequent attacks of paroxysmal trigeminal neuralgia (PTN); other orofacial neurologic deficits and generalised craniofacial skeletal thickening. The prompt recognition and management of associated disorders such as PTN is emphasized. Despite the lack of definitive treatment modalities for both osteopetrosis and PTN, the patient's quality of life must be sustained.

  8. Cryoanalgesia for post-herpetic neuralgia: a new treatment.

    Science.gov (United States)

    Calandria, Liliana

    2011-06-01

    The existent therapeutic options for post-herpetic neuralgia (PHN) are varied, albeit not sufficiently effective. The aim of this study was to try a new treatment modality for PHN. A spray of liquid nitrogen (LN) was used in 47 patients suffering from PHN as a stimulator of a mechanism not yet completely understood. The LN spray was carefully applied (so as not to freeze the skin surface) along the diseased sensory nerve dermatome, at weekly sessions lasting for 30 seconds each, with a mean of three applications per patient. The area corresponding to the dermatomes affected by the herpes zoster satisfactorily attenuated the herpetic neuralgia in all patients. Before the sixth treatment session, good or excellent improvement was obtained in 94% of the study patients. Pain was eliminated with one session in nine patients (19%), and with two sessions in eight patients (17%). We conclude that this non-freezing technique is absolutely safe and injury-free, and is very efficient in calming PHN. © 2011 The International Society of Dermatology.

  9. Bee venom treatment for refractory postherpetic neuralgia: a case report.

    Science.gov (United States)

    Lee, Seung Min; Lim, Jinwoong; Lee, Jae-Dong; Choi, Do-Young; Lee, Sanghoon

    2014-03-01

    Bee venom has been reported to have antinociceptive and anti-inflammatory effects in experimental studies. However, questions still remain regarding the clinical use of bee venom. This report describes the successful outcome of bee venom treatment for refractory postherpetic neuralgia. A 72-year-old Korean man had severe pain and hypersensitivity in the region where he had developed a herpes zoster rash 2 years earlier. He was treated with antivirals, painkillers, steroids, and analgesic patches, all to no effect. The patient visited the East-West Pain Clinic, Kyung Hee University Medical Center, to receive collaborative treatment. After being evaluated for bee venom compatibility, he was treated with bee venom injections. A 1:30,000 diluted solution of bee venom was injected subcutaneously along the margins of the rash once per week for 4 weeks. Pain levels were evaluated before every treatment, and by his fifth visit, his pain had decreased from 8 to 2 on a 10-point numerical rating scale. He experienced no adverse effects, and this improvement was maintained at the 3-month, 6-month, and 1-year phone follow-up evaluations. Bee venom treatment demonstrates the potential to become an effective treatment for postherpetic neuralgia. Further large-sample clinical trials should be conducted to evaluate the overall safety and efficacy of this treatment.

  10. Pain in trigeminal neuralgia: neurophysiology and measurement: a comprehensive review.

    Science.gov (United States)

    Kumar, S; Rastogi, S; Kumar, S; Mahendra, P; Bansal, M; Chandra, L

    2013-01-01

    Trigeminal neuralgia (TN) is defined as sudden, usually unilateral, severe, brief, stabbing recurrent episodes of pain within the distribution of one or more branches of the trigeminal nerve. It is the most frequent cranial neuralgia, the incidence being 1 per 1,000,00 persons per year. Pain attacks start abruptly and last several seconds but may persist 1 to 2 minutes. The attacks are initiated by non painful physical stimulation of specific areas (trigger points or zones) that are located ipsilateral to the pain. After each episode, there is usually a refractive period during which stimulation of the trigger zone will not induce the pain. According to the European Federation of Neurological Societies (EFNS) guidelines on neuropathic pain assessment and the American Academy of Neurology (AAN)-EFNS guidelines on TN management the neurophysiological recording of trigeminal reflexes represents the most useful and reliable test for the neurophysiological diagnosis of trigeminal pains. The present article discusses different techniques for investigation of the trigeminal system by which an accurate topographical diagnosis and profile of sensory fiber pathology can be determined. With the aid of neurophysiological recordings and quantitative sensory testing, it is possible to approach a mechanism-based classification of orofacial pain.

  11. Genitofemoral neuralgia: adding to the burden of chronic vulvar pain

    Directory of Open Access Journals (Sweden)

    Verstraelen H

    2015-11-01

    Full Text Available Hans Verstraelen,1 Eline De Zutter,1 Martine De Muynck2 1Department of Obstetrics and Gynaecology, Vulvovaginal Disease Clinic, Ghent University Hospital, Ghent, Belgium; 2Department of Physical Medicine and Rehabilitation, Ghent University Hospital, Ghent, Belgium Abstract: The vulva is a particularly common locus of chronic pain with neuropathic characteristics that occurs in women of any age, though most women with neuropathic type chronic vulvar pain will remain undiagnosed even following multiple physician visits. Here, we report on an exemplary case of a middle-aged woman who was referred to the Vulvovaginal Disease Clinic with debilitating vulvar burning and itching over the right labium majus that had been persisting for 2 years and was considered intractable. Careful history taking and clinical examination, followed by electrophysiological assessment through somatosensory evoked potentials was consistent with genitofemoral neuralgia, for which no obvious cause could be identified. Adequate pain relief was obtained with a serotonin–noradrenaline reuptake inhibitor and topical gabapentin cream. We briefly discuss the epidemiology, diagnosis, and treatment of genitofemoral neuralgia and provide a series of clues to guide clinicians in obtaining a presumptive diagnosis of specific neuropathic pain syndromes that may underlie chronic vulvar pain. We further aim to draw attention to the tremendous burden of chronic, unrecognized vulvar pain. Keywords: vulvar pain, genitofemoral nerve, neuropathic pain, vulvodynia, vulvar disease

  12. Ophthalmic branch radiofrequency thermocoagulation for atypical trigeminal neuralgia:a case report.

    Science.gov (United States)

    Du, Shibin; Ma, Xiaoliang; Li, Xiaoqin; Yuan, Hongjie

    2015-01-01

    Trigeminal neuralgia is an intense neuralgia involving facial areas supplied by trigeminal nerve. The pain is characterized by sudden onset, short persistence, sharp or lancinating. Trigeminal neuralgia commonly affects frontal areas, infraorbital or paranasal areas, mandibular areas and teeth. While Trigeminal neuralgia affecting merely the upper eyelid is rare. Here we report a case of atypical Trigeminal neuralgia confined to the upper eyelid. The patient was pain free during the follow-up period of 6 months after unusual ophthalmic branch radiofrequency thermocoagulation. A 55-year-old female patient was diagnosed as primary trigeminal neuralgia involving the right upper eyelid. As the pain could not be controlled by drug therapy, peripheral nerve branch radiofrequency thermocoagulation was recommended. A combination of infratrochlear, supratrochlear and lacrimal radiofrequency thermocoagulation was implemented in this case. The point where the bridge of the nose abuts the supraorbital ridge and the point slightly above the lateral canthus along outer border of the orbit were selected respectively as the puncture sites. After positive diagnostic test, radiofrequency thermocoagulation of the above-mentioned nerve branches was performed respectively. The patient was pain free immediately after the treatment and during the follow-up period of 6 months. Trigeminal neuralgia is a common severe and chronic facial neuralgia which requires accurate diagnosis and effective therapy. With typical clinical symptoms, normal neurological signs, normal CT and MRI findings, the patient was diagnosed as classic trigeminal neuralgia. As the patient was drug resistant, some invasive treatments were considered. Peripheral branch neurolysis was chosen for its minimal invasiveness, convenience, low risk and not affecting further invasive treatments. According to the anatomic data and the diagnostic test results, infratrochlear, supratrochlear and lacrimal nerve were responsible

  13. Glossopharyngeal neuralgia of tumor origin diagnosed in dental care. Case report

    OpenAIRE

    Marchetti, Gisele; Bonotto, Daniel; Cunali, Paulo Afonso

    2017-01-01

    ABSTRACT BACKGROUND AND OBJECTIVES: The glossopharyngeal neuralgia is a neuropathy considered rare that manifests itself in the IX cranial nerve distribution characterized by an electric shock-like pain, often associated with hyperalgesia and allodynia. The etiology may be related to vascular changes, brain tumor, or even idiopathic. The aim of this study was to report a case of glossopharyngeal neuralgia secondary to a brain tumor diagnosed in a dental clinic, highlighting its clinical mani...

  14. Magnetic resonance neurography for the identification of pudendal neuralgia

    Directory of Open Access Journals (Sweden)

    Claudia P. Cejas

    2017-06-01

    Full Text Available The pudendal nerve entrapment is an entity understudied by diagnosis imaging. Various causes are recognized in relation to difficult labors, rectal, perineal, urological and gynecological surgery, pelvic trauma fracture, bones tumors and compression by tumors or pelvic pseudotumors. Pudendal neuropathy should be clinically suspected, and confirmed by different methods such as electrofisiological testing: evoked potentials, terminal motor latency test and electromyogram, neuronal block and magnetic resonance imaging. The radiologist should be acquainted with the complex anatomy of the pelvic floor, particularly on the path of pudendal nerve studied by magnetic resonance imaging. High resolution magnetic resonance neurography should be used as a complementary diagnostic study along with clinical and electrophysiological examinations in patients with suspected pudendal nerve neuralgia.

  15. Gamma knife radiosurgery for medically refractory idiopathic trigeminal neuralgia

    International Nuclear Information System (INIS)

    Kang, J.H.; Yoon, Y.S.; Kang, D.W.; Chung, S.S.; Chang, J.W.

    2008-01-01

    Gamma knife radiosurgery (GKS) has been generally considered as a viable therapeutic option for the management of medically refractory idiopathic trigeminal neuralgia (TN). We reviewed our experience with GKS in patients with TN. Between Feb 1996 and May 2006. 77 patients with medical refractory idiopathic TN were treated using GKS. Thirty-six patients who had undergone other previous procedures, previous GKS, or had brain stem lesion, atypical symptoms, were excluded from this study. Pain improvement was achieved in 38 of the patients with TN (pain response rate 92.7 %). Twenty-three patients were pain free and 15 had reduced pain. There were no serious complications. We think that GKS is an effective treatment option for patients with medical refractory idiopathic TN. (author)

  16. Association between pain, central sensitization and anxiety in postherpetic neuralgia.

    Science.gov (United States)

    Schlereth, T; Heiland, A; Breimhorst, M; Féchir, M; Kern, U; Magerl, W; Birklein, F

    2015-02-01

    In postherpetic neuralgia (PHN), dorsal root ganglia neurons are damaged. According to the proposed models, PHN pain might be associated with nociceptive deafferentation, and peripheral (heat hyperalgesia) or central sensitization (allodynia). In 36 PHN patients, afferent nerve fibre function was characterized using quantitative sensory testing and histamine-induced flare analysis. Psychological factors were evaluated with the Hospital Anxiety and Depression Scale (HADS), disease-related quality of life (QoL) with SF-36 and pain with the McGill questionnaire [pain rating index (PRI)]. The patients were also divided into subgroups according to the presence or absence of brush-evoked allodynia as a sign of central sensitization. For all patients, warm, cold and mechanical detection was impaired (p Central sensitization (i.e., allodynia) might contribute to PHN pain. There was a striking association between anxiety, depression and age, and the magnitude of PHN pain. © 2014 European Pain Federation - EFIC®

  17. Trigeminal neuralgia – a coherent cross-specialty management program

    DEFF Research Database (Denmark)

    Heinskou, Tone; Maarbjerg, Stine; Rochat, Per Bjørnstad

    2015-01-01

    BACKGROUND: Optimal management of patients with classical trigeminal neuralgia (TN) requires specific treatment programs and close collaboration between medical, radiological and surgical specialties. Organization of such treatment programs has never been described before. With this paper we aim...... had a standardized basis before decision-making on impending surgery. The program ensured that referral of the subgroup of patients in need for surgery was standardized, ensured continuous evaluation of the need for adjustments in pharmacological management and formed the basis for scientific research....... to describe the implementation and feasibility of an accelerated cross-speciality management program, to describe the collaboration between the involved specialties and to report the patient flow during the first 2 years after implementation. Finally, we aim to stimulate discussions about optimal management...

  18. Postherpetic neuralgia: Therapeutic and prophylactic aspects and pregabalin therapy

    Directory of Open Access Journals (Sweden)

    E.G. Mendelevich

    2014-01-01

    Full Text Available Postherpetic neuralgia (PHN is one of the most common and persistent chronic pain syndromes caused by chickenpox virus affecting the peripheral and central nervous systems. PHN is a typical neuropathic pain resulting from injury or dysfunction of the somatosensory system whose development involves a few mechanisms. Elderly people are more prone to PHN, which is associated with the weakened immune system. Treatment of shingles cannot completely prevent subsequent neuralgia; however, some drugs can reduce its manifestations. The diagnosis of PHN is largely based on the duration of pain after rash onset. However, it is difficult to estimate the real rate of PHN development because there is neither consensus of opinion on this issue nor common criteria for pat duration (1 to 6 months, as shown by different data. The significant factors that may predispose to PHN are older age, female gender, and acute herpes zoster indicators, such as pain intensity, the severity of herpetic rash and infectious manifestations. Pain syndrome in PHN can reach a high intensity level, accompanied by the development of chronic fatigue, depression, and loss of social skills. There are several types of pain in PHN: constant, paroxysmal and allodynia, which are due to different pathophysiological mechanisms. Variability in the clinical manifestations of PHN may underlie the inadequate efficacy of one or other drug. The treatment of PHN poses definite difficulties. About 40-50% of patients continue to suffer from pain despite the fact that the multitude of currently available therapies is performed. Pregabalin, whose high efficacy and advantages in the treatment of pain in PHN are demonstrated in numerous studies, is one of the most effective first-line drugs for PHN. In-depth analysis suggests that inadequately low doses of pregabalin are frequently used in the treatment of PHN, which may lead to an insufficient analgesic effect.

  19. Advances in diagnosis and treatment of trigeminal neuralgia

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    Montano N

    2015-02-01

    Full Text Available Nicola Montano,1 Giulio Conforti,1 Rina Di Bonaventura,1 Mario Meglio,2 Eduardo Fernandez,1 Fabio Papacci1 1Institute of Neurosurgery, Catholic University, Rome, 2Institute of Neurosurgery, Azienda Ospedaliera Universitaria Integrata, Verona, Italy Abstract: Various drugs and surgical procedures have been utilized for the treatment of trigeminal neuralgia (TN. Despite numerous available approaches, the results are not completely satisfying. The need for more contemporaneous drugs to control the pain attacks is a common experience. Moreover, a number of patients become drug resistant, needing a surgical procedure to treat the neuralgia. Nonetheless, pain recurrence after one or more surgical operations is also frequently seen. These facts reflect the lack of the precise understanding of the TN pathogenesis. Classically, it has been related to a neurovascular compression at the trigeminal nerve root entry-zone in the prepontine cistern. However, it has been evidenced that in the pain onset and recurrence, various neurophysiological mechanisms other than the neurovascular conflict are involved. Recently, the introduction of new magnetic resonance techniques, such as voxel-based morphometry, diffusion tensor imaging, three-dimensional time-of-flight magnetic resonance angiography, and fluid attenuated inversion recovery sequences, has provided new insight about the TN pathogenesis. Some of these new sequences have also been used to better preoperatively evidence the neurovascular conflict in the surgical planning of microvascular decompression. Moreover, the endoscopy (during microvascular decompression and the intraoperative computed tomography with integrated neuronavigation (during percutaneous procedures have been recently introduced in the challenging cases. In the last few years, efforts have been made in order to better define the optimal target when performing the gamma knife radiosurgery. Moreover, some authors have also evidenced that

  20. Phenytoin and carbamazepine in trigeminal neuralgia: marketing-based versus evidence-based treatment

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    Keppel Hesselink JM

    2017-07-01

    Full Text Available Jan M Keppel Hesselink,1 Michael E Schatman2,31Institute for Neuropathic Pain, Bosch en Duin, the Netherlands; 2Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA; 3Boston Pain Care, Waltham, MA, USAIntroductionMost review articles support carbamazepine as a first-line pharmacotherapy for idiopathic trigeminal neuralgia.1–3 However, the empirical support for this recommendation is somewhat suspect. Phenytoin, as the prototype for all anticonvulsants, was already positioned as an analgesic compound 70 years ago. Since these initial findings, the data that have been gathered have supported the use of anticonvulsants as painkillers – from phenytoin up to and including more recent anticonvulsants such as gabapentin and pregabalin. Since 1942, a number of papers supported phenytoin’s therapeutic effects in trigeminal neuralgia (Table 1. The introduction of carbamazepine in 1962 by Geigy shifted the interest of neurologists from phenytoin as a treatment for trigeminal neuralgia to carbamazepine, without sound scientific evidence. To date, no convincing randomized controlled trials (RCTs have been published supporting the role of carbamazepine in trigeminal neuralgia, and we could not identify a single study comparing the effects of phenytoin with those of carbamazepine. Accordingly, phenytoin should probably be considered more often as a viable therapy for (treatmentresistant trigeminal neuralgia.

  1. Prophylaxis and treatment of acute and chronic postherpetic neuralgia

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    Anna Michalska-Bańkowska

    2014-06-01

    Full Text Available Herpes zoster (HZ is a disease caused by varicella zoster virus (VZV, where the initial contact leads to varicella. The low immunity of the patient might reactivate the virus and provoke symptoms of HZ, which is characterized by vesicles and blisters localized unilaterally and accompanied by pain. The greatest diagnostic problems occur in Zoster sine herpete and painless HZ. A significant complication of acute HZ infection is chronic postherpetic neuralgia (PHN, which manifests as dull and burning pain persisting for more than 3 months after the beginning of the rash. Senility, female gender, presence of prodromal pain, more severe skin lesions, dysaesthesia, and more intense acute PHN predispose to chronic PHN. Early diagnosis and treatment of HZ infection with antiviral medications prevent PHN. Use of local anesthetics is a very good choice in acute PHN treatment. Tricyclic antidepressants (amitriptyline, nortriptyline are conventional drugs which alleviate subacute PHN. Immunomodulatory drugs such as gabapentin help prevent or reduce the severity of PHN. The other therapeutic options are RFA (radiofrequency ablation, TENS (transcutaneous electrical nerve stimulation, physical methods such as magnetotherapy and laser therapy. The attenuated vaccine, used in patients over 60 years old, is expected to prevent the occurrence of PHN.

  2. Percutaneous high-frequency selective rhizotomy in the trigeminal neuralgia therapy in multiple sclerosis

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    V. M. Tyurnikov

    2012-01-01

    Full Text Available Trigeminal neuralgia is a rare symptom of multiple sclerosis affecting the disability. Multiple sclerosis related trigeminal neuralgia has been attributed to a demyelinating lesion in the pons. When the adequate pain drug-relieve therapy is not possible or when the patient becomes refractory to the treatment or can not continue pharmacological treatment because of the side effects, surgical intervention, including percutaneous radiofrequency rhizotomy is being discussed. Literature review and the data upon the efficiency and safety of this neurosurgical treatment in 16 patients with multiple sclerosis have been analyzed. Percutaneous radiofrequency rhizotomy has been proved to be a safe, reproducible and effective method of the symptomatic surgical treatment of trigeminal neuralgia in patients with multiple sclerosis in cases of the intolerance/inefficiency of the pharmacological therapy.

  3. Intercostal neuralgia as a symptom of an osteoblastoma in thoracic spine.

    Science.gov (United States)

    Kobayashi, Hiroshi; Shinoda, Yusuke; Ohki, Takahiro; Kawano, Hirotaka

    2015-07-02

    An osteoblastoma is a benign bone lesion most commonly affecting the spine; it is frequently found in the posterior elements of the vertebra. When an osteoblastoma originates in the spine, it usually causes dull and localised dorsal pain, but the period between symptom development and diagnosis can be long. MRI shows intense peritumoural oedema accompanying the osteoblastoma. We present a case of a 15-year-old boy with osteoblastoma at the level of the T8-9 left laminae causing intercostal neuralgia without direct invasion to the intercostal nerve. Immediately after surgery, intercostal neuralgia was diminished. To our knowledge, this is the first case of an osteoblastoma with intercostal neuralgia, which is possibly the key symptom for diagnosing an osteoblastoma in the thoracic spine. 2015 BMJ Publishing Group Ltd.

  4. Intercostal neuralgia as a symptom of an osteoblastoma in thoracic spine

    Science.gov (United States)

    Kobayashi, Hiroshi; Shinoda, Yusuke; Ohki, Takahiro; Kawano, Hirotaka

    2015-01-01

    An osteoblastoma is a benign bone lesion most commonly affecting the spine; it is frequently found in the posterior elements of the vertebra. When an osteoblastoma originates in the spine, it usually causes dull and localised dorsal pain, but the period between symptom development and diagnosis can be long. MRI shows intense peritumoural oedema accompanying the osteoblastoma. We present a case of a 15-year-old boy with osteoblastoma at the level of the T8–9 left laminae causing intercostal neuralgia without direct invasion to the intercostal nerve. Immediately after surgery, intercostal neuralgia was diminished. To our knowledge, this is the first case of an osteoblastoma with intercostal neuralgia, which is possibly the key symptom for diagnosing an osteoblastoma in the thoracic spine. PMID:26139654

  5. Congenital absence of the internal carotid artery diagnosed during investigation of trigeminal neuralgia

    Energy Technology Data Exchange (ETDEWEB)

    Uchino, A.; Sawada, A.; Kudo, S. [Department of Radiology, Saga Medical School, 5-1-1, Nabeshima, Saga (Japan); Hirakawa, N.; Totoki, T. [Department of Anesthesiology, Saga Medical School, 5-1-1, Nabeshima, Saga (Japan)

    2002-09-01

    Congenital absence of the unilateral internal carotid artery (ICA) was found in a patient during MR imaging examination for right trigeminal neuralgia. Magnetic resonance angiography showed complete absence of the right ICA and a large tortuous basilar artery (BA). The source images revealed a deformed right trigeminal nerve resulting from compression by the BA. Computed tomography of the skull base showed absence of the right carotid canal, suggesting agenesis of the right ICA. Longstanding hemodynamic stress may have caused the BA to become extremely tortuous, resulting in the trigeminal neuralgia. (orig.)

  6. [Herpes Zoster and post-herpetic neuralgia: everything to revise?].

    Science.gov (United States)

    Pasqualucci, A

    1999-01-01

    The treatment and prevention of the algic symptomatology of Post-Herpetic Neuralgia (PHN) are problems still to be solved. In our opinion the reason of this failure is to be found in an insufficient knowledge of the pathophysiological phenomena which cause the PHN. In fact, many fundamental aspects, such as its "temporal" and symptomatological definition and its pathogenesis are still unsolved. This revision tries to focus the problems and discrepancies hindering an improvement in PHN treatment and prevention. The literature reports three different symptomatological levels after herpes zoster acute phase: patients affected by pain and/or allodynia, patients with "abnormal sensations" (anesthesia, paresthesia, dysesthesia, prickling, itching, burning, etc.,) and patients in "complete recovery". Only two studies have analyzed the final incidence of these symptomatologies. Therefore, it is absolutely unclear whether the patients in "abnormal sensations", that is with a symptomatology which is definitely less weakening than pain, have to be considered in PHN (patients with pain) or in "complete recovery". On the contrary, from a clinical and physiopathological point of view this symptomatological difference may have a great importance: the symptomatological non-distinction could be the cause of the disagreement concerning PHN incidence data; this distinction could differentiate and compare in a reliable way the effects of the various therapies reported in the literature. The lack of a symptomatological classification does not facilitate a verification of the physiopathological hypothesis of PHN onset and maintenance. The differentiation among pain, "abnormal sensations" and "complete recovery" could correlate these three symptomatological conditions to the anatomopathological and viral data which according to literature characterize the evolution of Herpes Zoster acute phase in PHN. This would largely help to improve the therapeutic strategy.

  7. Salvage Gamma Knife Stereotactic Radiosurgery for Surgically Refractory Trigeminal Neuralgia

    International Nuclear Information System (INIS)

    Little, Andrew S.; Shetter, Andrew G.; Shetter, Mary E.; Kakarla, Udaya K.; Rogers, C. Leland

    2009-01-01

    Purpose: To evaluate the clinical outcome of patients with surgically refractory trigeminal neuralgia (TN) treated with rescue gamma knife radiosurgery (GKRS). Methods and Materials: Seventy-nine patients with typical TN received salvage GKRS between 1997 and 2002 at the Barrow Neurological Institute (BNI). All patients had recurrent pain following at least one prior surgical intervention. Prior surgical interventions included percutaneous destructive procedures, microvascular decompression (MVD), or GKRS. Thirty-one (39%) had undergone at least two prior procedures. The most common salvage dose was 80 Gy, although 40-50 Gy was typical in patients who had received prior radiosurgery. Pain outcome was assessed using the BNI Pain Intensity Score, and quality of life was assessed using the Brief Pain Inventory. Results: Median follow-up after salvage GKRS was 5.3 years. Actuarial analysis demonstrated that at 5 years, 20% of patients were pain-free and 50% had pain relief. Pain recurred in patients who had an initial response to GKRS at a median of 1.1 years. Twenty-eight (41%) required a subsequent surgical procedure for recurrence. A multivariate Cox proportional hazards model suggested that the strongest predictor of GKRS failure was a history of prior MVD (p=0.029). There were no instances of serious morbidity or mortality. Ten percent of patients developed worsening facial numbness and 8% described their numbness as 'very bothersome.' Conclusions: GKRS salvage for refractory TN is well tolerated and results in long-term pain relief in approximately half the patients treated. Clinicians may reconsider using GKRS to salvage patients who have failed prior MVD.

  8. Presentation of pain and nerve involvement in trigeminal neuralgia patients

    International Nuclear Information System (INIS)

    Luqman, U.; Ahmed, A.; Janjua, O.S.; Umair, M.

    2013-01-01

    Objective: To determine pain distribution and nerve involvement of trigeminal neuralgia (TN) patients at Armed Forces Institute of Dentistry, Rawalpindi. Material and Methods: A one year cross sectional study from Feb 2009 to Feb 2010 of TN patients was conducted in oral and maxillofacial surgery department, Armed Forces Institute of Dentistry, Rawalpindi. A detailed history of patients suffering from TN was taken followed by thorough extra-oral and intra-oral examination. The parameters analyzed included age of onset, gender, site of involvement, nerve branch involvement and clinical presentations. History and clinical features of already diagnosed cases with TN was included as such. Results: A total of 52 patients were included in the study. The patients had a mean age of 52.25 +- 14.82 years. The male to female ratio was 1:1.3. The mean age of onset was 48.5 +- 13.3 years. Right side was involved in 59.6% of the patients. V2 was most commonly involved nerve (59.6%), followed by V3 (53.8%) and V1 (13.7%). Forty six percent of patients gave history of extractions of teeth as a treatment for this condition. Forty two percent recalled or had previous medical records prescribed with antibiotics and pain killers. Conclusion: TN in our population is more frequent in females and with more right side involvement. Maxillary division is most commonly affected followed by the mandibular nerve. It is a rare disorder and most of these patients are inadequately diagnosed and treated. Keeping the disease in differential diagnosis of atypical pain without local pathology is advised. (author)

  9. An unusual presentation of trigeminal neuralgia caused by fibrous dysplasia (managed with radiofrequency lesioning

    Directory of Open Access Journals (Sweden)

    Muralidhar Joshi

    2016-01-01

    Full Text Available Fibrous dysplasia (FD is a skeletal developmental disorder of the unknown etiology, uncertain pathogenesis, and diverse histopathology with one-fourth involving head and neck. The aim of this article is to report a rare case of craniofacial FD of the maxillary sinus as an etiology of trigeminal neuralgia treated with radiofrequency lesioning.

  10. [Clinical efficacy observation on primary trigeminal neuralgia treated with joint needling method at the trigger point].

    Science.gov (United States)

    Chen, Zhang-mei; Wu, Xin-tian

    2012-06-01

    To observe the clinical efficacy on primary trigeminal neuralgia treated with joint needling method at the trigger point. One hundred and three cases of primary trigeminal neuralgia were divided into a joint needling group (53 cases) and a conventional needling group (50 cases) according to the visit sequence. In the joint needling group, the joint needling method was used at the trigger point in the mandibular joint [the positive point near to Xiaguan (ST 7)]; the conventional needling was used at Hegu (LI 4), Waiguan (TE 5), Taichong (LR 3) and Neiting (ST 44). In the conventional needling group, Xiaguan (ST 7) and Fengchi (GB 20) were used and the supplementary acupoints were selected according to the involved branches of trigeminal nerve. The conventional needling method was used. The Visual Analogue Scale (VAS) and the score of trigeminal neuralgia were adopted to assess the pain severity and the comprehensive symptoms before treatment and after the 1st and 2nd sessions of treatment separately. The efficacy was assessed. After the 1st and 2nd sessions of treatment, VAS score and the comprehensive symptom score were reduced obviously as compared with those before treatment in either group (P trigger point achieves the significant efficacy on primary trigeminal neuralgia, which is superior to that with the conventional needling method.

  11. Dose related efficacy of gabapentin in acute herpetic neuralgia among geriatric patients

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    Sanjay Kumar Kanodia

    2012-01-01

    Full Text Available Background: Herpes zoster is an intractable painful condition, more severe in elderly patients. The pain during the first 30 days of onset is known as Acute Herpetic Neuralgia. Multiple treatments using non-steroidal anti-inflammatory drugs (NSAIDs, opioids, and tricyclic anti-depressants are available, but their side effects limit their use in geriatric patients. Gabapentin is also used in chronic neuropathic pain; however, its role in acute herpetic neuralgia is less explored. Aim : This study was aimed to determine dose related efficacy and safety of gabapentin in reducing pain of acute herpetic neuralgia in geriatric patients. Materials and Methods: In this placebo-controlled, four-week trial including 56 subjects, 42 patients received gabapentin in the dosage of 300 mg (n=15, 600 mg (n=14, and 900 mg(n=13 per day in divided doses and 14 patients received placebo within 72 hours of onset of herpes zoster. Results: Subjects receiving gabapentin had a statistically significant reduction (P0.05. Conclusion: The results of this study show that gabapentin is effective in acute herpetic neuralgia in different doses with 600 mg/day being the more appropriate dose in terms of safety and efficacy.

  12. Neurolytic blockade of the obturator nerve in the treatment of idiopatic obturator neuralgia

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    Ćulafić Slobodan

    2008-01-01

    Full Text Available Introduction. Idiopathic obturator neuralgia is a rare chronic pain condition. It consists of pain radiating from the obturator nerve territory to the inner thigh. However, the symptomatic obturator neuralgia is commonly caused by the obturator canal bowel hernia that causes painful compressive neuropathy in more than 85% of the cases. Case report. A 61-year-old female who underwent right femoral amputation due to the occlusion of the aortofemoral vascular graft, complained of the pain characterized by its localization in the inguinal region and anterointernal side of the right inner thigh. Computer tomography and MRI findings excluded obturator canal herniation or lumbar plexopathy. A diagnosis of the obturator neuralgia was confirmed by an analgesic block of the obturator nerve. Thereafter, the neurolitic blockade of the right obturator nerve was done. The complete pain relief was achieved. Pain relief was complete in three-month follow-up period. Conclusion. Neurolitic blockade is an efficacious method in treating chronic pain caused by the idiopathic obturator neuralgia.

  13. Refractory trigeminal neuralgia treatment outcomes following CyberKnife radiosurgery

    International Nuclear Information System (INIS)

    Karam, Sana D; Tai, Alexander; Snider, James W; Bhatia, Shilpa; Bedrick, Edward J; Rashid, Abdul; Jay, Ann; Kalhorn, Christopher; Nair, Nathan; Harter, K William; Collins, Sean P; Jean, Walter

    2014-01-01

    A handful of studies have reported outcomes with CyberKnife radiosurgery (CKRS) for the treatment of trigeminal neuralgia. However, the follow-up has been short with no minimum follow-up required and have included patients with short duration of symptoms. Here we report our institutional experience on patients with a minimum follow-up of 1 year and a median follow-up of 28 months (mean 38.84 months). Twenty-five patients with medically and surgically intractable TN received CKRS with a mean marginal radiation dose of 64 Gy applied to an average isodose line of 86% of the affected trigeminal nerve. Follow-up data were obtained by clinical examination and telephone questionnaire. Outcome results were categorized based on the Barrow Neurological Institute (BNI) pain scale with BNI I-III considered to be good outcomes and BNI IV-V considered as treatment failure. BNI facial numbness score was used to assess treatment complications. A large proportion of patients (42.9%) reported pain relief within 1 month following CKRS treatment. The mean time to recurrence of severe pain was 27.8 months (range 1–129 months). At median follow-up of 28 months (mean 38.84 months), actuarial rate of freedom from severe pain (BNI ≥ III) was 72%. At last follow-up 2 (8%) patients had freedom from any pain and no medications (BNI I) and the majority (48%) had some pain that was adequately controlled with medications. Seven patients (28%) had no response to treatment and continued to suffer from severe pain (BNI IV or V). Patient’s diabetic status and overall post-treatment BNI facial numbness scores were statistically significant predictors of treatment outcomes. CKRS represents an acceptable salvage option for with medically and/or surgically refractory patients. Even patients with severely debilitating symptoms may experience significant and sustained pain relief after CKRS. Particularly, CKRS remains an attractive option in patients who are not good surgical candidates or possibly

  14. Trigeminal neuralgia--a coherent cross-specialty management program.

    Science.gov (United States)

    Heinskou, Tone; Maarbjerg, Stine; Rochat, Per; Wolfram, Frauke; Jensen, Rigmor Højland; Bendtsen, Lars

    2015-01-01

    Optimal management of patients with classical trigeminal neuralgia (TN) requires specific treatment programs and close collaboration between medical, radiological and surgical specialties. Organization of such treatment programs has never been described before. With this paper we aim to describe the implementation and feasibility of an accelerated cross-speciality management program, to describe the collaboration between the involved specialties and to report the patient flow during the first 2 years after implementation. Finally, we aim to stimulate discussions about optimal management of TN. Based on collaboration between neurologists, neuroradiologists and neurosurgeons a standardized program for TN was implemented in May 2012 at the Danish Headache Center (DHC). First out-patient visit and subsequent 3.0 Tesla MRI scan was booked in an accelerated manner. The MRI scan was performed according to a special TN protocol developed for this program. Patients initially referred to neurosurgery were re-directed to DHC for pre-surgical evaluation of diagnosis and optimization of medical treatment. Follow-up was 2 years with fixed visits where medical treatment and indication for neurosurgery was continuously evaluated. Scientific data was collected in a structured and prospective manner. From May 2012 to April 2014, 130 patients entered the accelerated program. Waiting time for the first out-patient visit was 42 days. Ninety-four percent of the patients had a MRI performed according to the special protocol after a mean of 37 days. Within 2 years follow-up 35% of the patients were referred to neurosurgery after a median time of 65 days. Five scientific papers describing demographics, clinical characteristics and neuroanatomical abnormalities were published. The described cross-speciality management program proved to be feasible and to have acceptable waiting times for referral and highly specialized work-up of TN patients in a public tertiary referral centre for headache

  15. Quantitative sensory testing in classical trigeminal neuralgia-a blinded study in patients with and without concomitant persistent pain

    DEFF Research Database (Denmark)

    Younis, Samaira; Maarbjerg, Stine; Reimer, Maren

    2016-01-01

    The diagnostic criteria of the third International Classification of Headache Disorders state that there should be no neurological deficits in patients with classical trigeminal neuralgia (TN) at clinical examination. However, studies demonstrating sensory abnormalities at bedside examination in TN...

  16. Straightening the trigeminal nerve axis by complete dissection of arachnoidal adhesion and its neuroendoscopic confirmation for trigeminal neuralgia without neurovascular compression

    Directory of Open Access Journals (Sweden)

    Mami Ishikawa, MD, PhD

    2017-12-01

    Conclusions: Straightening the trigeminal nerve axis by complete dissection of the arachnoidal adhesion around the trigeminal nerve was effective for typical trigeminal neuralgia without neurovascular compression.

  17. Analgesic therapy in postherpetic neuralgia: a quantitative systematic review.

    Directory of Open Access Journals (Sweden)

    Kathleen Hempenstall

    2005-07-01

    Full Text Available BACKGROUND: Postherpetic neuralgia (PHN is a complication of acute herpes zoster, which is emerging as a preferred clinical trial model for chronic neuropathic pain. Although there are published meta-analyses of analgesic therapy in PHN, and neuropathic pain in general, the evidence base has been substantially enhanced by the recent publication of several major trials. Therefore, we have conducted a systematic review and meta-analysis for both efficacy and adverse events of analgesic therapy for PHN. METHODS AND FINDINGS: We systematically searched databases (MEDLINE 1966-2004, EMBASE 1988-2004, CINAHL 1982-2002, and PubMed [29 October 2004] for trials of PHN. We also searched references of retrieved studies and review articles for further trials. We included trials that examined adult patients with PHN of greater duration than 3 mo, that were blinded, randomised, and had at least one measure of pain outcome. Dichotomous pain outcome data were extracted for 50% decrease in baseline pain using a hierarchy of pain/pain-relief measurement tools. Where available, dichotomous data were also collected for adverse events. Calculated estimates of efficacy included relative benefit and number needed to treat. Of 62 studies identified, 35 were randomised controlled trials. Of these, 31 were placebo controlled and suitable for meta-analysis, from which it was possible to extract dichotomous efficacy outcome data from 25. This meta-analysis revealed that there is evidence to support the use of the following orally administered therapies: tricyclic antidepressants, "strong" opioids, gabapentin, tramadol, and pregabalin. Topical therapies associated with efficacy were lidocaine 5% patch and capsaicin. Finally, a single study of spinal intrathecal administration of lidocaine and methyl prednisolone demonstrated efficacy, although this has yet to be replicated. Data suggest that the following therapies are not associated with efficacy in PHN: certain NMDA

  18. Prevention of postherpetic neuralgia with varicella-zoster hyperimmune globulin.

    Science.gov (United States)

    Hügler, Peter; Siebrecht, Peter; Hoffmann, Klaus; Stücker, Markus; Windeler, Jürgen; Altmeyer, Peter; Laubenthal, Heinz

    2002-01-01

    Recovery after an acute attack of herpes zoster is followed by postherpetic neuralgia (PHN) in 9-14% of all patients. Depending on the patient's age, the severity of the acute attack of herpes zoster and the dermatome involved, the incidence of PHN may be as high as 65%. The purpose of our study was to ascertain the incidence of PHN after a prophylactic intravenous injection of varicella-zoster hyperimmune globulin (VZV-IG) (Varitect Biotest Pharma). For this double-blind placebo-controlled randomised investigation we defined PHN as pain confined to the dermatome previously affected by herpes zoster, and we required a pain intensity of at least 15% points on a visual analogue scale (VAS) for this dermatome. The inclusion criteria were the dermatological diagnosis of herpes zoster together with age over 50 years. On Day 1, 20 patients received a single intravenous infusion of VZV-IG in a dose of 2mL/kg body weight, 20 patients (control group) received a single infusion of human albumin 5% in a dose of 2mL/kg body weight. All patients received acyclovir intravenously in a dose of 15mg/kg body weight per 24h for 5 days. The patients were followed up for a total of 42 days. The incidence of PHN at Day 42 was selected as the main outcome criterion for assessing the efficacy of prophylaxis. On reaching a significant difference between the groups (t test; alphaVAS and a NAS. As auxiliary outcome criteria, we used the McGill Pain-Rating Questionnaire in its German version, the revised multidimensional pain scale (RMSS) and the Freiburg symptom list (FBL). All results were assessed by the t test (alpha<0.05). The frequency of PHN in the placebo group was 70% (14/20), in the active treatment group it was 35% (7/20) at Day 42. The results of the McGill test showed the variability of the perception of pain in the placebo group significantly greater. No significant group differences were found in the FBL. Being tested with the RMSS, the patients of the placebo group assessed

  19. Utilización de pregabalina en neuralgia postherpética refractaria a terapia convencional Use of pregabalin in postherpetic neuralgia refractory to standard therapy

    OpenAIRE

    M. Garví; V. L. Villanueva; J. M. Asensio; J. A. de Andrés

    2008-01-01

    Tras un episodio de Herpes Zóster agudo, un dolor de duración superior a 3 meses cuya extensión supere las lesiones cutáneas, se clasifica como Neuralgia postherpética (NPH) (1). En su tratamiento se han utilizado diversos fármacos como analgésicos no opiáceos, antiinflamatorios no esteroideos (AINES), antidepresivos tricíclicos, anticonvulsivantes, fenotiacinas, antiarrítmicos y opiáceos con un éxito variable (2). Actualmente los antidepresivos tricíclicos y la gabapentina son considerados d...

  20. Improvement in clinical outcomes after dry needling in a patient with occipital neuralgia

    Science.gov (United States)

    Bond, Bryan M.; Kinslow, Christopher

    2015-01-01

    The primary purpose of this case report is to outline the diagnosis, intervention and clinical outcome of a patient presenting with occipital neuralgia. Upon initial presentation, the patient described a four-year history of stabbing neck pain and headaches. After providing informed consent, the patient underwent a total of four dry needling (DN) sessions over a two-week duration. During each of the treatment sessions, needles were inserted into the trapezii and suboccipital muscles. Post-intervention, the patient reported a 32-point change in her neck disability index score along with a 28-point change in her headache disability index score. Thus, it appears that subsequent four sessions of DN over two weeks, our patient experienced meaningful improvement in her neck pain and headaches. To the best of our knowledge, this is the first case report describing DN to successfully improve clinical outcomes in a patient diagnosed with occipital neuralgia. PMID:26136602

  1. Small Radiation Beam Dosimetry for Radiosurgery of Trigeminal Neuralgia: One Case Analysis

    International Nuclear Information System (INIS)

    Garcia-Garduno, O. A.; Larraga-Gutierrez, J. M.; Rodriguez-Villafuerte, M.; Martinez-Davalos, A.; Moreno-Jimenez, S.; Suarez-Campos, J. J.; Celis, M. A.

    2008-01-01

    The use of small radiation beams for trigeminal neuralgia (TN) treatment requires high precision and accuracy in dose distribution calculations and delivery. Special attention must be kept on the type of detector to be used. In this work, the use of GafChromic EBT registered radiochromic and X-OMAT V2 radiographic films for small radiation beam characterization is reported. The dosimetric information provided by the films (total output factors, tissue maximum ratios and off axis ratios) is compared against measurements with a shielded solid state (diode) reference detector. The film dosimetry was used for dose distribution calculations for the treatment of trigeminal neuralgia radiosurgery. Comparison of the isodose curves shows that the dosimetry produced with the X-OMAT radiographic film overestimates the dose distributions in the penumbra region

  2. Alcohol injection in the management of paroxysmal trigeminal neuralgia: a report of six cases.

    Science.gov (United States)

    Chindia, M L; Ng'ang'a, P M

    1994-01-01

    The report revisits the role of alcohol in the treatment of paroxysmal trigeminal neuralgia (PTN). The study included 6 patients, 3 male and 3 female, average age 50 years. In 3 cases PTN involved both the infraorbital and mental nerves; in 2 cases the infraorbital alone while one case had buccal branch involvement. In each case 2mls standard Lignocaine was infiltrated at each site followed by 2mls 60% sterile alcohol. All patients reported swelling postoperatively. One case with mental and infraorbital nerve involvement complained of oral dysaesthesia. Another patient with similar involvement failed to respond and developed trismus. Responders remained pain-free for 9 months on average. While paroxysmal trigeminal neuralgia (PTN) has been recognised for centuries, the aetiology and definitive treatment remain obscure. Since this is a debilitating condition, management should aim at improving the quality of life. Alcohol is available, affordable and offers useful results where medical resources provide limited PTN treatment modalities.

  3. Beneficio de la toxina botulínica tipo A en neuralgia del trigemino

    OpenAIRE

    Zúñiga, Carlos; Díaz, Sergio; Piedimonte, Fabián; Micheli, Federico

    2008-01-01

    Botulinum toxin has been thoroughly studied as a potential tool in the treatment of several pain syndromes. Therefore, we assessed the clinical effects of botulinum toxin type A injections in 12 patients with otherwise unresponsive idiopathic trigeminal neuralgia. Patients were infiltrated with 20-50 units of botulinum toxin in trigger zones. Those who presented with mandibular involvement were also infiltrated in the masseter muscle. The patients were assessed on a weekly basis using the Vis...

  4. Prolonged vertigo and ataxia after mandibular nerve block for treatment of trigeminal neuralgia

    OpenAIRE

    Arvind Chaturvedi; H H Dash

    2011-01-01

    Common complications of neurolytic mandibular nerve block are hypoesthesia, dysesthesia, and chemical neuritis. We report a rare complication, prolonged severe vertigo and ataxia, after neurolytic mandibular blockade in a patient suffering from trigeminal neuralgia. Coronoid approach was used for right sided mandibular block. After successful test injection with local anesthetic, absolute alcohol was given for neurolytic block. Immediately after alcohol injection, patient developed nausea and...

  5. Trigeminal neuralgia--a prospective systematic study of clinical characteristics in 158 patients

    DEFF Research Database (Denmark)

    Maarbjerg, Stine; Gozalov, Aydin; Olesen, Jes

    2014-01-01

    OBJECTIVE: To prospectively describe the clinical characteristics of classical trigeminal neuralgia (TN) in a standardized manner. BACKGROUND: TN is a rare disease and most clinicians only see a few patients. There is a lack of prospective systematic studies of the clinical characteristics of TN....... We hypothesized that contrary to current thinking, some TN patients suffer from sensory abnormalities at neurological examination. METHODS: Clinical characteristics such as demographics, pain characteristics, and comorbidities were systematically and prospectively collected from consecutive TN...

  6. Trigeminal neuralgia as the sole manifestation of an Arnold-Chiari type I malformation: case report.

    Science.gov (United States)

    Caranci, Giovanni; Mercurio, Alessio; Altieri, Marta; Di Piero, Vittorio

    2008-04-01

    Arnold-Chiari type I malformations usually manifest clinically with short-lasting headaches typically involving the occipital-nuchal region and precipitated by the Valsalva maneuver, coughing, sudden postural change, or physical exertion. We describe the case of an adult patient who presented with symptomatic trigeminal neuralgia caused by an Arnold-Chiari type I malformation. Unlike previous cases, the malformation involved the trigeminal ophthalmic division alone.

  7. Trigeminal Neuralgia Caused by Cerebellopontine Angle Arteriovenous Malformation Treated With Gamma Knife Radiosurgery.

    Science.gov (United States)

    Işik, Semra; Ekşi, Murat Şakir; Yilmaz, Baran; Toktaş, Zafer Orkun; Akakin, Akin; Kiliç, Türker

    2016-01-01

    Trigeminal neuralgia is a facial pain syndrome characterized as sudden onset and lightening-like sensation over somatosensorial branch(es) of fifth cranial nerve. Rarely, some underlying diseases or disorders could be diagnosed, such as multiple sclerosis, brain tumors, and vascular malformations. The authors present a 47-year-old man with trigeminal neuralgia over left V2 and V3 dermatomes. He had a previous transarterial embolization and long use of carbamazepine with partial response to treatment. Gamma knife radiosurgery (GKR) was planned. A marginal dose of 15 Gy was given to 50% isodose line. His pain was relieved by GKR in 1.5 years. Treatment of posterior fossa arteriovenous malformations causing trigeminal neuralgia, with GKR has a very limited use in the literature. It, however, is obvious that success rate as pain relief, in a very challenging field of functional neurosurgery, is satisfactory. Large series, however, are in need to make a more comprehensive statement about efficacy and safety of the procedure in these pathologies.

  8. Clinical observation on thoracic paravertebral nerve block with ozone treatment in patients with postherpetic neuralgia

    Directory of Open Access Journals (Sweden)

    GUO Xiang-fei

    2013-10-01

    Full Text Available Objective To analyze the clinical efficacy of thoracic paravertebral nerve block with ozone in the treatment of postherpetic neuralgia. Methods Eighty-five patients suffered postherpetic neuralgia were divided into 4 groups: Group A (oral drugs + intramuscular injection of vitamin B12 + local nerve block of lesion area, Group B (oral drugs + intramuscular injection of compound trivitamin B + local nerve block of lesion area, Group C (oral drugs + intramuscular injection of compound trivitamin B + thoracic paravertebral nerve block + local nerve block of lesion area, Group D (oral drugs + intramuscular injection of compound trivitamin B + thoracic paravertebral nerve block with ozone + local nerve block of lesion area. Treatment outcomes were evaluated by Visual Analogue Scale (VAS, Quality of Sleep (QS, Self-Rating Depression Scale (SDS and C-reactive protein (CRP before treatment and 4 weeks after treatment. Results After treatment, VAS, QS and SDS scores of 4 groups were lower than that before treatment, and the differences were statistically significant (P 0.05, for all, while a significant change in CRP was observed in patients of group D between before and after treatment (P < 0.05. The improvement of VAS, QS and SDS scores of group D was significantly better than other 3 groups (P < 0.05, for all. Conclusion Thoracic paravertebral nerve block combined with ozone is a quick and effective method for postherpetic neuralgia patients.

  9. Management of uncommon secondary trigeminal neuralgia related to a rare Arnold Chiari type I malformation

    Directory of Open Access Journals (Sweden)

    Zafar Ali Khan

    2017-12-01

    Full Text Available Background Trigeminal neuralgia (TN may sometimes present secondary to an intra-cranial cause. Arnold Chiari Malformation (ACM is downward herniation of the cerebellar tonsils through the foramen magnum that may be a cause of TN like pain in very rare cases. Aims The aim of this brief report is to suggest the proper management of uncommon secondary trigeminal neuralgia related to a rare Arnold Chiari type I malformation. Methods A male patient presented electric shock like stabbing pain on the right side of the face for more than ten years. The symptoms were typical of trigeminal neuralgia except that there was loss of corneal reflex on the right side and the patient also complained of gait & sleep disturbances. Complex and multilevel diagnosis was made. Results A multiplanar imaging through brain acquiring T1/T2W1 revealed ACM Type I Malformation with caudal displacement of cerebellar tonsils through foramen magnum. Conclusion Dental surgeons and oral and Maxillofacial Surgeons should exclude intra-cranial causes by Magnetic Resonance Imaging(MRI in patients of TN presenting with loss of corneal reflex, gait and sleep disturbances due to night time pain episodes.

  10. Laser heat stimulation of tiny skin areas adds valuable information to quantitative sensory testing in postherpetic neuralgia.

    Science.gov (United States)

    Franz, Marcel; Spohn, Dorothee; Ritter, Alexander; Rolke, Roman; Miltner, Wolfgang H R; Weiss, Thomas

    2012-08-01

    Patients suffering from postherpetic neuralgia often complain about hypo- or hypersensation in the affected dermatome. The loss of thermal sensitivity has been demonstrated by quantitative sensory testing as being associated with small-fiber (Aδ- and C-fiber) deafferentation. We aimed to compare laser stimulation (radiant heat) to thermode stimulation (contact heat) with regard to their sensitivity and specificity to detect thermal sensory deficits related to small-fiber dysfunction in postherpetic neuralgia. We contrasted detection rate of laser stimuli with 5 thermal parameters (thresholds of cold/warm detection, cold/heat pain, and sensory limen) of quantitative sensory testing. Sixteen patients diagnosed with unilateral postherpetic neuralgia and 16 age- and gender-matched healthy control subjects were tested. Quantitative sensory testing and laser stimulation of tiny skin areas were performed in the neuralgia-affected skin and in the contralateral homologue of the neuralgia-free body side. Across the 5 thermal parameters of thermode stimulation, only one parameter (warm detection threshold) revealed sensory abnormalities (thermal hypoesthesia to warm stimuli) in the neuralgia-affected skin area of patients but not in the contralateral area, as compared to the control group. In contrast, patients perceived significantly less laser stimuli both in the affected skin and in the contralateral skin compared to controls. Overall, laser stimulation proved more sensitive and specific in detecting thermal sensory abnormalities in the neuralgia-affected skin, as well as in the control skin, than any single thermal parameter of thermode stimulation. Thus, laser stimulation of tiny skin areas might be a useful diagnostic tool for small-fiber dysfunction. Copyright © 2012 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.

  11. Computed tomography-guided percutaneous ozone injection of the Gasserian ganglion for the treatment of trigeminal neuralgia.

    Science.gov (United States)

    An, Jian-Xiong; Liu, Hui; Chen, Ruo-Wen; Wang, Yong; Zhao, Wen-Xing; Eastwood, Derek; Williams, John P

    2018-01-01

    The aim of this study was to evaluate the therapeutic effect of computed tomography (CT)-guided percutaneous ozone injection for refractory trigeminal neuralgia. A retrospective evaluation was performed in the study. The study was conducted at a university hospital pain center. A total of 29 patients with a clinical diagnosis of refractory trigeminal neuralgia were enrolled. All patients were treated with a percutaneous ozone injection and one patient was excluded. There were 21 patients with classical trigeminal neuralgia (group A) and seven patients with painful trigeminal neuropathy caused by post-herpetic neuralgia (group B). The percutaneous injection was an oxygen-ozone mixture at an ozone concentration of 30 μg/mL into the Gasserian ganglion performed under CT guidance. The number of procedures performed varied from one to as many as 16. Outcomes were evaluated using visual analog scale (VAS) pain scores. The combined VAS scores were 7.11 ± 1.23 pretreatment, 2.86 ± 1.69 posttreatment ( P ozone injection is a safe and effective treatment for patients with refractory trigeminal neuralgia.

  12. Safety and efficacy of a Nav1.7 selective sodium channel blocker in patients with trigeminal neuralgia

    DEFF Research Database (Denmark)

    Zakrzewska, Joanna M; Palmer, Joanne; Morisset, Valerie

    2017-01-01

    , can be administered at therapeutic doses without titration, and has shown good tolerability in healthy individuals in phase 1 studies. We therefore assessed the safety and efficacy of BIIB074 in patients with trigeminal neuralgia in a phase 2a study. METHODS: We did a double-blind, multicentre......BACKGROUND: Current standard of care for trigeminal neuralgia is treatment with the sodium channel blockers carbamazepine and oxcarbazepine, which although effective are associated with poor tolerability and the need for titration. BIIB074, a Nav1.7-selective, state-dependent sodium-channel blocker...

  13. The accuracy of clinical diagnosis of discal sciatic neuralgia at construction labors: a comparison study

    Directory of Open Access Journals (Sweden)

    A. Khalvat

    2006-08-01

    Full Text Available Background: Mechanical low back pain (L.B.P is most common in middle-aged people especially in developing countries and the symptom compromises routine life activities of the patients. Disk herniation is the most frequent cause of LBP. The less costly way for diagnosing the cause of LBP is performing a careful physical examinations. This study aimed to evaluate the sensitivity and specificity of clinical diagnosis of the cause of Discal Sciatic Neuralgia at Construction Labors in comparison to MRI as the gold standard. Methods: In a descriptive- analytic study 60 middle-aged professional construction workers were evaluated. Their age range was 25-45 years old and all of them had the complaint of mechanical LBP. Medical history was taken and all cases under went a cautious physical examination. The presence of disk herniation between L4-L5 orL5-S1 was recorded according to clinical signs and symptoms. Lumbosacral MRI was performed for all cases and the results were compared to clinical data. Results: The clinical diagnosis of presence and severity of pathology was confirmed by MRI in all stages of discopathy in L5-S1 and L4-L5 vertebrae (sensitivity= 100%. Conclusion: This study showed that careful physical examinations will be sufficient for the sciatic neuralgia diagnosis and even the staging of disk herniation can be performed clinically. Requesting MRI as an expensive procedure is not recommended for diagnosis of Discal sciatic neuralgia because of feasibility of the cost effective way of precise physical examination.

  14. Influence of anatomic location of lidocaine patch 5% on effectiveness and tolerability for postherpetic neuralgia

    Directory of Open Access Journals (Sweden)

    Nalamachu S

    2013-06-01

    Full Text Available Srinivas Nalamachu,1 Matthew Wieman,2 Leah Bednarek,2 Surya Chitra21International Clinical Research Institute, Overland Park, KS, 2Endo Pharmaceuticals Inc, Malvern, PA, USAPurpose: Lidocaine patch 5% is recommended as a first-line therapy for postherpetic neuralgia pain in neuropathic pain guidelines. Postherpetic neuralgia can occur anywhere on the body but often follows acute herpes zoster occurring in trigeminal and brachial plexus dermatomes. An analysis was conducted to determine whether the anatomic location of lidocaine patch 5% is associated with variations in effectiveness or tolerability in patients with postherpetic neuralgia.Methods: This was a post hoc analysis by anatomic site of patch placement (head [including neck], trunk [chest, abdomen, back, hips], and extremities [arm, leg] of a 4-week, multicenter, open-label study that enrolled patients with persistent pain following herpes zoster infection. Effectiveness was measured by Brief Pain Inventory (BPI average pain intensity (0 [no pain] to 10 [worst imaginable pain] and the BPI subscale for pain relief (0% [no relief] to 100% [complete relief]. Tolerability was assessed on the basis of patient-reported adverse events.Results: Of 332 enrolled patients (59.6% women [n = 198]; 92.5% white [n = 307]; mean [standard deviation] age, 71.2 [13.9] years, those (n = 203 who applied lidocaine patch 5% to a single anatomic site only and had baseline and postbaseline pain score data were analyzed (trunk, n = 130; head, n = 41; extremities, n = 32. The frequency of adverse events differed significantly by anatomic location, with significantly more adverse events reported with patch placement on the head versus the extremities (P = 0.006 or trunk (P = 0.02. BPI average pain improved significantly from baseline in each of the three anatomic areas (mean score decrease, 1.50–2.04; P ≤ 0.002, with no significant difference in effectiveness by patch location.Conclusion: Lidocaine 5% patch was

  15. Prolonged vertigo and ataxia after mandibular nerve block for treatment of trigeminal neuralgia

    Directory of Open Access Journals (Sweden)

    Arvind Chaturvedi

    2011-01-01

    Full Text Available Common complications of neurolytic mandibular nerve block are hypoesthesia, dysesthesia, and chemical neuritis. We report a rare complication, prolonged severe vertigo and ataxia, after neurolytic mandibular blockade in a patient suffering from trigeminal neuralgia. Coronoid approach was used for right sided mandibular block. After successful test injection with local anesthetic, absolute alcohol was given for neurolytic block. Immediately after alcohol injection, patient developed nausea and vomiting along with severe vertigo, ataxia and hypertension. Neurological evaluation was normal except for the presence of vertigo and ataxia. Computerised tomography scan brain was also normal. Patient was admitted for observation and symptomatic treatment was given. Vertigo and ataxia gradually improved over 24 hours.

  16. Prolonged vertigo and ataxia after mandibular nerve block for treatment of trigeminal neuralgia.

    Science.gov (United States)

    Chaturvedi, Arvind; Dash, Hh

    2011-07-01

    Common complications of neurolytic mandibular nerve block are hypoesthesia, dysesthesia, and chemical neuritis. We report a rare complication, prolonged severe vertigo and ataxia, after neurolytic mandibular blockade in a patient suffering from trigeminal neuralgia. Coronoid approach was used for right sided mandibular block. After successful test injection with local anesthetic, absolute alcohol was given for neurolytic block. Immediately after alcohol injection, patient developed nausea and vomiting along with severe vertigo, ataxia and hypertension. Neurological evaluation was normal except for the presence of vertigo and ataxia. Computerised tomography scan brain was also normal. Patient was admitted for observation and symptomatic treatment was given. Vertigo and ataxia gradually improved over 24 hours.

  17. Intractable trigeminal neuralgia: A single institution experience in 26 patients treated with stereotactic gamma knife radiosurgery

    International Nuclear Information System (INIS)

    Mark, Rufus J.; Duma, Christopher M.; Jacques, Dean B.; Kopyov, Oleg V.; Copcutt, Brian

    1996-01-01

    Purpose: In patients with trigeminal neuralgia, severe pain can persist, or recur despite aggressive medical management and open surgery. Recently, Gamma Knife radiosurgery has been used with promising results. We report on our series of 26 patients with intractable trigeminal neuralgia treated with stereotactic Gamma Knife radiosurgery. Materials and Methods: Between 1991 and 1995, 26 patients with intractable trigeminal neuralgia were treated at our institution using stereotactic Gamma Knife radiosurgery. Medical management had failed in all cases. In addition, 13 patients underwent a total of 20 open surgeries, with transient, or no pain relief. There were 19 females, and 7 males. Patient ages ranged from 37 to 87 years, with a median of 74 years. All patients were treated with a 201 source Cobalt-60 Gamma Knife unit. All patients underwent placement of the Leksell frame, followed by MRI scanning and computer treatment planning. The target in all patients was the fifth cranial nerve root entry zone into the brainstem. Twenty-five patients received between 64.3 to 70 Gy prescribed to Dmax in one shot. One patient received 120 Gy to Dmax in one shot. The 4 mm collimator was used in 22 cases, and the 8 mm in 4 cases. Follow-up ranged from 5 to 55 months, with a median of 19 months. Complete resolution (CR) of pain was scored when the patient reported being pain free off all medication. Partial resolution (PR) was scored when the patient reported > 50% pain reduction after Gamma Knife treatment. Results: At last follow-up, 84.6% ((22(26))) reported CR or PR of pain after Gamma Knife treatment. Forty-two percent ((11(26))) of patients reported CR, and 42%((11(26))) reported PR of pain. There was a dose response. In patients receiving < 70 Gy, 25% ((3(12))) reported CR, while 57% ((8(14))) of those receiving ≥ 70 Gy reported CR. Complications occurred in two (8%) patients. One patient developed transient numbness of the face after 70 Gy, and a second patient

  18. Field-testing of the ICHD-3 beta diagnostic criteria for classical trigeminal neuralgia

    DEFF Research Database (Denmark)

    Maarbjerg, Stine; Sørensen, Morten Togo; Gozalov, Aydin

    2015-01-01

    INTRODUCTION: We aimed to field-test the beta version of the third edition of the International Classification of Headache Disorders (ICHD-3 beta) diagnostic criteria for classical trigeminal neuralgia (TN). The proposed beta draft of the 11th version of the International Classification of Diseases...... (ICD-11 beta) is almost exclusively based on the ICHD-3 beta classification structure although slightly abbreviated. We compared sensitivity and specificity to ICHD-2 criteria, and evaluated the needs for revision. METHODS: Clinical characteristics were systematically and prospectively collected from...

  19. [Treatment of neuralgia after surgical repair of inguinal hernia. Apropos of 47 cases].

    Science.gov (United States)

    Gatt, M T; Chevrel, J P

    1991-01-01

    A semiologic study is performed and therapeutic proposals are made on the basis of the anatomical and physiopathological data relating to residual neuralgia after the cure of a hernia. A series of 47 patients, 41 of whom were treated at the Multidisciplinary Pain Treatment Center of Avicenne Hospital (Bobigny) is analysed. The results are the following: 16 cures, 22 improvements, 6 failures, 3 patients lost to follow-up. The authors emphasize the difficulties of treatment, the poor effectiveness of second surgery as a rule, and the necessity of a general management.

  20. Botulinum neurotoxin type A for the treatment of pain: not just in migraine and trigeminal neuralgia.

    Science.gov (United States)

    Sandrini, Giorgio; De Icco, Roberto; Tassorelli, Cristina; Smania, Nicola; Tamburin, Stefano

    2017-12-01

    Despite their huge epidemiological impact, primary headaches, trigeminal neuralgia and other chronic pain conditions still receive suboptimal medical approach, even in developed countries. The limited efficacy of current pain-killers and prophylactic treatments stands among the main reasons for this phenomenon. Botulinum neurotoxin (BoNT) represents a well-established and licensed treatment for chronic migraine, but also an emerging treatment for other types of primary headache, trigeminal neuralgia, neuropathic pain, and an increasing number of pain conditions. We searched and critically reviewed evidence for the efficacy of BoNT for the treatment of chronic pain. Meta-analyses and randomized controlled trials (RCTs) suggest that BoNT potentially represents a multi-purpose drug for the treatment of pain in several disorders due to a favorable safety profile and a long-lasting relief after a single injection. BoNT is an emerging treatment in different pain conditions. Future RCTs should explore the use of BoNT injection therapy combined with systemic drugs and/or physical therapies as new pain treatment strategies.

  1. Practical considerations in the pharmacological treatment of postherpetic neuralgia for the primary care provider

    Directory of Open Access Journals (Sweden)

    Massengill JS

    2014-03-01

    Full Text Available Jamie S Massengill,1 John L Kittredge2 1JSM Medical, Edmond, OK, USA; 2Michiana Spine, Sports and Occupational Rehab, PC, Mishawaka, IN, USA Abstract: An estimated one million individuals in the US are diagnosed with herpes zoster (HZ; shingles each year. Approximately 20% of these patients will develop postherpetic neuralgia (PHN, a complex HZ complication characterized by neuropathic pain isolated to the dermatome that was affected by the HZ virus. PHN is debilitating, altering physical function and quality of life, and commonly affects vulnerable populations, including the elderly and the immunocompromised. Despite the availability of an immunization for HZ prevention and several approved HZ treatments, the incidence of PHN is increasing. Furthermore, management of the neuropathic pain associated with PHN is often suboptimal, and the use of available therapeutics may be complicated by adverse effects and complex, burdensome treatment regimens, as well as by patients' comorbidities and polypharmacy, which may lead to drug–drug interactions. Informed and comprehensive assessments of currently available pharmacological treatment options to achieve effective pain control in the primary care setting are needed. In this article, we discuss the situation in clinical practice, review currently recommended prevention and treatment options for PHN, and outline practical considerations for the management of this neuropathic pain syndrome, with a focus on optimal, individual-based treatment plans for use in the primary care setting. Keywords: herpes zoster, postherpetic neuralgia, primary care, clinical practice, pharmacological treatment, practical guidelines

  2. SU-E-T-420: Failure Effects Mode Analysis for Trigeminal Neuralgia Frameless Radiosurgery

    International Nuclear Information System (INIS)

    Howe, J

    2015-01-01

    Purpose: Functional radiosurgery has been used successfully in the treatment of trigeminal neuralgia but presents significant challenges to ensuring the high prescription dose is delivered accurately. A review of existing practice should help direct the focus of quality improvement for this treatment regime. Method: Failure modes and effects analysis was used to identify the processes in preparing radiosurgery treatment for TN. The map was developed by a multidisciplinary team including: neurosurgeon, radiation oncology, physicist and therapist. Potential failure modes were identified for each step in the process map as well as potential causes and end effect. A risk priority number was assigned to each cause. Results: The process map identified 66 individual steps (see attached supporting document). Corrective actions were developed for areas of high risk priority number. Wrong site treatment is at higher risk for trigeminal neuralgia treatment due to the lack of site specific pathologic imaging on MR and CT – additional site specific checks were implemented to minimize the risk of wrong site treatment. Failed collision checks resulted from an insufficient collision model in the treatment planning system and a plan template was developed to address this problem. Conclusion: Failure modes and effects analysis is an effective tool for developing quality improvement in high risk radiotherapy procedures such as functional radiosurgery

  3. [Clinical observation of post-herpetic neuralgia treated with TCM herbal cupping therapy].

    Science.gov (United States)

    Wu, Xi; Hu, Hui; Guo, Liang; Wang, Hui

    2013-02-01

    To compare the difference in the efficacy on post-herpetic neuralgia among TCM herbal cupping therapy, Chinese medicine thermal compressing therapy and mecobalamine. Fifty-seven cases were randomized into a TCM herbal cupping group, a thermal compressing group and a western medicine group, 19 cases in each one. The oral administration of ibuprofen was applied in every group. In the herbal cupping group, the bamboo cups soaked in the boiled Chinese herbal decoction were sucked on the most significant painful area. In the thermal compressing group, the towel soaked in the boiled Chinese herbal decoction was compressed on the most significant painful area. In the medication group, the muscular injection of mecobalamine was adopted. The treatment was given once a day, for 2 weeks totally in each group. SF-MPQ score and clinical efficacy before and after treatment were observed in each group. The remarkable effective rates were 78.9% (15/19), 36.8% (7/19) and 5.3% (1/19) in the TCM herbal cupping group, thermal compressing group and western medicine group separately. The efficacy in the TCM herbal cupping group was significantly superior to the thermal compressing group and western medicine group (all P cupping group was reduced more significantly as compared with the thermal compressing group and western medicine group (all P cupping therapy achieves the superior efficacy for post-herpetic neuralgia and relieves pain effectively of the patients, which is more advantageous than CM herbal thermal compressing therapy and Mecobalamine.

  4. Differential diagnostics of pain in the course of trigeminal neuralgia and temporomandibular joint dysfunction.

    Science.gov (United States)

    Pihut, M; Szuta, M; Ferendiuk, E; Zeńczak-Więckiewicz, D

    2014-01-01

    Chronic oral and facial pain syndromes are an indication for intervention of physicians of numerous medical specialties, while the complex nature of these complaints warrants interdisciplinary diagnostic and therapeutic approach. Oftentimes, lack of proper differentiation of pain associated with pathological changes of the surrounding tissues, neurogenic pain, vascular pain, or radiating pain from idiopathic facial pain leads to improper treatment. The objective of the paper is to provide detailed characterization of pain developing in the natural history of trigeminal neuralgia and temporomandibular joint dysfunction, with particular focus on similarities accounting for the difficulties in diagnosis and treatment as well as on differences between both types of pain. It might seem that trigeminal neuralgia can be easily differentiated from temporomandibular joint dysfunction due to the acute, piercing, and stabbing nature of neuralgic pain occurring at a single facial location to spread along the course of the nerve on one side, sometimes a dozen or so times a day, without forewarning periods. Both forms differ significantly in the character and intensity of pain. The exact analysis of the nature, intensity, and duration of pain may be crucial for the differential diagnostics of the disorders of our interest.

  5. Percutaneous CT-guided cryoablation for the treatment of refractory pudendal neuralgia

    Energy Technology Data Exchange (ETDEWEB)

    Prologo, J.D.; Williams, Roger [Emory University Hospital, Department of Radiology and Imaging Sciences Division of Interventional Radiology and Image-Guided Medicine, Atlanta, GA (United States); Lin, Roger C. [University Hospitals Case Medical Center, Department of Radiology, Cleveland, OH (United States); Corn, David [Case Western Reserve University, Department of Biomedical Engineering, Cleveland, OH (United States)

    2015-05-01

    To evaluate the safety and efficacy of percutaneous CT-guided cryoablation of the pudendal nerve for the treatment of refractory pudendal neuralgia. Eleven patients were selected to undergo percutaneous CT-guided cryoablation of the pudendal nerve based on established diagnostic criteria. Brief Pain Inventory questionnaires were administered prior to the procedure, during the immediate 24 h post procedure, and 45 days and 6 months following the procedure. Prior to treatment, the average level of pain on a scale from 0 (no pain) to 10 (worst pain imaginable) was 7.6, with pain described as ''burning'' (80%), ''pulling'' (37.5%), ''crushing'' (50%), ''pressure'' (84.5%), ''throbbing'' (50%), ''knife-life'' (52%), and ''other'' (60%). At 24 h, 45 days, and 6 months post-treatment, pain intensity dropped to 2.6, 3.5, and 3.1, respectively (p < 0.005). There were no procedure-related complications. CT-guided percutaneous cryoablation may represent a safe and efficacious option for selected patients with refractory pudendal neuralgia. (orig.)

  6. Possible role of an endovascular provocative test in the diagnosis of glossopharyngeal neuralgia as a vascular compression syndrome.

    Science.gov (United States)

    Matsushima, T; Goto, Y; Ishioka, H; Mihara, F; Fukui, M

    1999-01-01

    We utilized endovascular provocative techniques to identify the indications for microvascular decompression surgery in a serious case of glossopharyngeal neuralgia. This is the first reported case in which an endovascular provocative test was applied for diagnosis of glossopharyngeal neuralgia as a vascular compression syndrome. A 68-year-old woman presented with severe paroxysmal facial pain which could not be controlled by medical therapy. Partial effectiveness to carbamazepine led us to wonder whether or not the selection of microvascular decompression surgery would be appropriate. Pre-operative angiography was performed. During the examination a microcatheter was inserted into the right posterior inferior cerebellar artery (PICA), and an attack of typical glossopharyngeal neuralgia occurred. The patient thus underwent microvascular decompression surgery. The PICA was verified to compress the glossopharyngeal nerve and therefore was moved to induce decompression. The patient has since experienced no further pain for one year postoperatively. The diagnosis of glossopharyngeal neuralgia is sometimes complex and it is difficult to select the most appropriate surgical modality. In such cases this endovascular provocative technique may thus be useful for making a definitive decision or microvascular decompression surgery.

  7. Microvascular Decompression for Classical Trigeminal Neuralgia Caused by Venous Compression: Novel Anatomic Classifications and Surgical Strategy.

    Science.gov (United States)

    Wu, Min; Fu, Xianming; Ji, Ying; Ding, Wanhai; Deng, Dali; Wang, Yehan; Jiang, Xiaofeng; Niu, Chaoshi

    2018-05-01

    Microvascular decompression of the trigeminal nerve is the most effective treatment for trigeminal neuralgia. However, when encountering classical trigeminal neuralgia caused by venous compression, the procedure becomes much more difficult, and failure or recurrence because of incomplete decompression may become frequent. This study aimed to investigate the anatomic variation of the culprit veins and discuss the surgical strategy for different types. We performed a retrospective analysis of 64 consecutive cases in whom veins were considered as responsible vessels alone or combined with other adjacent arteries. The study classified culprit veins according to operative anatomy and designed personalized approaches and decompression management according to different forms of compressive veins. Curative effects were assessed by the Barrow Neurological Institute (BNI) pain intensity score and BNI facial numbness score. The most commonly encountered veins were the superior petrosal venous complex (SPVC), which was artificially divided into 4 types according to both venous tributary distribution and empty point site. We synthetically considered these factors and selected an approach to expose the trigeminal root entry zone, including the suprafloccular transhorizontal fissure approach and infratentorial supracerebellar approach. The methods of decompression consist of interposing and transposing by using Teflon, and sometimes with the aid of medical adhesive. Nerve combing (NC) of the trigeminal root was conducted in situations of extremely difficult neurovascular compression, instead of sacrificing veins. Pain completely disappeared in 51 patients, and the excellent outcome rate was 79.7%. There were 13 patients with pain relief treated with reoperation. Postoperative complications included 10 cases of facial numbness, 1 case of intracranial infection, and 1 case of high-frequency hearing loss. The accuracy recognition of anatomic variation of the SPVC is crucial for the

  8. Gabapentin for once-daily treatment of post-herpetic neuralgia: a review

    Directory of Open Access Journals (Sweden)

    Beal B

    2012-07-01

    Full Text Available Benjamin Beal,1 Tobias Moeller-Bertram,1,2 Jan M Schilling,1 Mark S Wallace11Division of Pain Medicine, Department of Anesthesiology, University of California, 2VA San Diego Healthcare System, San Diego, CA, USAAbstract: Post-herpetic neuralgia is a neuropathic pain syndrome resulting from an insult to the peripheral and central nervous systems caused by the varicella zoster virus. Spontaneous pain may result in the persistent sensation of burning, tingling, or aching and may be associated with thermally or mechanically provoked pain, resulting in hyperalgesia or allodynia. The majority of cases occur in patients over the age of 50 years. Gabapentin is a structural analog of gamma aminobutyric acid that binds to the α2-δ site of voltage-dependent calcium channels and modulates the influx of calcium, with a resulting reduction in excitatory neurotransmitter release. Gabapentin is effective in reducing neuropathic pain due to post-herpetic neuralgia when given at least three times per day, due to its short half-life, resulting in demonstrable fluctuations in plasma levels. Gabapentin has dose-limiting side effects that prevent some patients from achieving therapeutic plasma levels, such as somnolence (27.4%, dizziness (23.9%, and ataxia (7.1%. Gralise™ is a once-daily extended-release formulation of gabapentin that has been developed using AcuForm™ technology. AcuForm is a polymer-based drug delivery system that retains the tablet in the stomach and upper gastrointestinal tract for a sustained period of time. Once-daily dosing has been shown to provide comparable drug exposure with an identical daily dose of the immediate-release formulation when administered three times daily. Participants given Gralise 1800 mg daily had a statistically significant reduction in average daily pain intensity scores compared with placebo, reduced sleep interference due to pain, and a greater percent of participants reporting being much or very much improved on

  9. A Case of Occipital Neuralgia in the Greater and Lesser Occipital Nerves Treated with Neurectomy by Using Transcranial Doppler Sonography: Technical Aspects

    OpenAIRE

    Jung, Sang Jin; Moon, Seong Keun; Kim, Tae Young; Eom, Ki Seong

    2011-01-01

    Occipital neuralgia is usually defined as paroxysmal stabbing pain in the greater or lesser occipital nerve (GON or LON) distribution. In occipital neuralgia patients, surgical considerations are carefully taken into account if medical management is ineffective. However, identification of the occipital artery by palpation in patients with thick necks or small occipital arteries can be technically difficult. Therefore, we established a new technique using transcranial Doppler (TCD) sonography ...

  10. A review of percutaneous techniques for low back pain and neuralgia: current trends in epidural infiltrations, intervertebral disk and facet joint therapies

    OpenAIRE

    Filippiadis, Dimitrios K; Kelekis, Alexis

    2015-01-01

    Low back pain and neuralgia due to spinal pathology are very common symptoms debilitating numerous patients with peak prevalence at ages between 45 and 60 years. Intervertebral discs and facet joints act as pain sources in the vast majority of the cases. Diagnosis is based on the combination of clinical examination and imaging studies. Therapeutic armamentarium for low back pain and neuralgia due to intervertebral discs and/or facet joints includes conservative therapy, injections, percutaneo...

  11. Mindfulness meditation in older adults with postherpetic neuralgia: a randomized controlled pilot study.

    Science.gov (United States)

    Meize-Grochowski, Robin; Shuster, George; Boursaw, Blake; DuVal, Michelle; Murray-Krezan, Cristina; Schrader, Ron; Smith, Bruce W; Herman, Carla J; Prasad, Arti

    2015-01-01

    This parallel-group, randomized controlled pilot study examined daily meditation in a diverse sample of older adults with postherpetic neuralgia. Block randomization was used to allocate participants to a treatment group (n = 13) or control group (n = 14). In addition to usual care, the treatment group practiced daily meditation for six weeks. All participants completed questionnaires at enrollment in the study, two weeks later, and six weeks after that, at the study's end. Participants recorded daily pain and fatigue levels in a diary, and treatment participants also noted meditation practice. Results at the 0.10 level indicated improvement in neuropathic, affective, and total pain scores for the treatment group, whereas affective pain worsened for the control group. Participants were able to adhere to the daily diary and meditation requirements in this feasibility pilot study. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Radiofrequencia-termocoagulacao no tratamento da neuralgia do trigemio: analise de 100 casos

    OpenAIRE

    Motta, Pedro; Souza, Mario Tadeu Kroeff de; Sengupta, R. P.

    1980-01-01

    É relatada uma série de 100 pacientes com neuralgia do trigêmio tratados mediante termocoagulação percutânea com radiofrequência do gânglio de Gasser. Os autores descrevem os princípios básicos da termocoagulação e comentam alguns métodos terapêuticos empregados no combate da dôr antes do desenvolvimento dessa nova técnica. São relatadas as diferentes fases do procedimento cirúrgico, sendo os resultados analizados. Os autores concluem que a termocoagulação percutanea com radiofrequência tem s...

  13. Computed tomography-guided percutaneous ozone injection of the Gasserian ganglion for the treatment of trigeminal neuralgia

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    An JX

    2018-01-01

    Full Text Available Jian-Xiong An,1,2 Hui Liu,1 Ruo-Wen Chen,1,2 Yong Wang,1 Wen-Xing Zhao,1 Derek Eastwood,3 John P Williams4 1Department of Anesthesiology, Pain Medicine & Critical Care Medicine, Aviation General Hospital of China Medical University & Beijing Institute of Translational Medicine, Chinese Academy of Sciences, 2Department of Anesthesiology, Weifang Medical University, Beijing, People’s Republic of China; 3Department of Pain Services, Wirral University Teaching Hospital, Wirral, Merseyside, UK; 4Department of Anesthesiology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA Objective: The aim of this study was to evaluate the therapeutic effect of computed tomography (CT-guided percutaneous ozone injection for refractory trigeminal neuralgia. Design: A retrospective evaluation was performed in the study. Setting: The study was conducted at a university hospital pain center. Patients and methods: A total of 29 patients with a clinical diagnosis of refractory trigeminal neuralgia were enrolled. All patients were treated with a percutaneous ozone injection and one patient was excluded. There were 21 patients with classical trigeminal neuralgia (group A and seven patients with painful trigeminal neuropathy caused by post-herpetic neuralgia (group B. The percutaneous injection was an oxygen–ozone mixture at an ozone concentration of 30 mg/­mL into the Gasserian ganglion performed under CT guidance. The number of ­procedures performed varied from one to as many as 16. Outcomes were evaluated using visual analog scale (VAS pain scores. Results: The combined VAS scores were 7.11 ± 1.23 pretreatment, 2.86 ± 1.69 posttreatment (P < 0.05 and 3.25 ± 2.01 after 6-month follow-up (P < 0.05. In group A, the VAS scores were 7.10 ± 1.04 pretreatment and 2.90 ± 1.84 posttreatment (P < 0.05. In group B, the VAS scores were 7.14 ± 1.77 pretreatment and 2.71 ± 1.25 posttreatment (P < 0.05. After 6-months follow-up, the VAS score was 3.38

  14. Treatments' outcomes of patients suffered from trigeminal neuralgia in kerman, iran.

    Science.gov (United States)

    Faryabi, Javad; Joolhar, Maryam

    2014-09-01

    Trigeminal neuralgia (TN) presents with a shooting pain in maxillofacial region which compels the involved patients to visit many medical and dental physicians to relieve the pain. Hence, assessing the outcomes of different treatment modalities may help the patients and their clinicians choose a suitable practical method of treatment. The study was aimed to evaluate the outcomes of different treatments of TN and to determine which surgical or non-surgical treatment is better for controlling the pain. This study included 42 patients with trigeminal neuralgia. A questionnaire was completed for each patient in order to evaluate the pain control status of patients' treatment with non-surgical (pharmaceutical) and surgical modalities. The questionnaire consisted of questions on an datasheet , concerning the duration of involvement with the condition, type and dose of the medication(s) used, the surgical technique administrated, patient satisfaction with the treatment modality and the intensity and frequency of the pain if present. The purpose of the study and the necessary information regarding the questions of the data sheet was given in detail to the patients for a careful completion of the questionnaires. Data was analyzed by adopting t-test using SPSS software. The results showed that the patients treated with pharmaceutical modalities had relatively lower improvement rate than those treated with surgery combined with medication (p< 0.035). Carbamazepine was the most consumed medication for pain control and the microvascular decompression was the most performed surgical method in patients. Although medication therapy alone was less effective than surgery combined with medication, both treatment modalities were significantly effective in controlling the pain of patients.

  15. Prevention of Post-herpetic Neuralgia from Dream to Reality: A Ten-step Model.

    Science.gov (United States)

    Makharita, Mohamed Younis

    2017-02-01

    Herpes zoster (HZ) is a painful, blistering skin eruption in a dermatomal distribution caused by reactivation of a latent varicella zoster virus in the dorsal root ganglia (DRG). Post-herpetic neuralgia (PHN) is the most common complication of acute herpes zoster (AHZ).Severe prodrome, greater acute pain and dermatomal injury, and the density of the eruption are the risk factors and predictors for developing PHN. PHN has a substantial effect on the quality of life; many patients develop severe physical, occupational, social, and psychosocial disabilities as a result of the unceasing pain. The long-term suffering and the limited efficacy of the currently available medications can lead to drug dependency, hopelessness, depression, and even suicide. Family and society are also affected regarding cost and lost productivity. The pathophysiology of PHN remains unclear. Viral reactivation in the dorsal root ganglion and its spread through the affected nerve result in severe ganglionitis and neuritis, which induce a profound sympathetic stimulation and vasoconstriction of the endoneural arterioles, which decreases the blood flow in the intraneural capillary bed resulting in nerve ischemia. Our rationale is based on previous studies which have postulated that the early interventions could reduce repetitive painful stimuli and prevent vasospasm of the endoneural arterioles during the acute phase of HZ. Hence, they might attenuate the central sensitization, prevent the ischemic nerve damage, and finally account for PHN prevention.The author introduces a new Ten-step Model for the prevention of PHN. The idea of this newly suggested approach is to increase the awareness of the health care team and the community about the nature of HZ and its complications, especially in the high-risk groups. Besides, it emphasizes the importance of the prompt antiviral therapy and the early sympathetic blockades for preventing PHN. Key words: Acute herpes zoster, prevention, post

  16. Health economic evidence of 5% lidocaine medicated plaster in post-herpetic neuralgia

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    Liedgens H

    2013-11-01

    Full Text Available Hiltrud Liedgens,1 Marko Obradovic,1 Mark Nuijten2 1Grunenthal GmbH, Aachen, Germany; 2Ars Accessus Medica, Amsterdam, the Netherlands Background: Post-herpetic neuralgia (PHN is the most common and most debilitating complication of herpes zoster, and involves considerable associated costs. Objective: This paper presents results from nine health economic studies undertaken in eight European countries that compared lidocaine medicated plaster with gabapentin and/or pregabalin in PHN. It aims to support the increasing need for published cost-effectiveness data for health care decision-making processes in Europe. Methods: All studies were based on a similar core Markov model with data derived from clinical trials, local Delphi panels, and official national price and tariff lists. The main outcome measure was cost per quality-adjusted life year gained; time without pain or intolerable adverse events was also included as a secondary outcome measure. All studies focused on an elderly population of patients with PHN who had insufficient pain relief with standard analgesics and could not tolerate or had contraindications to tricyclic antidepressants. Results: Despite considerable differences in many of the variables used, the results showed remarkable similarity and suggested that use of lidocaine medicated plaster offered cost-savings in many of the countries studied, where it proved a highly cost-effective alternative to both gabapentin and pregabalin. Conclusion: Lidocaine medicated plaster is a cost-effective alternative to gabapentin and pregabalin in the treatment of PHN. These savings are largely the result of the superior safety profile of the lidocaine medicated plaster. Keywords: post-herpetic neuralgia, zoster, cost-effectiveness, lidocaine, plaster

  17. Amitriptyline Versus Pregabalin in Post Herpetic Neuralgia: A Randomized Clinical Trial

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    Arun Achar

    2013-09-01

    Full Text Available Objective: Post herpetic neuralgia is a most common complication of herpes zoster which is difficult to treat. Significant beneficial effects found when treated with antiviral, tricyclic antidepressant, anticonvulsive like gabapentine and pregabalin, opioid and non opioid analgesic etc. Primary prevention can also be done with vaccine. The aim of this randomized comparative study was to establish clinical efficacy with amitriptyline and pregabalin. Methods: An open ended randomized clinical trial was conducted to compared clinical efficacy of amitriptyline (n=25 and pregabalin (n=25. Amitriptyline was given 25 mg once daily and pregabalin 75 mg twice daily. Total period of treatment were 6 month and patients were reviewed at the end of 2months, 4months and 6months to evaluate the degree of improvement in pain perception and any adverse reaction. Results: Four types of patients were included in this study and among them thoracic type was the commonest (54%. It was followed by cervical (24%, trigeminal (16% and lumbosacral types (6%. According to VAS score, satisfactory significant improvements in pain perception was observed at the end of 2 months (36%vs 8%, p<0.05 and 4 months (61.9%vs 27.8%, p<0.05 in pregabalin group than amitriptyline group. The chances of improvement more than 6 times and 4 times higher in patients with pregabalin group than those in amitriptyline group. There is no significant improvement difference was noticed at the end of 6months between groups. However, improvement was 89%(OR=1.89, 95%CI: 0.53-6.68 higher in pregabalin group than amitriptyline group. More importantly dizziness was the commonest side effect in pregabalin group while dryness of mouth was the commonest side affect in amitriptyline group. Conclusion: In conclusion, therapy with pregabalin is better compare to amitriptyline in post herpetic neuralgia. However a similar study with larger augmentation is required to establish the findings.

  18. Multimodal Image-Based Virtual Reality Presurgical Simulation and Evaluation for Trigeminal Neuralgia and Hemifacial Spasm.

    Science.gov (United States)

    Yao, Shujing; Zhang, Jiashu; Zhao, Yining; Hou, Yuanzheng; Xu, Xinghua; Zhang, Zhizhong; Kikinis, Ron; Chen, Xiaolei

    2018-02-21

    To address the feasibility and predictive value of multimodal image-based virtual reality in detecting and assessing features of neurovascular confliction (NVC), particularly regarding the detection of offending vessels, degree of compression exerted on the nerve root, in patients who underwent microvascular decompression for nonlesional trigeminal neuralgia and hemifacial spasm (HFS). This prospective study includes 42 consecutive patients who underwent microvascular decompression for classic primary trigeminal neuralgia or HFS. All patients underwent preoperative 1.5-T magnetic resonance imaging (MRI) with T2-weighted three-dimensional (3D) sampling perfection with application-optimized contrasts by using different flip angle evolutions, 3D time-of-flight magnetic resonance angiography, and 3D T1-weighted gadolinium-enhanced sequences in combination, whereas 2 patients underwent extra experimental preoperative 7.0-T MRI scans with the same imaging protocol. Multimodal MRIs were then coregistered with open-source software 3D Slicer, followed by 3D image reconstruction to generate virtual reality (VR) images for detection of possible NVC in the cerebellopontine angle. Evaluations were performed by 2 reviewers and compared with the intraoperative findings. For detection of NVC, multimodal image-based VR sensitivity was 97.6% (40/41) and specificity was 100% (1/1). Compared with the intraoperative findings, the κ coefficients for predicting the offending vessel and the degree of compression were >0.75 (P impact on detection of small-caliber offending vessels with relatively slow flow speed in cases of HFS. Multimodal image-based VR using 3D sampling perfection with application-optimized contrasts by using different flip angle evolutions in combination with 3D time-of-flight magnetic resonance angiography sequences proved to be reliable in detecting NVC and in predicting the degree of root compression. The VR image-based simulation correlated well with the real

  19. A case report of complex auricular neuralgia treated with the great auricular nerve and facet blocks

    Directory of Open Access Journals (Sweden)

    Eghtesadi M

    2017-02-01

    Full Text Available Marzieh Eghtesadi,1 Elizabeth Leroux,2 Grisell Vargas-Schaffer3 1Department of Pain Clinic, Headache Management, Centre Hospitalier de l’Université de Montréal (CHUM, Centre de Recherche de l’Université de Montréal (CRCHUM, 2Department of General Neurology, Headache Management, Centre Hospitalier de l’Université de Montréal (CHUM, Centre de Recherche de l’Université de Montréal (CRCHUM, 3Department of Anesthesiology, Pain Clinic, Centre Hospitalier de l’Université de Montréal (CHUM, Centre de Recherche de l’Université de Montréal (CRCHUM, Montreal, QC, Canada Background: The great auricular nerve is a cutaneous branch of the cervical plexus originating from the C2 and C3 spinal nerves. It innervates the skin over the external ear, the angle of the mandible and the parotid gland. It communicates with the ansa cervicalis. Great auricular neuralgia is rarely diagnosed in clinical practice and can be refractory. We present a new approach using ultrasound-guided nerve blocks.Case: We present a case of a 41-year-old female with paroxysmal ear pain accompanied by dysautonomia, tingling in the tongue, dysphagia, dysarthria and abdominal symptoms. No significant findings were found on cervical and brain imaging. The patient responded partially to a great auricular nerve block. A combined approach using this block with facet block of C2 and C3 induced a more pronounced and prolonged benefit.Conclusion: Great auricular neuralgia is not often encountered in practice and can be accompanied by symptoms originating from the ansa cervicalis network. A combined approach of nerve blocks can be considered in refractory cases. Keywords: ansa cervicalis, neuropathic pain, facet block, red ear syndrome, great auricular nerve

  20. Proposal for evaluating the quality of reports of surgical interventions in the treatment of trigeminal neuralgia: the Surgical Trigeminal Neuralgia Score.

    Science.gov (United States)

    Akram, Harith; Mirza, Bilal; Kitchen, Neil; Zakrzewska, Joanna M

    2013-09-01

    The aim of this study was to design a checklist with a scoring system for reporting on studies of surgical interventions for trigeminal neuralgia (TN) and to validate it by a review of the recent literature. A checklist with a scoring system, the Surgical Trigeminal Neuralgia Score (STNS), was devised partially based on the validated STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) criteria and customized for TN after a literature review and then applied to a series of articles. These articles were identified using a prespecified MEDLINE and Embase search covering the period from 2008 to 2010. Of the 584 articles found, 59 were studies of interventional procedures for TN that fulfilled the inclusion criteria and 56 could be obtained in full. The STNS was then applied independently by 3 of the authors. The maximum STNS came to 30, and was reliable and reproducible when used by the 3 authors who performed the scoring. The range of scores was 6-23.5, with a mean of 14 for all the journals. The impact factor scores of the journals in which the papers were published ranged from 0 to 4.8. Twenty-four of the studies were published in the Journal of Neurosurgery or in Neurosurgery. Studies published in neurosurgical journals ranked higher on the STNS scale than those published in nonneurosurgical journals. There was no statistically significant correlation between STNS and impact factors. Stereotactic radiosurgery (n = 25) and microvascular decompression (n = 15) were the most commonly reported procedures. The diagnostic criteria were stated in 35% of the studies, and 4 studies reported subtypes of TN. An increasing number of studies (46%) used the recommended Kaplan-Meier methodology for pain survival outcomes. The follow-up period was unclear in 8 studies, and 26 reported follow-ups of more than 5 years. Complications were reported fairly consistently but the temporal course was not always indicated. Direct interview, telephone conversation

  1. Evaluation of the effectiveness of CT-guided infiltration in the treatment of Arnold's neuralgia

    Energy Technology Data Exchange (ETDEWEB)

    Aubry, Sebastien [CHU Sherbrooke, Departement de Radiologie, Sherbrooke, QC (Canada); Universite de Franche-Comte, Laboratoire Intervention, Imagerie, Ingenierie et Innovation en Sante, Besancon (France); Kastler, Bruno [Universite de Franche-Comte, Laboratoire Intervention, Imagerie, Ingenierie et Innovation en Sante, Besancon (France); CHU Jean Minjoz, Service de Radiologie A, Besancon (France); Bier, Vincent; Hussein, Hussein Haj [CHU Jean Minjoz, Service de Radiologie A, Besancon (France); Hadjidekov, Vassil [Alexandrovska Hospital, Radiology Department, Sofia (Bulgaria); Fergane, Bernard [CHU Jean Minjoz, Centre d' Evaluation et de Traitement de la Douleur, Besancon (France)

    2009-03-15

    The aim of this study was to evaluate the effectiveness of computed tomography (CT)-guided infiltration in the treatment of Arnold's neuralgia. A retrospective study included 31 patients suffering from Arnold's neuralgia and having undergone a total of 45 CT-guided infiltrations of the greater occipital nerve (GON), in a proximal site (emergence of the GON, technique 1, n = 24) or in two proximal sites (emergence of the GON and at the site of the first bend of the GON drawn by the GON, technique 2, n = 21). Infiltration was considered to be effective when pain relief was equal to or greater than 50% for at least 1 month. There was no significant difference between the two techniques regarding immediate pain relief effect (53.3% for technique 1 vs. 60.5% for technique 2, p = 0.5), but technique 2 yielded better persistence of pain relief effect (p = 0.01), leading to a significantly higher percentage of effective infiltrations with technique 2 (p = 0.03). Infiltrations carried out in a single site yield results that are comparable to those previously published. Infiltrations in two sites provide significantly better results and should now be preferred to other single-site techniques in order to reduce the rate of failure or recurrence of Arnold's neuralgia. (orig.)

  2. Keyhole craniotomy through retrosigmoid approach followed by microvascular decompression for primary trigeminal neuralgia:a report of 23 cases

    Directory of Open Access Journals (Sweden)

    Gang-ge CHENG

    2011-03-01

    Full Text Available Objective To explore the surgical technique,effects,and complications of keyhole craniotomy through retrosigmoid approach followed by microvascular decompression for primary trigeminal neuralgia.Methods The craniotomy with a keyhole incision above postauricular hairline followed by microvascular decompression was performed in 23 patients with primary trigeminal neuralgia.Dissection of intracranial part of trigeminal nerve under microscope was done to search for the offending vessels,which were thereby freed and between which and the root entry zone(REZ of trigeminal nerve the Teflon grafts were placed.Effects and complications were observed in follow-up,ranging from 1 month to 2 years.Results Out of 23 patients who were all found compression in REZ of trigeminal nerves by the offending vessels in operation,disappearance of symptoms post-surgery was found in 22 cases,face numbness on the surgical side in 3 cases and no effects in 1 case.Recurrence of pain was not observed in patients who had initially benefited from the surgery at the follow-up.Conclusion The keyhole craniotomy through retrosigmoid approach followed by microvascular decompression is safe and effective for primary trigeminal neuralgia,in which accurate technique during operation plays a vital role in the decrease of complications and the outcome post-surgery.

  3. Does increased nerve length within the treatment volume improve trigeminal neuralgia radiosurgery? a prospective double-blind, randomized study

    International Nuclear Information System (INIS)

    Flickinger, John C.; Pollock, Bruce E.; Kondziolka, Douglas; Phuong, Loi K.; Foote, Robert L.; Stafford, Scott L.; Lunsford, L. Dade

    2001-01-01

    Purpose: To test the hypothesis that increasing the nerve length within the treatment volume for trigeminal neuralgia radiosurgery would improve pain relief. Methods and Materials: Eighty-seven patients with typical trigeminal neuralgia were randomized to undergo retrogasserian gamma knife radiosurgery (75 Gy maximal dose with 4-mm diameter collimators) using either one (n=44) or two (n=43) isocenters. The median follow-up was 26 months (range 1-36). Results: Pain relief was complete in 57 patients (45 without medication and 12 with low-dose medication), partial in 15, and minimal in another 15 patients. The actuarial rate of obtaining complete pain relief (with or without medication) was 67.7%±5.1%. The pain relief was identical for one- and two-isocenter radiosurgery. Pain relapsed in 30 of 72 responding patients. Facial numbness and mild and severe paresthesias developed in 8, 5, and 1 two-isocenter patients vs. 3, 4, and 0 one-isocenter patients, respectively (p=0.23). Improved pain relief correlated with younger age (p=0.025) and fewer prior procedures (p=0.039) and complications (numbness or paresthesias) correlated with the nerve length irradiated (p=0.018). Conclusions: Increasing the treatment volume to include a longer nerve length for trigeminal neuralgia radiosurgery does not significantly improve pain relief but may increase complications

  4. Burden of herpes zoster and postherpetic neuralgia in Japanese adults 60 years of age or older: Results from an observational, prospective, physician practice-based cohort study.

    Science.gov (United States)

    Sato, Keiko; Adachi, Koichi; Nakamura, Hiroyuki; Asano, Kazuhiro; Watanabe, Akihiro; Adachi, Riri; Kiuchi, Mariko; Kobayashi, Keiju; Matsuki, Taizo; Kaise, Toshihiko; Gopala, Kusuma; Holl, Katsiaryna

    2017-04-01

    Approximately one in three persons will develop herpes zoster during their lifetime, and it can lead to serious complications such as postherpetic neuralgia. However, evidence on burden of herpes zoster and postherpetic neuralgia in Japan is limited. This prospective, observational, multicenter, physician practice-based cohort study was conducted in Kushiro, Hokkaido, Japan (Clinicaltrials.gov identifier NCT01873365) to assess the incidence and hospitalization rates of herpes zoster, and the proportion, clinical burden and risk factors for postherpetic neuralgia in adults aged 60 years or more. Within the study area, 800 subjects developed herpes zoster and 412 were eligible for the study. Herpes zoster incidence was 10.2/1000 person-years and higher among women and older subjects. Subjects with herpes zoster required on average 5.7 outpatient consultations. Herpes zoster-associated hospitalization rate was 3.4% (27/800). The proportion of postherpetic neuralgia and other complications was 9.2% (38/412) and 26.5% (109/412), respectively. Statistically significant association with the development of postherpetic neuralgia was male sex (odds ratio [OR], 2.51; 95% confidence interval [CI], 1.17-5.38), age of 70-74 years (OR, 3.51; 95% CI, 1.09-11.3), immunosuppressive therapy (OR, 6.44; 95% CI, 1.26-32.9), severe herpes zoster pain at first consultation (OR, 3.08; 95% CI, 1.10-8.62) and rash on upper arms (vs no rash on upper arms; OR, 3.46; 95% CI, 1.10-10.9). Considerable herpes zoster and postherpetic neuralgia burden exists among elderly in Japan, and there may be predictive factors at the first visit which could be indicative of the risk of developing postherpetic neuralgia. © 2016 The Authors. The Journal of Dermatology published by John Wiley & Sons Australia, Ltd on behalf of Japanese Dermatological Association.

  5. Síncope cardíaca reflexa por "nevralgia" do glossofaríngeo: rara apresentação dessa doença Cardiac syncope induced by glossopharyngeal "neuralgia": a rare presentation

    Directory of Open Access Journals (Sweden)

    Helio Korkes

    2006-11-01

    Full Text Available A primeira descrição de dor severa no trajeto do nervo glossofaríngeo foi realizada por Weisenberg, em 1910¹, em um paciente com tumor do ângulo ponto cerebelar. Entretanto, coube a Harris, em 1926², nomear como nevralgia do nervo glossofaríngeo esse raro quadro clínico, caracterizado por paroxismos de dor intensa, unilaterais, na região posterior da língua, no palato mole, na garganta e na região lateral e posterior da faringe, irradiando para o ouvido. A dor pode ser desencadeada por deglutição, tosse, bocejo ou mastigação e normalmente dura de segundos a minutos. A associaç��o de nevralgia do glossofaríngeo e síncope é muito rara e se deve a breves períodos de bradicardia, assistolia ou hipotensão, sendo a primeira descrição dessa associação, com essa fisiopatologia, realizada por Riley e cols., em 1942³.The first description of severe pain in the distribution of the glossopharyngeal nerve is credited to Weisenberg, in 1910¹, in a patient with cerebellopontine angle tumor. However, it was Harris, in 1926², who coined the term glossopharyngeal neuralgia to describe this rare condition characterized by paroxysms of excruciating pain located laterally at the back of the tongue, soft palate, throat, and lateral and posterior pharynx, radiating to the ear. Swallowing, coughing, yawning or chewing may trigger pain, which usually lasts from seconds to minutes. The association between glossopharyngeal neuralgia and syncope is very rare, being identified by brief episodes of bradycardia, asystole, and hypotension. Such an association, with this same pathophysiology, was first described by Riley et al³ in 1942.

  6. Pharmacological versus microvascular decompression approaches for the treatment of trigeminal neuralgia: clinical outcomes and direct costs

    Directory of Open Access Journals (Sweden)

    Almeida A

    2011-08-01

    Full Text Available Laurinda Lemos1,2, Carlos Alegria3, Joana Oliveira3, Ana Machado2, Pedro Oliveira4, Armando Almeida11Life and Health Sciences Research Institute (ICVS, School of Health Sciences, Campus de Gualtar, University of Minho, Braga, Portugal; 2Hospital Center of Alto Ave, Unit of Fafe, Fafe, Portugal; 3Department of Neurosurgery, Hospital São Marcos; 4Products and Systems Engineering, Campus de Azurém, University of Minho, Guimarães, PortugalAbstract: In idiopathic trigeminal neuralgia (TN the neuroimaging evaluation is usually normal, but in some cases a vascular compression of trigeminal nerve root is present. Although the latter condition may be referred to surgery, drug therapy is usually the first approach to control pain. This study compared the clinical outcome and direct costs of (1 a traditional treatment (carbamazepine [CBZ] in monotherapy [CBZ protocol], (2 the association of gabapentin (GBP and analgesic block of trigger-points with ropivacaine (ROP (GBP+ROP protocol, and (3 a common TN surgery, microvascular decompression of the trigeminal nerve (MVD protocol. Sixty-two TN patients were randomly treated during 4 weeks (CBZ [n = 23] and GBP+ROP [n = 17] protocols from cases of idiopathic TN, or selected for MVD surgery (n = 22 due to intractable pain. Direct medical cost estimates were determined by the price of drugs in 2008 and the hospital costs. Pain was evaluated using the Numerical Rating Scale (NRS and number of pain crises; the Hospital Anxiety and Depression Scale, Sickness Impact Profile, and satisfaction with treatment and hospital team were evaluated. Assessments were performed at day 0 and 6 months after the beginning of treatment. All protocols showed a clinical improvement of pain control at month 6. The GBP+ROP protocol was the least expensive treatment, whereas surgery was the most expensive. With time, however, GBP+ROP tended to be the most and MVD the least expensive. No sequelae resulted in any patient after drug

  7. Pulsed Radiofrequency to the Dorsal Root Ganglion in Acute Herpes Zoster and Postherpetic Neuralgia.

    Science.gov (United States)

    Kim, Koohyun; Jo, Daehyun; Kim, EungDon

    2017-03-01

    Latent varicella zoster virus reactivates mainly in sensory ganglia such as the dorsal root ganglion (DRG) or trigeminal ganglion. The DRG contains many receptor channels and is an important region for pain signal transduction. Sustained abnormal electrical activity to the spinal cord via the DRG in acute herpes zoster can result in neuropathic conditions such as postherpetic neuralgia (PHN). Although the efficacy of pulsed radiofrequency (PRF) application to the DRG in various pain conditions has been previously reported, the application of PRF to the DRG in patients with herpes zoster has not yet been studied. The aim of the present study was to compare the clinical effects of PRF to the DRG in patients with herpes zoster to those of PRF to the DRG in patients with PHN. Retrospective comparative study. University hospital pain center in Korea. The medical records of 58 patients who underwent PRF to the DRG due to zoster related pain (herpes zoster or PHN) were retrospectively analyzed. Patients were divided into 2 groups according to the timing of PRF after zoster onset: an early PRF group (within 90 days) and a PHN PRF group (more than 90 days). The efficacy of PRF was assessed by a numeric rating scale (NRS) and by recording patient medication doses before PRF and at one week, 4 weeks, 8 weeks, and 12 weeks after PRF. Pain intensity was decreased after PRF in all participants. However, the degree of pain reduction was significantly higher in the early PRF group. Moreover, more patients discontinued their medication in the early PRF group, and the PRF success rate was also higher in the early PRF group. The relatively small sample size from a single center, short duration of review of medical records, and the retrospective nature of the study. PRF to the DRG is a useful treatment for treatment-resistant cases of herpes zoster and PHN. Particularly in herpes zoster patients with intractable pain, application of PRF to the DRG should be considered for pain control

  8. Trigeminal neuralgia: how often are trigeminal nerve-vessel contacts found by MRI in normal volunteers

    International Nuclear Information System (INIS)

    Kress, B.; Schindler, M.; Haehnel, S.; Sartor, K.; Rasche, D.; Tronnier, V.

    2006-01-01

    Purpose: To assess prospectively how often contacts are found between the trigeminal nerve and arteries or veins in the perimesencephalic cistern via MRI in normal volunteers. Materials and methods: 48 volunteers without a history of trigeminal neuralgia were examined prospectively (MRI at 1.5T; T2-CISS sequence, coronal orientation, 0.9 mm slice thickness). Two radiologists decided by consensus whether there was a nerve-vessel contact in the perimesencephalic cistern. Results: In 27% of the volunteers, no contact was found between the trigeminal nerve and regional vessels, while in 73%, such a contact was present. In 61% of the cases, the offending vessel was an artery, in 39%, it was a vein. In 2 volunteers, a deformation of the nerve was noted. Conclusion: Contrary to what has been suggested by retrospective studies, the majority of normal volunteers, if studied prospectively, do show a contact between the trigeminal nerve and local vessels. A close proximity between the nerve and regional vessels is thus normal and is not necessarily proof of a pathological nerve-vessel conflict. (orig.)

  9. Report of cases in patients with acute herpetic neuralgia using a Mangifera indica extract

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    Beatriz Garrido-Suárez

    2011-07-01

    Full Text Available It has been accepted that neuroinflammation, oxidative stress and glial activation are involved in the central sensitization underlying neuropathic and inflammatory pain. Vimang® is the brand name of an aqueous extract of Mangifera indica L., Anacardiaceae, traditionally used in Cuba for its antioxidant, antiinflammatory, analgesic, and immunomodulatory properties. In the present study, we determined the possible effects of Vimang formulations in acute herpes zoster (n=12 patients, that received a daily dose of 1800 mg of extract (two coated Vimang tablets, 300 mg each, three times daily before meals associated to low doses of amitriptyline (10-25 mg/d. In addition to the tablets, they utilized compresses containing Vimang dissolution at 2% on skin lesions for thirty days. The average daily pain score using a Likert scale and variations in concomitant drug daily dosage were determined. The analgesic effect was observed from week 1 (p<0.001 with respect to baseline data and none showed post-herpetic neuralgia. Significant reduction of antidepressant medication (p<0.01 and analgesic rescue dosages (p=0.0035 with respect to the initial daily dosage were showed. No adverse events were reported. The results obtained in this report of cases suggest that Vimang supplementation might be beneficial to prevent and treat neuropathic pain.

  10. Gamma Knife Stereotactic Radiosurgery for Trigeminal Neuralgia Caused by a Developmental Venous Anomaly.

    Science.gov (United States)

    Harrison, Gillian; Lunsford, L Dade; Monaco Iii, Edward A

    2015-02-18

    Background: Trigeminal neuralgia (TN) is mostly caused by vascular compression of the nerve's root entry zone due to an ectatic artery. Rarer causes include compression from tumors, vascular malformations or multiple sclerosis plaques. Developmental venous anomalies (DVAs) are benign, aberrantly appearing venous structures that drain normal cerebral tissue. DVAs are a rare etiology of TN. The management of TN caused by a DVA is controversial as disruption of the DVA can be catastrophic. Methods: We report a case of a young man with severe medically refractory TN related to a brachium pontis DVA who was successfully treated by gamma knife stereotactic radiosurgery (GKSR) to the trigeminal nerve. Results: Within 2 weeks of GKSR, the patient reported experiencing 60% pain relief; 5 years postoperatively, he remains completely pain free with some mild sensory loss in the V2 and V3 areas. Conclusions: GKSR has an established role in the management of TN. This is the first reported case of using GKSR to treat TN caused by a DVA. In the setting of a DVA, GKSR should be an initial consideration for TN therapy after medical failure because of the high surgical risk related to disrupting the DVA. © 2015 S. Karger AG, Basel.

  11. Neuronal changes induced by Varicella Zoster Virus in a rat model of Postherpetic Neuralgia

    Science.gov (United States)

    Guedon, Jean-Marc G.; Yee, Michael B.; Zhang, Mingdi; Harvey, Stephen A. K.; Goins, William F.; Kinchington, Paul R.

    2015-01-01

    A significant fraction of patients with herpes zoster, caused by varicella zoster virus (VZV), experience chronic pain termed postherpetic neuralgia (PHN). VZV-inoculated rats develop prolonged nocifensive behaviors and serve as a model of PHN. We demonstrate that primary rat cultures show a post-entry block for VZV replication, suggesting the rat is not fully permissive. However, footpads of VZV infected animals show reduced peripheral innervation and innervating dorsal root ganglia (DRG) contained VZV DNA and transcripts of candidate immediate early and early genes. The VZV-infected DRG showed changes in host gene expression patterns, with 84 up-regulated and 116 down-regulated genes seen in gene array studies. qRT-PCR validated the modulation of nociception-associated genes Ntrk2, Trpv1, and Calca (CGRP). The data suggests that VZV inoculation of the rat results in a single round, incomplete infection that is sufficient to induce pain behaviors, and this involves infection of and changes induced in neuronal populations. PMID:25880108

  12. Association between neurovascular contact on MRI and response to gamma knife radiosurgery in trigeminal neuralgia

    International Nuclear Information System (INIS)

    Erbay, Sami H.; Bhadelia, Rafeeque A.; Gupta, Punita; O'Callaghan, Mark; Yun, Eric; Oljeski, Steven; Riesenburger, Ron

    2006-01-01

    Treatment with gamma knife radiosurgery (GKRS) provides adequate short-term pain control in about 70% of the patients with intractable trigeminal neuralgia (TN). The purpose of our study was to evaluate whether the presence of neurovascular contact (NVC) at the root entry zone of the trigeminal nerve on pre-gamma knife MR imaging predicts an increased likelihood of an adequate response to GKRS.We studied 40 consecutive patients who underwent GKRS for treatment of intractable TN. Two neuroradiologists blinded to the side of symptoms analyzed pre-treatment constructive interference in steady state (CISS) images to determine the presence of NVC by consensus. An adequate response was defined as freedom from pain with or without reduced need for medical therapy. Adequate short-term response to GKRS was seen in 29 (72.5%) of 40 patients. NVC was seen in 30 of the 40 patients. Twenty-five (83.3%) of 30 patients with NVC had adequate short-term response to GKRS. Only four (40%) of the 10 patients without NVC had adequate response to GKRS (X 2 =7.06; P<0.01). Patients with NVC were seven times more likely to have an adequate response to GKRS than those without NVC (odds ratio =7.5).The presence of NVC on pre-treatment MR imaging predicts an increased likelihood of an adequate response to GKRS. (orig.)

  13. Liposomal topical capsaicin in post-herpetic neuralgia: a safety pilot study

    Directory of Open Access Journals (Sweden)

    Manoel Jacobsen Teixeira

    2015-03-01

    Full Text Available Topical treatments have gained popularity for general use as an adjunct to systemic drugs in neuropathic pain, but their use produces variable clinical results and local adverse events. Objective To evaluate the safety and analgesic effect of a formulation of liposomal capsaicin (LC (0.025% in patients with post herpetic neuralgia (PHN. Method Patients who remained symptomatic after first-and second-line treatment were randomized to receive LC for six weeks in a placebo-controlled, crossover design study. Clinical assessment was performed at baseline, in the second, fourth and sixth week of treatment. Results Thirteen patients completed both treatment periods. Visual Analog Scale (VAS was significantly decreased after the end of the study (p = 0.008, however the effect of treatment was not significant (p = 0.076. There was no difference on global impression of change and other pain characteristics. LC was safe and well tolerated. However, at the concentration used, its analgesic effects were marginal and not significant.

  14. [Impacts of bleeding and cupping therapy on serum P substance in patients of postherpetic neuralgia].

    Science.gov (United States)

    Tian, Hao; Tian, Yong-Jing; Wang, Bing; Yang, Li; Wang, Ying-Ying; Yang, Jin-Sheng

    2013-08-01

    To observe the effect of bleeding and cupping therapy on postherpetic neuralgia (PHN) and preliminarily discuss the analgesic mechanism. Sixty-four cases of PHN were randomized into two groups, 32 cases in each one. In the bleeding and cupping group, the local pricking with syringe needle and cupping was applied in the local painful area, once every two days. And totally 8 treatments were required. In the pregabalin group, pregabalin was prescribed for oral administration, 150mg/time, twice a day. And totally 16 days of medication were required. Visual analogue scale (VAS) score and the changes of P substance content in the peripheral and local serum before and after treatment were observed in the two groups. VAS score and peripheral serum P substance after treatment were lower significantly than those before treatment in the two groups (all Pcupping group was much more significant (Pcupping group [(93.86 +/- 9.87) pg/mL vs (46.13 +/- 6.31) pg/mL, Pcupping therapy achieves the definite efficacy on PHN and it can reduce significantly peripheral and local serum P substance content in the patients. It is possibly one of the mechanisms of analgesic effect.

  15. An Open Study of Botulinum-A Toxin Treatment of Idiopathic Trigeminal Neuralgia

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    Karim Nikkhah

    2015-07-01

    Full Text Available Introduction: Trigeminal Neuralgia (TN is a unilateral, recurrent, sharp facial pain disorder that is limited to the distribution of divisions of the trigeminal nerve. The aim of this study was to evaluate the efficacy of Botulinum neurotoxin type A (BTX-A for alleviating the frequency and severity of TN pain. Materials and Methods: This trial was performed as a before and after study. We treated 31 patients (15 male and 16 female with mean age of 52 year old that their diagnosis was made at least 4.5 years before. We injected BTX-A in various parts of face and particularly in the origin of mandibular and maxillary branches of trigeminal nerve. Injection volume was determined by the necessity and pain intensity measured with visual analog scale up to 100U. Patients were evaluated before and after the injection and were followed after week, and each month, for a three months period. Other related variables were recorded such as: toxin complications, pain status variations by brushing, chewing, cold weather and patient’s satisfaction with their therapy. Results: showed that after injection, pain intensity and frequency decreased after tooth brushing, chewing and cold weather (P

  16. Trigeminal neuralgia post-styloidectomy in Eagle syndrome: a case report

    Directory of Open Access Journals (Sweden)

    Blackett John

    2012-10-01

    Full Text Available Abstract Introduction Eagle syndrome is a condition characterized by an elongated (>3cm styloid process with associated symptoms of recurrent facial or throat pain. In this report we present a case of Eagle syndrome exhibiting the typical findings of glossopharyngeal nerve involvement, as well as unusual involvement of the trigeminal nerve. Notably, this patient developed a classical trigeminal neuralgia post-styloidectomy. Case presentation A 68-year-old Caucasian woman presented with a 25-year history of dull pain along the right side of her throat, lateral neck, and jaw. Her symptoms were poorly controlled with medication until 15 years ago when she was diagnosed with Eagle syndrome, and underwent a manual fracture of her styloid process. This provided symptomatic relief until 5 years ago when the pain recurred and progressed. She underwent a styloidectomy via a lateral neck approach, which resolved the pain once again. However, 6 months ago a new onset of triggerable, electric shock-like facial pain began within the right V1 and V2 distributions. Conclusions Eagle syndrome is distressing to patients and often difficult to diagnose due to its wide variability in symptoms. It is easily confused with dental pain or temporomandibular joint disorder, leading to missed diagnoses and unnecessary procedures. Pain along the jaw and temple is an unusual but possible consequence of Eagle syndrome. An elongated styloid process should be considered a possible etiology of dull facial pain in the trigeminal distributions, in particular V3.

  17. Pain outside the body: defensive peripersonal space deformation in trigeminal neuralgia.

    Science.gov (United States)

    Bufacchi, R J; Sambo, C F; Di Stefano, G; Cruccu, G; Iannetti, G D

    2017-10-02

    Perception of space has been guiding effective therapeutic interventions in a number of unilateral chronic pain conditions. However little is known about how trigeminal neuralgia (TN), a condition in which trigeminal stimulation triggers paroxysmal facial pain, affects defensive peripersonal space (DPPS), the portion of space surrounding the body within which defensive responses are enhanced. Given that TN is unilateral, in TN patients the DPPS of the face might not be horizontally symmetric as in pain-free individuals, but instead larger around the affected side. We tested this a priori hypothesis by measuring the proximity-dependent modulation of the hand-blink reflex. Stimuli delivered to the hand ipsilateral to TN elicited a stronger blink, particularly when it was measured from the eye ipsilateral to TN and the hand was closer to the face. Geometric modelling revealed (1) that DPPS was larger on the side of space ipsilateral to TN, and (2) this asymmetry was consequent to an increased estimated potential of sensory events to cause harm when they occur ipsilaterally to TN. These observations demonstrate that neural mechanisms underlying body protection in TN are adjusted to reduce the likelihood that external events evoke the painful paroxysm typical of this condition.

  18. [Influence of manual therapy of cervical spine on typical trigeminal neuralgia: a case report].

    Science.gov (United States)

    Grgić, Vjekoslav

    2010-01-01

    This article presents the case of a 43-year-old female patient with pain in the cervical spine area and a typical trigeminal neuralgia (TN; French name "tic douloureux") in the receptive field of the second and the third branches of the left trigeminal nerve. The patient came to our medical practice for a manual therapy of the cervical spine as the application of the standard therapy had not given her any pain reduction in the cervical spine area. As the result of the manual therapy of the cervical spine (nonspecific traction mobilization, specific or segmental mobilization, manipulation), not only a significant pain reduction in the cervical spine area occurred but also a complete cessation of TN. Before manual treatment, and in spite of antiepileptic drugs therapy and acupuncture, the patient had suffered from everyday typical TN attacks. The cessation of typical TN after manual therapy of cervical spine suggests a conclusion that the painful stimuli from the cervical spine structures can be manifested not only as atypical facial pain and/or a cervicogenic headache, but also as a typical TN (painful stimuli from the cervical spine structures-->trigeminocervical nuclei-->convergence of the painful stimuli-->referred pain in the receptive field of the trigeminal nerve-->typical or atypical TN and/or cervicogenic headache).

  19. Intravenous Nefopam Reduces Postherpetic Neuralgia during the Titration of Oral Medications.

    Science.gov (United States)

    Joo, Young Chan; Ko, Eun Sung; Cho, Jae Geun; Ok, Young Min; Jung, Gyu Yong; Kim, Kyung Hoon

    2014-01-01

    The recently known analgesic action mechanisms of nefopam (NFP) are similar to those of anticonvulsants and antidepressants in neuropathic pain treatment. It is difficult to prescribe high doses of oral neuropathic drugs without titration due to adverse effects. Unfortunately, there are few available intravenous analgesics for the immediate management of acute flare-ups of the chronic neuropathic pain. The aim of this study was to determine the additional analgesic effects for neuropathic pain of NFP and its adverse effects during the titration of oral medications for neuropathic pain among inpatients with postherpetic neuralgia (PHN). Eighty inpatients with PHN were randomly divided into either the NFP or normal saline (NS) groups. Each patient received a 3-day intravenous continuous infusion of either NFP with a consecutive dose reduction of 60, 40, and 20 mg/d, or NS simultaneously while dose titrations of oral medications for neuropathic pain gradually increased every 3 days. The efficacy of additional NFP was evaluated by using the neuropathic pain symptom inventory (NPSI) score for 12 days. Adverse effects were also recorded. The median NPSI score was significantly lower in the NFP group from days 1 to 6 of hospitalization. The representative alleviating symptoms of pain after using NFP were both spontaneous and evoked neuropathic pain. Reported common adverse effects were nausea, dizziness, and somnolence, in order of frequency. An intravenous continuous infusion of NFP reduces spontaneous and evoked neuropathic pain with tolerable adverse effects during the titration of oral medications in inpatients with PHN.

  20. Epidemiologic assessment of trigeminal neuralgia in patients referred to the Imam clinic of Hamedan city during 2013-2015

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    Masoud Ghiasian

    2018-01-01

    Full Text Available Background: Trigeminal neuralgia is the most common disease of the fifth cranial nerve. This study aimed at evaluating the epidemiology of patients with the trigeminal neuralgia referred to Imam Clinic in Hamedan City, Iran. Materials and Methods: In this descriptive cross-sectional study, 40 patients with trigeminal neuralgia symptoms were studied. Diagnosis of patients was made based on the history, physical examination and paraclinical tests. Results: This study was conducted on 27 (67.5% females and 13 (32.5% males with the mean ages of 43.3±16.9 and 51.7±21.5 years, respectively (P=0.526.The incidence of this disease was higher among young women than others. The right side involvement was detected in 47.5%, left side involvement in 40% and bilateral involvement in 12.5% of the cases. Regarding the engaged nerve branch, simultaneous engagement of maxillary and mandibular nerves was seen in 47.5%, mandibular in 27.5%, maxillary in 20%, and ophthalmic in 5% of the individuals. The primary causes were seen in 42.5% and secondary causes in 57.5% of the cases. Among the secondary causes, face surgery and multiple sclerosis had the highest rate (39.1%, followed by tumors (21.7%. Also, 65% of the patients had normal MRI and 35% had abnormal one. Conclusion: Due to the similar symptoms of the disease such as dental pain, and also maxillofacial surgery in the elderly as one of the most common secondary causes of this disease, facial surgeons and dentists should know more about this disease to avoid unnecessary surgeries.

  1. Abordaje fisioterapéutico en la neuralgia occipital. Revisión bibliográfica.

    OpenAIRE

    Albalate Narro, María

    2017-01-01

    Introducción. La neuralgia occipital (ON) corresponde a un dolor unilateral o bilateral a nivel de la parte posterior del cuero cabelludo que sigue el recorrido de los nervios occipitales (mayor, menor y tercero), aunque puede irradiar a otras zonas. Se caracteriza por ser paroxístico o punzante, puede cursar con síntomas asociados y se produce por compresión y/o irritación de los citados nervios por causas muy diversas. La incidencia y la prevalencia de esta patología no han sido estudiadas ...

  2. Ensayo no aleatorizado del tratamiento con acupuntura de la neuralgia del trigémino resistente a tratamiento convencional

    OpenAIRE

    E. Collazo; F. Gómez Armenta

    2015-01-01

    Objetivos: valorar la efectividad global de la acupuntura como terapia complementaria en la reducción del dolor crónico en la neuralgia del trigémino resistente a terapias habituales en grupos apareados de pacientes en condiciones de práctica clínica real. Conocer en qué proporción disminuye el consumo de analgésicos en estos pacientes tras un ciclo de acupuntura. Determinar las reacciones adversas debidas a acupuntura. Material y métodos: estudio cuasi-experimental en 57 pacientes ambulatori...

  3. Gamma knife radiosurgery for trigeminal neuralgia: the initial experience of the Barrow Neurological Institute

    International Nuclear Information System (INIS)

    Rogers, C. Leland; Shetter, Andrew G.; Fiedler, Jeffrey A.; Smith, Kris A.; Han, Patrick P.; Speiser, Burton L.

    2000-01-01

    Purpose: To assess the efficacy and complications of Gamma Knife radiosurgery for trigeminal neuralgia. Methods and Materials: The Barrow Neurological Institute (BNI) Gamma Knife facility has been operational since March 17, 1997. A total of 557 patients have been treated, 89 for trigeminal neuralgia (TN). This report includes the first 54 TN patients with follow-up exceeding 3 months. Patients were treated with Gamma Knife stereotactic radiosurgery (RS) in uniform fashion according to two sequential protocols. The first 41 patients received 35 Gy prescribed to the 50% isodose via a single 4-mm isocenter targeting the ipsilateral trigeminal nerve adjacent to the pons. The dose was increased to 40 Gy for the remaining 13 patients; however, the other parameters were unvaried. Outcome was evaluated by each patient using a standardized questionnaire. Pain before and after RS was scored as level I-IV per our newly-developed BNI pain intensity scoring criteria (I: no pain; II: occasional pain, not requiring medication; III: some pain, controlled with medication; IV: some pain, not controlled with medication; V: severe pain/no pain relief). Complications, limited to mild facial numbness, were similarly graded by a BNI scoring system. Results: Among our 54 TN patients, 52 experienced pain relief, BNI score I in 19 (35%), II in 3 (6%), III in 26 (48%), and IV in 4 (7%). Two patients (4%) reported no relief (BNI score V). Median follow-up was 12 months (range 3-28). Median time to onset of pain relief was 15 days (range 0-192), and to maximal relief 63 days (range 0-253). Seventeen (31%) noted immediate improvement (≤ 24 h). Prior to RS, all patients were on pharmacologic therapy felt to be optimal or maximal. Twenty-two (41%) were able to stop medications entirely (BNI score I or II). Another 16 (30%), with BNI Score III relief, decreased medication intake by at least 50%. Patients with classical TN pain symptoms were more likely to stop medications than those with

  4. Long-term safety of gastroretentive gabapentin in postherpetic neuralgia patients.

    Science.gov (United States)

    Jensen, Mark P; Irving, Gordon; Rauck, Richard; Wallace, Mark; Sweeney, Mike; Vanhove, Geertrui F

    2013-09-01

    This study evaluated the long-term safety and tolerability of a gastroretentive formulation of gabapentin (G-GR) and its effect on weight gain in postherpetic neuralgia (PHN) patients participating in a 14-week, open-label extension to a 10-week double-blind study. Patients with PHN ≥ 3 months, who had completed participation in a phase 3 randomized, double-blind, placebo-controlled study of the safety and efficacy of G-GR in PHN, who wished to continue treatment with G-GR, and who the investigator thought would benefit from study participation received G-GR 1800 mg as an asymmetrically divided dose (600 mg AM/1200 mg PM) for an additional 14 weeks. Analyses were performed on safety data from patients who received G-GR for 10 weeks in the randomized controlled study and who then received an additional 14 weeks of G-GR, asymmetrically dosed in the current study. Safety assessments included the incidence and severity of adverse events (AEs), the occurrence of serious AEs, changes in physical and neurological examination findings, clinical laboratory assessments, and changes in weight. Eighty patients treated with G-GR in the randomized, controlled study participated in this 14-week extension study. The incidence of AEs commonly observed with gabapentin (dizziness, somnolence) was low and the frequency, intensity, and severity of AEs did not change with long-term treatment. The mean weight change from baseline in the randomized controlled study to the end of the extension study was +0.76 kg. Weight increase was reported as an AE for 2 (2.5%) patients. Long-term treatment (up to 24 wk) with G-GR of 1800 mg was well tolerated and associated with little weight gain (< 1 kg) in patients with PHN. No new safety issues emerged with G-GR long-term treatment.

  5. Pulsed Radiofrequency: A Management Option for Recurrent Trigeminal Neuralgia Following Radiofrequency Thermocoagulation.

    Science.gov (United States)

    Liao, Chenlong; Visocchi, Massimiliano; Yang, Min; Liu, Pengfei; Li, Shiting; Zhang, Wenchuan

    2017-01-01

    Pain relief comparable with radiofrequency thermocoagulation (RFT) alone and fewer side effects than RFT have been achieved by combination treatment with pulsed radiofrequency (PRF) and short-duration RFT in trigeminal neuralgia (TN). We report the successful management of recurrent TN after RFT with single PRF in 2 patients. The RFT treatment was performed in 2-3 cycles for each division, with the lesion setting at 75°C-80°C for 90 seconds. The PRF treatment was applied for 120 seconds, with a generator output of 45 V, not exceeding a temperature of 42°C at the tip of the electrode. In case 1, pain relief was immediately achieved by RFT (75°C for 90 seconds), with moderate hypesthesia. Relapse of the triggered pain occurred 6 months later, and PRF was then applied. Long-term (18 months) pain relief without any additional pharmacologic or other treatment was reported. In case 2, a second RFT treatment at a higher temperature (80°C) was performed after recurrence after the first RFT within a week. Accompanied by worse hypesthesia, complete pain relief lasted for 6 months until the recurrence of pain was triggered by toothbrushing. PRF was then applied, and complete analgesia with long-term follow-up (28 months) was achieved. The PRF treatment for recurrent TN after RFT in this study could be viewed as a combination of PRF and RFT treatments in succession. Therefore, PRF and RFT should be considered to be complementary rather than alternative in the management of TN. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Thalamic metabolic alterations with cognitive dysfunction in idiopathic trigeminal neuralgia: a multivoxel spectroscopy study

    Energy Technology Data Exchange (ETDEWEB)

    Wang, Yuan; Bao, Faxiu; Ma, Shaohui; Guo, Chenguang; Jin, Chenwang; Zhang, Ming [First Affiliated Hospital of Xi' an Jiaotong University, Department of Medical Imaging, Xi' an, Shaanxi (China); Li, Dan [First Affiliated Hospital of Xi' an Jiaotong University, Department of Respiratory and Critical Care Medicine, Xi' an, Shaanxi (China)

    2014-08-15

    Although abnormalities in metabolite compositions in the thalamus are well described in patients with idiopathic trigeminal neuralgia (ITN), differences in distinct thalamic subregions have not been measured with proton magnetic resonance spectroscopy ({sup 1}H-MRS), and whether there are correlations between thalamic metabolites and cognitive function still remain unknown. Multivoxel MRS was recorded to investigate the metabolic alterations in the thalamic subregions of patients with ITN. The regions of interest were localized in the anterior thalamus (A-Th), intralaminar portion of the thalamus (IL-Th), posterior lateral thalamus (PL-Th), posterior medial thalamus (PM-Th), and medial and lateral pulvinar of the thalamus (PuM-Th and PuL-Th). The N-acetylaspartate to creatine (NAA/Cr) and choline to creatine (Cho/Cr) ratios were measured in the ITN and control groups. Scores of the visual analogue scale (VAS) and the Montreal Cognitive Assessment (MoCA) were analyzed to correlate with the neuroradiological findings. The NAA/Cr ratio in the affected side of PM-Th and PL-Th in ITN patients was statistically lower than that in the corresponding regions of the thalamus in controls. The NAA/Cr ratio in the affected PM-Th was negatively associated with VAS and disease duration. Furthermore, decreases of NAA/Cr and Cho/Cr were detected in the affected side of IL-Th, and lower Cho/Cr was positively correlated with MoCA values in the ITN group. Our result of low level of NAA/Cr in the affected PM-Th probably serves as a marker of the pain-rating index, and decreased Cho/Cr in IL-Th may be an indicator of cognitive disorder in patients with ITN. (orig.)

  7. Comparative analyses of linac and Gamma Knife radiosurgery for trigeminal neuralgia treatments

    International Nuclear Information System (INIS)

    Ma, L; Kwok, Y; Chin, L S; Yu, C; Regine, W F

    2005-01-01

    Dedicated linac-based radiosurgery has been reported for trigeminal neuralgia treatments. In this study, we investigated the dose fall-off characteristics and setup error tolerance of linac-based radiosurgery as compared with standard Gamma Knife radiosurgery. In order to minimize the errors from different treatment planning calculations, consistent imaging registration, dose calculation and dose volume analysis methods were developed and implemented for both Gamma Knife and linac-based treatments. Intra-arc setup errors were incorporated into the treatment planning process of linac-based deliveries. The effects of intra-arc setup errors with increasing number of arcs were studied and benchmarked against Gamma Knife deliveries with and without plugging patterns. Our studies found equivalent dose fall-off properties between Gamma Knife and linac-based radiosurgery given a sufficient number of arcs (>7) and small intra-arc errors (<0.5 mm) were satisfied for linac-based deliveries. Increasing the number of arcs significantly decreased the variations in the dose fall-off curve at the low isodose region (e.g. from 40% to 10%) and also improved dose uniformity at the high isodose region (e.g. from 70% to 90%). As the number of arcs increased, the effects of intra-arc setup errors on the dose fall-off curves decreased. Increasing the number of arcs also reduced the integral dose to the distal normal brain tissues. In conclusion, linac-based radiosurgery produces equivalent dose fall-off characteristics to Gamma Knife radiosurgery with a high number of arcs. However, one must note the increased treatment time for a large number of arcs and isocentre accuracies

  8. Dosimetric analysis of trigeminal nerve, brain stem doses in CyberKnife radiosurgery of trigeminal neuralgia

    International Nuclear Information System (INIS)

    Sudahar, H.; Kurup, P.G.G.; Murali, V.; Velmurugan, J.

    2012-01-01

    CyberKnife radiosurgery treatment of Trigeminal neuralgia (TN) is performed as a non-invasive image guided procedure. The prescription dose for TN is very high. The brainstem is the adjacent critical organ at risk (OAR) which is prone to receive the very high target dose of TN. The present study is to analyze the dose distribution inside the tiny trigeminal nerve target and also to analyze the dose fall off in the brain stem. Seven TN cases treated between November 2010 and January 2012 were taken for this study retrospectively. The treatment plans were analyzed for target dose conformity, homogeneity and dose coverage. In the brainstem the volume doses D 1% and D 2% were taken for analyzing the higher doses in the brain stem. The dose fall off was analyzed in terms of D 5% and D 10% . The mean value of maximum dose within the trigeminal nerve target was 73.5±2.1 Gy (P=0.0007) and the minimum dose was 50.0±4.1Gy (P=0.1315). The mean conformity index was 2.19 and the probable reason could be the smallest CyberKnife collimator of 5mm used in the treatment plan. The mean D 1% , of the brainstem was 10.5±2.1Gy(P=0.5316) and the mean value of the maximum point dose within the brainstem was 35.6±3.8Gy. This shows the degree of dose fall off within the brainstem. Though the results of the present study are showing superior sparing of brain stem and reasonable of target coverage, it is necessary to execute the treatment plan with greater accuracy in CyberKnife as the immobilization is noninvasive and frameless. (author)

  9. Magnetic resonance imaging of vascular compression in trigeminal neuralgia and hemifacial spasms

    International Nuclear Information System (INIS)

    Nagaseki, Yoshishige; Horikoshi, Tohru; Omata, Tomohiro; Sugita, Masao; Nukui, Hideaki; Sakamoto, Hajime; Kumagai, Hiroshi; Sasaki, Hideo; Tsuji, Reizou.

    1991-01-01

    We show how neurosurgical planning can benefit from the better visualization of the precise vascular compression of the nerve provided by the oblique-sagittal and gradient-echo method (OS-GR image) using magnetic resonance images (MRI). The scans of 3 patients with trigeminal neuralgia (TN) and of 15 with hemifacial spasm (HFS) were analyzed for the presence and appearance of the vascular compression of the nerves. Imaging sequences consisted of an OS-GR image (TR/TE: 200/20, 3-mm-thick slice) cut along each nerve shown by the axial view, which was scanned at the angle of 105 degrees taken between the dorsal line of the brain stem and the line corresponding to the pontomedullary junction. In the OS-GR images of the TN's, the vascular compressions of the root entry zone (REZ) of the trigeminal nerve were well visualized as high-intensity lines in the 2 cases whose vessels were confirmed intraoperatively. In the other case, with atypical facial pain, vascular compression was confirmed at the rostral distal site on the fifth nerve, apart from the REZ. In the 15 cases of HFS, twelve OS-GR images (80%) demonstrated vascular compressions at the REZ of the facial nerves from the direction of the caudoventral side. During the surgery for these 12 cases, in 11 cases (excepting the 1 case whose facial nerve was not compressed by any vessels), vascular compressions were confirmed corresponding to the findings of the OS-GR images. Among the 10 OS-GR images on the non-affected side, two false-positive findings were visualized. It is concluded that OS-GR images obtained by means of MRI may serve as a useful planning aid prior to microvascular decompression for cases of TN and HFS. (author)

  10. Glossopharyngeal neuralgia with syncope as a sign of neck cancer recurrence Neuralgia glossofaríngea com síncope como um sinal de recidiva de câncer do pescoço

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    Reinaldo Teixeira Ribeiro

    2007-12-01

    Full Text Available Glossopharyngeal neuralgia with syncope as a sign of neck cancer is a very rare condition. A review of the literature revealed only 29 cases formerly reported. We present the first Brazilian case of such association. A 68-year-old man presented with paroxysmal excruciating pain over the right side of the neck, sometimes followed by syncope. Given the suspicion of recurrent tumor from a previously treated neck malignancy, a computed tomography scan was performed and a right parapharyngeal tumor was shown. Pain and syncope were successfully controlled with carbamazepine and the patient underwent palliative radiotherapy.Neuralgia glossofaríngea com síncope como um sinal de câncer do pescoço é uma condição muito rara. Uma revisão da literatura revelou apenas 29 casos relatados anteriormente. Apresentamos o primeiro caso brasileiro de tal associação. Um homem de 68 anos se apresentou com dores paroxísticas insuportáveis no lado direito do pescoço, algumas vezes seguidas de síncope. Dada a suspeita de recidiva tumoral derivada de uma malignidade cervical tratada previamente, realizou-se um exame de tomografia computadorizada que evidenciou um tumor parafaríngeo direito. As dores e as síncopes foram controladas satisfatoriamente com carbamazepina e o paciente foi submetido à radioterapia paliativa.

  11. Reação cutânea grave induzida por carbamazepina no tratamento da neuralgia pós-herpética: relato de caso Reacción cutánea grave inducida por la carbamazepina en el tratamiento de la neuralgia postherpética: relato de caso Severe carbamazepine-induced cutaneous reaction in the treatment of post-herpetic neuralgia: case report

    Directory of Open Access Journals (Sweden)

    João Batista Santos Garcia

    2010-08-01

    Full Text Available JUSTIFICATIVA E OBJETIVOS: O herpes zoster tem como principal complicação a neuralgia pós-herpética (NPH. Utiliza-se para o tratamento a carbamazepina (CXB, um anticonvulsivante bem tolerado, porém frequentemente associado a reações Cutâneas graves, como, por exemplo, a síndrome de Stevens-Johnson (SSJ e a necrólise epidérmica tóxica (NET. O objetivo deste trabalho é relatar um caso de SSJ/NET secundário ao uso de CBZ em paciente com NPH. RELATO DO CASO: Paciente do sexo feminino, com dor contínua em região torácica e dorso, intensa, em queimação, fisgada, choque, alteração de força de membro superior ipsilateral e sudorese. Apresentava lesões crostosas e eritematosas em região dorsal do tórax, com alodinia e disestesias em dermátomo acometido. Iniciou-se CBZ 300 mg.dia-1, amitriptilina (AMT 12,5 mg à noite e infiltração com anestésico local na região afetada. Após 15 dias, referia mal-estar, febre, dores musculares e artralgias com rash cutâneo leve e inespecífico. Retirou-se a carbamazepina imediatamente. Uma semana depois, foi internada com urticária e exantema generalizados, erupções Cutâneas eritematosas, bolhosas e máculas purpúricas por todo o corpo. A impressão era de SSJ/NET induzida por carbamazepina. Houve progressiva piora do quadro, com aumento do número e do tamanho das lesões Cutâneas, além de rash eritematoso macular generalizado, áreas de necrose e erosões, com destacamento simétrico da epiderme em face, pescoço, tórax, dorso e membros acometendo mais de 50% da área de superfície, além de envolvimento da mucosa bucal, conjuntival e genital com erosões vesiculares. Apresentou piora funcional progressiva, evoluindo com choque séptico e falência múltipla de órgãos, indo a óbito. CONCLUSÕES: A SSJ/NET é uma reação Cutânea grave com potencial para morbidade e mortalidade elevadas e que demanda intervenção rápida e tratamento adequado. Fica também o alerta para o uso

  12. Comparative efficacy and acceptability of antiepileptic drugs for classical trigeminal neuralgia: a Bayesian network meta-analysis protocol.

    Science.gov (United States)

    Qin, Zongshi; Xie, Shang; Mao, Zhi; Liu, Yan; Wu, Jiani; Furukawa, Toshi A; Kwong, Joey S W; Tian, Jinhui; Liu, Zhishun

    2018-01-21

    Trigeminal neuralgia (TN) affects 4 to 28.9/100 000 people worldwide, and antiepileptic drugs such as carbamazepine and oxcarbazepine are the firstline treatment options. However, the efficacy and safety of other antiepileptic drugs remain unclear due to insufficient direct comparisons. To compare the efficacy and acceptability of all currently available antiepileptic agents for the treatment of patients with classical TN. We will search the PubMed, EMBASE, Cochrane Library and Web of Science databases for unpublished or undergoing research listed in registry platforms. We will include all randomised controlled trials comparing two different antiepileptic drugs or one antiepileptic drug with placebo in patients with classical TN. The primary outcomes will be the proportion of responders and the number of subjects who dropout during the treatment. The secondary outcomes will include the two primary outcomes but in the follow-up period, changes in the self-reporting assessment scale for neuralgia and quality of life assessment. In terms of network meta-analysis, we will fit our model to a Bayesian framework using the JAGS and pcnetmeta packages of the R project. This protocol will not disseminate any private patient data. The results of this review will be disseminated through peer reviewed publication. CRD42016048640. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  13. Harvey Cushing's case series of trigeminal neuralgia at the Johns Hopkins Hospital: a surgeon's quest to advance the treatment of the 'suicide disease'.

    NARCIS (Netherlands)

    Adams, H.; Pendleton, C.; Latimer, K.; Cohen-Gadol, A.A.; Carson, B.S.; Quinones-Hinojosa, A.

    2011-01-01

    BACKGROUND: A review of Dr. Harvey Cushing's surgical cases at the Johns Hopkins Hospital provided insight into his early work on trigeminal neuralgia (TN). There was perhaps no other affliction that captured his attention in the way that TN did, and he built a remarkable legacy of successful

  14. After microvascular decompression to treat trigeminal neuralgia, both immediate pain relief and recurrence rates are higher in patients with arterial compression than with venous compression.

    Science.gov (United States)

    Shi, Lei; Gu, Xiaoyan; Sun, Guan; Guo, Jun; Lin, Xin; Zhang, Shuguang; Qian, Chunfa

    2017-07-04

    We explored differences in postoperative pain relief achieved through decompression of the trigeminal nerve compressed by arteries and veins. Clinical characteristics, intraoperative findings, and postoperative curative effects were analyzed in 72 patients with trigeminal neuralgia who were treated by microvascular decompression. The patients were divided into arterial and venous compression groups based on intraoperative findings. Surgical curative effects included immediate relief, delayed relief, obvious reduction, and invalid result. Among the 40 patients in the arterial compression group, 32 had immediate pain relief of pain (80.0%), 5 cases had delayed relief (12.5%), and 3 cases had an obvious reduction (7.5%). In the venous compression group, 12 patients had immediate relief of pain (37.5%), 13 cases had delayed relief (40.6%), and 7 cases had an obvious reduction (21.9%). During 2-year follow-up period, 6 patients in the arterial compression group experienced recurrence of trigeminal neuralgia, but there were no recurrences in the venous compression group. Simple artery compression was followed by early relief of trigeminal neuralgia more often than simple venous compression. However, the trigeminal neuralgia recurrence rate was higher in the artery compression group than in the venous compression group.

  15. Herpes zoster chronification to postherpetic neuralgia induces brain activity and grey matter volume change

    Science.gov (United States)

    Cao, Song; Qin, Bangyong; Zhang, Yi; Yuan, Jie; Fu, Bao; Xie, Peng; Song, Ganjun; Li, Ying; Yu, Tian

    2018-01-01

    Objective: Herpes zoster (HZ) can develop into postherpetic neuralgia (PHN), which is a chronic neuropathic pain (NP). Whether the chronification from HZ to PHN induced brain functional or structural change is unknown and no study compared the changes of the same brains of patients who transited from HZ to PHN. We minimized individual differences and observed whether the chronification of HZ to PHN induces functional and pain duration dependent grey matter volume (GMV) change in HZ-PHN patients. Methods: To minimize individual differences induced error, we enrolled 12 patients with a transition from HZ to PHN. The functional and structural changes of their brains between the two states were identified with resting-state functional MRI (rs-fMRI) technique (i.e., the regional homogeneity (ReHo) and fractional aptitude of low-frequency fluctuation (fALFF) method) and the voxel based morphometry (VBM) technology respectively. The correlations between MRI parameters (i.e., ΔReHo, ΔfALFF and ΔVBM) and Δpain duration were analyzed too. Results: Compared with HZ brains, PHN brains exhibited abnormal ReHo, fALFF and VBM values in pain matrix (the frontal lobe, parietal lobe, thalamus, limbic lobe and cerebellum) as well as the occipital lobe and temporal lobe. Nevertheless, the activity of vast area of cerebellum and frontal lobe significantly increased while that of occipital lobe and limbic lobe showed apparent decrease when HZ developed to PHN. In addition, PHN brain showed decreased GMV in the frontal lobe, the parietal lobe and the occipital lobe but increased in the cerebellum and the temporal lobe. Correlation analyses showed that some of the ReHo, fALFF and VBM differential areas (such as the cerebellum posterior lobe, the thalamus extra-nuclear and the middle temporal gyrus) correlated well with Δpain duration. Conclusions: HZ chronification induced functional and structural change in cerebellum, occipital lobe, temporal lobe, parietal lobe and limbic lobe

  16. Characterizing Treatment Utilization Patterns for Trigeminal Neuralgia in the United States.

    Science.gov (United States)

    Zakrzewska, Joanna M; Wu, Ning; Lee, John Y K; Werneburg, Brian; Hoffman, Deborah; Liu, Ying

    2018-02-19

    Trigeminal neuralgia (TN) is a rare orofacial disorder characterized by severe unilateral paroxysmal pain in the region of the fifth cranial nerve. Clinical guidelines recommend carbamazepine (only US Food and Drug Administration-approved drug for TN) and oxcarbazepine as first-line therapies. We utilized the US Truven Health MarketScan database to examine treatment patterns among patients with TN. Included patients were aged ≥18 years, newly diagnosed with TN (≥2 TN diagnoses ≥14 days apart; no diagnosis in the prior year), continuously enrolled 1 year pre-index, with ≥3 years' follow-up post-index. We assessed utilization of selected pharmacotherapies (carbamazepine, oxcarbazepine, pregabalin, gabapentin, baclofen, duloxetine, topiramate), surgery (posterior fossa, radiosurgery), and injections (peripheral anesthetic injections, Gasserian ganglion procedures) for TN. 3685 patients were included (2425 commercial, 1260 Medicare; 71.8% female; mean[SD] age, 59 [15] years). Overall, 72.5% of patients received at least 1 studied medication, most commonly carbamazepine (51.7%) or gabapentin (48.6%). Sixty-five percent of pharmacologically treated patients had ≥2 treatment episodes; 41.6% had ≥3 (defined by a change in pharmacotherapy [monotherapy/combination] regimen). Overall, 12.3% had surgery and 7.3% injections; 42.9% received opioids for TN. In the 3 years after diagnosis, patients with TN in the United States receive a variety of pharmacological treatments, including opioids, despite carbamazepine being the only approved medication. A notable proportion utilize surgeries/injections. A high proportion of pharmacologically treated patients receive multiple treatment episodes, suggesting frequent therapy switching, perhaps due to suboptimal efficacy/tolerability. Our data suggest a high burden of illness associated with TN.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License

  17. Tratamiento quirúrgico de la neuralgia del trigémino: una nueva técnica

    Directory of Open Access Journals (Sweden)

    Jorge Ángel Villegas

    1960-10-01

    Full Text Available In none of thes cases reported was their any morbility. There was no recurrence of pain and in all, no loss of sensation of the face took place. However, the decompression of the trigeminal root, does not in every case cure the neuralgia. Various authors report recurrences, varyng between 10 and 30 per cent, but when these cases are re-operated, the pain almost never returns. The great advantege of taarhoj's operation decompression over the classic resection of the nerve root is based on the conservation of normal sensation in the face and the absence of paresthesias so frequent in the latter operation, which in the opinion of many patients are more serious and unbearable than the proper tic douloureux.

  18. Efficacy and Quality of Life Outcomes in Patients With Atypical Trigeminal Neuralgia Treated With Gamma-Knife Radiosurgery

    International Nuclear Information System (INIS)

    Dhople, Anil; Kwok, Young; Chin, Lawrence; Shepard, David Ph.D.; Slawson, Robert; Amin, Pradip; Regine, William

    2007-01-01

    Purpose: To assess efficacy and quality of life (QOL) outcomes associated with gamma-knife radiosurgery (GK-RS) in treating atypical trigeminal neuralgia (ATN) compared with classic trigeminal neuralgia (CTN). Methods and Materials: Between September 1996 and September 2004, 35 cases of ATN were treated with GK-RS. Patients were categorized into two groups: Group I comprised patients presenting with ATN (57%); Group II consisted of patients presenting with CTN then progressing to ATN (43%). Median prescription dose 75 Gy (range, 70-80 Gy) was delivered to trigeminal nerve root entry zone. Treatment efficacy and QOL improvements were assessed with a standardized questionnaire. Results: With median follow-up of 29 months (range, 3-74 months), 72% reported excellent/good outcomes, with mean time to relief of 5.8 weeks (range, 0-24 weeks) and mean duration of relief of 62 weeks (range, 1-163 weeks). This rate of pain relief is similar to rate achieved in our previously reported experience treating CTN with GK-RS (p = 0.36). There was a trend toward longer time to relief (p = 0.059), and shorter duration of relief (p = 0.067) in patients with ATN. There was no difference in rate of, time to, or duration of pain relief between Groups I and II. Of the patients with ATN, 88% discontinued or decreased the use of pain medications. Among the patients with sustained pain relief, QOL improved an average of 85%. Conclusion: This is the largest reported GK-RS experience for the treatment of ATN. Patients with ATN can achieve rates of pain relief similar to those in patients with CTN. Further follow-up is necessary to assess adequately the durability of response

  19. Effects of dorsal root ganglion destruction by adriamycin in patients with postherpetic neuralgia Efeitos da destruição da raiz dorsal ganglionar pela adriamicina em pacientes com neuralgia pós-herpética

    Directory of Open Access Journals (Sweden)

    He Chun-jing

    2012-06-01

    Full Text Available PURPOSE: To investigate the effects of dorsal root ganglion destruction in patients with postherpetic neuralgia (PHN. METHODS: Seventy-two patients with PHN selected were randomly divided into two groups (n=36. Group A was the control group (treated by injection and group B was the group of dorsal root ganglion destruction by adriamycin. Visual analog scale scores (VAS, SAS, SF-MPQ scores. Clinical effects and therapy safety were evaluated before therapy, one week, three and six months after therapy. Forty-four patients were available for intention-to-treat analysis. RESULTS: The average pain scores on the Likert scale were significantly reduced at each point in group B. Patients in group B reported clinical effectiveness at six months as excellent response, good response, improved but unsatisfactory or unchanged 16, 12 and 8.VAS scores at each time point after the operation were lower than that before operation and in group A, there was significant difference. Patients showed significant improvement in sleep scores in group B. There was significant difference at T2 in group A than T1. There was no significant difference in group A at T3, T4 after the operation than that before operation. Between group comparison: there was significant difference between group A and group B at each time point after the operation. CONCLUSIONS: Dorsal root ganglion destruction by adriamycin under guidance of C-arm perspective, the puncture operation was accurate without any adverse reaction or serious complications, which could effectively relieve pain of patients with postherpetic neuralgia, but the long-term effects needed further study.OBJETIVO: Investigar os efeitos da destruição da raiz dorsal ganglionar em pacientes com neuralgia pós-herpética. MÉTODOS: Setenta e dois pacientes selecionados com neuralgia pós-herpética foram randomicamente distribuídos em dois grupos (n=36. Grupo A foi o grupo controle (tratado por injeção e o grupo B foi o grupo

  20. A review of percutaneous techniques for low back pain and neuralgia: current trends in epidural infiltrations, intervertebral disk and facet joint therapies.

    Science.gov (United States)

    Filippiadis, Dimitrios K; Kelekis, Alexis

    2016-01-01

    Low back pain and neuralgia due to spinal pathology are very common symptoms debilitating numerous patients with peak prevalence at ages between 45 and 60 years. Intervertebral discs and facet joints act as pain sources in the vast majority of the cases. Diagnosis is based on the combination of clinical examination and imaging studies. Therapeutic armamentarium for low back pain and neuralgia due to intervertebral discs and/or facet joints includes conservative therapy, injections, percutaneous therapeutic techniques and surgical options. Percutaneous, therapeutic techniques are imaging-guided, minimally invasive treatments which can be performed as outpatient procedures. In cases of facet joint syndrome, they include, apart from injections, neurolysis with radiofrequency/cryoablation, MR-guided high-intensity focused ultrasound and percutaneous fixation techniques. In case of discogenic pain, apart from infiltrations, therapeutic techniques can be classified in to two main categories: decompression (mechanical, thermal, chemical) techniques and biomaterials implantation/disc cell therapies. Strict sterility measures are a prerequisite and should include extensive local sterility and antibiotic prophylaxis. This article will report clinical and imaging findings for each pathology type and the association with treatment decision. In addition, we will describe in detail all possible treatment techniques for low back pain and neuralgia, and we will report recently published results of these techniques summarizing the data concerning safety and effectiveness as well as the level of evidence. Finally, we will try to provide a rational approach for the therapy of low back pain and neuralgia by means of minimally invasive imaging-guided percutaneous techniques.

  1. [Efficacy of intracutaneous methylene blue injection for moderate to severe acute thoracic herpes zoster pain and prevention of postherpetic neuralgia in elderly patients].

    Science.gov (United States)

    Cui, Ji-Zheng; Zhang, Jin-Wei; Zhang, Yun; Ma, Zheng-Liang

    2016-10-20

    To evaluate the clinical efficacy of intradermal injection of methylene blue for treatment of moderate to severe acute thoracic herpes zoster and prevention of postherpetica neuralgia in elderly patients. Sixty-four elderly patients with herpes zoster were randomized to receive a 10-day course of intradermal injection of methylene blue and lidocaine plus oral valaciclovir (group A, 32 cases) and intradermal injection of lidocaine plus oral valaciclovir (group B).Herpes evaluation index, pain rating index, incidence of postherpetic neuralgia, and comprehensive therapeutic effect were compared between the two groups at 11, 30 and 60 days after the treatment. The baseline characteristics were comparable between the two groups (all P>0.05). Compared with that in group B, the time for no new blister formation, blister incrustation and decrustation, and pain relief was significantly shortened in group A (Pmethylene blue can effectively shorten the disease course, reduce the pain intensity and prevent the development of postherpetic neuralgia in elderly patients with herpes zoster.

  2. Economic Burden of Herpes Zoster and Post-Herpetic Neuralgia in Adults 60 Years of Age or Older: Results from a Prospective, Physician Practice-Based Cohort Study in Kushiro, Japan.

    Science.gov (United States)

    Nakamura, Hiroyuki; Mizukami, Akiko; Adachi, Koichi; Matthews, Sean; Holl, Katsiaryna; Asano, Kazuhiro; Watanabe, Akihiro; Adachi, Riri; Kiuchi, Mariko; Kobayashi, Keiju; Sato, Keiko; Matsuki, Taizo; Kaise, Toshihiko; Curran, Desmond

    2017-12-01

    Herpes zoster has a high incidence rate among people aged ≥ 60 years and can lead to serious complications such as post-herpetic neuralgia. There are currently no data on the economic burden of herpes zoster and post-herpetic neuralgia in Japan, and the objective of this study was to address this gap. A total of 412 patients aged ≥ 60 years diagnosed with herpes zoster were recruited. Demographic, clinical, and healthcare resource utilization data on patients with herpes zoster or post-herpetic neuralgia collected via case report forms were used to estimate direct medical cost. Data obtained from a questionnaire survey among patients with herpes zoster/post-herpetic neuralgia were used to estimate transportation cost and productivity loss. The mean number of outpatient visits was 5.7. Prescription medications were the main cost driver accounting for 60% of the direct medical cost. The mean direct medical and total herpes zoster-related costs per patient were ¥43,925 and ¥57,112, respectively, and were higher in patients with post-herpetic neuralgia than in those with herpes zoster without complications. Direct medical cost represented 77%, productivity loss 19%, and transportation cost 4% of the total. This is the first study of the economic burden of herpes zoster and post-herpetic neuralgia in Japan and it demonstrated substantial direct medical cost as a result of the multiple outpatient visits and prescription medications required. These findings provide baseline data for possible future economic evaluations of new herpes zoster/post-herpetic neuralgia interventions. This cost analysis is part of a prospective, physician practice-based cohort study conducted between June 2013 and February 2015 in Kushiro, Japan (Clinicaltrials.gov identifier NCT01873365, registered on 6 June, 2013).

  3. Trigeminal Neuralgia: Evaluation of the Relationship Between the Region of Neuralgic Manifestation and the Site of Neurovascular Compression Under Endoscopy.

    Science.gov (United States)

    Zhang, Wenhao; Chen, Minjie; Zhang, Weijie; Chai, Ying

    2015-07-01

    This study aimed to evaluate the relationship among the pain region, branches of trigeminal nerve, and the neurovascular compression (NVC) location. A total of 123 consecutive patients with trigeminal neuralgia (TN) underwent endoscope-assisted microvascular decompression according to positive preoperative tomographic angiography. V2 alone was in 51 cases and V3 alone was in 64 cases. The location of NVC was classified into cranial, caudal, medial, or lateral sites. Some patients with multiple regions were recorded as medial + cranial, lateral + cranial, medial + caudal, and lateral + caudal. Twenty-eight (71.8%) of 39 patients with TN (V2) had their NVC at the medial site of the nerve. Twenty-seven (64.3%) of 42 patients with TN (V3) had their NVC at the lateral site of the nerve. There was a statistically significant difference (P = 0.0011  0.01). Evaluation of the relationship between the pain region and the NVC location by endoscopic images during microvascular decompression is more accurate. The second branch is mostly distributed in the medial area, and third branch is mainly distributed in the lateral area.

  4. Sensory abnormalities and masticatory function after microvascular decompression or balloon compression for trigeminal neuralgia compared with carbamazepine and healthy controls.

    Science.gov (United States)

    Ichida, Michelle Cristina; de Almeida, Antonio Nogueira; da Nobrega, Jose Claudio Marinho; Teixeira, Manoel Jacobsen; de Siqueira, José Tadeu Tesseroli; de Siqueira, Silvia R D T

    2015-06-01

    Idiopathic trigeminal neuralgia (iTN) is a neurological condition treated with pharmacotherapy or neurosurgery. There is a lack of comparative papers regarding the outcomes of neurosurgery in patients with iTN. The objective of this study was to investigate sensory thresholds and masticatory function in 78 patients with iTN who underwent microvascular decompression (MVD) or balloon compression (BC), and compare these treatments with carbamazepine and 30 untreated healthy controls. The authors conducted a case-controlled longitudinal study. Patients were referred to 1 of 3 groups: MVD, BC, or carbamazepine. All patients were evaluated before and after treatment with a systematic protocol composed of a clinical orofacial questionnaire, Research Diagnostic Criteria for temporomandibular disorders, Helkimo indices, and a quantitative sensory-testing protocol (gustative, olfactory, cold, warm, touch, vibration, superficial, and deep pain thresholds). Both MVD and BC were effective at reducing pain intensity (p = 0.012) and carbamazepine doses (p sweet (p = 0.014) and salty (p = 0.003) thresholds. The sour threshold decreased (p = 0.003) and cold and warm thresholds increased (p sensorial and motor deficits after BC need to be included as targets directly associated with the success of the surgery and need to be assessed and relieved as goals in the treatment of iTN.

  5. Subtemporal transtentorial approach for recurrent trigeminal neuralgia after microvascular decompression via the lateral suboccipital approach: case report.

    Science.gov (United States)

    Ogiwara, Toshihiro; Goto, Tetsuya; Kusano, Yoshikazu; Kuroiwa, Masafumi; Kiuchi, Takafumi; Kodama, Kunihiko; Takemae, Toshiki; Hongo, Kazuhiro

    2015-06-01

    Microvascular decompression (MVD) via lateral suboccipital craniotomy is the standard surgical intervention for trigeminal neuralgia (TN). For recurrent TN, difficulties are sometimes encountered when performing reoperation via the same approach because of adhesions and prosthetic materials used in the previous surgery. In the present case report the authors describe the efficacy of the subtemporal transtentorial approach for use in recurrent TN after MVD via the lateral suboccipital approach. An 86-year-old woman, in whom an MVD via a lateral suboccipital craniotomy had previously been performed for TN, underwent surgery for recurrent TN via the subtemporal transtentorial approach, which provided excellent visualization of the neurovascular relationships and the trigeminal nerve without adhesions due to the previous surgery. Her TN disappeared after the MVD. The present approach is ideal for visualizing the trigeminal root entry zone, and the neurovascular complex can be easily dissected using a new surgical trajectory. This approach could be another surgical option for reoperation when the previous MVD had been performed via the suboccipital approach.

  6. Hydrocephalus: an underrated long-term complication of microvascular decompression for trigeminal neuralgia. A single institute experience.

    Science.gov (United States)

    Muratorio, Francesco; Tringali, G; Levi, V; Ligarotti, G K I; Nazzi, V; Franzini, A A

    2016-11-01

    Hydrocephalus is a common complication of posterior fossa surgery, but its real incidence after microvascular decompression (MVD) for idiopathic trigeminal neuralgia (TN) still remains unclear. The aim of this study was to focus on the potential association between MVD and hydrocephalus as a surgery-related complication. All patients who underwent MVD procedure for idiopathic TN at our institute between 2009 and 2014 were reviewed to search for early or late postoperative hydrocephalus. There were 259 consecutive patients affected by idiopathic TN who underwent MVD procedure at our institution between 2009 and 2014 (113 men, 146 women; mean age 59 years, range 30-87 years; mean follow-up 40.92 months, range 8-48 months). Nine patients (3.47 %) developed communicating hydrocephalus after hospital discharge and underwent standard ventriculo-peritoneal shunt. No cases of acute hydrocephalus were noticed. Our study suggests that late communicating hydrocephalus may be an underrated potential long-term complication of MVD surgery.

  7. The cost-effectiveness of surgery for trigeminal neuralgia in surgically naïve patients: a retrospective study.

    Science.gov (United States)

    Holland, Marshall; Noeller, Jennifer; Buatti, John; He, Wenzhuan; Shivapour, E Torage; Hitchon, Patrick W

    2015-10-01

    For 75% of patients with trigeminal neuralgia (TN), the pain can be controlled with medication. For those who fail medication therapy, surgical options include microvascular decompression (MVD), percutaneous radiofrequency rhizotomy (RFR), and stereotactic radiosurgery (SRS). Few studies have explored the relative cost-effectiveness of these interventions, particularly in surgically naïve patients. A retrospective chart review performed between January 2003 and January 2013 identified a total of 89 patients who underwent surgical treatment for TN (MVD=27, RFR=23, SRS=39). Outcome measures included facial pain (excellent=no pain, no medications; good=no pain, medications required; fair=>50% decrease in pain; and poor=RFR=76.2±16, and SRS=74.5±12 (pRFR=4700±2200, and SRS=39,300±6000 (pRFR=52%, and SRS=28% (pRFR=74%, and SRS=31% (pRFR=59±76, and SRS=35±25. Mean quality adjusted pain-free years were MVD=1.58, RFR=2.28, and SRS=0.99. Cost-effectiveness calculations in US dollars showed MVD=31,800, RFR=2100, and SRS=39,600 (pRFR was the least expensive procedure, provided immediate relief, but was associated with the highest rates of facial numbness and recurrence. Based on cost-effectiveness, considering both cost and outcome, RFR was the most cost-effective, followed by MVD, and finally SRS. Copyright © 2015 Elsevier B.V. All rights reserved.

  8. Electroacupuntura en un caso de neuralgia postherpética con afectación de la rama oftálmica del V par craneal Electroacupuncture in a case of postherpetic neuralgia with involvement of the ophthalmic branch of the trigeminal nerve

    OpenAIRE

    P. Prieto; A. Carregal; M. Corujeira; I. Areán; A. Román; A. López

    2009-01-01

    Neuralgia postherpética: cuadro de dolor neuropático crónico que aparece como complicación de una infección por el virus de la varicela zóster. La clínica se caracteriza por un dolor intenso y episódico. El tratamiento de elección es farmacológico, pero en un porcentaje de pacientes no se consigue una adecuada respuesta terapéutica, bien por intolerancia a los fármacos bien por inadecuado control del dolor. Se presenta el caso clínico de una paciente con una neuralgia postherpética que afecta...

  9. The effects of temporary spinal cord stimulation (or spinal nerve root stimulation) on the management of early postherpetic neuralgia from one to six months of its onset.

    Science.gov (United States)

    Yanamoto, Fujio; Murakawa, Kazushige

    2012-01-01

    We examined the efficacy of temporary spinal cord stimulation involving the insertion of only a needle and quadripolar lead into the epidural space and applied using an extracorporeal stimulation generator for a few weeks of early postherpetic neuralgia from one to six months of its onset. Temporary spinal cord stimulation was applied in 33 patients with postherpetic neuralgia and in whom epidural block was effective. Temporary spinal cord stimulation was applied over seven days, and analgesic effects was evaluated based on visual analog scale (VAS) values before and after one, three, and six months following treatment. An analgesic effect was defined as a decrease of over 50% in the VAS value compared with before treatment. VAS values decreased significantly from 68.1 mm (standard deviation [SD]± 15.2) before treatment to 37.5 mm (SD ± 20.4) after one month, to 38.0 mm (SD ± 18.7) after three months, and to 35.0 mm (SD ± 21.3) after six months. In 21/33 (63.6%) cases, an analgesic effect, defined as a decrease in the VAS value of greater than 50%, was observed one month after treatment, in 20/33 (60.6%) cases such an effect was observed three months after treatment, and in 21/33 (63.6%) cases the effect was still observed six months after treatment. Temporary spinal cord stimulation is an effective analgesic method for early postherpetic neuralgia from one to six months of its onset. © 2012 International Neuromodulation Society.

  10. Trigeminal neuralgia due to neurovascular conflicts from venous origin: an anatomical-surgical study (consecutive series of 124 operated cases).

    Science.gov (United States)

    Dumot, Chloé; Sindou, Marc

    2015-03-01

    Veins as the source of trigeminal neuralgias (TN) lead to controversies. Only a few studies have specifically dealt with venous implication in neurovascular conflicts (NVC). The aim of this study was the anatomical-surgical description of the compressive veins found during micro-vascular decompression (MVD). Patients retained were those in whom a vein was considered compressive, alone, or in association with an artery. The study defined the type of vein involved, its situation along, the location around the root, and management. For this study, denomination of veins in relation with the root was revisited. Of the 326 consecutive patients who underwent MVD from 2005 to 2013, 124 (38.0 %) had a venous conflict, alone in 29 (8.9 %), or in association with an artery in 95 (29.1 %). The compressive veins belonged to one of the two venous systems described: the superficial or the deep superior petrosal venous system (sSPVS or dSPVS). A vein from sSPVS was found compressive in 81 cases (59.6 %), for the major part it was the pontine affluent of the superior petrosal vein (48 cases). The conflict was situated at TREZ in 28.4 %, mid-cisternal portion in 50.6 %, and porus in 8.6 %. The dSPVS was found compressive in 55 cases (40.4 %), almost always a transverse vein at porus (51 cases). Decompression was coagulation-division of the conflicting vein in 36.8 % and simple cleavage in the other. The study shows the frequent implication of veins in NVC as the source of TN. NVC are not only at TREZ but also at mid-cisternal portion and porus of Meckel cave.

  11. Combination of low frequency electroacupuncture plus subdissociative doses of ketamine in post-herpetic neuralgia patients. A pilot study

    Directory of Open Access Journals (Sweden)

    Bárbara B. Garrido-Suárez

    2017-11-01

    Full Text Available Context: Pain processing implicates multiple concurrent mechanisms of nociceptive transmission and modulation. Electroacupuncture (EA analgesia involves mainly the activation of the endogenous anti-nociceptive systems that modulate pain transmission in addition to the regulation of glial activity and inhibition of pro-inflammatory cytokines in the spinal cord. Aims: To examine the potential anti-hyperalgesic effects the EA and the combination EA-ketamine in patients with post-herpetic neuralgia (PHN. Methods: Sixty-eight patients with PHN irritable nociceptor type were randomly allocated to 3 groups: group I (n=26, that received treatment with EA (10 Hz, 2-3 mA, 0.5 ms, 20 min/15 sessions alone, group II (n=21 with a combination EA-ketamine (0.25-0.5 mg/kg, i.m. or group III (n=21 with sham EA-ketamine for 15 days. The average daily pain score (ADPS using the Likert scale, area and rate of dynamic allodynia, the rate of thermal allodynia, and frequency of intermittent lancinating pain were evaluated during five visits – before treatment and at 15, 30, 60, 90 days. Results: ADPS and sensory abnormalities decreased significantly concerning baseline data at 90 days in the three groups, but patients treated with the combination EA-ketamine significantly improved compared with the other groups. Conclusions: These results suggest that the combination EA-ketamine shows an early and long-term anti-hyperalgesic effect in PHN patients. However, a controlled clinical trial is necessary to confirm this hypothesis.

  12. The clinical significance of infrared thermography for the prediction of postherpetic neuralgia in acute herpes zoster patients.

    Science.gov (United States)

    Ko, E J; No, Y A; Park, K Y; Li, K; Seo, S J; Hong, C K

    2016-02-01

    Infrared thermography is a non-invasive diagnostic tool that provides information for damage to the nerve, there was some reports that thermal asymmetry of acute Herpes zoster (HZ) patients was significantly related to development of PHN. To identify whether infrared thermography is useful as a predictor for the development of postherpetic neuralgia (PHN) and as an objective assessment tool of subjective pain in acute HZ patients. Infrared thermography was performed on the affected body regions of 112 patients who had been diagnosed with an acute stage of HZ. Demographic and clinical data were recorded. Differences >0.5°C for the mean temperature across the face and trunk were considered abnormal. According to whether PHN developed or not, we analyzed the correlation of risk factors. The study consisted of a total of 112 subjects (46 males and 66 females) with an age range of 9-93 years. The following summarizes the analysis results. (1) As pain severity increased, the occurrence of PHN increased significantly. (2) In older patients, the occurrence of PHN was significantly higher. (3) As the temperature difference between the affected and contralateral dermatome (ΔT) increased, the occurrence of PHN increased significantly. (4) There is a statically significant association between diabetes mellitus and the occurrence of PHN. (5) There is no correlation between pain intensity and ΔT. In this study, we showed that infrared thermography is useful as a predictor of PHN development in acute HZ patients but is not useful as an objective assessment tool for indicating subjective pain. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  13. Presurgical visualization of the neurovascular relationship in trigeminal neuralgia with 3D modeling using free Slicer software.

    Science.gov (United States)

    Han, Kai-Wei; Zhang, Dan-Feng; Chen, Ji-Gang; Hou, Li-Jun

    2016-11-01

    To explore whether segmentation and 3D modeling are more accurate in the preoperative detection of the neurovascular relationship (NVR) in patients with trigeminal neuralgia (TN) compared to MRI fast imaging employing steady-state acquisition (FIESTA). Segmentation and 3D modeling using 3D Slicer were conducted for 40 patients undergoing MRI FIESTA and microsurgical vascular decompression (MVD). The NVR, as well as the offending vessel determined by MRI FIESTA and 3D Slicer, was reviewed and compared with intraoperative manifestations using SPSS. The k agreement between the MRI FIESTA and operation in determining the NVR was 0.232 and that between the 3D modeling and operation was 0.6333. There was no significant difference between these two procedures (χ 2  = 8.09, P = 0.088). The k agreement between the MRI FIESTA and operation in determining the offending vessel was 0.373, and that between the 3D modeling and operation was 0.922. There were significant differences between two of them (χ 2  = 82.01, P = 0.000). The sensitivity and specificity for MRI FIESTA in determining the NVR were 87.2 % and 100 %, respectively, and for 3D modeling were both 100 %. The segmentation and 3D modeling were more accurate than MRI FIESTA in preoperative verification of the NVR and offending vessel. This was consistent with surgical manifestations and was more helpful for the preoperative decision and surgical plan.

  14. Assessment of neurovascular compression in patients with trigeminal neuralgia with a boundary fusion three-dimensional magnetic resonance cisternogram/angiogram

    International Nuclear Information System (INIS)

    Satoh, Toru; Omi, Megumi; Ohsako, Chika; Onoda, Keisuke; Date, Isao

    2007-01-01

    Precise assessment of the complex nerve-vessel relationship at the root entry zone (REZ) of the trigeminal nerve is useful for the planning of the microvascular decompression (MVD) in patients with trigeminal neuralgia. We have applied a boundary imaging of fusion three-dimensional (3D) magnetic resonance (MR) cisternogram/angiogram. The boundary imaging allows virtual assessment of the spatial relationship of the neurovascular compression at the REZ of the trigeminal nerve. The boundary images depicted complex anatomical relationship of the offending vessels to the trigeminal nerve REZ. The presence of offending vessels, compressive site, and degree of neurovascular compression were assessed from various viewpoints in the cistern and virtually through the brainstem and trigeminal nerve per se. The 3D visualization of the nerve-vessel relationship with fusion images was consistent with the intraoperative findings. The boundary fusion 3D MR cisternogram/angiogram may prove a useful adjunct for the diagnosis and decision-marking process to execute the MVD in patients with trigeminal neuralgia. (author)

  15. Effect of duration of postherpetic neuralgia on efficacy analyses in a multicenter, randomized, controlled study of NGX-4010, an 8% capsaicin patch evaluated for the treatment of postherpetic neuralgia

    Directory of Open Access Journals (Sweden)

    Rauck Richard

    2010-10-01

    Full Text Available Abstract Background Postherpetic neuralgia (PHN is a painful and difficult to treat complication of acute herpes zoster. Current treatment options provide only partial relief and are often limited by poor tolerability. We evaluated the safety and efficacy of a single 60-minute application of NGX-4010, an 8% capsaicin patch, in patients with PHN. Methods This multicenter, double-blind, controlled study randomized 155 patients 2:1 to receive either NGX-4010 or a 0.04% capsaicin control patch. Patients were at least 18 years old with PHN for at least 3 months, and an average Numeric Pain Rating Scale (NPRS score of 3 to 9. The primary efficacy endpoint was the percentage change in NPRS score from baseline to weeks 2-8. Results The mean percent reduction in "average pain for the past 24 hours" NPRS scores from baseline to weeks 2-8 was greater in the NGX-4010 group (36.5% compared with control (29.9% although the difference was not significant (p = 0.296. PGIC analysis demonstrated that more NGX-4010 recipients considered themselves improved (much, or very much compared with control at weeks 8 and 12, but the differences did not reach statistical significance. Post hoc analyses of patients with PHN for at least 6 months showed significantly greater reductions in "average pain for the past 24 hours" NPRS scores from baseline to weeks 2-8 in NGX-4010 patients compared to controls (37.6% versus 23.4%; p = 0.0291. PGIC analysis in this subgroup demonstrated that significantly more NGX-4010 recipients considered themselves much or very much improved compared with control at week 12 (40% versus 20%; p = 0.0403;. Conclusions Although treatment appeared to be safe and well tolerated, a single 60-minute application of NGX-4010 failed to show efficacy in this study which included patients with PHN for less than 6 months. Large reductions in pain observed among control patients with pain for less than 6 months may have been due to spontaneous resolution of PHN

  16. Trigeminal Neuralgia Treated With Stereotactic Radiosurgery: The Effect of Dose Escalation on Pain Control and Treatment Outcomes

    Energy Technology Data Exchange (ETDEWEB)

    Kotecha, Rupesh [Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio (United States); Kotecha, Ritesh [MidMichigan Medical Center, Midland, Michigan (United States); Modugula, Sujith [Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio (United States); Murphy, Erin S. [Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio (United States); Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center, Cleveland Clinic, Cleveland, Ohio (United States); Jones, Mark; Kotecha, Rajesh [MidMichigan Medical Center, Midland, Michigan (United States); Reddy, Chandana A. [Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio (United States); Suh, John H. [Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio (United States); Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center, Cleveland Clinic, Cleveland, Ohio (United States); Barnett, Gene H. [Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center, Cleveland Clinic, Cleveland, Ohio (United States); Department of Neurosurgery, Neurological Institute, Cleveland Clinic, Cleveland, Ohio (United States); Neyman, Gennady [Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio (United States); Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center, Cleveland Clinic, Cleveland, Ohio (United States); Machado, Andre; Nagel, Sean [Department of Neurosurgery, Neurological Institute, Cleveland Clinic, Cleveland, Ohio (United States); Chao, Samuel T., E-mail: chaos@ccf.org [Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio (United States); Rose Ella Burkhardt Brain Tumor and Neuro-Oncology Center, Cleveland Clinic, Cleveland, Ohio (United States)

    2016-09-01

    Purpose: To analyze the effect of dose escalation on treatment outcome in patients undergoing stereotactic radiosurgery (SRS) for trigeminal neuralgia (TN). Methods and Materials: A retrospective review was performed of 870 patients who underwent SRS for a diagnosis of TN from 2 institutions. Patients were typically treated using a single 4-mm isocenter placed at the trigeminal nerve dorsal root entry zone. Patients were divided into groups based on treatment doses: ≤82 Gy (352 patients), 83 to 86 Gy (85 patients), and ≥90 Gy (433 patients). Pain response was classified using a categorical scoring system, with fair or poor pain control representing treatment failure. Treatment-related facial numbness was classified using the Barrow Neurological Institute scale. Log-rank tests were performed to test differences in time to pain failure or development of facial numbness for patients treated with different doses. Results: Median age at first pain onset was 63 years, median age at time of SRS was 71 years, and median follow-up was 36.5 months from the time of SRS. A majority of patients (827, 95%) were clinically diagnosed with typical TN. The 4-year rate of excellent to good pain relief was 87% (95% confidence interval 84%-90%). The 4-year rate of pain response was 79%, 82%, and 92% in patients treated to ≤82 Gy, 83 to 86 Gy, and ≥90 Gy, respectively. Patients treated to doses ≤82 Gy had an increased risk of pain failure after SRS, compared with patients treated to ≥90 Gy (hazard ratio 2.0, P=.0007). Rates of treatment-related facial numbness were similar among patients treated to doses ≥83 Gy. Nine patients (1%) were diagnosed with anesthesia dolorosa. Conclusions: Dose escalation for TN to doses >82 Gy is associated with an improvement in response to treatment and duration of pain relief. Patients treated at these doses, however, should be counseled about the increased risk of treatment-related facial numbness.

  17. Price of pain: population-based cohort burden of disease analysis of medication cost of herpes zoster and postherpetic neuralgia

    Directory of Open Access Journals (Sweden)

    Friesen KJ

    2016-08-01

    Full Text Available Kevin J Friesen,1 Jamie Falk,1 Silvia Alessi-Severini,1 Dan Chateau,2 Shawn Bugden1 1College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada; 2Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada Background: Pain is a main symptom of herpes zoster (HZ, and postherpetic neuralgia (PHN is a frequent complication occurring in 5% to 15% of cases, causing moderate to severe neuropathic pain. A population-based observational study was conducted to evaluate the treatment patterns and economic burden of prescription drug treatment of HZ and PHN pain in the province of Manitoba (Canada over a period of 15 years. Methods: Administrative health care data, including medical and hospital separation records, were examined to identify episodes of HZ using International Classification of Diseases-9/10 codes between April 1, 1997 and March 31, 2014. Episodes of PHN were identified using medical and prescription claims. Incident use of analgesic, antidepressant, or anticonvulsant drugs was used to determine prescription pain costs. Results: The age-adjusted incidence of HZ increased from 4.7 episodes/1,000 person-years in 1997/98 to 5.7/1,000 person-years in 2013/14. PHN occurred in 9.2% of HZ cases, a rate that did not change over the study period (P=0.57. The annual cost to treat HZ pain rose by 174% from 1997/98, reaching CAD $332,981 in 2011/12, 82.8% (95% confidence interval [CI] 81.2%, 84.3% of which was related to PHN. The per episode cost of HZ rose by 111% from $31.59 (95% CI $25.35, $37.84 to $66.81 (95% CI $56.84, $76.78 and by 94% for PHN from $292 (95% CI $225, $358 to $566 (95% CI $478, $655. These increases were driven by increasing use of anticonvulsants, primarily gabapentin, which accounted for 57% of the increase in cost. Conclusion: There has been an increase in the incidence of HZ and PHN and in the average cost associated with the

  18. Price of pain: population-based cohort burden of disease analysis of medication cost of herpes zoster and postherpetic neuralgia.

    Science.gov (United States)

    Friesen, Kevin J; Falk, Jamie; Alessi-Severini, Silvia; Chateau, Dan; Bugden, Shawn

    2016-01-01

    Pain is a main symptom of herpes zoster (HZ), and postherpetic neuralgia (PHN) is a frequent complication occurring in 5% to 15% of cases, causing moderate to severe neuropathic pain. A population-based observational study was conducted to evaluate the treatment patterns and economic burden of prescription drug treatment of HZ and PHN pain in the province of Manitoba (Canada) over a period of 15 years. Administrative health care data, including medical and hospital separation records, were examined to identify episodes of HZ using International Classification of Diseases-9/10 codes between April 1, 1997 and March 31, 2014. Episodes of PHN were identified using medical and prescription claims. Incident use of analgesic, antidepressant, or anticonvulsant drugs was used to determine prescription pain costs. The age-adjusted incidence of HZ increased from 4.7 episodes/1,000 person-years in 1997/98 to 5.7/1,000 person-years in 2013/14. PHN occurred in 9.2% of HZ cases, a rate that did not change over the study period (P=0.57). The annual cost to treat HZ pain rose by 174% from 1997/98, reaching CAD $332,981 in 2011/12, 82.8% (95% confidence interval [CI] 81.2%, 84.3%) of which was related to PHN. The per episode cost of HZ rose by 111% from $31.59 (95% CI $25.35, $37.84) to $66.81 (95% CI $56.84, $76.78) and by 94% for PHN from $292 (95% CI $225, $358) to $566 (95% CI $478, $655). These increases were driven by increasing use of anticonvulsants, primarily gabapentin, which accounted for 57% of the increase in cost. There has been an increase in the incidence of HZ and PHN and in the average cost associated with the prescription treatment of their resultant neuropathic pain. The primary driver of the increased episodic cost is the increased use of gabapentin. These changes have resulted in a substantial increase in the economic burden associated with HZ and PHN.

  19. Cognitive effects of electro-acupuncture and pregabalin in a trigeminal neuralgia rat model induced by cobra venom

    Directory of Open Access Journals (Sweden)

    Chen RW

    2017-08-01

    Full Text Available Ruo-Wen Chen,1,2 Hui Liu,2 Jian-Xiong An,1,2 Xiao-Yan Qian,2 Yi-De Jiang,2 Doris K Cope,3 John P Williams,3 Rui Zhang,1 Li-Na Sun1 1Department of Anesthesiology, Weifang Medical University, Weifang City, Shandong, 2Department of Anesthesiology, Pain Medicine and Critical Care Medicine, Aviation General Hospital of China Medical University and Beijing Institute of Translational Medicine, Chinese Academy of Sciences, Beijing, China; 3Department of Anesthesiology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA Objective: The objective of this study was to investigate the effects of electro-acupuncture (EA and pregabalin on cognition impairment induced by chronic trigeminal neuralgia (TN in rats. Design: Controlled animal study. Setting: Department of Anesthesiology, Pain Medicine and Critical Care Medicine, Aviation General Hospital of China Medical University. Subjects: Forty adult male Sprague Dawley rats. Methods: Rats were randomly divided into four groups. The TN model was induced by administration of cobra venom to the left infraorbital nerve. On postoperative day 14, either EA or pregabalin was administered, free behavioral activities were observed. Spatial learning and memory abilities were determined in the Morris water maze. The ultrastructural alterations of the Gasserian ganglion, medulla oblongata and hippocampus were examined by electron microscopy. The changes on long-term potentiation were investigated. Results: After treatment, the exploratory behavior increased and the grooming behavior decreased (P<0.05 for the EA group and pregabalin group compared with the cobra venom group; moreover, demyelination of neurons in Gasserian ganglion and medulla oblongata was reversed. The number of platform site crossings, the average percentages of time in the target quadrant and the field excitatory postsynaptic potential slopes increased (P<0.05 in the EA group compared to the cobra venom group. However, the pregabalin group

  20. Predictive Nomogram for the Durability of Pain Relief From Gamma Knife Radiation Surgery in the Treatment of Trigeminal Neuralgia

    International Nuclear Information System (INIS)

    Lucas, John T.; Nida, Adrian M.; Isom, Scott; Marshall, Kopriva; Bourland, John D.; Laxton, Adrian W.; Tatter, Stephen B.; Chan, Michael D.

    2014-01-01

    Purpose: To determine factors associated with the durability of stereotactic radiation surgery (SRS) for treatment of trigeminal neuralgia (TN). Methods and Materials: Between 1999 and 2008, 446 of 777 patients with TN underwent SRS and had evaluable follow-up in our electronic medical records and phone interview records. The median follow-up was 21.2 months. The Barrow Neurologic Institute (BNI) pain scale was used to determine pre- and post-SRS pain. Dose-volume anatomical measurements, Burchiel pain subtype, pain quality, prior procedures, and medication usage were included in this retrospective cohort to identify factors impacting the time to BNI 4-5 pain relapse by using Cox proportional hazard regression. An internet-based nomogram was constructed based on predictive factors of durable relief pre- and posttreatment at 6-month intervals. Results: Rates of freedom from BNI 4-5 failure at 1, 3, and 5 years were 84.5%, 70.4%, and 46.9%, respectively. Pain relief was BNI 1-3 at 1, 3, and 5 years in 86.1%, 74.3%, and 51.3% of type 1 patients; 79.3%, 46.2%, and 29.3% of type 2 patients; and 62.7%, 50.2%, and 25% of atypical facial pain patients. BNI type 1 pain score was achieved at 1, 3, and 5 years in 62.9%, 43.5%, and 22.0% of patients with type 1 pain and in 47.5%, 25.2%, and 9.2% of type 2 patients, respectively. Only 13% of patients with atypical facial pain achieved BNI 1 response; 42% of patients developed post-Gamma Knife radiation surgery (GKRS) trigeminal dysfunction. Multivariate analysis revealed that post-SRS numbness (hazard ratio [HR], 0.47; P<.0001), type 1 (vs type 2) TN (HR, 0.6; P=.02), and improved post-SRS BNI score at 6 months (HR, 0.009; P<.0001) were predictive of a durable pain response. Conclusions: The durability of SRS for TN depends on the presenting Burchiel pain type, the post-SRS BNI score, and the presence of post-SRS facial numbness. The durability of pain relief can be estimated pre- and posttreatment by using our

  1. Glycerol rhizotomy versus gamma knife radiosurgery for the treatment of trigeminal neuralgia: An analysis of patients treated at one institution

    International Nuclear Information System (INIS)

    Henson, Clarissa Febles; Goldman, H. Warren; Rosenwasser, Robert H.; Downes, M. Beverly; Bednarz, Greg; Pequignot, Edward C.; Werner-Wasik, Maria; Curran, Walter J.; Andrews, David W.

    2005-01-01

    Background: Medically refractory trigeminal neuralgia (TN) has been treated with a variety of minimally invasive techniques, all of which have been compared with microvascular decompression. For patients not considered good surgical candidates, percutaneous retrogasserian glycerol rhizotomy (GR) and gamma knife (GK) radiosurgery are two minimally invasive techniques in common practice worldwide and used routinely at Jefferson Hospital for Neuroscience. Using a common pain scale outcomes questionnaire, we sought to analyze efficacies and morbidities of both treatments. Methods and Materials: Between June 1994 and December 2002, 79 patients were treated with GR and 109 patients underwent GK for the treatment of TN. GR was performed with fluoroscopic guidance as an overnight inpatient procedure. GK was performed using a single 4-mm shot positioned at the root exit zone of the trigeminal nerve. Radiation doses of 70-90 Gy prescribed to the 100% isodose line were used. Treatment outcomes including pain response, pain recurrence, treatment failure, treatment-related side effects, and overall patient satisfaction with GK and GR were compared using a common outcomes scale. Using the Barrow Neurologic Institute pain scale, patients were asked to define their level of pain both before and after treatment: I, no pain and no pain medication required; I, occasional pain not requiring medication; IIIa, no pain and pain medication used; IIIb, some pain adequately controlled with medication; IV, some pain not adequately controlled with medication; and V, severe pain with no relief with medication. We used posttreatment scores of I, II, IIIa, and IIIb to identify treatment success, whereas scores of IV and V were considered treatment failure. Results were compiled from respondents and analyzed using SAS software. Statistical comparisons used log-rank test, univariate and multivariate logistic regression, Fisher's exact test, and Wilcoxon test with significance established at p < 0

  2. Efficacy and tolerability of gastric-retentive gabapentin for the treatment of postherpetic neuralgia: results of a double-blind, randomized, placebo-controlled clinical trial.

    Science.gov (United States)

    Irving, Gordon; Jensen, Mark; Cramer, Marilou; Wu, Jacqueline; Chiang, Yu-Kun; Tark, Marvin; Wallace, Mark

    2009-01-01

    To determine the efficacy and safety of a gastric-retentive, extended-release gabapentin (gabapentin ER) taken once or twice daily for treatment of postherpetic neuralgia. Using an enrichment design, a randomized, double-blind, placebo-controlled study was conducted in 158 patients who had experienced pain for at least 3 months after healing of acute herpes zoster skin rash and who had a baseline average daily pain (ADP) score of > or =4 on a 0 to 10 Numerical Rating Scale. Patients received gabapentin ER either once daily (1800 mg PM) or twice daily (600 mg AM, 1200 mg PM) or placebo for 4 weeks. Efficacy measures included changes from baseline to end point in ADP score and average daily sleep interference score. Mean (SEM) changes for ADP score were -1.93 (0.28), -2.24 (0.29), and -1.29 (0.29) in the gabapentin ER once daily, twice daily, and placebo groups, respectively (P=0.089 and 0.014 for gabapentin ER once daily and twice daily, respectively, vs. placebo), with 25.5%, 28.8%, and 11.8% of patients, respectively, reporting > or =50% decrease from baseline in ADP score. Mean (SEM) changes in sleep interference scores were -1.94 (0.30), -2.28 (0.30), and -1.16 (0.30), respectively (P=0.048 and 0.006 for gabapentin ER once daily and twice daily, respectively, vs. placebo). Common adverse events in the gabapentin ER once daily, twice daily, and placebo groups, respectively, were dizziness (22.2%, 11.3%, and 9.8%) and somnolence (9.3%, 7.5%, and 7.8%). Gabapentin ER administered twice daily is effective and safe for the treatment of pain associated with postherpetic neuralgia.

  3. Evidence of and experience with the use of onabotulinumtoxinA in trigeminal neuralgia and primary headaches other than chronic migraine.

    Science.gov (United States)

    Santos-Lasaosa, S; Cuadrado, M L; Gago-Veiga, A B; Guerrero-Peral, A L; Irimia, P; Láinez, J M; Leira, R; Pascual, J; Porta-Etessam, J; Sánchez Del Río, M; Viguera Romero, J; Pozo-Rosich, P

    2017-11-20

    In the field of headaches, onabotulinumtoxinA (onabotA) is well established as a treatment for chronic migraine (CM). In recent years, it has been used increasingly to treat other primary headaches (high-frequency episodic migraine, trigeminal-autonomic cephalalgias, nummular headache) and trigeminal neuralgia. As this treatment will progressively be incorporated in the management of these patients, we consider it necessary to reflect, with a fundamentally practical approach, on the possible indications of onabotA, beyond CM, as well as its administration protocol, which will differ according to the type of headache and/or neuralgia. This consensus document was drafted based on a thorough review and analysis of the existing literature and our own clinical experience. The aim of the document is to serve as guidelines for professionals administering onabotA treatment. The first part will address onabotA's mechanism of action, and reasons for its use in other types of headache, from a physiopathological and clinical perspective. In the second part, we will review the available evidence and studies published in recent years. We will add an "expert recommendation" based on our own clinical experience, showing the best patient profile for this treatment and the most adequate dose and administration protocol. Treatment with onabotA should always be individualised and considered in selected patients who have not responded to conventional therapy. Copyright © 2017 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

  4. Stereotactic radio surgery and radio frequency rhizotomy for trigeminal neuralgia in multiple sclerosis: A single institution experience.

    Science.gov (United States)

    Holland, Marshall T; Teferi, Nahom; Noeller, Jennifer; Swenson, Andrea; Smith, Mark; Buatti, John; Hitchon, Patrick W

    2017-11-01

    For patients with medically unresponsive trigeminal neuralgia (TN), surgical options include micro vascular decompression (MVD), radiofrequency rhizotomy (RF), and stereotactic radio surgery (SRS). Multiple sclerosis (MS) is a demyelinating condition that can be associated with TN, but is not amenable to treatment with MVD. We sought to identify the outcome differences of patients with TN in MS undergoing SRS or RFR in an attempt to identify factors that may influence outcomes. We also evaluated cost outcomes, both initially and over time, based on the index procedure. We performed a retrospective review of our experience with 17 cases. A single institution retrospective chart review was performed. Since 1997, 17 patients with TN and MS have been treated at our institution. All patients underwent a preoperative MRI to rule out a compressive lesion. Patients either underwent SRS (n=7) or RFR (n=10) as their index procedure and were evaluated as a group based on this first procedure. Outcome measures included preoperative Expand Disability Status Score (EDSS) scores, pre- and postoperative facial pain and medication use, post-intervention facial numbness, need for subsequent procedures, and duration of follow-up. Charges for the index procedure, subsequent interventions, and total costs were tabulated and analyzed in 2017 US dollars, adjusting for inflation. The median age of patients at first operation in each group was 58.5±10.9 and 63.5±7.5 for SRS and RFR respectively. There were no significant differences in basic demographics. Overall, 71% of these patients had an excellent or good initial pain outcome. Over time, 60% of RFR and 29% of SRS patients required additional procedures to obtain satisfactory pain relief. The patients who underwent RFR as their index procedure required a significantly higher number of procedures to achieve adequate pain relief (RFR=2.7 vs SRS=2.0 [p=0.04]). The average index procedure costs in US dollars were significantly different

  5. Fact Sheet: Trigeminal Neuralgia

    Science.gov (United States)

    ... large number of conditions that can cause facial pain, obtaining a correct diagnosis is difficult, but finding the cause of the ... projects are exploring the mechanisms involved with chronic pain and ... diagnostic methods and treatments. Other research addresses TN through ...

  6. Effect of Concomitant Pain Medications on Response to Pregabalin in Patients with Postherpetic Neuralgia or Spinal Cord Injury-Related Neuropathic Pain.

    Science.gov (United States)

    Schug, Stephan A; Parsons, Bruce; Almas, Mary; Whalen, Ed

    2017-01-01

    Patients with neuropathic pain (NeP) often receive combination therapy with multiple agents in the hopes of improving both pain and any comorbidities that may be present. While pregabalin is often recommended as a first-line treatment of NeP, few studies have examined the effects of concomitant medications on the efficacy of pregabalin. To examine the effects of concomitant medications on the efficacy and safety of pregabalin for the treatment of NeP. Data were derived from 7 randomized placebo-controlled trials of pregabalin (150, 300, 600, and flexible 150 - 600 mg/d) for the treatment of postherpetic neuralgia (PHN) and 2 randomized placebo-controlled trials for the treatment of NeP due to spinal cord injury (SCI-NeP). On each day, patients rated the severity of their pain and pain-related sleep interference (PRSI) over the previous 24 hours on a scale from 0 to 10, with higher scores indicating greater severity. Patients were also continually monitored for the occurrence of adverse events. A pooled retrospective analyses of data from randomized clinical trials. Changes from baseline in mean weekly pain and PRSI scores were compared between patients who received concomitant NeP medications and patients who did not receive concomitant NeP medications. Results of these comparisons are presented separately for the PHN (through 4, 8, and 12 weeks) and SCI-NeP (through 12 weeks) cohorts. Common adverse events are also presented for each treatment group. Pregabalin significantly improved both pain and PRSI scores relative to placebo at most dose levels and time points examined. Notably, little difference was observed in the extent of therapeutic response to pregabalin between patients who received concomitant NeP medications and patients who did not receive concomitant NeP medications. Additionally, the profile of treatment-emergent adverse events appeared to be largely unaffected by the use of concomitant NeP medications in the pooled patient population. Our analysis

  7. Associations of Perceived Mental Stress, Sense of Purpose in Life, and Negative Life Events With the Risk of Incident Herpes Zoster and Postherpetic Neuralgia: The SHEZ Study.

    Science.gov (United States)

    Takao, Yukiko; Okuno, Yoshinobu; Mori, Yasuko; Asada, Hideo; Yamanishi, Koichi; Iso, Hiroyasu

    2018-02-01

    In the present population-based prospective study, we examined the associations of psychosocial factors with the incidence of herpes zoster (HZ) and postherpetic neuralgia (PHN). Data were collected from 12,359 participants (≥50 years of age) who answered a self-completed health questionnaire in the Shozu County of Kagawa Prefecture in Japan. During a 3-year follow-up between December 2008 and November 2012, HZ and PHN were diagnosed in 400 and 79 subjects, respectively. We used Cox regression analysis to estimate hazard ratios of incident HZ and PHN according to psychosocial factors, adjusting for age, sex, histories of HZ, cancer, and diabetes, smoking and drinking habits, and time from disease onset to treatment. Men with high levels of mental stress were twice as likely to be at risk for incident HZ. The risk of incident HZ was approximately 60% lower among men and women who reported a high sense of purpose in life. Women who experienced negative life events-particularly changes in their work, living environment, and relationships-had a 2- to 3-fold higher risk of incident PHN. Psychosocial factors such as perceived mental stress, sense of purpose in life, and negative life events may contribute to the development of HZ and PHN in the general population. © The Author(s) 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  8. Long-term outcome of percutaneous balloon compression for trigeminal neuralgia patients elder than 80 years: A STROBE-compliant article.

    Science.gov (United States)

    Ying, Xiang; Wang, Hao; Deng, Shanghua; Chen, Yinggao; Zhang, Jie; Yu, Wenhua

    2017-09-01

    This article evaluates the long-term outcome of percutaneous balloon compression (PBC) for trigeminal neuralgia (TN) patients elder than 80 years. A total of 138 elderly patients aged above 80 years with primary TN, who were admitted to Neurosurgery Department, Hangzhou First People's Hospital from January 2007 to December 2011 for PBC treatment, were retrospectively analyzed in this study. The postoperative cure rate of immediate pain was 98.6% (Barrow Neurological Institute [BNI] classes I, II); according to the follow-up, the pain cure rates at 1, 2, 3, 4, and 5 years after surgery were 93.5%, 90.4%, 84.7%, 80.4%, and 72.9%, respectively. In our group, postoperative diplopia was reported in 1 case, masticatory muscle weakness in 3 cases, and herpes labialis in 19 cases. A total of 100% of pain-cured patients exhibited facial numbness and facial hypoesthesia. No serious complications occurred in this group of patients. PBC is an effective and safe procedure for TN treatment and can be employed as the preferred regimen for elderly TN patients aged above 80 years in poorer physical condition.

  9. Descompresión microvascular en neuralgia del trigémino: Reporte de 36 casos y revisión de la literatura

    Science.gov (United States)

    Campero, Alvaro; Ajler, Pablo; Campero, Abraham Agustín

    2014-01-01

    Objetivo: El propósito del presente trabajo es presentar los resultados de 36 pacientes con diagnóstico de neuralgia del trigémino (NT), en los cuales se realizó una descompresión microvascular (DMV). Material y Método: Desde junio de 2005 a mayo de 2012, 36 pacientes con diagnóstico de NT fueron operados por el primer autor (AC), realizando una DMV. Se evaluó: Edad, sexo, tiempo de sintomatología previo a la cirugía, hallazgos intraoperatorios (a través de los videos quirúrgicos), y resultados postoperatorios. Resultados: De los 36 pacientes operados, 25 fueron mujeres y 11 varones. El promedio de edad fue de 48 años. El seguimiento postoperatorio fue en promedio de 38 meses. De los 36 pacientes, 32 (88%) evolucionaron sin dolor hasta la fecha. De los 4 casos con recurrencia de dolor, en dos pacientes se observó como hallazgo intraoperatorio un conflicto venoso. Conclusión: La DMV como tratamiento de la NT es un procedimiento efectivo y seguro. El hallazgo intraoperatorio de una “compresión” venosa podría indicar una evolución postoperatoria desfavorable. PMID:25379343

  10. Preoperative assessment of trigeminal neuralgia and hemifacial spasm using constructive interference in steady state-three-dimensional fourier transformation magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Yamakami, Iwao; Kobayashi, Eiichi; Hirai, Shinji; Yamaura, Akira [Chiba Univ. (Japan). School of Medicine

    2000-11-01

    Results of microvascular decompression (MVD) for trigeminal neuralgia (TN) and hemifacial spasm (HFS) may be improved by accurate preoperative assessment of neurovascular relationships at the root entry/exit zone (REZ). Constructive interference in steady state (CISS)-three-dimensional Fourier transformation (3DFT) magnetic resonance (MR) imaging was evaluated for visualizing the neurovascular relationships at the REZ. Fourteen patients with TN and eight patients with HFS underwent MR imaging using CISS-3DFT and 3D fast inflow with steady-state precession (FISP) sequences. Axial images of the cerebellopontine angle (CPA) obtained by the two sequences were reviewed to assess the neurovascular relationships at the REZ of the trigeminal and facial nerves. Eleven patients subsequently underwent MVD. Preoperative MR imaging findings were related to surgical observations and results. CISS MR imaging provided excellent contrast between the cranial nerves, small vessels, and cerebrospinal fluid (CSF) in the CPA. CISS was significantly better than FISP for delineating anatomic detail in the CPA (trigeminal and facial nerves, petrosal vein) and abnormal neurovascular relationships responsible for TN and HFS (vascular contact and deformity at the REZ). Preoperative CISS MR imaging demonstrated precisely the neurovascular relationships at the REZ and identified the offending artery in all seven patients with TN undergoing MVD. CISS MR imaging has high resolution and excellent contrast between cranial nerves, small vessels, and CSF, so can precisely and accurately delineate normal and abnormal neurovascular relationships at the REZ in the CPA, and is a valuable preoperative examination for MVD. (author)

  11. Neuralgia do trigêmeo bilateral por cisticerco racemoso unilateral no ângulo-ponto cerebelar: relato de caso

    OpenAIRE

    AGUIAR,PAULO HENRIQUE; MIURA,FLÁVIO KEY; NAPOLI,PAULO ROBERTO; SENDENSKI,MAURÍCIO; ROTTA,JOSÉ MARCUS; CESCATO,VALTER ÂNGELO; TEIXEIRA,MANOEL JACOBSEN; MARINO JUNIOR,RAUL

    2000-01-01

    Descrevemos o caso de uma paciente de 42 anos portadora de cisticerco racemoso na região do ângulo ponto-cerebelar (APC) direito com trigeminalgia bilateral mais intensa no lado ipsilateral à localização do parasita. O cisticerco foi totalmente removido por meio de craniotomia suboccipital. No primeiro dia pós-operatório houve desaparecimento bilateral da dor. Duas hipóteses fisiopatológicas foram aventadas para explicar a sintomatologia: lesões que ultrapassam os limites da cisterna do APC p...

  12. Characteristics, treatment, and health care expenditures of Medicare supplemental-insured patients with painful diabetic peripheral neuropathy, post-herpetic neuralgia, or fibromyalgia.

    Science.gov (United States)

    Johnston, Stephen S; Udall, Margarita; Alvir, Jose; McMorrow, Donna; Fowler, Robert; Mullins, Daniel

    2014-04-01

    To describe the characteristics, treatment, and health care expenditures of Medicare Supplemental-insured patients with painful diabetic peripheral neuropathy (pDPN), post-herpetic neuralgia (PHN), or fibromyalgia. Retrospective cohort study. United States clinical practice, as reflected within a database comprising administrative claims from 2.3 million older adults participating in Medicare supplemental insurance programs. Selected patients were aged ≥65 years, continuously enrolled in medical and prescription benefits throughout years 2008 and 2009, and had ≥1 medical claim with an International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis code for DPN, PHN, or fibromyalgia, followed within 60 days by a medication or pain intervention procedure used in treating pDPN, PHN, or fibromyalgia during 2008-2009. Utilization of, and expenditures on, pain-related and all-cause pharmacotherapy and medical interventions in 2009. The study included 25,716 patients with pDPN (mean age 75.2 years, 51.2% female), 4,712 patients with PHN (mean age 77.7 years, 63.9% female), and 25,246 patients with fibromyalgia (mean age 74.4 years, 73.0% female). Patients typically had numerous comorbidities, and many were treated with polypharmacy. Mean annual expenditures on total pain-related health care and total all-cause health care, respectively, (in 2010 USD) were: $1,632, $24,740 for pDPN; $1,403, $16,579 for PHN; and $1,635, $18,320 for fibromyalgia. In age-stratified analyses, pain-related health care expenditures decreased as age increased. The numerous comorbidities, polypharmacy, and magnitude of expenditures in this sample of Medicare supplemental-insured patients with pDPN, PHN, or fibromyalgia underscore the complexity and importance of appropriate management of these chronic pain patients. Wiley Periodicals, Inc.

  13. FV-100 versus valacyclovir for the prevention of post-herpetic neuralgia and the treatment of acute herpes zoster-associated pain: A randomized-controlled trial.

    Science.gov (United States)

    Tyring, Stephen K; Lee, Patricia; Hill, Gordon T; Silverfield, Joel C; Moore, Angela Yen; Matkovits, Theresa; Sullivan-Bolyai, John

    2017-07-01

    This prospective, parallel-group, randomized, double-blind, multicenter study compared the efficacy and safety of FV-100 with valacyclovir for reducing pain associated with acute herpes zoster (HZ). Patients, ≥50 years of age, diagnosed with HZ within 72 h of lesion appearance who had HZ-associated pain, were randomized 1:1:1 to a 7-day course of either FV-100 200 mg QD (n = 117), FV-100 400 mg QD (n = 116), or valacyclovir 1000 mg TID (n =117). Efficacy was evaluated on the basis of the burden of illness (BOI; Zoster Brief Pain Inventory scores); incidence and duration of clinically significant pain (CSP); pain scores; incidence and severity of post-herpetic neuralgia (PHN); and times to full lesion crusting and to lesion healing. Safety was evaluated on the basis of adverse event (AE)/SAE profiles, changes in laboratory and vital signs values, and results of electrocardiograms. The burden of illness scores for pain through 30 days were 114.5, 110.3, and 118.0 for FV-100 200 mg, FV-100 400 mg, and valacyclovir 3000 mg, respectively. The incidences of PHN at 90 days for FV-100 200 mg, FV-100 400 mg, and valacyclovir 3000 mg were 17.8%, 12.4%, and 20.2%, respectively. Adverse event and SAE profiles of the two FV-100 and the valacyclovir groups were similar and no untoward signals or trends were evident. These results demonstrate a potential for FV-100 as an antiviral for the treatment of shingles that could both reduce the pain burden of the acute episode and reduce the incidence of PHN compared with available treatments. © 2016 Wiley Periodicals, Inc.

  14. Epidemiology and long-term disease burden of herpes zoster and postherpetic neuralgia in Taiwan: a population-based, propensity score-matched cohort study.

    Science.gov (United States)

    Lu, Wan-Hsuan; Lin, Chih-Wan; Wang, Chen-Yu; Chen, Liang-Kung; Hsiao, Fei-Yuan

    2018-03-20

    The objectives of this study were to characterize the burden of herpes zoster, as well as the longitudinal and incremental changes of healthcare service utilization among individuals with herpes zoster and postherpetic neuralgia (PHN) compared to those without. Using the National Health Insurance Research Database (NHIRD), we established a herpes zoster cohort of people diagnosed with herpes zoster between 2004 and 2008 as study cases. Another subset of the NHIRD, which was randomly selected from all elderly beneficiaries between 2004 and 2008 served as a non-herpes-zoster elderly control pool. Each case was then assigned one matched control according to age, gender, index date and propensity score. PHN cases were defined as those with persisting pain for more than 90 days after the onset of herpes zoster. Between 2004 and 2008, about 0.6 million patients were newly diagnosed with herpes zoster. The incidence increased with age, and most cases were identified during the summer period. Herpes zoster cases were found to have higher consumption of all types of healthcare services in the first year after the index date. Such increases were particularly obvious for patients with PHN, who showed incremental increases on average of 16.3 outpatient visits, 0.4 emergency room visits and 0.24 inpatient admissions per year. The incidence of herpes zoster increased with age and changed according to the seasons. Patients with herpes zoster were associated with higher healthcare utilization and this increase in healthcare utilization was most obvious for herpes zoster patients with PHN.

  15. Neuralgia do trigêmeo bilateral por cisticerco racemoso unilateral no ângulo-ponto cerebelar: relato de caso

    Directory of Open Access Journals (Sweden)

    AGUIAR PAULO HENRIQUE

    2000-01-01

    Full Text Available Descrevemos o caso de uma paciente de 42 anos portadora de cisticerco racemoso na região do ângulo ponto-cerebelar (APC direito com trigeminalgia bilateral mais intensa no lado ipsilateral à localização do parasita. O cisticerco foi totalmente removido por meio de craniotomia suboccipital. No primeiro dia pós-operatório houve desaparecimento bilateral da dor. Duas hipóteses fisiopatológicas foram aventadas para explicar a sintomatologia: lesões que ultrapassam os limites da cisterna do APC poderão através da cisterna pré-pontina alcançar a cisterna do APC atingindo o trigêmeo contralateral; lesões com grande efeito de massa poderão provocar rotação do tronco cerebral e deslocamento e tração de estruturas ipsi e contralaterais, provocando compressão arteriovenosa sobre o trigêmeo contralateral na porção superior da cisterna do APC. Salientamos a necessidade de exames de imagem ante qualquer algia craniofacial e observamos que, em lesões na região do APC, a cisticercose não pode ser esquecida.

  16. para palmito

    Directory of Open Access Journals (Sweden)

    Francisco Paulo Chaimsohn

    2007-01-01

    Full Text Available Densidades de siembra, arreglos espaciales y fertilización en pejibaye (Bactris gasipaes cv Diamantes-10 para palmito. La investigación se llevó a cabo en la Estación Experimental Los Diamantes (Guápiles, Costa Rica, el 3 de octubre del 2003, cuyo objetivo fue la evaluación del efecto de diferentes densidades de siembra (3.333, 5.000 y 6.666 plantas/ha, arreglos espaciales, y diversos métodos de fertilización (química, orgánica, sobre el crecimiento de las plantas de pejibaye para producción de palmito. Se consideraron las variables diámetro y altura del tallo primario y el número de hojas y rebrotes como indicadores de producción. El período de evolución abarcó sólo los primeros 25 meses de crecimiento en el campo. El número de hojas, la altura y el diámetro del tallo no mostraron diferencias de respuesta relevantes. Sólo el número de rebrotes disminuyó al aumentar la densidad de la población, cuando se midió a los 15 meses de edad. El efecto de la fertilización se hizo evidente después de la primera cosecha, realizada a los 20 meses, debido al aumento de la competencia entre plantas, ahora más desarrolladas. Fue entonces cuando la fertilización química indujo la producción de un mayor número y vigor de los rebrotes. Sin embargo, las prácticas evaluadas 25 meses después de la siembra, no habían infl uido hasta ese momento en el número de palmitos cosechados, ni tampoco había afectado las características físicas de los sectores foliar y caulinar del palmito.

  17. The PINE study: rationale and design of a randomised comparison of epidural injection of local anaesthetics and steroids versus care-as-usual to prevent postherpetic neuralgia in the elderly [ISRCTN32866390

    Directory of Open Access Journals (Sweden)

    Verheij Theo

    2004-01-01

    Full Text Available Abstract Background Postherpetic neuralgia (PHN is by far the most common complication of herpes zoster (HZ and one of the most intractable pain disorders. Since PHN is seen most often in the elderly, the number of patients with this disorder is expected to increase in our ageing society. PHN may last for months to years and has a high impact on the quality of life. The results of PHN treatment are rather disappointing. Epidural injection of local anaesthetics and steroids in the acute phase of HZ is a promising therapy for the prevention of PHN. Since randomised trials on the effectiveness of this intervention are lacking, the PINE (Prevention by epidural Injection of postherpetic Neuralgia in the Elderly study was set up. The PINE study compares the effectiveness and cost-effectiveness of a single epidural injection of local anaesthetics and steroids during the acute phase of HZ with that of care-as-usual (i.e. antivirals and analgesics in preventing PHN in elderly patients. Methods / design The PINE study is an open, multicenter clinical trial in which 550 elderly (age ≥ 50 yr. patients who consult their general practitioner in the acute phase of HZ (rash Conclusion The PINE study is aimed to quantify the (cost- effectiveness of a single epidural injection during the acute phase of HZ on the prevention of PHN.

  18. Is There a Safe and Effective Way to Treat Trigeminal Neuralgia Associated with Vertebrobasilar Dolichoectasia? Presentation of 8 Cases and Literature Review.

    Science.gov (United States)

    Vanaclocha, Vicente; Herrera, Juan Manuel; Martínez-Gómez, Deborah; Rivera-Paz, Marlon; Calabuig-Bayo, Cristina; Vanaclocha, Leyre

    2016-12-01

    Surgical treatment of trigeminal neuralgia (TN) associated with vertebrobasilar dolichoectasia is challenging. We analyze the treatments for this disease, discussing the advantages and drawbacks, and present our own technique and series. This retrospective study covered the period January 2006 through January 2016. Vertebrobasilar dolichoectasia deviation from midline, basilar artery (BA) and vertebral artery diameter, and BA apex distance above the posterior clinoid process were measured on preoperative and postoperative magnetic resonance imaging. The BA was repositioned and kept in place with coagulation of the clival dura, Teflon pledgets, and fibrin glue. We also performed a thorough literature review using PubMed. Our cases included 5 men and 3 women with mean age 64.88 years ± 10.32 (range, 48-81 years); 7 cases were TN, and 1 case was painful tic convulsif. Pain was on the left side in 6 cases and on the right in 2 cases. All cases affected cranial nerve V 2 and/or V 3 divisions. Both V 2 and V 3 were affected in 4 cases, V 3 was affected in 3 cases, and V 2 was affected in 1 case. Hypertension was present in 5 cases. TN disappeared postoperatively in all cases. One patient took clonazepam 2 mg/24 hours for 3 months because of facial dysesthesia. Postoperative complications included hearing loss in 1 patient; facial paresis plus diplopia in 1 patient, which resolved in 3 months; and arterial hypertension. Postoperative arterial hypertension improved in all affected patients, although only 2 patients discontinued antihypertensive medications. Mean follow-up time was 56.50 months ± 40.08 (range, 14 months to 9 years 9 months). No patient showed pain recurrence. TN associated with vertebrobasilar dolichoectasia can be treated surgically with minimal morbidity. BA repositioning has the highest success rate. Our technique of inducing a dural scar to fix the BA in its new position away from the trigeminal nerve is simple, not technically demanding, and highly

  19. Self-regulation of brain activity in patients with postherpetic neuralgia: a double-blind randomized study using real-time FMRI neurofeedback.

    Science.gov (United States)

    Guan, Min; Ma, Lijia; Li, Li; Yan, Bin; Zhao, Lu; Tong, Li; Dou, Shewei; Xia, Linjie; Wang, Meiyun; Shi, Dapeng

    2015-01-01

    A pilot study has shown that real-time fMRI (rtfMRI) neurofeedback could be an alternative approach for chronic pain treatment. Considering the relative small sample of patients recruited and not strictly controlled condition, it is desirable to perform a replication as well as a double-blinded randomized study with a different control condition in chronic pain patients. Here we conducted a rtfMRI neurofeedback study in a subgroup of pain patients - patients with postherpetic neuralgia (PHN) and used a different sham neurofeedback control. We explored the feasibility of self-regulation of the rostral anterior cingulate cortex (rACC) activation in patients with PHN through rtfMRI neurofeedback and regulation of pain perception. Sixteen patients (46-71 years) with PHN were randomly allocated to a experimental group (n = 8) or a control group (n = 8). 2 patients in the control group were excluded for large head motion. The experimental group was given true feedback information from their rACC whereas the control group was given sham feedback information from their posterior cingulate cortex (PCC). All subjects were instructed to perform an imagery task to increase and decrease activation within the target region using rtfMRI neurofeedback. Online analysis showed 6/8 patients in the experimental group were able to increase and decrease the blood oxygen level dependent (BOLD) fMRI signal magnitude during intermittent feedback training. However, this modulation effect was not observed in the control group. Offline analysis showed that the percentage of BOLD signal change of the target region between the last and first training in the experimental group was significantly different from the control group's and was also significantly different than 0. The changes of pain perception reflected by numerical rating scale (NRS) in the experimental group were significantly different from the control group. However, there existed no significant correlations between BOLD signal

  20. Dedicated Linear Accelerator Radiosurgery for Trigeminal Neuralgia: A Single-Center Experience in 179 Patients With Varied Dose Prescriptions and Treatment Plans

    International Nuclear Information System (INIS)

    Smith, Zachary A.; Gorgulho, Alessandra A.; Bezrukiy, Nikita; McArthur, David; Agazaryan, Nzhde; Selch, Michael T.; De Salles, Antonio A.F.

    2011-01-01

    Purpose: Dedicated linear accelerator radiosurgery (D-LINAC) has become an important treatment for trigeminal neuralgia (TN). Although the use of gamma knife continues to be established, few large series exist using D-LINAC. The authors describe their results, comparing the effects of varied target and dose regimens. Methods and Materials: Between August 1995 and January 2008, 179 patients were treated with D-LINAC radiosurgery. Ten patients (5.58%) had no clinical follow-up. The median age was 74.0 years (range, 32-90 years). A total of 39 patients had secondary or atypical pain, and 130 had idiopathic TN. Initially, 28 patients received doses between 70 and 85 Gy, with the 30% isodose line (IDL) touching the brainstem. Then, using 90 Gy, 82 consecutive patients were treated with a 30% IDL and 59 patients with a 50% IDL tangential to the pons. Results: Of 169 patients, 134 (79.3%) experienced significant relief at a mean of 28.8 months (range, 5-142 months). Average time to relief was 1.92 months (range, immediate to 6 months). A total of 31 patients (19.0%) had recurrent pain at 13.5 months. Of 87 patients with idiopathic TN without prior procedures, 79 (90.8%) had initial relief. Among 28 patients treated with 70 Gy and 30% IDL, 18 patients (64.3%) had significant relief, and 10 (35.7%) had numbness. Of the patients with 90 Gy and 30% IDL at the brainstem, 59 (79.0%) had significant relief and 48.9% had numbness. Among 59 consecutive patients with similar dose but the 50% isodoseline at the brainstem, 49 patients (88.0%) had excellent/good relief. Numbness, averaging 2.49 on a subjective scale of 1 to 5, was experienced by 49.7% of the patients, Conclusions: Increased radiation dose and volume of brainstem irradiation may improve clinical outcomes with the trade-off of trigeminal dysfunction. Further study of the implications of dose and target are needed to optimize outcomes and to minimize complications.

  1. Herpes Zoster Vaccine Effectiveness against Incident Herpes Zoster and Post-herpetic Neuralgia in an Older US Population: A Cohort Study

    Science.gov (United States)

    Langan, Sinéad M.; Smeeth, Liam; Margolis, David J.; Thomas, Sara L.

    2013-01-01

    Background Herpes zoster is common and has serious consequences, notably post-herpetic neuralgia (PHN). Vaccine efficacy against incident zoster and PHN has been demonstrated in clinical trials, but effectiveness has not been studied in unselected general populations unrestricted by region, full health insurance coverage, or immune status. Our objective was to assess zoster vaccine effectiveness (VE) against incident zoster and PHN in a general population-based setting. Methods and Findings A cohort study of 766,330 fully eligible individuals aged ≥65 years was undertaken in a 5% random sample of Medicare who received and did not receive zoster vaccination between 1st January 2007 and 31st December 2009. Incidence rates and hazard ratios for zoster and PHN were determined in vaccinated and unvaccinated individuals. Analyses were adjusted for age, gender, race, low income, immunosuppression, and important comorbidities associated with zoster, and then stratified by immunosuppression status. Adjusted hazard ratios were estimated using time-updated Cox proportional hazards models. Vaccine uptake was low (3.9%) particularly among black people (0.3%) and those with evidence of low income (0.6%). 13,112 US Medicare beneficiaries developed incident zoster; the overall zoster incidence rate was 10.0 (9.8–10.2) per 1,000 person-years in the unvaccinated group and 5.4 (95% CI 4.6–6.4) per 1,000 person-years in vaccinees, giving an adjusted VE against incident zoster of 0.48 (95% CI 0.39–0.56). In immunosuppressed individuals, VE against zoster was 0.37 (95% CI 0.06–0.58). VE against PHN was 0.59 (95% CI 0.21–0.79). Conclusions Vaccine uptake was low with variation in specific patient groups. In a general population cohort of older individuals, zoster vaccination was associated with reduction in incident zoster, including among those with immunosuppression. Importantly, this study demonstrates that zoster vaccination is associated with a reduction in PHN. Please

  2. Gabapentin extended-release tablets for the treatment of patients with postherpetic neuralgia: a randomized, double-blind, placebo-controlled, multicentre study.

    Science.gov (United States)

    Wallace, Mark S; Irving, Gordon; Cowles, Verne E

    2010-01-01

    Postherpetic neuralgia (PHN) is a neuropathic pain syndrome that may develop subsequent to healing of herpes zoster rash. This study aimed to determine the efficacy and safety of gabapentin extended-release (gabapentin ER) tablets for the treatment of patients with PHN and to determine whether optimal benefits might be achieved with once-daily (QD) or divided-dose (DD) administration. This was a 10-week, randomized, double-blind, placebo-controlled, multicentre trial comparing gabapentin ER (total daily dose 1800 mg) either QD or as an asymmetrical DD with placebo in 407 patients with post-zoster pain for >or=3 months and a baseline average daily pain score (ADP)>or=4 on a 0-10 Likert numerical rating scale. The primary efficacy outcome was the ADP score mean change from baseline to week 10 using baseline observation carried forward (BOCF). Secondary efficacy outcomes included changes to week 10 in last observation carried forward (LOCF) ADP score, LOCF average daily sleep interference score, Short-Form McGill Pain Questionnaire score, Neuropathic Pain Scale score, and Brief Pain Inventory score. Of 407 randomized patients, 400 were included in the intent-to-treat population (gabapentin ER QD, n=134; gabapentin ER DD, n=135; placebo, n=131). Between-group differences in the least squares (LS) mean changes in BOCF ADP scores did not reach statistical significance (gabapentin ER QD -1.85 [p=0.110 vs placebo]; gabapentin ER DD -1.72 [p=0.255 vs placebo]; placebo -1.42). In the LOCF analysis, the LS mean ADP score for the gabapentin ER QD group, but not for the DD group, improved compared with placebo (gabapentin ER QD, -2.28; p=0.032 vs placebo). Improvements compared with placebo were also observed in the gabapentin ER QD group, but not for the DD group, for mean daily sleep interference scores (gabapentin ER QD, -2.49; placebo, -1.63; p<0.001). Most adverse events (AEs) were mild or moderate. Among gabapentin-treated patients, 12% and 11% withdrew due to AEs, most

  3. SU-F-T-647: Linac-Based Stereotactic Radiosurgery (SRS) in the Treatment of Trigeminal Neuralgia: Detailed Description of SRS Procedural Technique and Reported Clinical Outcomes

    Energy Technology Data Exchange (ETDEWEB)

    Pokhrel, D; Sood, S; Badkul, R; Jiang, H; Stepp, T; Camarata, P; Wang, F [University of Kansas Hospital, Kansas City, KS (United States)

    2016-06-15

    Purpose: SRS is an effective non-invasive alternative treatment modality with minimal-toxicity used to treat patients with medically/surgically refractory trigeminal neuralgia root(TNR) or those who may not tolerate surgical intervention. We present our linac-based SRS procedure for TNR treatment and simultaneously report our clinical outcomes. Methods: Twenty-eight TNR-patients treated with frame-based SRS at our institution (2009–2015) with a single-fraction point-dose of 60-80Gy to TNR were included in this IRB-approved study. Experienced neurosurgeon and radiation oncologist delineated the TNR on 1.0mm thin 3D-FIESTA-MRI that was co-registered with 0.7mm thin planning-CT. Treatment plans were generated in iPlan (BrainLAB) with a 4-mm diameter cone using 79 arcs with differential-weighting for Novalis-TX 6MV-SRS(1000MU/min) beam and optimized to minimize brainstem dose. Winston-Lutz test was performed before each treatment delivery with sub-millimeter isocenter accuracy. Quality assurance of frame placement was maintained by helmet-bobble-measurement before simulation-CT and before patient setup at treatment couch. OBI-CBCT scan was performed for patient setup verification without applying shifts. On clinical follow up, treatment response was assessed using Barrow Neurological Institute Pain Intensity Score(BNI-score:I–V). Results: 26/28 TNR-patients (16-males/10-females) who were treated with following single-fraction point-dose to isocenter: 80Gy(n=22),75Gy(n=1),70Gy(n=2) and 60Gy(n=1, re-treatment) were followed up. Median follow-up interval was 8.5-months (ranged:1–48.5months). Median age was 70-yr (ranged:43–93-yr). Right/left TNR ratio was 15/11. Delivered total # of average MUs was 19034±1204. Average beam-on-time: 19.0±1.3min. Brainstem max-dose and dose to 0.5cc were 13.3±2.4Gy (ranged:8.1–16.5Gy) and 3.6±0.4Gy (ranged:3.0–4.9Gy). On average, max-dose to optic-apparatus was ≤1.2Gy. Mean value of max-dose to eyes/lens was 0.26Gy/0.11Gy

  4. Subvenciones para instituciones

    International Development Research Centre (IDRC) Digital Library (Canada)

    IDRC CRDI

    Subvenciones para instituciones Directrices para gastos de proyectos aceptables. GFAPE-09-2015. 2 ... más de 5.000 CAD. Los costos pueden incluir el precio base de compra, costos de transporte y otros ... personas que recogen datos e información o que trabajan de manera eventual, el mantenimiento y la operación de ...

  5. Oro para Colombia

    OpenAIRE

    Rubio Forero, María Claudia

    2016-01-01

    Las mujeres han debido atravesar un largo camino partiendo de la discriminación hasta empezar un proceso de equidad en la sociedad y en el deporte, de esta manera llegar a ser parte de un evento como los Juegos Olímpicos. Esta tesis toma el caso de tres atletas colombianas y describe su proceso de formación para lograr dos medallas de oro para el país.

  6. Estrategias para negociaciones exitosas.

    Directory of Open Access Journals (Sweden)

    José B. Parra V

    2010-01-01

    Full Text Available Las estrategias de negociación son herramientas para disminuir conflictos o para intercambiar bienes y servicios. Una negociación exitosa crea relaciones de solidaridad y propicia reciprocidad, cooperación y confianza para quienes tendrán relaciones permanentes de negociación con beneficios para ambas partes. Una estrategia de negociación exitosa requiere manejar el desarrollo del ambiente social del grupo de personas, con la finalidad de tener presente las fronteras que no pueden irrumpirse. Otro aspecto importante, es el lenguaje corporal utilizado por las personas y las tácticas que se practican. El manejo de esta información permite diseñar diferentes modelos de negociaciones para cada caso específico. Este documento propone la utilización de la herramienta MONACO, diseñada por los autores, que es un software útil para encontrar los mejores tácticas posibles dentro de una negociación; basándose en el lenguaje corporal que muestra el negociante oponente durante cada oferta monetaria. El uso de este software da al negociador la oportunidad de manejar las negociaciones con mayor control, el negociador que usa el software puede elegir una estrategia de acuerdo a las relaciones que espera mantener con el negociador oponente.

  7. Once-daily gastroretentive gabapentin for postherpetic neuralgia: integrated efficacy, time to onset of pain relief and safety analyses of data from two phase 3, multicenter, randomized, double-blind, placebo-controlled studies.

    Science.gov (United States)

    Rauck, Richard L; Irving, Gordon A; Wallace, Mark S; Vanhove, Geertrui F; Sweeney, Michael

    2013-08-01

    Treatment options for postherpetic neuralgia (PHN), a complication of herpes zoster, are commonly unsatisfactory and associated with adverse events. To evaluate the efficacy, onset of pain relief, and safety of gastroretentive gabapentin (G-GR) in patients with PHN. In two placebo-controlled studies, 357 patients with PHN were randomized to 1800mg G-GR and 364 patients were randomized to placebo taken with the evening meal. Patients underwent a two week titration, eight weeks of stable dosing, and one week of tapering. Efficacy assessments included change in average daily pain (ADP) score from baseline to Week 10, time to onset of pain relief, the proportion of patients feeling improved using the Patient Global Impression of Change, and the proportion of responders (≥30% pain reduction). At Week 10, patients randomized to G-GR reported greater reductions in ADP score compared with placebo (-37.0% vs. -29.1; P=0.0025). More G-GR patients felt improved compared with placebo (44% vs. 33%; P=0.003) and responded to treatment (54% vs. 41%; P=0.001). As early as Day 2, greater pain reductions were observed for the G-GR group compared with the placebo group (-6.6% vs. -1.6%; P=0.0017). The median time to a one point or greater reduction in ADP score was four days for G-GR and six days for placebo (P<0.0001). The most frequently reported adverse events were dizziness (G-GR, 11%; placebo, 2%) and somnolence (G-GR, 5%; placebo, 3%). PHN pain reduction after G-GR treatment can be observed as early as the second day of dosing and continues for at least 10 weeks. Copyright © 2013 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

  8. Modified skin incision for avoiding the lesser occipital nerve and occipital artery during retrosigmoid craniotomy: potential applications for enhancing operative working distance and angles while minimizing the risk of postoperative neuralgias and intraoperative hemorrhage.

    Science.gov (United States)

    Tubbs, R Shane; Fries, Fabian N; Kulwin, Charles; Mortazavi, Martin M; Loukas, Marios; Cohen-Gadol, Aaron A

    2016-10-01

    Chronic postoperative neuralgias and headache following retrosigmoid craniotomy can be uncomfortable for the patient. We aimed to better elucidate the regional nerve anatomy in an effort to minimize this postoperative complication. Ten adult cadaveric heads (20 sides) were dissected to observe the relationship between the lesser occipital nerve and a traditional linear versus modified U incision during retrosigmoid craniotomy. Additionally, the relationship between these incisions and the occipital artery were observed. The lesser occipital nerve was found to have two types of course. Type I nerves (60%) remained close to the posterior border of the sternocleidomastoid muscle and some crossed anteriorly over the sternocleidomastoid muscle near the mastoid process. Type II nerves (40%) left the posterior border of the sternocleidomastoid muscle and swung medially (up to 4.5cm posterior to the posterior border of the sternocleidomastoid muscle) as they ascended over the occiput. The lesser occipital nerve was near a midpoint of a line between the external occipital protuberance and mastoid process in all specimens with the type II nerve configuration. Based on our findings, the inverted U incision would be less likely to injure the type II nerves but would necessarily cross over type I nerves, especially more cranially on the nerve at the apex of the incision. As the more traditional linear incision would most likely transect the type I nerves and more so near their trunk, the U incision may be the overall better choice in avoiding neural and occipital artery injury during retrosigmoid approaches. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. Tiempo para un cambio

    Science.gov (United States)

    Woltjer, L.

    1987-06-01

    En la reunion celebrada en diciembre dei ano pasado informe al Consejo de mi deseo de terminar mi contrato como Director General de la ESO una vez que fuera aprobado el proyecto dei VLT, que se espera sucedera hacia fines de este aAo. Cuando fue renovada mi designacion hace tres aAos, el Consejo conocia mi intencion de no completar los cinco aAos dei contrato debido a mi deseo de disponer de mas tiempo para otras actividades. Ahora, una vez terminada la fase preparatoria para el VLT, Y habiendose presentado el proyecto formalmente al Consejo el dia 31 de marzo, y esperando su muy probable aprobacion antes dei termino de este ano, me parece que el 10 de enero de 1988 presenta una excelente fecha para que se produzca un cambio en la administracion de la ESO.

  10. Instrucciones para autores

    OpenAIRE

    Martinez, Ana

    2012-01-01

    Instrucciones para autoresNota preliminar: ¡Es de suma importancia que antesde enviar cualquier documento a la Revista GeologíaColombiana, lea y cumpla cuidadosamente cada uno delos subíndices de las Normas para autores!A partir del Volumen 35 (2010) recibimos artículosprincipalmente a través del sistema digital enhttp://www.revistas.unal.edu.co/index.php/geocol/index.Si quiere enviar un artículo, por favor regístrese comoAutor en el menú INGRESAR (aquí pueden registrarsetambién evaluadores u...

  11. Master Plan para UNIMAK

    OpenAIRE

    Llorente Moreno, Francisco; Navarrete Mancebo, Gonzalo; Cruz Pinilla, Javier de la; García Méndez, María; Lacastagneratte de Figueiredo, Laura

    2012-01-01

    El Master Plan de UNIMAK se presenta como una apuesta a futuro, no solo para la Universidad de Makeni, sino también para la propia ciudad de Makeni. Se pretende potencias la Universidad como una referencia a nivel regional y como desencadenante de la estructura de trazado de la ciudad. El proyecto plantea potencial la dualidad que existe entre la infraestructura viaria y la red verde , existente en la ciudad, introduciéndola en el nuevo desarrollo del campus universitario y dotándola de la i...

  12. alternativas para promoverla

    Directory of Open Access Journals (Sweden)

    Carlos Muñoz Izquierdo

    2006-01-01

    Finalmente, se analizan las políticas que han sido aplicadas con el fin de combatir ese problema, y se sugieren algunos cursos de acción que se consideran potencialmente más eficaces para lograr ese propósito.

  13. Silo para cereales. Bandholm

    Directory of Open Access Journals (Sweden)

    Editorial, Equipo

    1960-09-01

    Full Text Available El silo de Bandholm, para cereales, construido en la isla de Lolland, tiene una capacidad de 13 a 14.000 toneladas. Esta estructura se ha subdividido en células individuales de unas 400 toneladas de capacidad cada una. La obra ha sido proyectada y construida por Christiani & Nielsen.

  14. Instrucciones para autores y autoras

    OpenAIRE

    Casa de la Mujer, Revista

    2015-01-01

    Le recomendamos leer este documento a profundidad para queconozca las políticas y normas para postular a consideración su escrito.Estas instrucciones se organizan en tres apartados: I. Datos básicos,II. Políticas y III. Lineamientos para presentar el escrito; para la citacióny referenciación con APA se ofrece el documento titulado Guía dereferenciación y citación con APA.

  15. ParaChoice Model.

    Energy Technology Data Exchange (ETDEWEB)

    Heimer, Brandon Walter [Sandia National Lab. (SNL-CA), Livermore, CA (United States); Levinson, Rebecca Sobel [Sandia National Lab. (SNL-CA), Livermore, CA (United States); West, Todd H. [Sandia National Lab. (SNL-CA), Livermore, CA (United States)

    2017-12-01

    Analysis with the ParaChoice model addresses three barriers from the VTO Multi-Year Program Plan: availability of alternative fuels and electric charging station infrastructure, availability of AFVs and electric drive vehicles, and consumer reluctance to purchase new technologies. In this fiscal year, we first examined the relationship between the availability of alternative fuels and station infrastructure. Specifically, we studied how electric vehicle charging infrastructure affects the ability of EVs to compete with vehicles that rely on mature, conventional petroleum-based fuels. Second, we studied how the availability of less costly AFVs promotes their representation in the LDV fleet. Third, we used ParaChoice trade space analyses to help inform which consumers are reluctant to purchase new technologies. Last, we began analysis of impacts of alternative energy technologies on Class 8 trucks to isolate those that may most efficaciously advance HDV efficiency and petroleum use reduction goals.

  16. Resina pet para recipientes

    OpenAIRE

    Montenegro, Ricardo Sá Peixoto; Monteiro Filha, Dulce Corrêa; Pan, Simon Shi Koo

    1996-01-01

    O mercado potencial de resina PET para recipientes é grande, com ampla expectativa de expansão. A nível mundial, esta ocorrendo um ciclo de expansão que deverá levar a uma sobrecapacidade, pressionando os preços para baixo. No Brasil, a escassez de resina PET tem retardado sua maior utilização em recipientes, notadamente de bebidas carbonatadas e em mercados em desenvolvimento, como o de óleo comestível e água mineral. Com a entrada em operação da fábrica da Nitrocarbono e da expansão da Rhod...

  17. Educando para la ignorancia

    Directory of Open Access Journals (Sweden)

    Miguel Durán

    1996-06-01

    Full Text Available Más que describir una situación particular, los autores buscan con este escrito motivar al estudiante para que asuma posiciones críticas; así como dar un campanazo de alerta a los profesores, en relación a los conocimientos que transmiten a sus alumnos y la forma en que lo hacen; todo con el ánimo de generar verdaderos espacios de reflexión en la universidad.

  18. INICIATIVAS PARA EL CAMBIO

    Directory of Open Access Journals (Sweden)

    César Alfonso Defrancisco-Larrañaga

    2013-07-01

    Full Text Available El planeta no atraviesa por su mejor momento en materia de conservación y renovación de sus recursos naturales. Claramente en los últimos tiempos los recursos hídricos han venido haciéndose cada vez menores; el hombre ha notado con preocupación y vivido en carne propia este fenómeno, que de no ser tratado a tiempo, podría atentar contra la existencia misma. Esto lo ha alentado a buscar métodos que sirvan como solución para contrarrestar éste mal y crear conciencia entre sus iguales, para así poder garantizar su permanencia y la de su entorno durante muchas generaciones. En países desarrollados del continente europeo y en algunos lugares de América del norte, el uso de sistemas de reutilización y tratamiento de aguas grises y aprovechamiento de las aguas lluvias se ha convertido en una constante y nos están dando las pautas para poder seguir el ejemplo y así de esta manera poder aportar a la causa ambiental y a su vez crear un ahorro en nuestros gastos mensuales de consumo.

  19. Bullying: Conhecer para Prevenir

    Directory of Open Access Journals (Sweden)

    Elisabete Fernandes

    2016-01-01

    Full Text Available O bullying é um fenómeno que suscita a apreensão de toda a sociedade. Deste modo, enquanto pais, educadores e profissionais, devemos reconhecer que a violência entre pares em meio escolar afeta gravemente o desenvolvimento saudável das crianças. Conhecer e identificar as causas que estão na origem do bullying, bem como as consequências que este comportamento acarreta no desenvolvimento psicossocial dos seus alvos, é fundamental para melhor intervir. Proteger as crianças e jovens de hoje contribui para potenciar um futuro sem violência, através da existência de adultos equilibrados. Assim, a criação e implementação de estratégias de prevenção do bullying em contexto escolar constitui-se como dever social, porquanto só através de diversificadas conjugações de esforços será possível contribuir para um amanhã mais seguro.

  20. para mejorar el %R

    Directory of Open Access Journals (Sweden)

    Alfredo Díaz Mata

    2001-01-01

    Full Text Available En este trabajo se revisan dos indicadores técnicos bursátiles que están estrechamente relacionados, el oscilador estocástico %K de Lane y el oscilador %R de Williams; asimismo, se evalúa el uso de dos mecanismos asociados con el primero y que no suelen utilizarse con el %R: el proceso de frenado (slowing y el uso de un promedio móvil del propio oscilador estocástico como disparadores de señales de compra y de venta. Realizando simulaciones con 27 acciones y el Índice de Precios y Cotizaciones de la Bolsa Mexicana de Valores se verifica la hipótesis principal y se comprueba que, efectivamente, en muchos casos, el uso del proceso de frenado con el oscilador %R de Williams permite tomar mejores decisiones. Por otro lado, se concluye que de los dos disparadores de señales el que mejor funciona, tanto para %K como para %R es el uso de cotas inferior y superior. Este artículo surgió en el curso de una investigación sobre el análisis técnico bursátil de acciones que se puede realizar en su totalidad por computadora y que, esencialmente, excluye el análisis gráfico. Uno de los propósitos del estudio es determinar si es posible, y bajo qué mecanismos, establecer un sistema de análisis bursátil que le permita al inversionista tomar decisiones de inversión en acciones en la Bolsa Mexicana de Valores sin tener que emplear la considerable cantidad de tiempo que es necesario para el análisis gráfico tradicional. Durante este estudio se realizó un análisis preliminar de unos 120 indicadores técnicos para, por un lado, conocerlos con cierto detalle y, por otra parte, aislar aquellos que prometían ser de utilidad para el objetivo de la investigación. Fue en este proceso cuando se detectó que existen dos indicadores que están relacionados y que permiten un análisis por separado que tiene, cuando menos, dos ventajas. En primer lugar está el placer que da a quien gusta de estos temas encontrarse con indicadores que, de acuerdo

  1. Inmunopotenciadores para la acuicultura

    Directory of Open Access Journals (Sweden)

    Rocmira Pérez

    2014-04-01

    Full Text Available La acuicultura es una de las actividades económicas de mayor crecimiento para la producción de alimentos. Uno de sus principales retos es la obtención de grandes volúmenes de producción con la mayor calidad posible. Esto conlleva a una reducción de la aplicación de antibióticos y productos quimioterapéuticos. Una de las estrategias más prometedoras es la aplicación de inmunopotenciadores, principalmente en los cultivos intensivos. El objetivo de este trabajo fue revisar los principales inmunopotenciadores, así como las tendencias y retos de su uso mundial. Se resumen las particularidades moleculares y funcionales de los mismos y se hace énfasis en los más estudiados: levamisol, ß-glucanos, lipopolisacárido, vitamina C, extractos de plantas y hormonas. Todos estos compuestos de naturaleza heterogénea inciden mayoritariamente en los componentes de la inmunidad innata de los peces, fortaleciendo y potenciando la resistencia a enfermedades; adicionalmente algunos de ellos tienen funciones antiestrés y favorecen su crecimiento. Se concluye que los inmunopotenciadores constituyen una estrategia viable para reducir las pérdidas por problemas sanitarios en el sector de la acuicultura; pero aún quedan por solucionar aspectos como la vía de administración y la etapa de inmunización adecuada para cada especie y tipo de cultivo.

  2. Democracia para ciudadanos ciborgs

    Directory of Open Access Journals (Sweden)

    Juan Varela

    2007-07-01

    Full Text Available Enumera los instrumentos imprescindibles de la ciberpolítica para campañas electorales en España, cuando se renovaron los cargos municipales. La política vuelve a ser personal cuando ciudadanos y políticos se hablan cara a cara y cita varios ejemplos, reconociendo la recuperación de la comunicación directa. La ciberdemocracia es muy exigente. Los políticos prefieren la magia de la imagen. La sociedad no sabe como detener la propaganda viral que bombardea a los buscadores de red.

  3. Para pensar o afeto

    Directory of Open Access Journals (Sweden)

    Aluisio Pereira de Menezes

    Full Text Available Apresentação de um conjunto de formulações relativas ao “afeto” anteriores ao surgimento da psicanálise. Dificuldade da psicanálise em construir uma concepção propriamente psicanalítica. Contribuição da fenomenologia de Husserl para o estudo do afeto. Atualidade das concepções do afeto marcadas pelas neurociências. As maneiras principais de ver o problema da conceituação do afeto no pensamento psicanalítico.

  4. Nombrados para el mal

    OpenAIRE

    Lara, Claudio; Sanchez, Mariela

    2011-01-01

    El presente trabajo se encuentra inscripto en la investigación Las vicisitudes del lazo amoroso en la época actual en el Gran La Plata. En ella, nuestro rasgo de investigación fue establecer algunas coordenadas para pensar que los signos de la Declinación del Nombre del Padre deben leerse en la transformación del registro del amor, dejando por fuera el registro que más desarrollos ha tenido dentro del campo del psicoanálisis: el de los ideales y el de la autoridad. La propuesta es que si El n...

  5. Bullying: Conhecer para Prevenir

    OpenAIRE

    Elisabete Fernandes; Sónia Henriques; Susana Mendes; Esperança Ribeiro

    2016-01-01

    O bullying é um fenómeno que suscita a apreensão de toda a sociedade. Deste modo, enquanto pais, educadores e profissionais, devemos reconhecer que a violência entre pares em meio escolar afeta gravemente o desenvolvimento saudável das crianças. Conhecer e identificar as causas que estão na origem do bullying, bem como as consequências que este comportamento acarreta no desenvolvimento psicossocial dos seus alvos, é fundamental para melhor intervir. Proteger as crianças e jovens de hoje contr...

  6. Paisajismo para La Reserva

    OpenAIRE

    Fernández,Teodoro

    2004-01-01

    El paisaje de Santiago está fuertemente determinado por el ejercicio de una voluntad. En un secano, con cuatro meses lluviosos y una sequía larga, los santiaguinos han construido a través de los años un jardín de riego soportado por múltiples dispositivos: acequias, canales, pozos y estanques. Es posible inaugurar para la ciudad otra manera de ejercer esa voluntad de paisaje: no una transformación impositiva, sino la comprensión de los procesos y relaciones naturales entre lluvia, torrentes, ...

  7. Cristalizadores para soro concentrado

    OpenAIRE

    TULER PERRONE, Italo; Simeão, Moise; Schuck, Pierre; Stephani, Rodrigo; De Carvahlo, Antonio Fernandes

    2016-01-01

    Na industria de secagem de lacteos observa-se que a secagem do soro é mais complicada do que a secagem do leite. São frequentes as adesões dentro do spray dryer, ciclones e tubulações, assim como o empedramento do produto durante o processamento ou durante a estocagem e o transporte. Ao buscarmos mecanismos para maior controle e padronização da tecnologia de produção do soro em pó nos deparamos com diversos requisitos de qualidade como: acidez e pH do soro, microbiota contaminante, teor de sa...

  8. "Colaborar para Competir"

    Directory of Open Access Journals (Sweden)

    Martha Liliana Hijuelos-Cárdenas

    2015-06-01

    Full Text Available De acuerdo con Michael Porter, los Clusters se definen como “Una agrupación de empresas e instituciones relacionadas entre sí, pertenecientes a un mismo sector o segmento de mercado, que se encuentran próximas geográficamente y que colaboran para ser más competitivas”. Los Clusters son en última instancia una herramienta de competitividad basada en la cooperación de sus miembros, y es una de las estrategias recientes, en el país, para incrementar la productividad y competitividad y las apuestas productivas desde el nivel local. Y es precisamente esta cercanía geográfica de las empresas de un mismo sector, lo que a la vez que genera la competencia entre ellas, también les facilita el acceso a insumos y a conocimientos específicos y en última instancia les permite promover la innovación.

  9. Principios teatrales para docentes

    Directory of Open Access Journals (Sweden)

    R. Irene Arroyo Zúñiga

    2005-01-01

    Full Text Available Este trabajo pretende dar herramientas a los docentes para que puedan utilizarlas como parte de las actividades dentro de un plan de elección, en cualquier disciplina. Además encontrará una exposición de los elementos que componen el arte de la representación escénica, como son: 1. Expresión corporal; es la capacidad de expresar emociones partiendo únicamente de nuestro cuerpo. 2. Impostación; es la habilidad de proyectar la voz sin lastimar las cuerdas vocales. 3. Dicción; es la pronunciación correcta de las palabras. 4. Actuación; es la posibilidad de crear un personaje partiendo de los recursos expresivos y de la forma natural en que el alumno acostumbra a reaccionar. Técnica de improvisación, en éste artículo propongo una serie de seis pasos que pueden ser de gran ayuda a la hora de usar el teatro como recurso didáctico. El teatro a lo largo de la historia ha sido usado para transmitir conocimientos, valores, creencias y todo aspecto inherente a los individuos y su entorno social. Por lo tanto debemos aprovechar al máximo los beneficios que nos ofrece el teatro como educadores

  10. para las lenguas

    Directory of Open Access Journals (Sweden)

    Manuel Tost Planet

    2005-01-01

    Full Text Available La publicación del Marco común europeo de referencia para las lenguas, del Consejo de Europa –aún poco conocido en nuestro país– está teniendo ya una notable influencia en todos los ámbitos de la enseñanza de las lenguas y de un modo particular en la elaboración de materiales de nueva generación para el aprendizaje de las lenguas extranjeras. Tras presentar elementos contextuales de la situación del FLE en nuestro país, que tienen, pensamos, una cierta relevancia, en esta contribución se describen precisamente algunos aspectos fragmentarios de dicho Marco y se evocan, por último, los principales ejes en torno a los cuales se mueve la actual innovación didáctica, en lo que se refiere más concretamente a las actividades de aprendizaje en el aula de idiomas.

  11. Serie: Madera para construcción Acabados para madera

    OpenAIRE

    Sáenz-Muñoz, Marta

    2012-01-01

    Durante mucho tiempo, la madera ha sido utilizada como material de construcción para resolver principalmente objetivos estructurales; sin embargo, actualmente, el uso de la madera ha tomado mucho auge en la estética de las construcciones, para brindar apariencia y calidez. En la actualidad, el mercado ofrece una amplia gama productos para dar diversos “acabados” a la madera, los cuales sirven para resaltar la belleza de algunas de ellas, realzar características como el color y la veta, o bien...

  12. Contratados peninsulares para Cuba

    Directory of Open Access Journals (Sweden)

    Iglesias García, Fe

    1994-12-01

    Full Text Available Not available.

    Ante las presiones británicas, la metrópoli española y los ideólogos de los hacendados cubanos tuvieron que dar, desde la tercera década del siglo XIX, una respuesta a la previsible escasez de mano de obra esclava. El artículo estudia los sistemas de contrata implantados en la isla para abastecer de mano de obra blanca y barata a Cuba, deteniéndose particularmente la autora en el estudio de las condiciones de semiesclavitud que se escondían en las mencionadas contratas y en el perfil de los inmigrantes (profesiones, sexo, edad, procedencia....

  13. Sustantivos para definir homofobia

    OpenAIRE

    Campo Árias, Adalberto; Herazo, Edwin; Oviedo, Heidi

    2013-01-01

    Introducción. El término ‘homofobia’ es un concepto que se introdujo en el contexto académico hace más de 40 años. Sin embargo, la acepción ha tenido reparos y cambios en el tiempo. Objetivo. Revisar los sustantivos usados en los últimos doce años para definir homofobia. Metodología. Se realizó una búsqueda sistemática en Medline a través de Pubmed de publicaciones tipo editorial, cartas al editor, comentarios y entrevista en español o inglés. Se realizó un análisis cualitativo (teoría fundam...

  14. Bases para proyectiles dirigidos

    Directory of Open Access Journals (Sweden)

    Editorial, Equipo

    1959-03-01

    Full Text Available Aunque actualmente no se ha llegado a una línea general de métodos o sistemas que gobiernen un tipo característico de rampa y servicios auxiliares necesarios para el lanzamiento al espacio de proyectiles dirigidos a grandes alturas y distancias, las experiencias obtenidas en diferentes ensayos, utilizando distintos tipos de proyectiles y trayectorias balísticas, han sentado toda una serie de procedimientos, datos y conclusiones de gran valor balístico que, aun teniendo en cuenta la continua evolución del proyectil, sus formas, combustibles y alcances, se conocen ya, con bastante aproximación, las condiciones mínimas que ha de reunir una base dedicada a este tipo de lanzamientos.

  15. Registrar para avanzar

    Directory of Open Access Journals (Sweden)

    Laia Matarranz Torres

    2017-06-01

    Full Text Available El farmacéutico comunitario es un profesional sanitario con un enorme potencial para mejorar no solo el uso de los medicamentos (detectando, por ejemplo, resultados negativos de la medicación, sino también la prevención de enfermedades y la promoción de la salud pública. Sin duda, el desarrollo y el impulso que están teniendo los servicios profesionales farmacéuticos (SPF desde hace años pueden contribuir decisivamente a que este potencial se consolide de una forma definitiva, obteniendo el reconocimiento del conjunto del sistema sanitario, incluyendo tanto a otros profesionales de la salud (médicos, enfermería, medicina especializada… como a la Administración y, por supuesto, a los propios pacientes beneficiarios de estos servicios. Es cierto que la figura del farmacéutico y su ejercicio sanitario han estado tradicionalmente bien considerados por la población, pero no es menos verdad que la integración de la actividad asistencial de la farmacia comunitaria en el Sistema Nacional de Salud (SNS es, cuanto menos mejorable, y que, incluso, algunas manifestaciones ponen en entredicho de vez en cuando la labor científico-asistencial de las farmacias o generan dudas sobre su capacidad para formar parte de pleno derecho de los equipos de salud que deben trabajar de forma coordinado en la mejora de la atención sanitaria de los pacientes.

  16. The para-petroleum industry

    International Nuclear Information System (INIS)

    2002-07-01

    The para-petroleum industry includes societies that realize studies and installations for the deposits exploitation. This document presents the situation of the para-petroleum industry in 2001, the world investment growth of the activity, the french societies financial results and an inventory of the main operations in the amalgamation domain. (A.L.B.)

  17. Trigeminal neuralgia and facial nerve paralysis

    International Nuclear Information System (INIS)

    Borges, Alexandra

    2005-01-01

    The trigeminal nerve is the largest of the cranial nerves. It provides sensory input from the face and motor innervation to the muscles of mastication. The facial nerve is the cranial nerve with the longest extracranial course, and its main functions include motor innervation to the muscles of facial expression, sensory control of lacrimation and salivation, control of the stapedial reflex and to carry taste sensation from the anterior two-thirds of the tongue. In order to be able adequately to image and follow the course of these cranial nerves and their main branches, a detailed knowledge of neuroanatomy is required. As we are dealing with very small anatomic structures, high resolution dedicated imaging studies are required to pick up normal and pathologic nerves. Whereas CT is best suited to demonstrate bony neurovascular foramina and canals, MRI is preferred to directly visualize the nerve. It is also the single technique able to detect pathologic processes afflicting the nerve without causing considerable expansion such as is usually the case in certain inflammatory/infectious conditions, perineural spread of malignancies and in very small intrinsic tumours. Because a long course from the brainstem nuclei to the peripheral branches is seen, it is useful to subdivide the nerve in several segments and then tailor the imaging modality and the imaging study to that specific segment. This is particularly true in cases where topographic diagnosis can be used to locate a lesion in the course of these nerves. (orig.)

  18. Management of trigeminal neuralgia by radiofrequency ...

    African Journals Online (AJOL)

    The outcome depends on the type of TN with best results with classical idiopathic type. Also better results occurred with isolated V3 affection. The radiofrequency thermocoagulation of trigeminal nerve is a low risk, highly effective and minimally invasive procedure that should be started with in all cases of TN.

  19. Foreign Body Induced Neuralgia: A Diagnostic Challenge

    Directory of Open Access Journals (Sweden)

    S. Padmashree

    2013-01-01

    Full Text Available Neuropathic pain is caused by neural injury or painful states associated with either peripheral or central nerve injury. One of the aetiologies of this type of pain is iatrogenic trauma. This case highlights the features of peripheral neuropathic pain caused by foreign body left in the mental foramen following a previous surgical procedure. The foreign body was detected on routine radiographic evaluation. Once the foreign body was removed by surgical intervention, the pain resolved. This stresses the importance of routine radiographic evaluation in proper diagnosis and treatment planning in the management of neuropathic pain. This paper also sheds light on the role of iatrogenic mechanical cause of peripheral neuropathic pain and warrants a tough degree of caution on the part of oral clinicians.

  20. Perbedaan Atypical Odontalgia Dengan Trigeminal Neuralgia

    OpenAIRE

    Nasution, Eldelina Ariani

    2010-01-01

    Suatu aspek yang paling menjadi tantangan dan manfaat bagi dokter adalah mendiagnosa dan merawat rasa nyeri. Diperkirakan 22% populasi umum mengalami rasa nyeri orofasial pada periode 6 bulan sekali. Selain itu, rasa nyeri yang menetap dan kronik lebih banyak terjadi di regio kepala dan leher daripada di bagian tubuh yang lain. Dalam mendiagnosa rasa nyeri orofasial sering terjadi kesalahan.1 Menurut Asosiasi Internasional untuk penelitian rasa nyeri (International Association for Study o...

  1. Trigeminal neuralgia and facial nerve paralysis

    Energy Technology Data Exchange (ETDEWEB)

    Borges, Alexandra [IPOFG, Department of Radiology, Lisbon (Portugal)

    2005-03-01

    The trigeminal nerve is the largest of the cranial nerves. It provides sensory input from the face and motor innervation to the muscles of mastication. The facial nerve is the cranial nerve with the longest extracranial course, and its main functions include motor innervation to the muscles of facial expression, sensory control of lacrimation and salivation, control of the stapedial reflex and to carry taste sensation from the anterior two-thirds of the tongue. In order to be able adequately to image and follow the course of these cranial nerves and their main branches, a detailed knowledge of neuroanatomy is required. As we are dealing with very small anatomic structures, high resolution dedicated imaging studies are required to pick up normal and pathologic nerves. Whereas CT is best suited to demonstrate bony neurovascular foramina and canals, MRI is preferred to directly visualize the nerve. It is also the single technique able to detect pathologic processes afflicting the nerve without causing considerable expansion such as is usually the case in certain inflammatory/infectious conditions, perineural spread of malignancies and in very small intrinsic tumours. Because a long course from the brainstem nuclei to the peripheral branches is seen, it is useful to subdivide the nerve in several segments and then tailor the imaging modality and the imaging study to that specific segment. This is particularly true in cases where topographic diagnosis can be used to locate a lesion in the course of these nerves. (orig.)

  2. para promover la salud

    Directory of Open Access Journals (Sweden)

    Ma. del Consuelo Chapela

    2002-01-01

    Full Text Available Hablar de educación a distancia sustentada en el desarrollo de la cibernética obliga a reflexionar sobre sus definiciones, objetivos y medios, especialmente si pensamos en las necesidades de la fracción de población que no tiene acceso a las posibilidades que ofrece el desarrollo tecnológico. En este trabajo se presenta e ilustra con un ejemplo práctico, una perspectiva sobre las posibilidades de la educación a distancia desde las necesidades de la promoción de la salud entre grupos de población marginada en el mundo virtual. Se propone la creación de bibliotecas itinerantes regionales que pongan a disposición de la población con acceso limitado a la información, la tecnología comunicativa necesaria para apoyar los trabajos de promoción de la salud.

  3. Para-bosons and Para-fermions in Quantum Mechanics

    International Nuclear Information System (INIS)

    Cattani, M.S.D.; Fernandes, N.C.

    1982-01-01

    Within the framework of the ordinary quantum mechanics, a detailed study of the energy eigenfunctions of N identical particles using the irreducible representations of the permutation group in the Hilbert space is performed. It is shown that the para-states, as occurs with the boson and fermion states, are compatible with the postulates of quantum mechanics and with the principle of indistinguishability. A mathematical support for the existence of para-bosons and para-fermions is given. Gentile's quantum statistics is, in a certain sense, justified. (Author) [pt

  4. Marcadores para la Realidad Aumentada para fines educativos

    Directory of Open Access Journals (Sweden)

    María Reina Zarate Nava

    2013-12-01

    Full Text Available La Realidad Aumentada (AR es considerada por algunos expertos como la tecnología en crecimiento para el 2014, en diferentes sectores: ingeniería, educación, juegos y negocios, siendo este último el más usado en él 2013. Sin embargo en el sector educativo la AR se presenta en algunos proyectos que se han desarrollado para diferentes áreas de las ciencias, como Química, Física y Matemáticas, lo anterior con el objetivo de facilitar el proceso de Enseñanza-Aprendizaje. En el presente artículo se presenta el modelo de patrones utilizado para un Proyecto AR enfocado en Química, el cual presenta un conjunto de patrones que fueron valorados para facilitar el rastreo de los objetos y a su vez el entendimiento de algunos materiales de los laboratorios de Química I.

  5. Una agenda para educadores

    Directory of Open Access Journals (Sweden)

    Robert O. McClintock

    2007-01-01

    Full Text Available Las instituciones educativas constituyen los principales factores en la construcción social de un nuevo sistema educativo. Las escuelas y los educadores controlan y producen propiedad intelectual de una extraordinaria profundidad y amplitud. Los cambios producidos por las tecnologías digitales están consiguiendo que el acceso y la producción de conocimiento sea más accesible y universal. Lo que es, a la vez, un gran logro de apertura curricular, pero también un grave peligro de perder la perspectiva eminentemente “educativa” de la transmisión del conocimiento en la escuela. Los nuevos recursos permiten a los educadores romper el ciclo de reproducción en los logros educativos, acercarse al medio y a la familia y transformar la escuela. Los educadores y las escuelas deben asumir el reto de constituir comunidades de aprendizaje. Así como de atreverse a producir y difundir ese conocimiento con soporte digital. Lo contrario sería una terrible abdicación. El artículo traza un recorrido histórico sobre esta función de la escuela y su adaptación a los medios y recursos de cada época. Tras lo cual, aboga por asumir el desafío actual de las TICs, para renovar el vínculo progresista con la posteridad y construir un mejor futuro. Los nuevos recursos permiten a los educadores romper el ciclo de reproducción en los logros educativos, acercarse al medio y a la familia y transformar la escuela.

  6. Uma ferramenta para planejamento de estudos para concursos

    Directory of Open Access Journals (Sweden)

    Leonardo Pimentel

    2015-11-01

    Full Text Available De acordo com a constituição brasileira, a única forma de se tornar um empregado do governo é passar em um concurso público. O exame de conhecimento do cargo é um dos componentes mais importantes de um concurso. Estudar para esse exame é uma tarefa que requer planejamento. Um meio de obter um bom planejamento é construir uma grade de horários que relacione as matérias a serem estudadas com os respectivos horários disponíveis para o estudo. Esse tipo de problema se assemelha bastante à gerência de projetos, em que se procura estabelecer a distribuição das atividades ao longo do tempo disponível. Assim, torna-se interessante explorar a dinâmica de estudos para concursos como um projeto. O presente trabalho apresenta a ferramenta de apoio ao estudos - Passe-me, baseada no ciclo PDCA (do inglês, Plan-Do-Check-Act. Por se tratar de uma ferramenta web, o tempo de resposta para produzir uma grade de estudos é fundamental. A ferramenta faz uso de algoritmo genético para calcular a grade de horários priorizando a velocidade de resposta. A ferramenta foi avaliada em diferentes cenários de uso e obteve desempenho satisfatório durante a produção da grade de estudos.

  7. Masterplan para UNIMAK y Estrategias para la ciudad de Makeni

    OpenAIRE

    Bacete Cebrian, Laura

    2012-01-01

    El proyecto se desarrolla en tres escalas. Por un lado están las propuestas a nivel ciudad muy relacionadas con la siguiente escala, la de la universidad, y por último hay una escala de detalle, tanto para ciudad como para universidad. Se plantea la creación de unos nodos interconectados por los corredores verdes de la ciudad que den servicios básicos a la ciudad tales gestión de residuos, equipamientos públicos, puntos de agua, saneamiento...)

  8. Taller para desarrollar la creatividad

    OpenAIRE

    MARTÍNEZ GUEROLA, BEATRIZ

    2015-01-01

    [ES] Partimos de la base de que la creatividad es una capacidad realmente valiosa, no solo para el ámbito artístico, si no para cualquier aspecto de la vida. Este proyecto está enfocado a un taller diseñado para que a partir de técnicas de expresión gráfico-plásticas podamos estimular y desarrollar la creatividad, principalmente en niños de tercer ciclo de primaria. Con este proyecto relacionamos el arte y la creatividad que se asocia a esté con la educación. Martínez Guerola, B. (2015). T...

  9. Estrategias Digitales Para Los Negocios

    OpenAIRE

    Sánchez, Nicolás David; Porras, María Paula

    2016-01-01

    Este trabajo es para fines institucionales de la Universidad del Rosario. A lo largo del segundo semestre del año 2016 entendimos la importancia de los medios digitales para las empresas, por lo cual el profesor Juan Manuel Méndez nos dio el caso de las bicicletas de Nairo Quintana con el cual teníamos que desarrollar un plan de estrategias digitales acorde con el contexto actual del sector de las bicicletas, en donde se creara y desarrollara la marca de la agencia digital creada por los estu...

  10. CODIFEXA - Colecciones Digitales para Exactas

    OpenAIRE

    Olguín, Luis Alberto; Klenzi, Raúl O.

    2013-01-01

    La construcción de repositorios institucionales (RI) por parte de facultades de universidades argentinas es cada vez más significativa, pero para que este tipo de emprendimientos – generalmente con presupuestos ajustados – tenga sustentabilidad en el tiempo es necesario “mostrar que es útil” para la institución - los docentes en particular - en el sentido que permite aumentar la visibilidad de la producción científica local y por ende el impacto entre sus pares. El proyecto que aquí descri...

  11. Dramatizar: levantarse para jugar, sentarse para escuchar un cuento

    OpenAIRE

    Gorria Serrano, Guillermo

    2015-01-01

    En el presente trabajo abordaremos la educación infantil, de una manera ambiciosa a través del movimiento y de la dramatización. Lo que proponemos es una educación basada en la naturaleza del niño como animal y apoyada con palabras de Rudolf Steiner, basándonos en cómo juegan todos los animales al ser educados, en cómo se imitan los unos a otros, entre mayores y pequeños. Es la base para un modelo pedagógico basado en el juego, el movimiento y la dramatización, para que los niños dejen un bue...

  12. MODELO PARA ESTABLECER SANCIONES PECUNIARIAS PARA DELITOS AMBIENTALES

    Directory of Open Access Journals (Sweden)

    LUIS DIEGO VÉLEZ GÓMEZ

    2012-01-01

    Full Text Available Este artículo pretende exponer el modelo básico que sustenta el desarrollo de multas óptimas; en él se muestra la forma de desincentivar los intereses del violador de la normatividad ambiental, e igualmente el método para alcanzar efectos compensatorios sobre los daños cometidos al medio ambiente. El desarrollo del tema sobre sanciones pecuniarias (multas y penalidades (encarcelamiento toma la relación contractual entre el agente (la empresa y el principal (La entidad reguladora para, a través de esta relación, entrar en la determinación de un diseño eficaz de sanciones. Se utilizara el modelo de agente-principal para examinar los efectos de las sanciones corporativas e individuales sobre los incentivos de cumplimiento en el contexto ambiental; además se emplearán los conceptos de bienes públicos, bienes comunes y externalidades como categorías de análisis que permiten la identificación y valoración de daños ambientales.

  13. MODELO PARA LA CREACIÓN DEL CONOCIMIENTO PARA PYMES

    Directory of Open Access Journals (Sweden)

    Marino Valencia Rodríguez

    2009-01-01

    Full Text Available La creciente importancia del conocimiento, como nuevo factor de producción, hace que la creación y transferencia se convierta en una de las principales prioridades de las organizaciones. El presente artículo describe tanto los fundamentos de la teoría de los recursos y capacidades de la empresa como el enfoque de la gestión del conocimiento, con sus procesos de generación y transferencia del conocimiento. Estos sirven de guía básica teórica para alcanzar el siguiente objetivo: Diseñar un modelo de generación y transferencia de conocimiento para los procesos de dirección, gestión humana y del conocimiento para PyMES, con el fin de que éstas alcancen mayores niveles de competitividad. El modelo se diseña, a partir del direccionamiento estratégico de la organización. Está conformado por tres etapas, articuladas con elementos y actividades. Las acciones se enfocan en dos factores clave de éxito: la cultura organizacional y la formación. La utilización del modelo permitirá a las PyMES optimizar los recursos y capacidades disponibles, lo cual se refleja en el desempeño del trabajador y en el fortalecimiento de la cultura organizacional.

  14. FRANQUICIAS. Una Alternativa para Emprendedores

    Directory of Open Access Journals (Sweden)

    Jorge Enrique Silva Duarte

    2003-07-01

    Full Text Available Este artículo presenta las ventajas de las franquicias como alternativa de negocios. Para un emprendedor exitoso ya establecido es más rentable permitir el uso de su conocimiento explícito mediante el formato de negocio de su firma y recibir regalías mensuales sobre las ventas brutas, que invertir en la apertura de cada nuevo punto. Igualmente, para quien desee iniciarse como empresario, la modalidad de franquicia es muy interesante: en primer lugar, porque empieza con un negocio ya probado, utiliza la imagen extendida de la franquicia y recibe un apoyo corporativo del franquiciador; adicionalmente, detrás del formato de negocio que contrata, está el capital relacional, en otras palabras, la experticia del franquiciador, el conocimiento del mercado, la base de clientes y de proveedores y el capital humano.

  15. Encuestas para llegar al poder

    Directory of Open Access Journals (Sweden)

    Luis Eladio Proaño

    2015-01-01

    Full Text Available Las encuestas son parte fundamental de los procesos políticos. Pero en América Latina apenas se utilizan. Además, la mayoría de la población las considera sospechosas. Un director de campaña moderno, necesita datos precisos para que su candidato tenga posibilidades ciertas de ganar. Con las encuestas sí se puede.

  16. Argumentos para repensar el "desarrollo"

    Directory of Open Access Journals (Sweden)

    María Luisa Eschenhagen

    2001-06-01

    Full Text Available Con este trabajo se quiere hacer una aproximación al problema desde una perspectiva diferente, considerando nuevos argumentos que hasta hace muy poco tiempo no se habían tenido en cuenta y que se vienen formulando de una manera muy interesante en los últimos años. El objetivo del artículo es presentar tres argumentos para señalar la necesidad de repensar, desde sus fundamentos, el concepto de desarrollo.

  17. Diagramas de Bianchi para Susy

    Directory of Open Access Journals (Sweden)

    Sara Cruz y Cruz

    2006-01-01

    Full Text Available Se revisa el origen de los solitones como soluciones de la ecuación de Korteweg-de Vries y su presencia en la formulación supersimétrica de la Mecánica Cuántica. Se introducen los diagramas de Bianchi como una herramienta simbólica para construir socios supersimétricos de un Hamiltoniano dado.

  18. Financiamiento para construir la finca.

    Directory of Open Access Journals (Sweden)

    Túpac Barahona.

    1998-08-01

    Full Text Available Las instituciones financieras convencionales y no convencionales tienden a excluir de los servicios de crédito a los sectores más frágiles del campesinado, por considerarlos clientes altamente riesgosos. En este artículo, se discute el sentido económico y social que tendrían que desarrollar esquemas de financiamiento para campesinos con economías débiles, pero con un potencial de desarrollo latente.

  19. requisito para pensar la paz

    Directory of Open Access Journals (Sweden)

    Jaidivi Núñez Varón

    2006-01-01

    Full Text Available Este documento señala puntos de discusión para reflexionar sobre cómo la justicia basada en la construcción social tiene la posibilidad de convertirse en un requisito para pensar la paz. El análisis inicia desde algunos horizontes planteados por la sociología jurídica, la antropología jurídica, la psicología social y el derecho. El objetivo es permitir que el lector tenga preguntas que contribuyan para pensar la paz en un país que tiene la coyuntura del conflicto armado y que cuestiona la justicia desde el escalamiento de la violencia en el espacio cotidiano. Se señalan algunos puntos de la relación entre la justicia y la paz desde la construcción del Estado, identificando los momentos y características de la conexión de estos dos conceptos en el curso de los acontecimientos históricos. Se presenta la concepción de la justicia a través de la óptica del pensamiento complejo y se plantea una discusión de cómo pensar la paz desde la construcción social.

  20. Estrategia para la sustentabilidad ambiental

    Directory of Open Access Journals (Sweden)

    Cecilia Erbiti

    2006-01-01

    Full Text Available En el contexto de los postulados conceptuales y metodológicos de la planificación estratégica y de sustentabilidad ambiental, el objetivo de esta investigación es describir el proceso de formulación del Plan de Ordenamiento Territorial del Municipio de Tandil (POTM y analizar su potencialidad para avanzar hacia la sustentabilidad ambiental del sistema. Los resultados de la misma muestran que el POTM no sólo prioriza principios, objetivos y estrategias que materializan las diferentes manifestaciones de la sustentabilidad (económica, social, ecológica y política, sino que la totalidad del Plan se fundamenta en el concepto de desarrollo sostenible y, con ello, se establecen prioridades de actuación que posibilitarán la gestión ambiental urbana. Si bien el POTM muestra una gran potencialidad para avanzar hacia la sustentabilidad del territorio, la implementación y cumplimiento del mismo constituye un fuerte desafío para las autoridades de aplicación.

  1. para asegurar un hijo sano

    Directory of Open Access Journals (Sweden)

    Carmen Amarilis Guerra de Castillo

    2006-01-01

    Full Text Available Esta investigación etnográfica focalizada exploró las creencias, los valores, los hábitos y los padrones comportamentales de las embarazadas diabéticas atendidas en el Hospital Doctor Enrique Tejera, quienes residen en tres comunidades urbanas pobres de la ciudad de Valencia - Venezuela, con el objetivo de encontrar el significado del cuidado de si para dichas grávidas. Se utilizó como referencial teórico el Modelo del Análisis de la Salud y la Teoría Antropológica de la Salud, siendo fundamentales para revelar aquello que estaba implícito en el comportamiento de las mujeres con relación a su cuidado. Surgieron tres temas: la salud y la enfermedad - valores culturales del cuidado de si; las prácticas del cuidado de la salud y cuidándose en el embarazo garantiza tener un hijo más saludable. Los temas culturales revelaron que las creencias, los valores, los hábitos y los patrones culturales comportamentales, conforme las tres maneras de acción identificadas, pueden ser preservadas, acomodadas y re-estructuradas para proporcionar un cuidado culturalmente congruente.

  2. Nueva Sede para la Academia

    Directory of Open Access Journals (Sweden)

    Mario Camacho Pinto

    1994-06-01

    Full Text Available

    Una nueva sede adecuadamente dotada siempre estuvo en la mente de nuestros expresidentes Académicos César Augusto Pantoja, Hernando Groot, Pablo Gómez Martínez, Jorge Cavelier Gaviria y Efraim Otero-Ruiz, con quienes me tocó en suerte trabajar 12 años consecutivos, cerca de ellos a través de mi cargo de Coordinardor de la Comisión Permanente de Biblioteca y Publicaciones y de la Revista MEDICINA que se ha venido publicando sin interrupciones dentro de un compañerismo ejemplar; además de otras distinciones operativas que me inducen a expresar gratitud.

    Ahora, además, como Secretario de la Coporación por elección unánime de la Asamblea hace dos años, he sido testigo ático de una intensa, inteligente e inagotable actividad que nuestro Presidente Académico Juan Jacobo Muñoz Delgado quien siempre con el visto bueno de la Junta Directiva, mediante un acelerado ritmo de trabajo se impuso la tarea de convertir en realidad inmediata tan anhelada y necesaria idea.

    En efecto, la nueva sede fue inaugurada oficialmente el día 2 de septiembre de 1993.

    Este Editorial es la constancia escrita de tal febril actividad que para proporcionar evidencia a los lectores de “MEDICINA” resumo en breves incisos que muestran el tránsito a un estado con superávit de excepción para esta clase de instituciones:

    1. Terminación de la obra ya iniciada de la remodelación arquitectónica, tanto exterior de seguridad y aspecto como interior con suficientes y modernas instalaciones.

    2. Cerramiento total con altas y elegantes rejas metálicas y doble portería por la calle 69 y la carrera 7a.

    3. Aparcadero lujosamente adoquinado, amplio y seguro para 30 automóviles.

    4. Decoración interior estéticamente consultada, bien lograda en cortinas y clásicas lámparas de cristal obsequiadas por conocidos académicos. Un par de originales urnas precolombianas en el hall de entrada.

    5. Zona social doble, amplia

  3. PLATAFORMA PARA LA VENTA DE VIDEOJUEGOS DIGITALES PARA PC

    OpenAIRE

    Gómez-Eguílar, Javier

    2013-01-01

    A lo largo del trabajo vamos a exponer nuestra propia idea de negocio de una nueva empresa, llamada GAMERINET, que se dedique a la venta de videojuegos de ordenador en descarga digital a través de nuestra web. Para ello vamos a ver una breve introducción a este sector de negocio y su historia, haremos un análisis de las condiciones actuales del sector, a través del análisis del entorno específico (5 Fuerzas de Porter) y del análisis del entorno general (Análisis PEST). Posterio...

  4. NUEVOS MODELOS PARA PREDECIR EL PUNTO FLASH PARA ALCANOS PUROS

    OpenAIRE

    Richart Vázquez-Román; Edna M. Valenzuela-Acosta; Florianne Castillo-Borja

    2010-01-01

    En este trabajo se desarrollan dos modelos predictivos de la temperatura normal de punto de inflamación. Los modelos propuestos consideran términos adimensionales en su expresión, los cuales han reducido el error en la predicción de la temperatura del punto de inflamación para alcanos. Se observó que la relación entre la temperatura en el punto de inflamación y la de ebullición aparentemente tienen poca variabilidad por lo cual se puede deducir una regla heurística. La dispersión del error co...

  5. TRABALHAR PARA ESTUDAR / ESTUDAR PARA TRABALHAR: REALIDADE E POSSIBILIDADES

    Directory of Open Access Journals (Sweden)

    Janes Siqueira

    2011-07-01

    Full Text Available O trabalho que apresentamos é parte da pesquisa com os estudantes das licenciaturas e da pedagogia da Universidade de Santa Cruz do Sul-UNISC-RS-Brasil. Este está inserido na linha de pesquisa: educação, trabalho e emancipação. Queremos compreender, à luz do materialismo histórico e dialético e das categorias da crítica da economia política, os significados atribuídos pelos estudantes universitários ao fenômeno trabalho e estudo. É uma pesquisa preferentemente qualitativa de natureza dialética. Para Marx, a essência da realidade humana reside no trabalho, mas a fonte de toda a riqueza está na natureza. Logo, trabalho, natureza e sociedade estão em relação dialética. Trabalho, portanto, é a ideia central articuladora, e natureza e sociedade devem ser estudadas em conexão com o trabalho. Marx trata o trabalho, no modo de produção capitalista, como impedimento ao desenvolvimento humano. Propõe o mesmo como um ato de criação e auto-expressão humana que não deve ter um valor. A compreensão dessa premissa é necessária para que os trabalhadores possam significar e ressignificar o trabalho para além da ideologia dominante. Algumas categorias aparecem como relevantes para a análise: condições de trabalho e de estudo, necessidade de formação, predominância do trabalho sobre o estudo, dificuldade de conciliar tempo de estudo e de trabalho. Na relação com o objeto de estudo, ressaltaremos a crise estrutural do capital, a desregulamentação das leis do trabalho e sua flexibilização e as contradições entre trabalho e estudo bem como quais possibilidades emancipatórias são visualizadas ou sonhadas pelos trabalhadores-estudantes. PALAVRAS-CHAVE: contradições entre trabalho e educação, condições e significados, realidade e possibilidades.

  6. NUEVOS MODELOS PARA PREDECIR EL PUNTO FLASH PARA ALCANOS PUROS

    Directory of Open Access Journals (Sweden)

    Richart Vázquez-Román

    2010-01-01

    Full Text Available En este trabajo se desarrollan dos modelos predictivos de la temperatura normal de punto de inflamación. Los modelos propuestos consideran términos adimensionales en su expresión, los cuales han reducido el error en la predicción de la temperatura del punto de inflamación para alcanos. Se observó que la relación entre la temperatura en el punto de inflamación y la de ebullición aparentemente tienen poca variabilidad por lo cual se puede deducir una regla heurística. La dispersión del error con la regla heurística se reduce al incorporar las energías de evaporación y reacción en la correlación. Se desarrolló un método basado en contribución de grupos combinada con los grupos adimensionales propuestos para reducir aún más el error en la predicción de la temperatura del punto de inflamación, incluyendo la capacidad de distinguir la diferencia entre los isómeros. Los resultados obtenidos de los modelos propuestos son aceptables y mejoran a las correlaciones de uso actual.

  7. Agenda para la Reforma Monetaria

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    Jane D'Arista

    2010-01-01

    Full Text Available El papel de la política monetaria en la creación de las condiciones que culminaron en la crisis actual y el fracaso de los esfuerzos de la Fed para descongelar el crédito en 2008 y 2009 son componentes críticos en el análisis que se requiere como fundamento para el contexto de reforma. Esta colaboración argumenta que la conexión entre la liquidez excedente, el crecimiento de la deuda, las burbujas de activos creadas por la deuda y la crisis financiera que se generó, son desenlaces de los fracasos en la política monetaria y regulatoria, que reflejan un debilitamiento substancial en la habilidad de la Fed de instrumentar iniciativas contra cíclicas. Se argumenta que el grado de efectividad de la política monetaria puede -y debe- ser restaurada y se propone un nuevo sistema de manejo de reservas que puede acceder a reservas contra activos y no contra depósitos y que aplica requerimientos de reservas a todos segmentos del sector financiero. Se concluye que un cambio en el sistema actual de implementación de la política monetaria es necesario para terminar con la contracción crediticia, confrontar el impacto de la crisis actual sobre el sector financiero y la economía y asegurar el éxito de cualquier estímulo fiscal que se emprenda.

  8. Nuevo nombre para antiguos conceptos

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    Alexandra Ayala Marín

    2015-01-01

    Full Text Available El periodismo cívico, público o comunitario son tres denominaciones para un mismo fenómeno surgido en los E.U. y que va difundiéndose por América Latina, precisamente donde su esencia (el protagonismo y la participación real del perceptor en los procesos comunicacionales surgió y se desarrolló hace décadas. La autora al entrevistar a Carlos Alvares Teijeiro, uno de los estudiosos del tema, ofrece algunos aspectos de esta (nueva? práctica periodística que tiene que ver con la democracia

  9. Turismo accesible, turismo para todos

    OpenAIRE

    Núñez Bello, Miguel

    2012-01-01

    El sector turístico representa el 10,2 por ciento del Producto Interior Bruto (PIB) y el 11,5 por ciento del empleo en España. La actividad turística y sus grandes beneficios han posibilitado que nuestro país sea destino y referencia en este sector. ¿Lo es también en turismo accesible? El turismo para todos no puede ser excluyente bajo ninguna razón o circunstancia. Amparado en el derecho y la Constitución, la sensibilidad que se percibe no puede quedar solo en buenas palabras sino en actuaci...

  10. Mandevilla (Apocynaceae, Mesechiteae para Brasil

    Directory of Open Access Journals (Sweden)

    J. Francisco Morales

    2005-01-01

    Full Text Available Se describen dos nuevas especies de Mandevilla (Apocynoideae, Mesechiteae subgénero Exothostemon, endémicas de Brasil. Mandevilla abortiva se encuentra relacionada con un grupo de especies conformado por M. huberi, M. obtusifolia y M. pachyphylla, discutiéndose sus afinidades con esos taxones. Mandevilla clandestina ha sido confundida por largo tiempo con M. scabra, diferenciándose por sus flores más pequeñas. Se incluyen descripciones completas, ilustraciones y el listado de especímenes examinados para ambos taxones.

  11. Entre velos: Maya para contrabajo

    OpenAIRE

    Rosa María Rodríguez Hernández

    2014-01-01

    Maya para contrabajo se materializa a partir de una imagen de Pepe Romero, cuyo texto interpreta a La decadencia de la mentira de Oscar Wilde. La estructura de Maya es binaria, especular y asimétrica; su poética obedece al juego verdad/mentira que subyace en la obra artística y en la vivencia del artista. Maya trae a la memoria las voces de los Upanishad, Schopenhauer, Shakespeare y Beethoven, influencias éstas en la obra de Wagner y, todas ellas, en la de Eliot. Los aspectos gestuales y visu...

  12. Pequenos para idade gestacional: fator de risco para mortalidade neonatal

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    Almeida Márcia Furquim de

    1998-01-01

    Full Text Available OBJETIVO: Estudar as variáveis contempladas na Declaração de Nascimento (DN como possíveis fatores de risco para nascimentos pequenos para a idade gestacional (PIG e o retardo de crescimento intra-uterino como fator de risco para a mortalidade neonatal. MATERIAL E MÉTODO: As variáveis existentes na DN foram obtidas diretamente de prontuários hospitalares. Os dados referem-se a uma coorte de nascimentos obtida por meio da vinculação das declarações de nascimento e óbito, correspondendo a 2.251 nascimentos vivos hospitalares, de mães residentes, ocorridos no Município de Santo André, Região Metropolitana de São Paulo, no período de l/1 a 30/6/1992, e aos óbitos neonatais verificados nessa coorte. RESULTADOS: Obteve-se a proporção de 4,3% de nascimentos PIG, significativamente maior entre os recém-nascidos de pré-termo e pós-termo, entre os nascimentos cujas mães tinham mais de 35 anos de idade e grau de instrução inferior ao primeiro grau completo. Os recém-nascidos PIG apresentam maior risco de morte neonatal que aqueles que não apresentavam sinais de retardo de crescimento intra-uterino. CONCLUSÕES: Em áreas com menor freqüência de baixo peso ao nascer, é importante investigar a presença de retardo de crescimento intra-uterino entre os nascimentos prematuros e não apenas nos nascimentos de termo. O registro da data da última menstruação (ou da idade gestacional em semanas não agregadas na DN facilitaria a detecção de PIGs na população de recém-nascidos.

  13. Edificio para viviendas, en Barcelona

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    Barba Corsini, F.

    1967-05-01

    Full Text Available This building has a garage basement, a ground floor with a communed playing zone for all the children of the block, and the entrance vestibule. The rest of the building is occupied with apartments, of about 200 m2 each, which are functionally designed, and are suitable for medium sized average income families. Special attention has been given to the external facades, which, among other things, are of extremely simple design.El edificio contiene: en el sótano, un guardacoches; en la planta baja, una zona de juegos común para los niños de todas las viviendas, además de los vestíbulos. El resto de la superficie edificada está destinado a viviendas, de unos 200 m2, construidos con distribución funcional y adecuada para familias medias ya constituidas. Fue dedicada una especial atención a la composición de las fachadas, que ofrecen, entre otros atractivos, el de su elegante sencillez.

  14. Para onde vai a Geografia?

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    Angélica Karina Dillenburg Horii

    2015-12-01

    Full Text Available O presente artigo aborda a evolução da Geografia enquanto pensamento científico, analisando seu objeto de estudo e suas categorias de análise durante todo o percurso da criação desse saber. Observa primeiramente a formação da Geografia Clássica, que teve seus princípios já instituídos na Antiguidade com Ptolomeu e Estrabão, desdobrando-se no período Iluminista com Ritter e Humboldt que fornecerão uma nova temporalidade a essa ciência. Atinge seu ápice na Modernidade Industrial com a racionalidade de Kant, onde Ratzel e La Blache utilizarão o determinismo e o possibilismo para constituir um discurso científico para a Geografia. Finaliza apontando a nova compreensão do mundo, conhecida como pós-modernismo por David Harvey (1992 ou por Milton Santos (1996 como Globalização, que junto a outros geógrafos e pesquisadores, indicam caminhos de análise dessa ciência na compreensão do seu objeto de estudo. Um diálogo entre os autores na construção do pensamento geográfico.

  15. Aprender para la vida o para el placer

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    Diobaldo César Heredia Gutiérrez

    2011-07-01

    Full Text Available El proceso enseñanza aprendizaje, se corresponde con un sistema comunicativo por excelenciaque requiere una alta dosis de amor que garantice el disfrute o goce de los participantes, enun interactuar de búsqueda y descubrimiento satisfactorio. Para imprimirle un alto grado de calidad, esdeseable la participación de estudiantes y docentes más emprendedores y críticos y menos académicoso dependientes, por ello el aprendizaje autónomo es clave, el logro u objetivo, entonces, es estudiantesque aprendan como si fueran a enseñar y docentes investigadores, proactivos y expertos en las materiasque enseñan.

  16. Internet como instrumento para la Yihad

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    Alfonso Merlos García

    2006-01-01

    Full Text Available Las extraordinarias ventajas que ofrece Internet lo han convertido en un instrumento clave y dinámico en la estrategia de los yihadistas. Los medios de comunicación, la clase política y las agencias de seguridad e información han tendido a concentrar sus esfuerzos en la neutralización del ciberterrorismo sin prestar suficiente atención a los múltiples usos de Internet que están haciendo los neosalafistas: para la propaganda y para la guerra psicológica, para el reclutamiento y para la financiación, para la documentación y para la planificación de atentados. Las democracias deberían considerar el coste que tendrá la derrota frente al movimiento yihadista globalizado en la batalla por el ciberespacio

  17. Inteligencia Emocional para tiempos de crisis

    OpenAIRE

    Fernández-Berrocal, Pablo

    2014-01-01

    La Inteligencia Emocional se concibe como un conjunto de habilidades, tanto básicas como complejas, dirigidas a “unificar las emociones y el razonamiento”, esto es, usar las emociones para facilitar el razonamiento y los procesos de pensamiento, y usar nuestro razonamiento para pensar de forma inteligente acerca de nuestras emociones (Mayer y Salovey, 1997). En concreto, la IE se define como una habilidad mental que incluye “la capacidad para percibir, valorar y expresar las emociones con...

  18. Software hipermedia para apoyo de evaluaciones automatizadas

    OpenAIRE

    Grosclaude, Eduardo

    2003-01-01

    Las organizaciones educativas requieren adecuado soporte informático para la optimización de procesos colaborativos en la enseñanza. Se necesita definir una arquitectura de desarrollo de estas aplicaciones sobre sistemas distribuidos. Se presentan los objetivos de un proyecto de investigación sobre Software para Procesos Colaborativos, en el marco del cual se han desarrollado dos aplicaciones experimentales para apoyar la evaluación automatizada. Se describen estas aplicaciones, sus resultado...

  19. Sistema de realidad aumentada para aplicaciones Android

    OpenAIRE

    Fernández Sánchez, Natalia Mercedes

    2012-01-01

    El objetivo principal de este proyecto es la creación de un sistema de realidad aumentada para el sistema operativo Android con idea de que sea utilizado para la creación de un videojuego, pero que a su vez sea lo suficientemente versátil como para poder utilizarse en otro tipo de aplicaciones. De este objetivo principal podemos obtener los objetivos secundarios: - Conocer las características que ofrecen los teléfonos móviles y como éstas pueden ser aprovechadas para la crea...

  20. Adesao ao guia alimentar para populacao brasileira

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    Eliseu Verly Junior

    2013-12-01

    Full Text Available OBJETIVO : Analisar a adesão ao Guia Alimentar para População Brasileira. MÉTODOS : Amostra composta por participantes do Inquérito de Saúde de São Paulo (n = 1.661 que preencheram dois recordatórios de 24 horas. Foi utilizado modelo bivariado de efeito misto para a razão entre o consumo de energia do grupo de alimentos e o consumo calórico total. A razão estimada foi utilizada para calcular o percentual de indivíduos com consumo abaixo ou acima da recomendação. RESULTADOS : Pelo menos 80,0% da população consome abaixo do recomendado para: leite e derivados; frutas e sucos de frutas; e cereais, tubérculos e raízes; aproximadamente 60,0% para legumes e verduras; 30,0% para feijões; e 8,0% para carnes e ovos. Adolescentes apresentaram a maior inadequação para legumes e verduras (90,0%, e o estrato de maior renda foi associado à menor inadequação para óleos, gorduras e sementes oleaginosas (57,0%. CONCLUSÕES : Foi observado consumo inadequado dos grupos de alimentos relacionados com aumento do risco de doenças crônicas.

  1. Paisajes para un desarrollo sustentable y participativo

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    Rafael Mata Olmo

    2014-11-01

    Para terminar, el texto recoge una experiencia de proyecto territorial de paisaje, la del Plan Insular de Menorca (Islas Baleares, España, aprobado en 2003. Se sintetizan sus determinaciones sobre la protección de determinados terrenos por sus altos valores paisajísticos, sus directrices para que las políticas sectoriales (turismo, agricultura, infraestructuras, etc. incorporen criterios paisajísticos, y sus iniciativas para la gestión y mejora del paisaje y para el fomento del acceso público a su contemplación y disfrute.

  2. Programa de Seguridad y Desalojo para Instituciones

    OpenAIRE

    Duque Escobar, Gonzalo

    1999-01-01

    El siguiente Programa de Seguridad y Desalojo ha sido adaptado de uno similar, desarrollado en Venezuela, para instituciones educativas. Se trata de una metodología desarrollada por del FUNDARIS útil para proceder a desarrollar simulacros con base en tres (3) actividades: la planeación, la ejecución y la evaluación. Esta propuesta adaptada para el programa de gestión del riesgo sísmico en el Eje Cafetero, adelantado por la UN y el CINEP, hace parte del curriculum para el Curso Internacional d...

  3. Profesiones emergentes para los comunicadores

    Directory of Open Access Journals (Sweden)

    Manuel Ortiz Marín

    2015-01-01

    Full Text Available Señala el autor que en México se ha iniciado una lenta pero segura transformación del campo profesional de la comunicación. La carrera de Comunicación ocupa el octavo lugar entre las carreras más demandadas en la Educación Superior de México, que con la fuerte avalancha tecnológica y el surgimiento de la apertura de nuevos espacios sociales y político-económicos han impulsado otras formas de hacer comunicación. Dos son los campos más opcionados: medios de comunicación masiva, y lo organizacional y la publicidad, aunadas al surgimiento del marketing político. Hoy se demanda del profesional nuevas y dinámicas competencias para enfrentar escenarios laborales antes no explorados.

  4. para su puesta en marcha

    Directory of Open Access Journals (Sweden)

    Sergio Franco Maass

    2004-01-01

    Full Text Available Los sistemas de información geográfica (SIG tienen una gran aplicación en la gestión municipal; permiten cumplir con dos objetivos fundamentales: el registro de información territorial y el análisis de problemas territoriales específicos. Con el fin de determinar la viabilidad de este tipo de tecnologías en el ámbito municipal, se enfrentó el problema de la localización de instalaciones para la disposición final de residuos sólidos urbanos en el municipio de Toluca, Estado de México. Se identifican ciertos aspectos que limitan la práctica de los SIG: la diversidad entre los municipios, los problemas administrativos, las deficiencias de la información y la carencia de recursos humanos, técnicos y financieros.

  5. Comunicadores para la informaclon ambiental

    Directory of Open Access Journals (Sweden)

    Luz Marina Cabrera Morillo

    2013-07-01

    Full Text Available La Red Colombiana de Formación Ambiental en convenio con la Corporación Autónoma de los Valles del Sinú y del San Jorge y con el apoyo del Politécnico Grancolombiano, desarrolló un diplomado en Periodismo Ambiental en la ciudad de Montería, Departamento de Córdoba. La experiencia que ha contribuido a fortalecer la construcción de la cultura ambiental en la región; le ha permitido mayor visibilidad a los proyectos de la Corporación y facilitado la participación ciudadana. Este documento presenta el contexto de la formación de los comunicadores para la información ambiental, las características del diplomado y establece algunos de los logros alcanzados.

  6. Tipologia para a contabilidade ambiental

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    Nazlhe Faride Chein Schekaiban

    2007-06-01

    Full Text Available Este artigo revê a visão, as propostas e o desenvolvimento da contabilidade ambiental, refletindo sobre suas implicações, com a finalidade de descobrir e encontrar sua importância e situação. Para se chegar a esse resultado foi preciso realizar uma revisão epistemológica moldada e processo reflexivo de sustentabilidade e da aproximação ao usuário, da percepção da realidade contábil no México e da gerência interna das organizações. As conclusões mostram a contabilidade ambiental no México fora da re-alidade operativa do modelo contábil regional, aumentando a importância de se criar uma cultura capaz de examinar o controle da missão deste tipo de contabilidade.

  7. Una minga para el posdesarrollo

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    Arturo Escobar

    2011-01-01

    Full Text Available El artículo sintetiza algunas conclusiones a las que han llegado movimientos sociales y académicos en las últimas dos décadas al reflexionar sobre la globalización y sus implicaciones; el modelo dominante, basado en las nociones de "desarrollo" y "modernidad", ha entrado en crisis. Por lo tanto, se hace necesario avanzar en una transición cultural que se pueda comprender como un cambio de época y no sólo como una época de cambios. Para llevar a cabo esta transformación, se deben resolver las con-tradicciones existentes entre el neodesarrollismo y el postdesarrollo, por supuesto, a favor de éste último.

  8. Olhar para "Talco de vidro"

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    Lielson Zeni

    2015-06-01

    Full Text Available Aqui se busca uma forma de olhar para as histórias em quadrinhos emprestando as lentes e olhares de Maurice Merleau-Ponty. O objeto em estudo é a obra de Marcello Quintanilha, mais especificamente o álbum Talco de Vidro. Através das ideias propostas por Merleau-Ponty, tentou-se entender os mecanismos de corte, interrupção típica das HQs como um espaço entre, um lugar onde a imaginação do leitor possa ser ativada e as significações surjam. Tudo isso é levado em conta tendo por fundo a história de Rosângela, personagem de Talco de Vidro que enxerga o mundo de uma maneira bastante particular.

  9. Entre velos: Maya para contrabajo

    Directory of Open Access Journals (Sweden)

    Rosa María Rodríguez Hernández

    2014-01-01

    Full Text Available Maya para contrabajo se materializa a partir de una imagen de Pepe Romero, cuyo texto interpreta a La decadencia de la mentira de Oscar Wilde. La estructura de Maya es binaria, especular y asimétrica; su poética obedece al juego verdad/mentira que subyace en la obra artística y en la vivencia del artista. Maya trae a la memoria las voces de los Upanishad, Schopenhauer, Shakespeare y Beethoven, influencias éstas en la obra de Wagner y, todas ellas, en la de Eliot. Los aspectos gestuales y visuales de Maya entrelazan con la danza de Pina Bausch y con la retórica (hypotiposis.

  10. MERCADEO SOCIAL PARA LA SALUD

    Directory of Open Access Journals (Sweden)

    Renata Seidel

    2015-01-01

    Full Text Available Se ofrece un amplio análisis sobre la industria electoral, recordando que un candidato a presidente es "un producto para la venta". Se Desmenuzan las estrategias utilizadas en el plebiscito chileno,las elecciones norteamericanas con el NO a BUSH. El Mercadeo Social es una nueva metodología utilizada en proyectos de desarrollo a nivel de campo por ello se hace un esclarecimiento y clarifica el vínculo con la comunicación. Se agrega temas como: Los modelos de recepción de mensajes cuyos marcos conceptuales y metodologías aún no se han adaptado al potencial de esta línea de trabajo.Se analiza la agonía de las radios mineras en Bolivia en la que 42 años de historia y heroísmo se desmoronan.

  11. Trabalhar para estudar/estudar para trabalhar: realidade e possibilidades

    Directory of Open Access Journals (Sweden)

    Janes Teresinha fraga Siqueira

    2011-01-01

    Full Text Available O trabalho que apresentamos é parte da pesquisa, ainda não concluída, com os estudantes das licenciaturas e da pedagogia da Universidade de Santa Cruz do Sul- UNISC-RS-Brasil. Este está inserido na linha de pesquisa: educação, trabalho e emancipação do mestrado em educação desta Universidade. Queremos compreender, à luz do materialismo histórico e dialético e das categorias da crítica da economia política, os significados atribuídos pelos estudantes universitários ao fenômeno trabalho e estudo. É uma pesquisa preferentemente qualitativa de natureza dialética. Para Marx, a essência da realidade humana reside no trabalho, mas a fonte de toda a riqueza está na natureza. Logo trabalho, natureza e sociedade estão em relação dialética. Trabalho, portanto, é a ideia central articuladora, e natureza e sociedade devem ser estudadas em conexão com o trabalho. Marx trata o trabalho, no modo de produção capitalista, como um impedimento ao desenvolvimento humano. Propõe omesmo como um ato de criação e auto-expressão humana que não deve ter um valor. A compreensão dessa premissa é necessária para que os trabalhadores possam significar e ressignificar o trabalho para além da ideologia dominante. Algumas categorias aparecem como relevantes para a análise: condições de trabalho e de estudo, necessidade de formação, predominância do trabalho sobre o estudo, dificuldade deconciliar tempo de estudo e de trabalho. Na relação com o objeto de estudo, ressaltaremos a crise estrutural do capital, a desregulamentação das leis do trabalho e sua flexibilização e as contradições entre trabalho e estudo bem como quais possibilidades emancipatórias são visualizadas ou sonhadas pelos trabalhadores estudantes.Resume Ce travail constitue une partie de la recherche entreprise avec les étudiants du cours de pédagogie de l´Universidade de Santa Cruz do Sul – UNISC – RS – Brésil. Il est intégré dans le champ de

  12. Riesgos y oportunidades para el periodismo audiovisual

    Directory of Open Access Journals (Sweden)

    Alberto García Avilés

    2015-01-01

    Full Text Available Muchas empresas informativas han puesto en marcha diversas fórmulas para que las redacciones de distintos medios compartan recursos, trabajen conjuntamente en las coberturas y produzcan noticias para diversos soportes. Refiere lo que debe ser el periodista polivalente y su formación

  13. Cubierta de madera para una nave industrial

    Directory of Open Access Journals (Sweden)

    Hossdorf, Heinz

    1958-05-01

    Full Text Available Para la ampliación de los talleres de Hans Schmidlin, de Basilea, Suiza, dedicados a la prefabricación de elementos de construcción de madera y metales ligeros para fachadas, se ha construido una nueva nave, rectangular, de 49x55,4 m en planta.

  14. McPhone para iPhone

    OpenAIRE

    Beristain Villar, Iker

    2013-01-01

    Diseño e implementación de una aplicación "McPhone" para dispositivos móviles, que mejora y evoluciona el sistema de realizar pedidos en un restaurante de comida rápida. Un desarrollo para dispositivos Apple, es decir, Iphone bajo iOS. Idioma Español.

  15. Programa de conservacion para aves migratorias neotropicales

    Science.gov (United States)

    Deborah Finch; Marcia Wilson; Roberto Roca

    1992-01-01

    Mas de 250 especies de aves terrestres migran a Norte America durante la epoca reproductiva para aprovechar los sistemas templados. No obstante, las aves migratorias neotropicales pasan la mayor parte de su ciclo de vida en los habitat tropicales y subtropicales de paises latinoamericanos y caribefios donde viven en una asociacion cercana con las aves residentes. Para...

  16. Criterios para seleccionar proveedor de servicios gestionados

    OpenAIRE

    IBM

    2013-01-01

    Los servicios gestionados abarcan una gama de capacidades , creando opcionespara las organizaciones de TI que buscan beneficiarse de forma externa prestado servicios que les permiten centrarse en más negocios temas y funciones estratégicas y actividades. el Cloud Computing aumenta esta gama de opciones, que proporciona un mayor potencial que nunca para las organizaciones de TI para transformar .

  17. Recursos para un aprendizaje significativo

    Directory of Open Access Journals (Sweden)

    Juan LARA GUERRERO

    2009-11-01

    Full Text Available RESUMEN: Partimos del supuesto de que una de las cuestiones que más preocupa al profesorado en su práctica educativa radica en que el aprendizaje de sus alumnos sea significativo. Somos conscientes de que, para conseguir este tipo de aprendizaje, es necesario introducir una serie de cambios en la dinámica de la clase. Comenzamos diferenciando el aprendizaje maquinal del significativo. Continuamos aclarando una confusión muy extendida entre muchos educadores, que creen que el aprendizaje por recepción es repetitivo y que el efectuado por descubrimiento es forzosamente significativo. Posteriormente, planteamos una serie de interrogantes para aclarar algunas cuestiones que le pueden ser útiles a los educadores en su práctica cotidiana. Terminamos presentando la estrategia de organización, que cuenta con dos instrumentos, a nuestro juicio muy eficaces, para ayudar a los estudiantes, a aprender de manera significativa: los mapas conceptuales y la técnica heurística V.ABSTRACT: We start from the assumption that one of the questions that most worry the teaching staff in its educational practice consists in that its pupils' learning is significant. We are aware that, to obtain this kind of learning, it is necessary to introduce a series of changes in the classroom dynamics. We begin by making a distinction between mechanical and significant learning. We continué making clear a very extended confusión amongst many teachers, who believe that learning by reception is repetitive and that the one done by serendipity is necessarily significant. Afterwards, we créate a series of questions to clarify with some answers that can be useful to teachers in their everyday practice. We finish showing the organization strategy, which has two instruments, that in our opinión are very effective, to help students learning in a significant way: conceptual maps and the V heuristic technique.RÉSUMÉ: Nous partons de la supposition de qu'une des questions que

  18. El Ensayo, Para Formar Profesionales Reflexivos

    Directory of Open Access Journals (Sweden)

    Nestor Perico-Granados

    2015-07-01

    Full Text Available El presente artículo es producto de investigación, como resultado de la reflexión hecha a lo largo de muchos años de experiencia profesional y docente en diferentes universidades estudiando, redactando y evaluando ensayos. Presenta la importancia del ensayo como instrumento y dispositivo de la formación en la educación y especialmente se hace hincapié en la incidencia que tiene cuando se trabaja de manera apropiada, para prestar un servicio en la formación reflexiva. Se dan unas pautas para una aproximación a su definición y precisa los elementos fundamentales y otros complementarios para su elaboración. Desarrolla un primer proceso para escribir un ensayo, a través de la jerarquización de las ideas. Finalmente, se proponen unas conclusiones que pueden ser útiles para quienes quieran escribir ensayos.

  19. Modelos para estimar as exigências de energia metabolizável para poedeiras

    OpenAIRE

    Sakomura,Nilva Kazue; Basaglia,Roberta; Sá-Fortes,Cristina M. L.; Fernandes,João Batista K.

    2005-01-01

    Objetivou-se, com este trabalho, elaborar um modelo para estimar as exigências de energia metabolizável (EM) para poedeiras leves da linhagem Lohmann LSL, utilizando-se o método fatorial. Para determinar o efeito da temperatura sobre as exigências de EM para mantença, foram conduzidos experimentos em câmaras climáticas com temperaturas constantes de 12, 22 e 31ºC, utilizando a técnica do abate comparativo. A exigência de energia líquida para o ganho de peso foi determinada por meio da regress...

  20. Una red para la gente

    Directory of Open Access Journals (Sweden)

    Raúl Trejo Delarbre

    2004-02-01

    Full Text Available La próxima Cumbre Mundial de la Sociedad de la Información ha revitalizado, en numerosos países, el debate acerca de las nuevas tecnologías de la comunicación y los usos que pueden tener. Lamentablemente en México hemos estado casi del todo ajenos a esa intensa, extensa y en otras latitudes fructífera discusión. Ni los especialistas interesados en estos temas, ni la sociedad que es a la postre beneficiaria o damnificada según sea el empleo de tales tecnologías, ni los organismos del Estado a cargo de tales asuntos, han propiciado la reflexión colectiva que nos podría permitir tanto afinar las posiciones de nuestro país rumbo a la cumbre de Ginebra y Túnez como deliberar, en ese contexto, acerca de lo mucho que nos falta para tener un país auténticamente imbricado en la construcción de una auténtica Sociedad de la Información.

  1. Periodistas para la era digital

    Directory of Open Access Journals (Sweden)

    Fernando Villalobos G.

    2014-12-01

    Full Text Available La formación de los periodistas del siglo XXI en la era digital se concibe como un reto y el mayor desafío. Los medios digitales demandan especialización y dominio de las nuevas tecnologías. Las universidades, principales gestores de este cambio, en la sociedad del conocimiento, requieren trabajar en la reformulación de nuevos pensum y en tres terrenos fundamentales: el perfil del egresado, el estilo pedagógico y el nuevo modo de relacionarse con el mundo exterior. Se necesita de una oferta académica referida al ciberperiodismo y a la cibercomunicación. La profesión periodística, y específicamente la formación de los comunicadores registra cambios importantes debido a las nuevas tecnologías, ahora el aula es el mundo globalizado e interconectado por la gran autopista de la información, por ello, la formación del comunicador social, demanda renovadas prácticas educativas. Las universidades deben repensar el papel que están obligadas a desempeñar, reformular los pensum académicos y ofertar la cibercomunicación y el ciberperiodismo para estar al día de las grandes transformaciones.

  2. Residencia para familias - Anglet (Francia

    Directory of Open Access Journals (Sweden)

    Hébrard, J. R.

    1971-11-01

    Full Text Available This residential hotel has 806 beds, which can be increased to 1,100 by adding some double beds. Its size and colour blends well with the picturesque surrounding, known as «Chambre d'Amour». The hotel involves 120 large apartments, and 50 smaller one, as well as 25 rooms for the staff, and flats for the manager and other senior officials. There is a hall, large living room, bar, rooms for playing games, nursery, and an additional hostel with 40 flats and staff rooms. The design is of a linear, continuous style, emphasizing its horizontal extension, though contrast is provided by a higher block, housing the vertical circulation facilities.Con un total de 806 plazas hoteleras, ampliables a 1.100 (si se utilizan literas, este conjunto, por su volumen y color se integra en el pintoresco paisaje del paraje conocido por «Chambre d'Amour». Comprende: 120 apartamentos; 50 más pequeños; 25 habitaciones para empleados; los apartamentos del director, gobernanta y recepcionistas; las zonas de vida en común: hall, salón, bar, sala de juegos y guardería; un albergue con 40 apartamentos; y las dependencias de la administración. Presenta un volumen lineal y continuo, modelando una composición de ritmo horizontal predominante, a la que le imprime gran variedad el cuerpo vertical de hormigón visto que contiene las circulaciones verticales.

  3. Um lugar para a Filosofia?

    Directory of Open Access Journals (Sweden)

    Samir Dessbesel Ferreira

    2010-01-01

    Full Text Available De que modo pode a Filosofia integrar-se às demais disciplinas da grade curricular dos cursos técnicos do IFSul? E como se insere uma disciplina como essa em instituições de ensino que têm tradicionalmente como foco o ensino tecnológico e profissionalizante, como são os Institutos Federais? Primeiramente, a Filosofia poderia contribuir na formação do profissional egresso, desenvolvendo-lhe competências relacionadas ao filosofar, em especial as relacionadas ao raciocínio abstrato e à comunicação, o que poderia vir a fazer a diferença no mercado de trabalho. Assim, os Institutos Federais ofereceriam um ensino de excelência com o objetivo de formar o técnico mais bem qualificado possível ao mercado de trabalho. Todavia, o aparelhamento técnico de nossos jovens, embora essencial para o desenvolvimento do País, não pode apresentar-se como a preocupação prioritária dos educadores, pois é fundamental considerar-se a formação integral da pessoa humana. Qual educação, afinal, queremos? E qual o papel da escola pública em nossa sociedade? O direcionamento unilateral à qualificação profissional pode levar-nos à formação de uma espécie de “superpeão”. A escola não pode ser serva do mercado. Ela tem o papel maior de agente de questionamento e transformação da sociedade. A concepção de Ensino Médio Técnico-Integrado nos parece orientar-se antes para a formação “integral” do cidadão, da pessoa em sua totalidade. O trabalho não é apenas uma relação econômica, mas também ética, política e estética. Deve ser uma forma de realização, de humanização do mundo, e não de coisificação do homem. É sempre possível pensar nossos espaços de educação formal como um compartilhar humano de sentidos, de afetos, de vivências, de posturas, de identidades. A esses espaços deverá a qualificação técnica sempre agregar-se, jamais sobrepor-se.

  4. pipetas usadas para I. A.

    Directory of Open Access Journals (Sweden)

    J. Castañeda

    2004-01-01

    Full Text Available La vagina y cerviz de las cerdas son estimuladas físicamente durante la inseminación. Este contacto puede afectar características reproductivas tales como el transporte espermático y el proceso de ovulación. En el presente trabajo se evaluaron desde el punto de vista económico y reproductivo, tres tipos de pipetas utilizadas para I. A. de cerdas de diferente material y forma. Se utilizaron 120 animales multíparos asignados de acuerdo a su orden de entrada al celo, en forma sucesiva a uno de tres grupos experimentales: 1 I. A. mediante pipeta reusable de hule tipo Melrose ( Medata, 2 I. A. con pipeta desechable de punta plástica en espiral y 3 I. A. con pipeta desechable con punta de poliestireno redonda (Medi chimica. No se encontró diferencia (P>0.05 entre los porcentajes de gestación, parición y promedio de lechones nacidos vivos por parto, en el tiempo de aplicación del semen, ni en el volumen del mismo, arrojado por las cerdas en los 10 min. posteriores a la I. A. Los valores promedio fueron de: 91.7%, 86.7%, 10.4 ± 2.8, 7.8 ± 2.6 min. y 10.4 ± 11.3 ml, respectivamente. El análisis de regresión, no mostró significancia en cuanto a paridad en ninguna de las variables estudiadas (P>0.05. Se concluye que las pipetas evaluadas no difieren en su efecto sobre el desarrollo reproductivo de la piara. Sin embargo, la pipeta reusable tipo Melrose ofrece ventaja económica bajo las condiciones del presente estudio

  5. Guión informativo para radio

    OpenAIRE

    Borja Bonilla, Jhonatan Marcelo

    2006-01-01

    El presente trabajo investigativo bibliográfico y práctico, sobre el tema "GUION INFORMATIVO PARA RADIO" tiene como objetivo principal crear una guía tanto para los alumnos de comunicación social como para los comunicadores en la práctica. Después de varias entrevistas realizadas a diferentes comunicadores de las radios, se ha tomado en cuenta que en la ciudad de Cuenca se desconoce la necesidad de trabajar con guiones. Por tal motivo es importante realizar y profundizar en esta tesis sobr...

  6. Modelo computacional para projeto de compressores axiais

    OpenAIRE

    Fernando de Oliveira Lopes

    2007-01-01

    Resumo: Este trabalho apresenta o desenvolvimento de um programa computacional para modelagem inicial de compressores axiais de vários estágios pertencentes ao conjunto de turbinas a gás. O desenvolvimento do programa se baseia na metodologia adotada por Saravanamutto et al. (2001), faz uso da Primeira Lei da Termodinâmica para cálculo de potência consumida pelo compressor e da Segunda Lei da Termodinâmica para determinar o grau de irreversibilidade do sistema. O programa calcula a quantidade...

  7. Desafios e Tecnologias para Cidades do Futuro

    Directory of Open Access Journals (Sweden)

    Antonio Mendes Silva Filho

    2012-05-01

    Full Text Available Este artigo trata questões apresentadas em palestra deste autor onde foi discutido os atuais desafios das cidades urbanas e é feito prospecto destacando tecnologias que podem prover suporte a essa demanda. Nesse sentido, apresenta-se um diagnóstico da situação atual das cidades em função do processo de urbanização e apontam-se desafios a serem enfrentados pela sociedade para dotarem as cidades de infra-estrutura adequada para (possíveis cenários futuros de modo a torná-las prontas para atender esta demanda.

  8. Un reto para adolescentes, confrontando imposiciones.

    OpenAIRE

    2012-01-01

    a) Título, b) párrafo de apertura, c) desarrollo o redacción del caso, d) párrafo de cierre, e) notas de enseñanza: resumen del caso, objetivos temas relacionados, actividades previas para el alumno, actividades para el profesor, actividades durante la sesión para el alumno, uso de pizarrón, distribución del tiempo, análisis del caso, epílogo del caso, f) anexos y g) referencias.

  9. Plan de marketing para BMW Lifestyle

    OpenAIRE

    Mendoza Cuadra, Mónica; Rodríguez Bandach, Hurr; Rubatto García, Rodolfo

    2015-01-01

    Perú representa para BMW la tercera plaza más importante de la región, liderando por 14 años consecutivos las ventas del segmento de autos de lujo (para ser considerados en el segmento de lujo, premium o gama alta, cualquier marca debe cumplir con prestaciones y beneficios exclusivos para el usuario, precio alto y no de fácil acceso). En los últimos años este segmento viene creciendo pese a las fluctuaciones de la coyuntura económica. Aprovechando este posicionamiento, BMW es la primera ...

  10. Educación para la sostenibilidad

    Directory of Open Access Journals (Sweden)

    Educadores por la sostenibilidad

    2006-04-01

    Full Text Available La importancia dada por los expertos en sostenibilidad al papel de la educación queda reflejada en el lanzamiento mismo de la Década de la Educación para el Desarrollo Sostenible o, mejor, para un futuro sostenible (2005-2014 a cuyo impulso y desarrollo esta destinado este artículo, así como la página web que la Organización de Estados Iberoamericanos ha habilitado dentro de su portal digital, para la celebración de la Década.

  11. COGNITIO: UM PROCESSO PARA REUSO DE REQUISITOS

    Directory of Open Access Journals (Sweden)

    Ceres Germanna Braga Morais

    2010-11-01

    Full Text Available Este artigo apresenta um processo de reuso de requisitos, denominado Cognitio, o qual busca fornecer ganhos na produtividade e qualidade dos softwares gerados, de forma que os stakeholders se sintam motivados tanto para desenvolver software com reuso quanto para o reuso. Para a formação do repositório, organizamos as informações relacionadas aos requisitos através da linguagem Q7, e apresentamos através do framework NFR como o nosso processo pode ser aplicado.

  12. Oxitocina: nuevas perspectivas para una droga antigua

    OpenAIRE

    Steven L. CLARK; Kathleen Rice SIMPSON; G. Eric KNOX; Thomas J. GARITE

    2010-01-01

    La oxitocina es el medicamento más comúnmente asociada con la prevención de complicaciones perinatales y recientemente fue incluida por el Instituto para la Administración Medicamentosa Segura (Institute for Safe Medication Practices - ISMP) en una pequeña lista de medicamentos “con alto grado de riesgos”, lo que puede “necesitar salvaguardas especiales para reducir el riesgo de error”. Las recomendaciones actuales para administrar este medicamento son vagas en relación a la indicación, tiemp...

  13. Conferencia educación para todos

    Directory of Open Access Journals (Sweden)

    Lucía Lemos

    2015-01-01

    Full Text Available América Latina tiene 42 millones de analfabetos. La crisis creada por la deuda externa produce fuertes restricciones presupuestarias en todos los sectores. En Tailandia (1990 se realizó la Conferencia Mundial sobre "Educación para Todos" se presentó la nueva visión de encontrar un camino para lograr una educación por todos y para todos.La autora, trata de sintetizar los documentos que circularon en la reunión.

  14. Modelo de requisitos para sistemas embebidos

    OpenAIRE

    González Palacio, Liliana; Urrego Giraldo, Germán

    2008-01-01

    En este artículo se presenta un modelo de requisitos como apoyo para la construcción de sistemas embebidos. En la actualidad, las metodologías de Ingeniería de Requisitos propuestas para este dominio no establecen continuidad en su proceso de desarrollo, ya que poseen una fuerte orientación a la etapa de diseño y un énfasis más débil en la etapa de análisis. Además, dichas metodologías ofrecen pautas para tratar los requisitos luego de que han sido obtenidos, pero no proponen herramient...

  15. Actitud Positiva: la base para la competitividad

    Directory of Open Access Journals (Sweden)

    Marco Anderson Espinoza

    2008-04-01

    Full Text Available Una estrategia empresarial enfocado en el mejoramiento continuo de la productividad para la competitividad, depende significativamente del manejo inteligente de tres variables visibles:Calidad, Entrega oportuna y Costo. No obstante, estas tres variables no suelen sersuficientes. La estrategia debe ser complementada con el manejo adecuado de variables intangibles como la Motivación y las Condiciones de Trabajo, con la aplicación de Tecnología Ambientalmente Amigable, en un marco de Actitud Positiva.A final de cuentas, la Actitud Positiva es fundamental para el recurso humano de cualquier organización, a fin de construir una plataforma sólida y estable que sirva de base para soportar un proceso sostenible de mejoramiento de la productividad, para aumentar la competitividad como estrategia empresarial exitosa.

  16. Quitovac : Olla para hacer le tepache

    OpenAIRE

    Rodriguez-Loubet , François

    1985-01-01

    Quitovac, Municipio General Plutarco Elías Calles, Sonora. Quitovac IV. Don Luciano unto a la Olla de Cachito. Olla para hacer el Tepache de Pitoya en la piesta del "Queso", siglo pasado y principios de Este.

  17. Competencias del profesorado universitario para la interculturalidad

    OpenAIRE

    Shestakova, Nataliya; Domínguez Garrido, María Concepción; Cacheiro González, María Luz

    2016-01-01

    La presente investigación está dedicada a las competencias del profesorado universitario para la interculturalidad. Se trata de un estudio exploratorio con un enfoque mixto, cualitativo y cuantitativo, cuyo objetivo es conocer las competencias intercu

  18. Regulaciones para el transporte de sustancias infecciosas

    OpenAIRE

    Casquero, José

    2005-01-01

    Para el propósito de transporte, se define como sustancia infecciosa, aquellas que son conocidas o razonablemente esperadas que contengan patógenos (bacterias, virus, rickettsias, parásitos, hongos, y priones)

  19. Using ParaPost Tenax fiberglass and ParaCore build-up material to restore severely damaged teeth.

    Science.gov (United States)

    Caicedo, Ricardo; Castellon, Paulino

    2005-01-01

    This article describes a technique using ParaPost Tenax Fiber White, ParaPost Cement, and ParaPost ParaCore build-up material to restore a tooth with a significant loss of tooth structure. After successful root canal therapy, the posts were bonded in the canals and the core was built using ParaPost ParaCore build-up material. At that point, the tooth was prepared to receive a conventional porcelain-fused-to-metal crown.

  20. Páginas web para el aprendizaje

    Directory of Open Access Journals (Sweden)

    Isabel ÁLVAREZ

    2016-04-01

    Full Text Available Este artículo plantea la construcción de paginas web como vehículo para facilitar la integracion de las tecnologias de la informacion y la comunicacion en el aula para futuros maestros. El término Página Web Coherente enfatiza la utilización de páginas cuyo objetivo principal es promover el aprendizaje siguiendo un proceso colaborativo, una estructura integradora y un contenido educativo.

  1. Entrenamiento de fuerza para la salud

    OpenAIRE

    Ortiz Cervera, Vicente

    1996-01-01

    Este artículo describe de manera breve y clara los efectos del entrenamiento de fuerza sobre la salud, al mismo tiempo da pautas para la realización y programación de los entrenamientos de fuerza para la salud en distintas edades. Se muestran las diferentes variables del entrenamiento de la fuerza junto con ejemplos de entrenamientos, basándose en las pautas marcadas en la revisión bibliográfica descrita.

  2. Un almuerzo para llevar saludable (Packing Smart)

    Centers for Disease Control (CDC) Podcasts

    2011-08-22

    En este podcast para niños, los chicos de Kidtastics hablan sobre almuerzos creativos para llevarse a la escuela, que ayuden a mantenerse con energía el resto del día.  Created: 8/22/2011 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 1/3/2012.

  3. Amendoins silvestres para uso ornamental.

    Directory of Open Access Journals (Sweden)

    Renato Ferraz de Arruda Veiga

    2003-06-01

    Full Text Available Algumas espécies silvestres de amendoim (Arachis spp. gênero Arachis L. (Fabaceae, vêm sendo utilizadas como forração em jardins no Brasil, porém todas com pouca variabilidade já que a distribuição do germoplasma é feita sempre pelos mesmos acessos4. Por outro lado, inúmeras coletas têm sido realizadas, particularmente pela Embrapa Recursos Genéticos e Biotecnologia (Cenargen, disponibilizando acessos até então inacessíveis à pesquisa científica. Em virtude dessa nova disponibilidade e igualmente de híbridos resultantes de pesquisas do Cenargen, organizou-se este trabalho. Foram objeto desta pesquisa cinco espécies: A. glabrata Benth., A. helodes Mart. ex Krapov.& Rigoni, A. pintoi‘Krapov.& W.C.Gregory, A. repens Handro e A. kempff-mercadoi Krapov.,W.C.Gregory & C.E.Simpson, e seis híbridos originados dos paternais: A. appressipila Krapov.&W.C.Gregory, A. paraguariensis Chodat & Hassl., A. pintoi, A. repens e A. vallsi Krapov.& W.C.Gregoryi. O experimento foi desenvolvido no período dos anos agrícolas de 1998 a 2000, na Fazenda Santa Elisa do Instituto Agronômico (IAC, em Campinas (SP, anotando-se o número de flores por planta, a velocidade de desenvolvimento, a capacidade de cobertura do solo, aspectos ornamentais como exuberância das flores e folíolos, coloração e, ainda, sanidade e vigor dos acessos. Os híbridos apresentaram um bom comportamento, porém com ciclo anual, ao passo que os acessos de Arachis kempffmercadoi, A.helodes, A. repens e A. glabrata mostraram-se mais recomendáveis para o uso em jardins por serem perenes. Todos os acessos ficam mais bonitos no verão em razão do período de floração e graças ao verde de sua massa foliar.

  4. UM TRATADO PARA O AMOR

    Directory of Open Access Journals (Sweden)

    Maria José Caldeira do Amaral

    2015-07-01

    Full Text Available No Tratado do Amor Cortês - Tractatus de Amore - André Capelão deseja oferecer ao leitor a arte cortês de amar, a beleza do desejo erótico e a disciplina da paixão constitutiva dessa arte que é amar. O maior argumento dessa obra é efetivar o suspiro fundo que a dimensão amorosa infunde na alma do homem e da mulher aos quais foi concedida a virtude. Para esse autor, escriba da chancelaria real e talvez, não se sabe com certeza, um Ordo Sacratus, o amor é a raiz de toda cortesia, a fonte de todo bem. Nosso objetivo, então, é encontrar nessa suma amorosa construída nos enlaces da Literatura de Cavalaria Medieval, os desdobramentos essenciais dessa vida afetiva bela e virtuosa no enredo profundo do qual emerge o afeto, a fé e a contradição da experiência humana do sofrimento amoroso. Palavras Chave: Literatura Medieval. Amor Cortês, André Capelão, virtude, desejo. Abstract: With the treaty toward the love - Tractatus de Amore – André Capelão offers to the reader the courteous’ art for love, the erotic desire’s beauty and the  suffering discipline belong this love’s art  is. The best reason of this literary composition is to achieve the depth sigh that the loving dimension infuses into the lovers’s soul, the man and the woman wich this virtue was conceded. For this author, the royal chancery scribe and perhaps, no one knows for sure, a Sacratus Ordo, love is the root of all free, the source of all good. Our goal, then, is to find this sum loving built in interlacing of Medieval Knights literature, the essential developments of this beautiful and virtuous love life in the deep storyline which emerges affection, faith and the contradiction of the human experience of love suffering. Key words: Medieval Literature. Courteous Love. André Capelão. Virtue.

  5. Agricultura familiar para el desarrollo rural incluyente

    Directory of Open Access Journals (Sweden)

    Laksmi Reddiar Krishnamurthy

    2017-04-01

    Full Text Available Las comunidades indígenas Mayas de la península de Yucatán han practicado la antigua tradición de agricultura familiar, en particular los huertos caseros, para garantizar su seguridad alimentaria. Con el objetivo de mejorar la práctica tradicional considerando paradigmas de la ciencia moderna, por una parte, se colectaron datos para definir la complejidad estructural y diversidad funcional a partir de 20 huertos familiares en cinco comunidades: X - Maben, X - Pichil, X - Yatil, San José II y Melchor Ocampo; y por otra, se organizaron grupos de discusión para dilucidar la estrategia de gestión practicada por las comunidades nativas. Los resultados mostraron que los huertos son manejados principalmente por las mujeres. También mostraron que el propósito principal del crecimiento y mantenimiento de los huertos familiares es garantizar la producción de alimentos nutritivos durante todo el año. Y, por último que los huertos caseros también sirven para propósitos secundarios tales como la provisión de productos y servicios para la medicina tradicional. El estudio sugiere que se debe de promover e invertir en huertos caseros para mejorar las estrategias de desarrollo incluyente en ambientes socio-culturales y biofísicos similares.

  6. Estrategia para elevar la motivación laboral; factor imprescindible para mejorar nuestra productividad.

    OpenAIRE

    Reina de los Ángeles Carballé Piñón

    2015-01-01

    Este trabajo "Estrategia para elevar la motivación laboral; factor imprescindible para mejorar nuestra productividad" resulta de la investigación realizada para tesis de maestría; se realizó el estudio de 2 entidades, nos permitió conocer las principales posiciones que sobre motivación existen, factores que la influencian, cómo incide en el desempeño laboral y que acciones diseñar para elevarla. Las 2 entidades seleccionadas, claves en el desempeño empresarial son un centro de interfase y un...

  7. Alimentos balanceados para perros en Costa Rica

    Directory of Open Access Journals (Sweden)

    Ruth Vargas

    2001-01-01

    Full Text Available Diagnóstico de la comercialización de alimentos balanceados para perros en Costa Rica. Para ampliar los reportes oficiales de la comercialización de alimentos para perros se creó una base de datos que incluyó cantidad, costo, empaque y formulación durante el período 1998 a agosto del 2000. De 1995 a 1998 y de 1996 a 1999 la producción nacional incrementó un 90,4% y la importación un 42,56% respectivamente, ocupando los alimentos nacionales un 72% del tonelaje y un 70% del valor en dólares americanos. No fue posible determinar cuál es el empaque más comercializado, pero si que los alimentos extrusados son los que ocupan el primer lugar y que los alimentos recomendados para cachorros y adultos son los que más se comercializan. La ausencia de datos en las declaraciones sugiere la necesidad de incrementar el control en las mismas en caso de requerirse un estudio de mercado, ya que contrariamente a esta situación el mayor número de garantías inscritas corresponden separadamente para las fases de cachorros y adultos. Merece también atención que las garantías indican mayores porcentajes de proteína cruda que los recomendados por la AAFCO y que al menos 36 fórmulas son recomendadas para estados sanitarios específicos (p.e. para perros con problemas de alergias, cálculos renales, pérdidas de pelo, etc. sin que oficialmente se encuentre registrada ninguna fórmula medicada

  8. Percutaneous radiofrequency rhizotomy and neurovascular decompression of the trigeminal nerve for the treatment of facial pain Rizotomia percutânea por radiofreqüência e a descompressão neurovascular do nervo trigêmeo no tratamento das algias faciais

    Directory of Open Access Journals (Sweden)

    Manoel J. Teixeira

    2006-12-01

    Full Text Available OBJECTIVE: To determine the outcomes of 354 radiofrequency rhizotomies and 21 neurovascular decompressions performed as treatment for 367 facial pain patients (290 idiopathic trigeminal neuralgia, 52 symptomatic trigeminal neuralgia, 16 atypical facial pain, 9 post-herpetic neuralgia. METHOD: Clinical findings and surgery success rate were considered for evaluation. A scale of success rate was determined to classify patients, which considered pain relief and functional/sensorial deficits. RESULTS: Radiofrequency rhizotomy was performed in 273 patients with idiopathic trigeminal neuralgia and in all other patients, except for trigeminal neuropathy; neurovascular decompression was performed in 18 idiopathic trigeminal neuralgia patients; 100% idiopathic trigeminal neuralgia, 96.2% symptomatic trigeminal neuralgia, 37.5% atypical facial pain and 88.9% post-herpetic neuralgia had pain relief. CONCLUSION: Both techniques for idiopathic trigeminal neuralgia are usefull. Radiofrequency rhizotomy was also efficient to treat symptomatic facial pain, and post-herpetic facial pain, but is not a good technique for atypical facial pain.OBJETIVO: Determinar eficácia e achados pós-operatórios após 354 rizotomias por radiofreqüência e 21 descompressões neurovasculares como tratamento de 367 pacientes com dor facial (290 neuralgia idiopática do trigêmeo, 52 neuralgia sintomática do trigêmeo, 16 dor facial atípica, 9 neuralgia pós-herpética. MÉTODO: Achados clínicos e taxa de sucesso das cirurgias foram considerados para a avaliação. Uma escala avaliando alívio da dor e complicações sensoriais e funcionais foi utilizada para classificar os pacientes. RESULTADOS: A rizotomia por radiofreqüência foi realizada em 273 pacientes com neuralgia idiopática do trigêmeo e em todos os outros pacientes, exceto neuropatia trigeminal; descompressão neurovascular foi realizada em 18 pacientes com neuralgia idiopática do trigêmeo; 100% dos pacientes

  9. Studies on Bis(Para Anisidine Acetylacetonato) Nickel (II) Complex ...

    African Journals Online (AJOL)

    Studies on Bis(Para Anisidine Acetylacetonato) Nickel (II) Complex. HN Aliyu, UL Bilyamin. Abstract. Schiff base was prepared from the reaction of para anisidine and acetylacetone. Bis(para anisidineacetylacetonato)nickel(II) complex was synthesized by the reaction of the prepared para anisidineacetylacetone ligand and ...

  10. Cross-elicitation responses to 2-methoxymethyl-para-phenylenediamine in para-phenylenediamine-allergic individuals

    NARCIS (Netherlands)

    Schuttelaar, M.-L.; Coenraads, P.-J.; Blömeke, B.; Goebel, C.

    2016-01-01

    The introduction of a methoxymethyl side chain into para-phenylenediamine (PPD) resulted in the development of a new hair dye molecule: 2-methoxymethyl-para-phenylenediamine (Me-PPD). Besides having excellent hair colouring properties, this PPD derivate has significantly lower skin-sensitizing

  11. LITERATURA PARA JOVENS LEITORES: UMA PROPOSTA

    Directory of Open Access Journals (Sweden)

    Gizelle Kaminski Corso

    2011-08-01

    Full Text Available Percebendo que o público-alvo das adaptações de textos clássicos não é tão somente a criança e o adolescente – leitores jovens, aos quais supostamente destinam-se as literaturas “infantil” e “infantojuvenil”, proponho neste texto uma nova classificação para as adaptações literárias, vendo-as não mais apenas como “adaptações para a literatura infantojuvenil”, mas como “literatura para jovens leitores”. Como tais textos são também lidos por adultos, por propósitos diversos, reconheço que o conceito proposto abrange um número maior de leitores. Para tanto, faço um breve percurso histórico-crítico acerca do aparecimento das adaptações no cenário literário brasileiro com a finalidade de corroborar e justificar a pertinência da classificação sugerida para as adaptações.

  12. Biocomercio: una alternativa para el desarrollo sostenible

    Directory of Open Access Journals (Sweden)

    Carlos Murillo R.

    2008-01-01

    Full Text Available El desarrollo sostenible en países ricos en biodiversidad dependerá de la capacidad de los gobiernos de implementar los arreglos institucionales necesarios para conciliar la preservación de los recursos naturales con el uso de los mismos para la producción de bienes y servicios que puedan potenciar el crecimiento económico y un mayor bienestar para las comunidades locales donde estos recursos se encuentren. Este es el objetivo de la Iniciativa de Biocomercio que ha venido impulsando la Conferencia de Naciones Unidas para el Comercio y el Desarrollo (UNCTAD en distintos países de Latinoamérica. En el tanto estos principios y los establecidos en el CDB se puedan viabilizar e inspiren los distintos Programas Nacionales de Biocomercio en los países de la región, parecería no haber dudas de que la Iniciativa abre nuevas puertas para el uso, aprovechamiento y desarrollo sostenible de los mismos.

  13. Modelo para el análisis de una aptitud cognitiva para el aprendizaje

    Directory of Open Access Journals (Sweden)

    Clara Cecilia Uribe Hernández

    2009-01-01

    Full Text Available La investigación en el campo de las aptitudes cognitivas para el aprendizaje requiere una forma de abordarlas y definir sus características y componentes. A su vez, esta definición debe conducir al investigador a la creación de pruebas de medición que ayuden al análisis de este tipo de aptitudes y su relación con otras variables del aprendizaje. Para dar respuesta a esas necesidades, el objetivo de este artículo es proponer la creación de un modelo para el análisis de una aptitud cognitiva para el aprendizaje, cuya estructura conste de cuatro elementos principales. Dos de ellos relacionados con los enfoques y consideraciones para emprender su estudio; los otros dos, con la definición de la aptitud, a través de sus características y sus componentes.

  14. Nuevo lenguaje para un nuevo medio

    Directory of Open Access Journals (Sweden)

    Inma Martín Herrera

    2014-12-01

    Full Text Available El concepto tradicional de comunicación unidereccional se ha roto para convertirse en comunicación pluridireccional que permitirá la retroalimentación informativa. Las nuevas formas de redactar, contar diseñar y presentar la información en Internet exige nuevos hábitos de lectura por parte de la audiencia. El lector deberá tomar conciencia de que está frente a un medio diferente con el que debe familiarizarse para hacer uso correcto del soporte digital, se informará adecuadamente para disfrutar de las ventajas del innovador medio, conocido como Periodismo de servicios o Nuevo Periodismo.

  15. Libertad religiosa, camino para la paz

    Directory of Open Access Journals (Sweden)

    Antonio Alonso

    2011-01-01

    Full Text Available La libertad religiosa es el núcleo del Mensaje para la XLIV Jornada Mundial de la Paz que ha dirigido Benedicto XVI. Cuestión, sin duda, extraordinariamente delicada, pues comporta graves implicaciones en materia de seguridad principalmente por dos motivos: primero, porque su violación supone una injusticia difícil de compaginar con el respeto a los Derechos Humanos; segundo, porque dicha libertad no puede ser esgrimida como pretexto para atropellar los derechos de los demás conciudadanos o incluso socavar la propia seguridad del Estado. El Santo Padre denuncia, a su vez, los estragos del relativismo y de los fanatismos, tanto religioso como anti-religioso, y propone el ejercicio del diálogo basado en la razón para superar los obstáculos en la convivencia interpuestos por estas amenazas a la paz y la seguridad.

  16. Una carrera para fortalecer las organizaciones

    Directory of Open Access Journals (Sweden)

    Flora Alcívar Rivera

    2017-08-01

    Full Text Available Los  recientes  cambios  en  la  estructura  económica mundial.  han dado como resultado modificaciones en el  terreno de  la ciencia.  la  tecnología.  la  cultura  y la educación.  comprometiendo  a  tus  Instituciones  de Educación  Superior a  fortalecer  y  a  acrualizar  los Programas de Estudio, buscando que sean relevantes y útiles  para  los Alumnos.  para  las  Empresas  y para  la Sociedad a la que se

  17. Rutina AUTOLISP para el despiece de columnas

    Directory of Open Access Journals (Sweden)

    Lorena Cocunubo Carreño

    2014-06-01

    Full Text Available El proyecto de creación de una herramienta Autolisp para el dibujo automático de los despieces de vigas sometidas a flexión y a cortante se desarrolla en un ambiente de programación informática LISP. Se inicia con la programación en el Visual Lisp de AutoCAD del algoritmo que permite tomar información de anchos de luz, sección transversal y momentos resistentes la viga para que automáticamente ejecute los comandos y el resultado final sea un despiece detallado de los hierros por flexión junto con los estribos por cortante separados adecuadamente. Los resultados están sujetos a criterios de diseños de la NSR-10 para así garantizar la seguridad del diseño sísmico.

  18. Estrategias de mercado para el frijol centroamericano

    Directory of Open Access Journals (Sweden)

    Lourdes Mart\\u00EDnez

    2004-01-01

    Full Text Available Estrategias de mercado para el frijol centroamericano. En los últimos años, el sub-sector de frijol en Centro América ha sido testigo de varios cambios dinámicos. Si no se encuentran medidas para incrementar la competitividad regional de este sub-sector, los países centroamericanos experimentarán impactos negativos en las áreas sociales y económicas de considerable magnitud, especialmente ahora que Centro América necesita ajustar su economía a los nuevos requerimientos de mercados mas abiertos, como el Tratado Centroamericano de Libre Comercio con USA (TLC. Vendedores de frijoles a nivel intermediario y de consumo final, así como técnicos de oficinas gubernamentales dedicadas al mercadeo de frijoles en Centro América fueron entrevistados para documentar los cambios experimentados, identificar los obstáculos que frenan la viabilidad del sub-sector e identificar las oportunidades de incremento de mercados en el futuro para los productores y vendedores de frijol. Los resultados muestran que para que continúen siendo competitivos, los países centroamericanos deben incrementar la productividad a través del apoyo a las investigaciones para el mejoramiento de variedades de frijol, especialmente aquellas que los consumidores prefieren por características específicas (e.g. color. También es imprescindible el fortalecimiento de los programas de distribución de variedades mejoradas a los productores; las mejoras en la transmisión de información de mercado a los productores; el fortalecimiento de los contactos entre productores, comercializadores a nivel mayorista y supermercados; y una política más específica de apertura de mercados de exportación, especialmente con los Estados Unidos.

  19. Oxitocina: nuevas perspectivas para una droga antigua

    Directory of Open Access Journals (Sweden)

    Steven L. CLARK

    2010-12-01

    Full Text Available La oxitocina es el medicamento más comúnmente asociada con la prevención de complicaciones perinatales y recientemente fue incluida por el Instituto para la Administración Medicamentosa Segura (Institute for Safe Medication Practices - ISMP en una pequeña lista de medicamentos “con alto grado de riesgos”, lo que puede “necesitar salvaguardas especiales para reducir el riesgo de error”. Las recomendaciones actuales para administrar este medicamento son vagas en relación a la indicación, tiempo de uso, dosis y el monitoreo de los efectos maternos y fetales. Una revisión de los datos clínicos y farmacológicos disponibles sugiere que las orientaciones específicas y basadas en evidencias para administrar oxitocina durante el parto puede derivarse de datos disponibles. Si implementadas, estas prácticas pueden reducir la probabilidad de daños al paciente. Esto sugiere el foco de las orientaciones para la administración electiva limitada de oxitocina, considerar estrategias que disminuyan la necesidad de usar oxitocina, confiar en terapéuticas de bajas dosis de oxitocina, la adhesión a definiciones semicuantitativas específicas sobre parto adecuado e inadecuado, y la aceptación de que, una vez que la actividad uterina adecuada sea alcanzada, es generalmente preferible esperar más tiempo que aumentar la infusión de oxitocina. El uso de protocolos conservadores y específicos para monitorear los efectos de la oxitocina en la madre y en el bebé tiende no sólo a aumentar los resultados, mas también a reducir los conflictos entre miembros del equipo obstétrico. Implementar estas orientaciones parece ser apropiada en una cultura cada vez más focalizada en la seguridad del paciente.

  20. Desenvolvimento de sonda gama para cirurgia radioguiada

    OpenAIRE

    José Oliveira da Silva, Iran

    2008-01-01

    O uso de técnicas de cirurgia radioguiada tem crescido e tem se mostrado muito eficiente para as cirurgias de câncer. O procedimento inicia-se antes da cirurgia com a administração ao paciente de um radiotraçador, geralmente emissor gama, que tem grande afinidade pelas células tumorais. Durante a cirurgia, uma sonda detectora de radiação gama é usada para identificar as regiões em que houve maior concentração do material radioativo e, portanto, os locais de células tumorais. ...

  1. Sistemas de labranza para suelos salinos

    OpenAIRE

    Hervé, Dominique; Mita, V.; Paz, B.

    2001-01-01

    Mejorar los sistemas de labranza para cultivar suelos salinos es un reto para el sur del Altiplano boliviano. Se comparo durante dos anos (1994-95 y 1995-96) el surcado en faja con discos, practicado por los campesinos de la provincia Villarroel, y el subsolado a 50 cm de profundidad solo o combinado con el surcado. Se buscaba asi romper la costra en suelos muy arcillosos y llevar las sales a mayor profundiad que los horizontes colonizados por las raices de los cultivos de quinua (raiz pivota...

  2. El centro del mundo para los gallegos

    OpenAIRE

    Mandianes Castro, Manuel

    1982-01-01

    Estudio sobre la noción de espacio en Galicia. Se pretende demostrar que para los gallegos el universo tiene un centro, con diferentes niveles de aprehensión, alrededor del cual se organiza la comunidad. Para este trabajo se han realizado encuestas entre los habitantes de la región de la Limia (Orense) y los de Loureses. El trabajo se divide en tres apartados atendiendo a los distintos niveles de percepción del centro del mundo: "lareira" (hogar), "encrucillada" (encrucijada) y cementerio.

  3. Bienes públicos para ciencia abierta

    OpenAIRE

    Cabezas Bullemore, Alberto

    2017-01-01

    La exposición presenta cómo se deben conceptualizar los bienes públicos y el rol que le cabe a LA Referencia para promoverlos. Por tanto, se da un contexto de los objetivos de esta esta red y las áreas que cubre para luego detallar este concepto y las propuestas en desarrollo. La Red Federada Latinoamericana de Repositorios Institucionales hoy se sitúa como una plataforma de articulación entre organismos gubernamentales de ciencia y tecnología de América Latina que impulsan, con diversos grad...

  4. Valores de referência para carboxiemoglobina

    Directory of Open Access Journals (Sweden)

    Maria Elisa P. B. de Siqueira

    1997-12-01

    Full Text Available INTRODUÇÃO: Os valores de referência de indicadores biológicos são utilizados como parâmetros para interpretação de resultados de valores obtidos em indivíduos expostos ocupacionalmente aos agentes químicos. O Grupo Brasileiro para Estabelecimento dos Valores de Referência tem se dedicado a estas determinações objetivando estabelecer valores de referência para os diferentes bioindicadores em diversas regiões do País. Determinaram-se os valores de referência para a carboxiemoglobina (COHb no Sul de Minas Gerais. MATERIAL E MÉTODO: A COHb foi analisada pelo método espectrofométrico, otimizado no laboratório de análises toxicológicas. Em todas as amostras também foram realizadas análises de alguns parâmetros bioquímicos e hematológicos para atestar o estado de saúde da população, constituída de 200 voluntários não-fumantes e não-expostos, por motivo profissional, ao monóxido de carbono. Cada indivíduo respondeu um questionário para levantamento de dados relevantes à interpretação dos resultados. Os valores de referência foram expressos em termos da média ± desvio-padrão, intervalo de confiança 95% e valor de referência superior. A distribuição estatística dos resultados obtidos foi realizada para possibilitar sua comparação com grupos de trabalhadores, preferentemente à avaliação individual. RESULTADOS E CONCLUSÕES: O valor médio ± desvio-padrão para a carboxiemoglobina foi de 1,0 % ± 0,75; o intervalo de confiança 95%, entre 0,9 e 1,1 % e o valor de referência superior, de 2,5%. Através do teste t de Student (p < 0,05 não foi detectada diferença nos valores de acordo com o sexo, idade ou uso de bebidas alcoólicas. Os valores de referência encontrados foram similares aos reportados em outros países.

  5. Valores de referência para carboxiemoglobina

    Directory of Open Access Journals (Sweden)

    Siqueira Maria Elisa P. B. de

    1997-01-01

    Full Text Available INTRODUÇÃO: Os valores de referência de indicadores biológicos são utilizados como parâmetros para interpretação de resultados de valores obtidos em indivíduos expostos ocupacionalmente aos agentes químicos. O Grupo Brasileiro para Estabelecimento dos Valores de Referência tem se dedicado a estas determinações objetivando estabelecer valores de referência para os diferentes bioindicadores em diversas regiões do País. Determinaram-se os valores de referência para a carboxiemoglobina (COHb no Sul de Minas Gerais. MATERIAL E MÉTODO: A COHb foi analisada pelo método espectrofométrico, otimizado no laboratório de análises toxicológicas. Em todas as amostras também foram realizadas análises de alguns parâmetros bioquímicos e hematológicos para atestar o estado de saúde da população, constituída de 200 voluntários não-fumantes e não-expostos, por motivo profissional, ao monóxido de carbono. Cada indivíduo respondeu um questionário para levantamento de dados relevantes à interpretação dos resultados. Os valores de referência foram expressos em termos da média ± desvio-padrão, intervalo de confiança 95% e valor de referência superior. A distribuição estatística dos resultados obtidos foi realizada para possibilitar sua comparação com grupos de trabalhadores, preferentemente à avaliação individual. RESULTADOS E CONCLUSÕES: O valor médio ± desvio-padrão para a carboxiemoglobina foi de 1,0 % ± 0,75; o intervalo de confiança 95%, entre 0,9 e 1,1 % e o valor de referência superior, de 2,5%. Através do teste t de Student (p < 0,05 não foi detectada diferença nos valores de acordo com o sexo, idade ou uso de bebidas alcoólicas. Os valores de referência encontrados foram similares aos reportados em outros países.

  6. Cuestionarios Interactivos para Autoevaluación

    OpenAIRE

    Sánchez García, Juan Francisco; Martínez María Dolores, Soledad María; Bernal García, Juan Jesús

    2007-01-01

    La autoevaluación es un instrumento valioso para que el propio alumno pueda medir el grado de conocimientos adquiridos de la materia en cuestión, al tiempo sirve para adiestrarlo en el tipo de prueba que se utilizará posteriormente en el examen. Por otro lado, dado que en la adaptación al Espacio Europeo de Educación Superior (E3S) tiene particular importancia la labor realizada por el propio alumno, los pruebas de autoevalución adquieren, si cabe, una mayor relevancia. Por todo ello, hemos e...

  7. FILOSOFÍA..., ¿PARA QUÉ?

    OpenAIRE

    Tinajero, Fernando

    2011-01-01

    Un pedido tan gentil como inexplicable me ha hecho regresar sobre un tema que, hace ya algunos años, creí haber abandonado para siempre: el tema, elemental y complejo al mismo tiempo, de la enseñanza de filosofía. Está por demás decir que mi primera reacción fue la de negarme a tan inesperada invitación, y estaba seguro de que para hacerlo me sobraban motivos —verdaderos motivos—, no pretextos. No obstante, algo que todavía no alcanzó a comprender me movió a rehusar la...

  8. Redes para formación

    OpenAIRE

    Canella López, Rubén

    1999-01-01

    Desde la Universidad Nacional de Lomas de Zamora, Buenos Aires – Argentina - el Laboratorio de Medios de la Facultad de Ciencias Sociales trabajando para el desarrollo tecnológico aplicado a la comunicación y la educación presenta RED DE ENSEÑANZA SATELITAL INTERACTIVA (RESI), un sistema de enseñanza por satélite de alta interactividad con capacidad para transmitir imagen, sonido y datos a distancia en tiempo real, entre el aula presencial y las distintas aulas virtuales. La emisión es ge...

  9. Dielectroforesis para sistemas micro-escala

    Directory of Open Access Journals (Sweden)

    Roberto Carlos Gallo Villanueva

    2013-01-01

    Full Text Available Las técnicas electrocinéticas ofrecen una alternativa con gran potencial para manipular partículas biológicas. Este artículo brinda un panorama general sobre una de esas técnicas, la dielectroforesis como un método para separar y concentrar muestras biológicas. El enfoque principales sobre diseños recientes de laboratorios montados en microdispositivos que aplican la técnica mencionando sus principales aplicaciones.

  10. Ethernet para a rede de transporte

    OpenAIRE

    Davim, João Pedro Morais

    2010-01-01

    Actualmente, as redes de transporte utilizam principalmente tecnologia SDH sobre uma camada WDM. Esta dissertação aborda a mudança da tecnologia das redes de transporte, de SDH para Carrier Ethernet. Depois de descrever as limitações que a tecnologia Ethernet tem ao operar em redes de tranporte, passamos a descrever a definição de tecnologia Carrier Ethernet segundo o Metro Ethernet Forum. De seguida são apresentadas dois protocolos propostos para suportar a tecnologia Carri...

  11. Educar y comunicar para la diferencia

    Directory of Open Access Journals (Sweden)

    Daniel Prieto Castillo

    2015-01-01

    Full Text Available El autor reflexiona en torno al pensamiento de Simón Rodríguez y Paulo Freire, enfatiza en la importancia de la educación para la diferencia, la educación para la transformación de las sociedades, frente a un igualamiento por exclusión y por opresión. Sobre la base de su experiencia educativa, planea la validez de la mediación pedagógica que acompaña el aprendizaje, es decir, a la tarea de construirse y de apropiarse el mundo y de uno mismo, desde el umbral del otro.

  12. Estimativa de carbono individual para Araucaria angustifolia

    OpenAIRE

    Sanquetta,Carlos Roberto; Corte,Ana Paula Dalla; Mognon,Francelo; Maas,Greyce Charllyne Benedet; Rodrigues,Aurélio Lourenço

    2014-01-01

    As florestas são importantes sumidouros de carbono que contribuem para mitigar mudanças climáticas. Quantificar o estoque de carbono é fundamental para dimensionar este potencial de mitigação. Araucaria angustifolia (Bert.) O. Ktze. Araucariaceae é uma espécie florestal chave no sul do Brasil, devido à sua importância ecológica e econômica. Este estudo visou a analisar comparativamente dois procedimentos de estimativa do estoque individual de carbono (C) de A. angustifolia, em povoamentos imp...

  13. Imaging of limbic para-neoplastic encephalitis

    International Nuclear Information System (INIS)

    Rimmelin, A.; Sellat, F.; Morand, G.; Quoix, E.; Clouet, P.L.; Dietemann, J.L.

    1997-01-01

    Para-neoplastic limbic encephalitis is a rare syndrome mostly associated with small cell lung cancer. We present the case of a 69-year-old man with selective amnesia suggesting limbic encephalitis. A neuroendocrine cell lung cancer was found, confirming the diagnostics of para-neoplastic limbic encephalitis. Contrast-enhanced cerebral CT was normal whether magnetic resonance imaging showed signal abnormalities of the medial part of temporal lobes and hippocampal regions. Because neurologic improvement may follow treatment of the primary tumor, early diagnosis is important. (authors)

  14. Vivienda sostenible para un consumo casi nulo

    OpenAIRE

    MENDOZA GÓMEZ, CLAUDIA MARÍA

    2014-01-01

    Este TFG pretende aplicar los conceptos de eficiencia energética y sostenibilidad en la edificación para conseguir una vivienda con un consumo casi nulo. Para ello, es necesario reducir la demanda y los consumos así como las emisiones de CO2, contribuyendo de esa forma a cuidar el medio ambiente, a reducir los gases de efecto invernadero y la huella de carbono de la vivienda. El propósito es conseguir una vivienda sostenible que aproveche todo el potencial de las energías renovables y, ello i...

  15. Microtúnel modular para cultivos

    OpenAIRE

    Wozniak, Lorena; Pagliaro, Miguel

    2013-01-01

    El desarrollo del microtúnel tiene sus orígenes en la carencia de un sistema de cobertura para diversos cultivos, que se adapte a las distintas realidades y a las necesidades de los pequeños y medianos productores familiares. Para diseñar el producto se tuvieron en cuenta las siguientes cuestiones: la transportabilidad, la facilidad y la rapidez en el armado o en la construcción, la posible reposición de los componentes, la disponibilidad de recursos y el acceso a los centros urbanos, entre o...

  16. Neurocisticercosis: Afiches para Capacitación

    OpenAIRE

    MARCELO ROJAS C

    2007-01-01

    En el sistema universitario (me atrevo a decir, de todo el mundo), es poco el contenido educativo relativo a la Transferencia tecnológica para efectos de la capacitación de la sociedad sobre problemas de salud (claros ejemplos desafiantes para los veterinarios son la hidatidosis y cisticercosis) y otros; manejados en términos de cambios de conducta. Los términos de control y prevención están dados en un lenguaje académico, muy abstracto y obviamente intrascedente en la comunidad. Al punto que...

  17. Workup and Management of Persistent Neuralgia following Nerve Block

    Directory of Open Access Journals (Sweden)

    Paul David Weyker

    2016-01-01

    Full Text Available Neurological injuries following peripheral nerve blocks are a relatively rare yet potentially devastating complication depending on the type of lesion, affected extremity, and duration of symptoms. Medical management continues to be the treatment modality of choice with multimodal nonopioid analgesics as the cornerstone of this therapy. We report the case of a 28-year-old man who developed a clinical common peroneal and lateral sural cutaneous neuropathy following an uncomplicated popliteal sciatic nerve block. Workup with electrodiagnostic studies and magnetic resonance neurography revealed injury to both the femoral and sciatic nerves. Diagnostic studies and potential mechanisms for nerve injury are discussed.

  18. Workup and Management of Persistent Neuralgia following Nerve Block

    OpenAIRE

    Weyker, Paul David; Webb, Christopher Allen-John; Pham, Thoha M.

    2016-01-01

    Neurological injuries following peripheral nerve blocks are a relatively rare yet potentially devastating complication depending on the type of lesion, affected extremity, and duration of symptoms. Medical management continues to be the treatment modality of choice with multimodal nonopioid analgesics as the cornerstone of this therapy. We report the case of a 28-year-old man who developed a clinical common peroneal and lateral sural cutaneous neuropathy following an uncomplicated popliteal s...

  19. Workup and Management of Persistent Neuralgia following Nerve Block.

    Science.gov (United States)

    Weyker, Paul David; Webb, Christopher Allen-John; Pham, Thoha M

    2016-01-01

    Neurological injuries following peripheral nerve blocks are a relatively rare yet potentially devastating complication depending on the type of lesion, affected extremity, and duration of symptoms. Medical management continues to be the treatment modality of choice with multimodal nonopioid analgesics as the cornerstone of this therapy. We report the case of a 28-year-old man who developed a clinical common peroneal and lateral sural cutaneous neuropathy following an uncomplicated popliteal sciatic nerve block. Workup with electrodiagnostic studies and magnetic resonance neurography revealed injury to both the femoral and sciatic nerves. Diagnostic studies and potential mechanisms for nerve injury are discussed.

  20. Occipital Neuralgia after Hair Transplantation and Its Treatment

    Directory of Open Access Journals (Sweden)

    Jason Siefferman

    2015-01-01

    Full Text Available While undergoing full thickness tissue harvest from the posterior scalp, a 72-year-old man experienced immediate severe pain in the right occiput and was unable to complete the procedure. The pain was constant “sharp” and “shocking” with numbness in the distribution of the lesser occipital nerve, exacerbated by physical activity, and local anesthetic blocks provided temporary complete relief. After numerous treatments over several years, including oral analgesics, botulinum toxin injections, and acupuncture, proved ineffective, pulsed radiofrequency neuromodulation provided greater than 80% relief for 5 months.

  1. Premissas para o ensino superior do design

    Directory of Open Access Journals (Sweden)

    André Luis Marques da Silveira

    2016-12-01

    Full Text Available Este artigo aborda a temática da Educação Superior e objetivo identificar premissas para o Ensino em Design no Brasil. Para tanto, efetua um estudo dos conteúdos das comunicações da área em periódicos e livros quanto ao assunto. O método de investigação utilizado foi a análise de conteúdo e observou as seguintes etapas de investigação: registro de dados, interpretação inferencial e categorização. Num primeiro momento, identifica a frequência do aparecimento de índices lexicais quanto ao relato de problemas no processo de Ensino-aprendizagem do Design e as proposições para o seu enfrentamento. Procede uma interpretação inferencial destes dados e, por fim, propõe como resultado, um conjunto de doze premissas que devem ser observadas quanto ao Ensino Superior em Design, a saber: 1 Incentivar o empreendedorismo; 2 Nivelar a Formação; 3 Desenvolver estrategistas; 4 Pensar a ética na atuação profissional; 5 Educar para o social; 6 Valorizar os ideias humanistas; 7 Repensar as estruturas acadêmicas; 8 Focar na aprendizagem baseada em problemas; 9 Aceitar os novos paradigmas; 10 Fomentar o pensamento crítico reflexivo; 11 Estimular a transdisciplinaridade; 12 Focar nas economias emergentes.

  2. Premissas para o Ensino Superior do Design

    Directory of Open Access Journals (Sweden)

    André Luis Marques da Silveira

    2016-12-01

    Full Text Available Este artigo aborda a temática da Educação Superior e objetivo identificar premissas para o Ensino em Design no Brasil. Para tanto, efetua um estudo dos conteúdos das comunicações da área em periódicos e livros quanto ao assunto. O método de investigação utilizado foi a análise de conteúdo e observou as seguintes etapas de investigação: registro de dados, interpretação inferencial e categorização. Num primeiro momento, identifica a frequência do aparecimento de índices lexicais quanto ao relato de problemas no processo de Ensino-aprendizagem do Design e as proposições para o seu enfrentamento. Procede uma interpretação inferencial destes dados e, por fim, propõe como resultado, um conjunto de doze premissas que devem ser observadas quanto ao Ensino Superior em Design, a saber: 1 Incentivar o empreendedorismo; 2 Nivelar a Formação; 3 Desenvolver estrategistas; 4 Pensar a ética na atuação profissional; 5 Educar para o social; 6 Valorizar os ideias humanistas; 7 Repensar as estruturas acadêmicas; 8 Focar na aprendizagem baseada em problemas; 9 Aceitar os novos paradigmas; 10 Fomentar o pensamento crítico reflexivo; 11 Estimular a transdisciplinaridade; 12 Focar nas economias emergentes.

  3. Para uma abordagem virtuosa do Jornalismo

    Directory of Open Access Journals (Sweden)

    Rogério Christofoletti

    2012-06-01

    Full Text Available As últimas décadas têm favorecido o crescimento do interesse e dos estudos sobre a ética jornalística. No Brasil e em outras praças, as abordagens deste tema têm sido na maioria das vezes por um caráter deontológico ou utilitarista. Neste artigo, chamamos a atenção para uma perspectiva que privilegie as virtudes como pontos de partida para os debates acerca das condutas dos profissionais. Uma ética das virtudes remete a Aristóteles e aos estoicos, mas vem sendo retomada por autores mais contemporâneos, como Macintyre e Comte-Sponville, entre outros. No jornalismo, esta abordagem não é definitiva ou totalizante, mas contribui para uma compreensão mais ampla da discussão, chamando inclusive a atenção para recomendações éticas úteis, práticas e atuais.

  4. Educación para la paz

    Directory of Open Access Journals (Sweden)

    Federico Mayor Zaragoza

    2003-01-01

    Full Text Available La educación para la paz ha experimentado un desarrollo importante en los últimos 20 años, y el 2000 ha sido declarado Año Internacional para la Cultura de Paz. Exige un esfuerzo de pariicipación y una capacidad crítica para facilitar el paso de una cultura de guerra a un cultura de paz. Se trata de ayudar a todos los ciudadanos a observar y reflexionar sobre el conjunto de la tierra y de quienes la habitan. De escuchar a los jóvenes y ser escuchado. La educación para la paz ha de ser considerada como contenido transversal de la educación. La situación actual, los conflictos interétnicos e interculturales , la exclusión y la marginalidad, las sociedades pobres y las ricas son cuestiones que reclaman una educación par la paz. De la cultura de imposición hemos de pasar a la cultura del diálogo y parti-cipación, solidaridad, compromiso, tolerancia y respeto. Es necesario construir otro mundo en el que podamos asegurar a nuestros descendientes el futuro. La paz es un comportamiento, es traducir a la práctica los principios de con-vivencia, de solidaridad, de fraternidad. Sólo así «vendrá el amanecer (y brilla-rá mucha luz en nuestro camino»

  5. FOTOBIORREACTOR: HERRAMIENTA PARA CULTIVO DE CIANOBACTERIAS

    Directory of Open Access Journals (Sweden)

    Luis Guillermo Ramírez Mérida

    2014-05-01

    Full Text Available Las cianobactérias son organismos eficientes en la conversión de energía solar y producen una gran variedad de metabolitos. En la actualidad son el centro de atención para la producción de biocombustible, son usadas como biofertilizantes, control de contaminación ambiental y como fuente de nutrientes en alimentación humana y animal. Con el fin de proporcionar crecimiento y aprovechar el potencial de las cianobacterias, se requieren fotobiorreactores eficientes. Aunque se han propuesto muchos tipos de fotobiorreactores, no existe un reactor ideal, solo unos pocos pueden utilizarse para la producción de biomasa de cianobacterias. De hecho, la elección del fotobiorreactor más adecuado depende de la situación, ya que tanto las especies de algas disponibles y el destino final jugarán un papel importante. Uno de los principales factores que limita su aplicación práctica en cultivos de biomasa es la transferencia de masa. Por esto, entender el coeficiente de transferencia de masa en los fotobiorreactores es necesario para una operación eficiente del cultivo de biomasa en cianobacterias. En esta revisión, se discuten varios tipos de fotobiorreactores muy promisorios para la producción de biomasa de cianobacterias.

  6. ¿Para qué conmemorar?

    Directory of Open Access Journals (Sweden)

    Javier Esteinou Madrid

    2015-01-01

    Full Text Available El autor se cuestiona el para qué conmemorar los 500 años de la conquista española e invita a reflexionar como hombre contemporáneo y no desde el olvido pidiendo que la sociedad se humanice. Descubra su identidad y valorice su cultura.

  7. ESPIRITUALIDADE PARA OUTRO MUNDO POSSÍVEL

    Directory of Open Access Journals (Sweden)

    Agenor Brighent

    2007-01-01

    Full Text Available Teve lugar, em Nairobi, o II Fórum Mundial de Teologia e Libertação, entre os dias 16e 19de janeiro de 2007.O primeiro havia sido realizado em Porto Alegre, em janeiro de 2005, cujos resultados estão publicados em L.C. SUSIN (org., Teologia para outro mundo possível, São Paulo: Paulinas, 2006 (485 pp.. O segundo teve como tema - "espiritualidade para outro mundo possível". Fizeram-se presentes 300participantes, oriundos dos cinco Continentes, em sua maioria da África, especialmente de Nairobi, seguida da Europa, América, Ásia e Oceania, respectivamente. Para além da reflexão e dos conteúdos, o simples encontro e cruzamento de buscas e realizações em esfera planetária, já justifica por si só o evento. Em tempos de crise de paradigmas e dos metarrelatos, a experiência se erige como lugar privilegiado para repensar a razão e as razões do existir, do mundo e da fé. Os trabalhos tiveram lugar no Carmelite Center, nos arredores da contrastante capital do Quênia.

  8. Protocolo de Enfermagem para consulta de puericultura

    Directory of Open Access Journals (Sweden)

    Fabiane do Amaral Gubert

    2015-01-01

    Full Text Available presentar un protocolo de Enfermería para consulta de puericultura, basado en el Modelo de Enfermería de Roper-Logan-Tierney. Método: para construir el protocolo, se realizaron: revisión de la literatura, selección y lectura de los documentos relevantes para el área de salud del niño. Resultados: el desarrollo textual del protocolo, dividido en cinco capítulos según los marcos del crecimiento y desarrollo del lactante; inserción de las variables – cuestiones del protocolo, dispuestas de acuerdo con las actividades de vida propuestas en el modelo de Enfermería; y evaluación del contenido por nove investigadores a través del Índice de Validez de Contenido, con la mayoría de los artículos superior al 0,80. Conclusión: el protocolo producido se señaló como útil para orientar la atención de Enfermería en puericultura, lo que permite atención estandarizada y dirigida a la atención integral de la salud de niños en sus primeros meses de vida.

  9. Retos para la agricultura en Costa Rica

    Directory of Open Access Journals (Sweden)

    Oscar Arias M.

    2005-01-01

    Full Text Available Retos para la agricultura en Costa Rica es un análisis crítico del desarrollo agrícola de Costa Rica de los últimos 25 años. La diversificación agrícola que promovió Costa Rica en la década de los ochenta, permitió ampliar la oferta exportable y reducir la vulnerabilidad de la dependencia económica de productos tradicionales, como café y banano. Los retos de la economía global y el establecimiento de tratados comerciales con muchos países, hacen necesario que el país promueva en el sector agrícola la exportación con mayor valor agregado, para lo cual es necesario una modernización y reconversión productiva, ya que el modelo actual está agotado. Debemos mejorar sustancialmente los bienes y servicios que ofrecemos; para este propósito, algunos aspectos como la imagen de marca del país con tradición democrática, respeto a los derechos laborales, así como las buenas prácticas de manejo ambiental, deben publicitarse. Como una herramienta clave para la incorporación de mayor valor agregado a nuestra producción agrícola, debemos promover la inversión en investigación y desarrollo, que históricamente ha sido escasa (0,4% del PIB. En vista de que el Estado Costarricense ha demostrado una incapacidad crónica para impulsar la ciencia y la tecnología como una herramienta para nuestro desarrollo, se propone un estímulo a la inversión privada y el fortalecimiento de una alianza con el Estado y las universidades. Se analiza la conveniencia del fortalecimiento de la autosuficiencia alimentaria y de que las empresas pequeñas y medianas jueguen un papel más activo en la agro-exportación. Respecto a los tratados comerciales que se han venido negociando, se considera la conveniencia para el país, ya que son instrumentos para integrar nuestro quehacer económico a nivel mundial, y nuestro deber es el de luchar para que el sector agropecuario tenga oportunidad de subsistir competitivamente según esas nuevas reglas y

  10. Modelos para estimar consumo e exigências nutricionais para poedeiras comerciais

    OpenAIRE

    Palma Bendezu, Hilda Cristina [UNESP

    2016-01-01

    O objetivo deste trabalho foi elaborar um modelo para calcular as ingestões de aminoácidos e energia para a fase de maturação sexual e produção de ovos. As exigências de energia, aminoácidos e consumo de ração foram calculados pelo método fatorial, considerando na fase de maturação sexual a quantidade de nutrientes requerida para mantença e a quantidade de nutrientes necessários para crescimento e deposição de nutrientes corporais em cada componente do corpo (ovário, oviduto, corpo livre de ...

  11. Capacidades locales para el desarrollo turístico: reflexiones para su abordaje

    OpenAIRE

    Barbini, Bernarda

    2008-01-01

    El artículo plantea una propuesta teórico-metodológica para la realización de diagnósticos de potencialidad para el desarrollo local a través del turismo, entendiéndolo como fenómeno. Fil: Barbini, Bernarda. Universidad Nacional de Mar del Plata. Facultad de Ciencias Económicas y Sociales; Argentina.

  12. Modelo estocástico multivariado para valuar opciones financieras

    OpenAIRE

    Fuentes de Maria C., Marco A.

    1998-01-01

    La presente tesis expone un modelo multivariado estocástico para el proceso de precios de activos financieros, en particular, acciones, con el propósito de utilizarlo para la valuación de opciones.

  13. Lineamientos para implementar repositorios académicos

    OpenAIRE

    UPC, Repositorio Academico; Huaroto, Libio

    2015-01-01

    La ponencita aborda aspectos relacionados con normaitvas y lineamientos para implementar repositorios acaddémicos, asi mismo, aborda temas sobre repositorios de datos, iniciativas, esperiencias. Al final se propone algunos puntos para diseñar indicadores.

  14. Criterios para proyecto de sifones en colectores

    Directory of Open Access Journals (Sweden)

    Galán Soraluce, Francisco

    1987-04-01

    Full Text Available Exposition of the criteria and ways to be developed, for the construction of siphons for large and little flow that can assure the cleanness of the horizontal lengths, carried out in Pamplona zone. These results can be reached fitting a reservoir at the entrance of the sewer to make periodical cleanliness and programming the working of the pipes.

    Se describen a continuación los criterios y el modo de desarrollarlos, utilizados en la Comarca de Pamplona para construir sifones para caudales grandes y pequeños, que tengan asegurada la limpieza de los tramos horizontales. Se consigue este resultado disponiendo un depósito junto a la cámara de entrada que asegura limpiezas periódicas, y programando el funcionamiento de las tuberías.

  15. Proyectos Productivos para Mujeres: Discurso y Experiencias

    Directory of Open Access Journals (Sweden)

    Mónica Enriquez Monzón

    2003-01-01

    Full Text Available El estudio de las interrelaciones del grupo de mujeres de la comunidad de Amor de Dios con organizaciones sociales para la ejecución de proyectos productivos, indicó la existencia de la participación militante de las mujeres en tales organizaciones y una participación motivada por la búsqueda de alternativas que alivien su autodenominada situación de pobreza. Sin embargo, las condiciones de los actuales proyectos no sugieren que éstos formen parte de una estrategia diseñada para la atención de las mujeres ni mucho menos, apuntan a una mejoría en sus condiciones de vida.

  16. para la república Argentina

    Directory of Open Access Journals (Sweden)

    Adriana I. Hladki

    2007-01-01

    Full Text Available Se describen doce especies del género Xylaria que se citan por primera vez para la Argentina: Xylaria adscendens, X. allantoidea, X. coccophora, X. cubensis, X. fissilis, X. gracillima, X. luxurians, X. melanura, X. multiplex, X. myosurus, X. kretschmarioidea y X. pseudoapiculata. El registro de las últimas dos especies es el segundo a nivel mundial. Se describen por primera vez los estromas anamórficos o estériles obtenidos en cultivo de X. kretschmarioidea, X. luxurians y X. melanura, y los cultivos en agar-avena de X. pseudoapiculata. Se sinominiza X. torulosa con X. coccophora, y se citan nuevos sustratos u hospedantes para la mayoría de las especies.

  17. CAMBIO ESTRATÉGICO PARA ENTORNOS TURBULENTOS

    Directory of Open Access Journals (Sweden)

    HUGO ALBERTO RIVERA RODRIGUEZ

    2010-01-01

    Full Text Available En los últimos años, las empresas se han visto enfrentadas a un entorno turbulento,caracterizado principalmente por presentar incertidumbre, dinamismo y complejidad. La incertidumbre se hace evidente al momento de tomar decisiones, sin lograr tener certeza sobre lo que puede pasarle a la empresa, el dinamismo se logra observar por el cambio permanente en las necesidades de los clientes y surgimiento de nuevos productos, que origina incremento de la rivalidad por precio, y la complejidad puede identifi carse en el surgimiento de nuevos actores con los que se debe interactuar para llevar a cabo una transacción. La academia de la administración ha buscado mecanismos para enfrentarse a la turbulencia. En el presente documento se presenta una revisión teórica del concepto de turbulencia, haciendo énfasis en la forma como debe enfrentarse el fenómeno mediante el cambio estratégico.

  18. Novos tempos para nossa jovem Tempus

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    Ana Valéria Machado MENDONÇA

    2014-12-01

    Full Text Available A Revista Tempus Actas em Saúde Coletiva chega ao final de 2014 com muitos motivos para comemorar, muitas foram as vitórias, entre elas, o lançamento dos seus dois últimos números do ano. Ao lançarmos os Números 3 e 4, o primeiro nesta semana e o segundo na próxima, trazemos uma nova formatação visual, normativa e editorial, segundo as exigências da base de dados LILACS - Literatura Latino-Americana e do Caribe em Ciências da Saúde, um dos mais expressivosindexadoresda América Latina e Caribe.Isso mesmo, fomos avaliados positivamente e estamos a um passo de mais uma importante indexação para nosso periódico científico.

  19. Rius para principiantes, recepción

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    Mario Kaplún

    2015-01-01

    Full Text Available ¿En qué se basa la complicidad entre el medio y sus usuarios? Ni la imposición externa, ni la gratificación de los programas explican por qué las audiencias prestan su consenso legitimando en parte la mediocridad. Para el autor la explicación requiere contextualizar la recepción y analizar los "modos de uso" de los medios. Por ese camino no descubrimos el funcionamiento del principio del placer sino un síntoma más de la trágica desarticulación social. Intenta proponer dos pautas teóricas y metodológicas para el estudio de la recepción masiva. Un abordaje de esa naturaleza implica la exploración de los condicionamientos sociales de la recepción que desarrolla a continuación.

  20. Material instruccional como recurso para escuelas unidocentes

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    Irma Encinas Ramírez

    1992-11-01

    Full Text Available En el 11 Seminario sobre "Análisis y Perspectivas de la Educación en el Perú" (1985, organizado por el Centro de Investigaciones y Servicios Educativos (CISE-PUC, en la Comisión Educación Rural se analizaron y discutieron los aspectos más relevantes de la amplia problemática de este sector. En tal sentido los problemas referentes a las escuelas unidocentes dieron margen a que un grupo de estudiantes de nuestra Facultad se interesara en ahondar su estudio para ofrecer las respuestas y alternativas más convenientes. Consideramos que este trabajo es significativo y de actualidad, pues hasta el presente, los profesores de centros unidocentes carecen decapacitación específica, de orientaciones, medios y recursos didácticos para hacer frente a su difícil labor.

  1. Observadores Distribuidos Garantistas para Sistemas en Red

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    Ramón A. García

    2017-07-01

    Full Text Available Resumen: En este artículo se propone un observador distribuido garantista para sistemas en red, considerando de forma explícita el problema de los retardos variables en las comunicaciones. Se asume que la información intercambiada entre agentes llega siempre a su destino, si bien las comunicaciones están sujetas a retardos variables, cuyo valor máximo se supone conocido. Cada observador trabaja con información parcial, y necesita comunicarse con observadores vecinos para llevar a cabo una estimación del estado completo del sistema. Para representar a los conjuntos garantistas, cuya función es acotar en tiempo real la región en la que se encuentra el estado del sistema, se ha optado por la utilización de zonotopos. Esto permite integrar de forma sencilla la información recibida por cada agente. Finalmente se presentan resultados de simulación para validar el algoritmo propuesto. Abstract: This paper proposes a guaranteed distributed observer for networked systems, taking into account the problem of the variable delays in communications. We assume that the information exchanged among the agents always arrives to its destination, although the communication are subject to variable delays, whose maximum value is known. Each observer works with partial information, and needs to communicate with neighbouring observers to carry out an estimation of the complete state of the system. The guaranteed sets, whose function is to delimit in real time the region in which the state of the system belong to, are represented by zonotopes. This kind of sets allows a simple integration of the information received by each agent. Finally some results obtained with the proposed algorithm are shown in simulations. Palabras clave: Estimación Distribuida, Observadores de Estado, Sistemas con Retardos, Sistemas en red, Zonotopos, Keywords: Distributed Estimation, State Observers, Delays Systems, Networked systems, Zonotopes

  2. Actitud Positiva: la base para la competitividad

    OpenAIRE

    Anderson-Espinoza, Marco

    2008-01-01

    Una estrategia empresarial enfocado en el mejoramiento continuo de la productividad para la competitividad, depende significativamente del manejo inteligente de tres variables visibles:Calidad, Entrega oportuna y Costo. No obstante, estas tres variables no suelen sersuficientes. La estrategia debe ser complementada con el manejo adecuado de variables intangibles como la Motivación y las Condiciones de Trabajo, con la aplicación de Tecnología Ambientalmente Amigable, en un marco de Actitud Pos...

  3. Factores claves para iniciar una empresa

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    Irenarco Rueda Reyna

    2015-04-01

    Full Text Available RESUMEN El artículo presenta en forma esquemática los aspectos relevantes para la conformación de una empresa,  desde la planeación acertada, el mercado, los medios de producción,  personal y financiamiento. Resalta asimismo la importancia de las clasificaciones y características que debe tener el indicador  de negocios.

  4. Masculinidad-masculinidades. Camino para un cambio

    OpenAIRE

    Rodríguez del Pino, Juan Antonio

    2017-01-01

    Taller para trabajar en el aula el género (Masculinidad). Analizar como se construye la masculinidad así como influye en ese proceso el Patriarcado. Analizar el papel de los hombres en la sociedad. Determinar como viven los hombres su sexualidad y los conceptos de Micromachismos y posmachismos. Como hacerles frente y propuestas de nuevas formas de ser hombre, más igualitario

  5. Receptores para el virus de la rabia

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    Jaime E. Castellanos

    2001-12-01

    Full Text Available El virus de la rabia causa una infección en el sistema nervioso que puede provocar la muerte. La patogenia y el neurotropismo de este virus han sido estudiados extensamente con el objeto de explicar el porque la letalidad de la enfermedad y proponer nuevas alternativas terapéuticas. El proceso de adsorción del virus a la célula bianco se considera un evento que define el neurotropismo del virus. Se piensa que debe existir una molécula en la superficie de las neuronas que une con alta afinidad al virus y da comienzo al proceso infeccioso. Durante los últimos años se han propuesto varias proteínas, carbohidratos y lipidos complejos, como receptores para el virus de rabia y se han hecho nuevas proposiciones de terapia antirreceptor. Además de los gangliósidos y fosfolípidos para los que se ha hallado evidencia sobre su participación en la adsorción del virus de la rabia, hay datos experimentales sobre la participación del receptor nicotinico de acetilcolina. la molécula de adhesión celular neural y el receptor de baja afinidad para neurotrofinas en la infección neurona1 En este articulo se hace una revisión de los datos que sustentan a cada una de las moléculas propuestas, se discuten sus implicaciones para la explicación del neurotropismo del virus de rabia y la exploración de nuevas terapias antivirales.

  6. Controlador empotrado para PBX de ocho abonados

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    René Yañes de la Rivera

    2011-11-01

    Full Text Available Normal 0 21 false false false ES X-NONE X-NONE MicrosoftInternetExplorer4 /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Tabla normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-priority:99; mso-style-qformat:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:"Times New Roman"; mso-fareast-theme-font:minor-fareast; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;} Como parte del Proyecto Ramal del MIC “Plataforma de Conmutación de Paquetes”, previsto para el desarrollo de productos y tecnologías de origen cubano en el campo de la telefonía, se ha trabajado en el desarrollo de una central telefónica privada (PBX basada en el diseño digital con lógica programable. En el presente artículo se propone el diseño de un controlador de llamada empotrado para la atención de ocho abonados que constituye uno de los bloques fundamentales de dicha PBX. El controlador, desarrollado en VHDL y empotrado en un FPGA Cyclone II de Altera,  permite a través de dos tarjetas de abonado previamente desarrolladas, generar toda la señalización de abonado y establecer hasta cuatro conversaciones simultáneas.

  7. ALGUNAS CARTAS DE CONTROL BIVARIADAS PARA ATRIBUTOS

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    CAROLINA OSPINA HINCAPIE

    2010-01-01

    Full Text Available Muchos procesos industriales son de naturaleza multivariada dado que la calidad de un producto depende de más de una variable. El control multivariado de procesos captura la relación en las variables asociadas al proceso, si se ignora esta correlación y se utilizan gráficos de control univariados para cada variable por separado se puede concluir erróneamente acerca del estado del proceso. En variables continuas correlacionadas se han realizado muchas investigaciones, sin embargo se encuentran pocos trabajos que traten sobre atributos correlacionados. En este trabajo se comparan tres cartas de control para variables aleatorias binomiales bivariadas, correlacionadas entre sí, las cuales miden atributos. Las cartas son: La carta de Hotelling basada en la aproximación de la distribución binomial multivariada a la distribución normal multivariada. La carta MNP la cual es una extensión de las cartas univariadas, y la carta que es una metodología no paramétrica basada en el índice de profundidad de Mahalanobis. La comparación se hace vía simulación utilizando como medida de comparación, la longitud promedio de racha (ARL. Dentro del trabajo se presenta un ejemplo aplicado de las metodologías para construir cartas de control para variables binomiales bivariadas en una empresa de telecomunicaciones. De los resultados se aprecia, en términos generales, que la carta MNP es la mejor tanto en control como fuera de control.

  8. Diagnóstico molecular para Leishmaniasis

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    Ysabel Montoya

    1997-01-01

    Full Text Available El potencial diagnóstico de epitopes inmunodominantes seleccionados fue ensayado satisfactoriamente a fin de obtener una prueba serodiagnóstica alternativa para la Leishmaniasis Tegumentaria Americana. Dos proteínas recombinantes prometedoras de L. (v. peruviana referidas como T-26-U2/T26-U4 fueron reconocidas por sueros individuales de pacientes con Leishmaniasis Tegumentaria Americana usando Western Blot. La sensibilidad de la prueba fue de 86% con sueros permanentes con Leishmaniasis peruana.

  9. Composición para suplemento alimenticio

    OpenAIRE

    Fuente, Miguel Ángel de la; Juárez, Manuela; Gómez Cortés, Pilar; García García, Alfonso; Rodríguez Lozano, Juan Carlos; Bach Ariza, Alejandro

    2008-01-01

    [ES] Composición que comprende una combinación extrusionada de semilla de lino, salvado de trigo y harina de girasol. Además, la presente invención se refiere al uso de dicha composición como suplemento alimenticio para animales, y la obtención, mediante el uso de dicho suplemento, de leche enriquecida en ácidos a-linolénico y ruménico.

  10. Novedades en Cyrtopodium (Orchidaceae para la Argentina 2

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    Marcela I. Sánchez

    2012-07-01

    Full Text Available Se describe por primera vez para la flora argentina una especie del género Cyrtopodium, C. paniculatum (Ruiz & Pav. Garay. Se incluyen sinónimos, observaciones ecológicas y una clave para diferenciarla de las entidades afines. Además se aclara la identidad de C. pflanzii, previamente citada para la Argentina.

  11. un reto para el desarrollo rural sostenible

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    María Enriqueta Cózar Valero

    2005-01-01

    Full Text Available Tras el éxodo rural masivo que marcó las décadas de los años cincuenta a los setenta, el abandono del medio rural ha continuado, con menor intensidad, aunque con una participación femenina cada vez más dominante. Este abandono de las áreas rurales, junto con los cambios en las pautas de comportamiento demográficas y sociales de las mujeres rurales en las dos últimas décadas del siglo XX, podría comprometer el desarrollo sostenible del medio rural granadino, tan necesario para frenar la despoblación que viene sufriendo desde mediados del siglo pasado. Este artículo se centra en el análisis de las variables sociodemográficas que permiten conocer tanto las oportunidades como las limitaciones que enfrentan las mujeres rurales a comienzos del siglo XXI, así como las opciones para que contribuyan al desarrollo de sus lugares de origen. La base territorial usada en este artículo se corresponde con las agrupaciones municipales que se han formado para acceder a las subvenciones de la iniciativa LEADER PLUS y del programa PRODER A.

  12. Cuestionarios Interactivos para Autoevaluación

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    Sánchez García, Juan Francisco

    2007-01-01

    Full Text Available La autoevaluación es un instrumento valioso para que el propio alumno pueda medir el grado de conocimientos adquiridos de la materia en cuestión, al tiempo sirve para adiestrarlo en el tipo de prueba que se utilizará posteriormente en el examen. Por otro lado, dado que en la adaptación al Espacio Europeo de Educación Superior (E3S tiene particular importancia la labor realizada por el propio alumno, los pruebas de autoevalución adquieren, si cabe, una mayor relevancia. Por todo ello, hemos elaborado unos test interactivos con hoja de calculo, para cubrir el doble propósito de evaluar los conocimientos alcanzados por nuestros alumnos, relativos tanto a la materia, como al manejo en sí de la propia herramienta informática de la hoja de cálculo. Se muestran ejemplos concretos relacionados con las matemáticas y la hoja de cálculo Excel.

  13. EXPERIENCIA INTEGRADORA PARA EDUCACIÓN AMBIENTAL

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    Jorge F. Coronel

    2015-01-01

    Full Text Available En este trabajo se relacionó la práctica experimental de laboratorio co n el análisis de problemas ambientales. El objetivo de este trabajo es analizar una propuesta que vinculó el trabajo experimental con la situación del ambiente local para promover el cuidado de la naturaleza y su uso con sostenibilidad . Esta estrategia brindó un enfoque integrador aportando a los alumnos de profesorado una alternativa de aprendizaje con exper iencias sencillas para el estudio cualitativo de l ambiente local y motivar a l análisis de problemas asociad o s. Las experiencias permitieron caracterizar las muestras de suelo, agua y aire del lugar de residencia de los alumnos. La información experimental obtenida potenció la discusión de la situación ambiental actual. E l enfoque de enseñanza basado en problemas socio - científicos posibilit ó la visión interdisciplinar del tema , redimensionando valores y acciones para el cuidado ambiental y el desarrollo sustentable.

  14. UM MODELO INFORMACIONAL PARA EMPRESAS MULTIPLANTA

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    Rogério Matos Dias

    2006-09-01

    Full Text Available Este estudo objetiva conceber, testar e demonstrar a aplicabilidade de um modelo informacional que possibilite a gestão integrada das operações da cadeia de suprimentos para firmas geograficamente dispersas – também denominadas empresas multiplanta. Para tanto, foram aplicados os métodos de pesquisa de caso e pesquisa-ação em uma empresa representativa do setor mínero-metalúrgico em âmbito mundial, a Rio Doce Manganês S.A., subsidiária da Cia. Vale do Rio Doce. A pesquisa pretende demonstrar que o modelo de sistema informacional proposto, por meio da automatização dos processos transacionais e gerenciais, é capaz de prover recursos de planejamento e controle nos níveis operacional, tático e estratégico, devido a sua capacidade de incrementar velocidade e qualidade nos processos de análise e decisão. Adicionalmente, pretende conduzir, após análise dos resultados e avaliação das contribuições a empresa estudada, a um modelo informacional adequado para gerir as operações de outras empresas de mineração e metalurgia com características semelhantes.

  15. Los consorcios exportadores: Estrategia para vender extralocalmente

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    Margot Cajigas Romero

    2006-01-01

    Full Text Available Bajo el título Los consorcios exportadores: Estrategia para vender extralocalmente,se expone cómo a través de una investigación exploratoria, realizada mediante la interacción de empresarios en una mesa de trabajo, cumplida con reuniones periódicas por más de un año, se consigue diseñar un sistema de unión entre empresas locales, para que vendan sus productos en mercados seleccionados de Colombia y algunas otrasnaciones. El comercio internacional no es unjuego de suma cero, es dable encontrar mercados externos dónde venderlos productos de economías en desarrollo, el primer mercado donde se debe competir es el propio mercado nacional y los empresarios aceptan organizarse para buscar vender en mercados seleccionados de Colombia y el mundo mediante la estrategia Coexco(Comercializadoras Extralocales de Colombia es el mensaje último del artículo.

  16. Internet: um novo desafio para os educadores

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    Rosane de Albuquerque dos Santos Abreu

    2003-06-01

    Full Text Available A penetração das novas tecnologias digitais na educação trouxe desafios para os educadores. Demonstram já ter absorvido o uso dos computadores, mas parecem achar mais difícil lidar com a Internet. Uma revisão da literatura especializada revela que o uso desta é visto por eles como mais ameaçador e complexo e que essa visão é, ao menos em parte, causada por fatores emocionais. Dado que esses estudos não investigam esses fatores emocionais em profundidade, uma pesquisa exploratória foi realizada com o objetivo de fazê-lo. Foram entrevistadas dez professoras, que se encontravam engajadas em diferentes atividades dentro de escolas e já usavam a Internet há pelo menos dois anos. A análise do discurso por elas produzido durante as entrevistas gerou resultados interessantes. Embora usem a Internet como um instrumento de trabalho (principalmente para pesquisas, seu uso para objetivos educacionais parece ser uma fonte de conflitos internos, porque, na maior parte dos casos, representaria um potencial de mudanças radicais na pedagogia tradicional, vistas como uma ameaça ao seu papel tradicional como professoras. Elas não sabem como ser educadoras em uma sociedade em rede e isso gera muita ansiedade.

  17. Recomendaciones para la vigilancia de Aedes aegypti

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    Roberto Barrera

    2016-09-01

    Full Text Available La enfermedades causadas por arbovirus transmitidos por Aedes aegypti, como el dengue, el chikungunya y el zika, continúan aumentando en incidencia anual y expansión geográfica. Una limitación clave para el control de A. aegypti ha sido la ausencia de herramientas eficaces para vigilar su población y poder determinar las medidas de control que realmente funcionan. La vigilancia de A. aegypti se ha basado principalmente en la obtención de los índices aédicos, los cuales guardan poca relación con el número de hembras del mosquito, que son las responsables de la transmisión de los virus. El reciente desarrollo de técnicas de muestreo de adultos de este vector promete facilitar las labores de vigilancia y control. En esta revisión se presentan las diversas técnicas de vigilancia del mosquito, así como una discusión sobre su utilidad, con recomendaciones para lograr una vigilancia entomológica más efectiva.

  18. A leitura: um passaporte para a vida

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    Armindo Teixeira Mesquita

    2011-06-01

    Full Text Available Nas sociedades actuais, a capacidade para usar material escrito é indispensável ao acesso a todo tipo de informação, tornando o uso da leitura cada vez mais necessário à participação real do cidadão em actividades produtivas e colectivas, porque ajuda a formar seres pensantes. O contacto com os livros deve ser iniciado o mais cedo possível, não só pelo manuseio, como também pela história contada ou pelos jogos rítmicos. Com efeito, na idade da infância, toda a energia do indivíduo é dirigida para a construção da sua identidade. Logo, as primeiras leituras entram no período da formação e da fundação, isto é, consignamos à leitura uma grande força de desenvolvimento pessoal. Os livros, para além de auxiliares na aprendizagem do mundo, formam o leitor no gosto. Formar o gosto e possibilitar escolhas são realidades fundamentais na vida adulta.

  19. HACER PARA PENSAR: IDEAS, ESPACIOS Y HERRAMIENTAS

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    Claudia Urrea Giraldo

    2012-01-01

    Full Text Available Con el presente ensayo se busca compartir la experiencia de aprendizaje diseñada y desarrollada por un grupo interdisciplinario de profesores y profesoras de la Universidad de Costa Rica. La actividad contó con la participación de docentes de distintas disciplinas académicas. La propuesta se concretó en un taller que utilizó el lenguaje de programación Scratch y las tarjetas Pico, como oportunidad para modelar un ambiente de aprendizaje construccionista. Ideas poderosas, espacios y herramientas se pusieron a disposición de los y las participantes para la construcción de historias digitales, modelos y simulaciones. El objetivo final fue que los y las profesoras pudieran vivenciar, a través de una experiencia práctica, el ambiente de aprendizaje construccionista, las ideas y las herramientas, para que más adelante las pudieran extrapolar en sus propias disciplinas y cursos.

  20. Ensino de Lutas para a Cidadania

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    Fernanda Martins Brandão

    2016-12-01

    Full Text Available O projeto “Ensino de Lutas para a Cidadania” beneficia meninos de famílias que vivem em situação de vulnerabilidade social na cidade de Juiz de Fora. O objetivo é o ensino do judô mediado pelos valores do esporte para o desenvolvimento humano. São atendidos 60 meninos com idade que variam entre seis e doze anos. Todos os beneficiados são alunos de escola pública e participam do projeto no contraturno escolar. A metodologia prioriza a formação esportiva orientada por valores, o uso de estratégias problematizadoras, relações dialógicas e participativas potencializadoras do protagonismo juvenil e do projeto de vida dos beneficiados. A maioria dos meninos manifestam maior integração social e disciplina para a aprendizagem do judô. A inclusão no ensino do judô vem proporcionando maior conhecimento de suas habilidades pessoais e sociais, estimulando a tomada de decisão e oportunizando a prática do judô em academias da cidade, ampliando o campo de oportunidades dos beneficiados no esporte. Palavras-chave: Judô. Cidadania. Inclusão. Área Temática: Educação

  1. Docencia para el logro y educación para emprender

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    Luis Gerardo Rodríguez Gómez

    1994-05-01

    Full Text Available RESUMEN En el primer artículo, el autor plasmó los elementos relevantes para una propuesta de educación para emprender. En este describe el desarrollo docente como expresión de una intensión, saber y un quehacer, encaminados a la formación del hombre emprendedor. El artículo se divide en tres partes. En la primera, se reseña los factores que orientan la intensión docente para emprender, a partir de un discurso y formas metodológicas establecidas con esa intención. En segundo lugar, se asume el espacio y tiempo la clase como unidad de análisis, para lograr objetivos de tipo institucional, programático y temático y en la parte final, se examina la evaluación docente y se hacen consideraciones generales para una propuesta de evaluación,  que surge al investigar la actuación del maestro.

  2. Labbtex: Toolbox para generación de informes en LATEX para Matlab

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    José Luis Almazán Gárate

    2012-10-01

    Full Text Available En este artículo se presenta el software desarrollado por el Equipo H3lite dentro del Departamento de Ingeneniería Civil. Transportes de la Escuela de Ingenieros de Caminos, Canales y Puertos de la Universidad Politécnica de Madrid para la generación de informes enLATEX mediante el software Matlab® y la integración en sus rutinas, Labbtex.La librería Labbtex proporciona un marco flexible para mezclar texto y código Matlab® para la generación automática de documentos. Un rchivo fuente simple contiene el texto de documentación y el código Matlab, al correr la aplicación se genera un documento final LATEX que contiene el texto, gráficos y tablas indicados con el formato de un documento LATEX. El código Matlab genera un documento LATEX usando la sintaxis. Así, LATEX (para composición de texto de alta calidad y Matlab® (para cálculo matemático pueden usarse simultáneamente. Esto permite la generación de informes en tiempo real con un uso de recursos mínimo.

  3. Meios e fins do desenvolvimento para Celso Furtado

    Directory of Open Access Journals (Sweden)

    Fabio Antonio de Campos

    2014-10-01

    Full Text Available O objetivo desse artigo é expor o conceito de desenvolvimento para Celso Furtado. Para tanto, nos interessa apresentar o desenvolvimento nacional como um fim em sua abordagem sobre a formação social brasileira Para atingir tal estágio, os meios para o autor seriam assegurados por um típico desenvolvimento capitalista. Dentro dessa problemática, mostraremos também o alcance e os limites dessa concepção para o caráter dependente e subdesenvolvido do capitalismo brasileiro.

  4. Competencia para desarrollar la alfabetización digital

    OpenAIRE

    González Rodríguez, José Santiago; Navarrete Aguirre, Mariana; Molina Zacate, Ma. Gabriela

    2011-01-01

    Introducción, Objetivos Generales, Temario: (1) ¿Qué significa la competencia para desarrollar la alfabetización digital? (2) ¿Por qué es relevante que adquiera la competencia para desarrollar la alfabetización digital en mi formación? (3) ¿Cómo aprendo la competencia para desarrollar la alfabetización digital? (4) ¿Cómo aplico la competencia para desarrollar la alfabetización digital? (5) ¿Cómo puedo autoevaluar mi competencia para desarrollar la alfabetización digital (...

  5. Estimaciones para el Teorema de Ceros de Hilbert

    OpenAIRE

    Sombra, Martín

    1998-01-01

    Se introduce una nueva noción de altura para variedades afines. Esta noción extiende al caso de una variedad arbitraria la noción de altura de Weil de una variedad de dimensión cero y la noción de altura de una hipersuperficie. Se obtiene una Desigualdad de Bézout Aritmética para la intersección de variedades. Se estudian luego los aspectos cuantitativos del Teorema de Ceros de Hilbert. La noción de altura de variedades se aplica para obtener nuevas cotas para los grados y para las alturas de...

  6. ELEMENTOS PARA LA CONSTRUCION DE UN PERFIL PARA EL GERENTE SOCIAL EN UN ENTORNO GLOBALIZADO

    Directory of Open Access Journals (Sweden)

    Antonio Bastidas Unigarro

    2009-07-01

    Full Text Available El perfil del gerente social adecuado para enfrentar los retos del mundo globalizado se ha estructurado a partir de cuatro requerimientos fundamentales: los conocimientos, la experiencia, las habilidades y las actitudes, los cuales se analizan como competencias indispensables para administrar la problemática compleja, llena de incertidumbres y desafíos del nuevo milenio. La propuesta para la construcción de un perfil de este gerente parte de considerar tres tipos de competencias: las funcionales, las comportamentales y los requisitos de estudio y experiencia. Su construcción parte del análisis de la Gerencia Social en el estado neoliberal, escenario, que reclama la formación de gerentes sociales comprometidos en la construcción de una sociedad mas justa, incluyente, participativa, democrática y solidaria.

  7. Procedimiento para el cierre de canteras de materiales para construcción en Cuba

    Directory of Open Access Journals (Sweden)

    Julio Montero-Matos

    2016-03-01

    Full Text Available Con el propósito de facilitar a los concesionarios de canteras de materiales para la construcción una herramienta metodológica para efectuar el cierre de estas y garantizar una minería sostenible se propuso un procedimiento en seis etapas a partir del diagnóstico realizado en 22 canteras, ubicadas en tres regiones mineras cubanas. El procedimiento busca disminuir los impactos ambientales provocados por la explotación de las canteras y ofrecer a la industria un estándar para lograr uniformidad en la planificación y ejecución del cierre con un costo mínimo.

  8. Construir-se para educar. Caminhos para a edocomunicação

    Directory of Open Access Journals (Sweden)

    Daniel Prieto Castillo

    2017-09-01

    Full Text Available Neste ensaio nos deteremos no significado de ‘construir-se’ no sentido comunicacional para educar a partir de minha experiência nos últimos 30 anos em propostas de capacitação docente para colegas universitários. Desde uma recorrente ideia de ‘formar’, recuperamos a memória de Simón Rodríguez para pensar o ‘construir-se’. Neste intento, vamos nos ocupar de dois conceitos desenvolvidos ao longo de meu trabalho das últimas décadas: a mediação pedagógica e o método do texto paralelo.

  9. La estrategia educativa 2020 o las limitaciones del Banco Mundial para promover el "aprendizaje para todos"

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    Antoni Verger

    2011-12-01

    Full Text Available LA NUEVA Estrategia Educativa 2020 del Banco Mundial establece las prioridades de reforma educativa en países en vías de desarrollo para la década siguiente. El título explícito de la estrategia, Aprendizaje para Todos, es un claro reconocimiento de que, más allá de políticas centradas en el acceso, se debe hacer algo más para asegurar que la educación derive en experiencias positivas de aprendizaje. Sin embargo, como este artículo sostiene, las opciones de políticas explícitas y latentes en la Estrategia 2020 no son las más adecuadas para lograr el Aprendizaje para Todos. El artículo desarrolla tres tipos de argumentos al respecto. El primero se refiere al fuerte apego del Banco a un conocimiento disciplinario y un enfoque metodológico que es insuficiente para entender lo que aprenden los niños en la escuela y por qué. El segundo argumento se refiere al sesgo pro-mercado de la Estrategia por lo que respecta a la reforma del sector público y a nuevas formas de oferta educativa. En tercer lugar, el artículo señala las principales ausencias de la Estrategia, con especial atención a las omisiones relacionadas con la compleja relación entre educación y pobreza.

  10. Flora da Paraíba, Brasil: Loganiaceae Flora of Paraíba, Brazil: Loganiaceae

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    Kiriaki Nurit

    2005-06-01

    Full Text Available Neste trabalho apresenta-se o tratamento taxonômico da família Loganiaceae, como parte do projeto "Flora da Paraíba", que vem sendo realizado com o objetivo de identificar e catalogar as espécies da flora local. Realizouse coletas e observações de campo para as identificações, descrições e ilustrações botânicas que foram efetuadas após estudos morfológicos, com o auxílio da bibliografia especializada, complementados pela análise de fotos de tipos, espécimes dos herbários EAN, JPB e IPA, e comparação com material identificado por especialistas. Registrou-se para a Paraíba quatro espécies: Spigelia anthelmia L., com ampla distribuição, e três espécies de Strychnos, somente coletadas em remanescentes de Mata Atlântica, S. atlantica Krukoff & Barneby, S. parvifolia A. DC. e S. trinervis (Vell. Mart.This work constitutes a taxonomic treatment of the Loganiaceae family as part of the project "Flora da Paraíba", which have been carried out with the objective to identify and catalogue the species of the local flora. The botanical identifications and illustrations were made by morphological studies supported by bibliography, analysis of the types, specimens from herbaria EAN, JPB and IPA, and comparison with samples previously identified by specialists, complemented by field observations. Four species of Loganiaceae belonging two genera were found in State of Paraíba: Spigelia anthelmia L. that has wide distribution and three species of Strychnos, found on remains of Atlantic forest, which are S. atlantica Krukoff & Barneby, S. parvifolia A. DC. and S. trinervis (Vell. Mart.

  11. Fatores de risco para nascimento de crianças pequenas para idade gestacional

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    Ana Maria Krusser Zambonato

    2004-02-01

    Full Text Available OBJETIVO: Determinar os fatores de risco para o nascimento de crianças pequenas para a idade gestacional. MÉTODOS: Nos meses de outubro a dezembro de 1996, cinco maternidades de Pelotas, RS, foram visitadas diariamente para entrevistar puérperas. O peso ao nascer foi obtido do registro dos berçários. A idade gestacional foi calculada a partir da data da última menstruação. Considerou-se como pequena para a idade gestacional (PIG aquelas crianças cujo peso ao nascer, de acordo com o sexo e a idade gestacional, estava abaixo do percentil 10 da população de referência de Williams. O teste qui-quadrado foi usado nas análises bivariadas e a regressão logística, não-condicional, na análise multivariada. RESULTADOS: Foram estudadas 1.082 puérperas e a prevalência de nascimento PIG foi de 13,1%. Mesmo após controle para possíveis fatores de confusão, as crianças cuja renda familiar era ³10 salários-mínimos. Um pré-natal de baixa qualidade também aumentou a chance de PIG (OR: 3,28 IC95% 1,09-9,91. Baixa estatura materna e exposição ao tabaco também estiveram associados com nascimentos PIG. CONCLUSÕES: O baixo nível socioeconômico, tabagismo materno, estatura materna e pré-natal de baixa qualidade foram os principais fatores de risco para PIG.

  12. Fatores de risco para nascimento de crianças pequenas para idade gestacional

    Directory of Open Access Journals (Sweden)

    Zambonato Ana Maria Krusser

    2004-01-01

    Full Text Available OBJETIVO: Determinar os fatores de risco para o nascimento de crianças pequenas para a idade gestacional. MÉTODOS: Nos meses de outubro a dezembro de 1996, cinco maternidades de Pelotas, RS, foram visitadas diariamente para entrevistar puérperas. O peso ao nascer foi obtido do registro dos berçários. A idade gestacional foi calculada a partir da data da última menstruação. Considerou-se como pequena para a idade gestacional (PIG aquelas crianças cujo peso ao nascer, de acordo com o sexo e a idade gestacional, estava abaixo do percentil 10 da população de referência de Williams. O teste qui-quadrado foi usado nas análises bivariadas e a regressão logística, não-condicional, na análise multivariada. RESULTADOS: Foram estudadas 1.082 puérperas e a prevalência de nascimento PIG foi de 13,1%. Mesmo após controle para possíveis fatores de confusão, as crianças cuja renda familiar era superscript three10 salários-mínimos. Um pré-natal de baixa qualidade também aumentou a chance de PIG (OR: 3,28 IC95% 1,09-9,91. Baixa estatura materna e exposição ao tabaco também estiveram associados com nascimentos PIG. CONCLUSÕES: O baixo nível socioeconômico, tabagismo materno, estatura materna e pré-natal de baixa qualidade foram os principais fatores de risco para PIG.

  13. Objeto de aprendizaje para la formación docente orientado a desarrollar competencias para usar recursos educativos abiertos

    OpenAIRE

    Lugo López, Ahabael; Lozano Martínez, Fernando Gustavo; Ramírez Montoya, María Soledad

    2014-01-01

    1. Introducción; 2. Referente teórico; 2.1 Competencias docentes; 2.2 Definición y características de los Recursos Educativos Abiertos; 2.3 Competencias para usar recursos educativos abiertos para la práctica educativa; 2.4 Objetos de aprendizaje abiertos; 3. Marco metodológico; 3.1 Descripción del objeto de aprendizaje para desarrollar competencias para usar recursos educativos abiertos para la práctica educativa; 3.2 Competencias didácticas del objeto; 3.3 Componentes tecnológicos del objet...

  14. Alternativas para tratamento cl??nico e nutricional para diab??ticas gestantes

    OpenAIRE

    Coelho, Narayane de Lima

    2011-01-01

    A presen??a de diabetes mellitus durante a gesta????o torna a gravidez de risco. Estima-se que em 2030 o n??mero de diab??ticos atingir?? 366 milh??es, acometendo 11,3 milh??es de brasileiros. O objetivo deste trabalho foi realizar uma revis??o sobre os tratamentos cl??nicos e nutricionais mais recentes para diab??ticas que se encontram gestantes. Foi realizada uma pesquisa bibliogr??fica utilizando as bases de dados SCIELO, PUBMED e LILACS para identificar artigos relevantes, publicados ent...

  15. Buscador de 'Gadgets' ROP para la construcción de 'payloads' para ARM.

    OpenAIRE

    VAÑÓ GARCÍA, FERNANDO

    2015-01-01

    [VAL] A partir de la aparici´on de la t´ecnica de protecci´on NX (Non eXecutable), la inyecci´on de c´odigo como m´etodo de ejecuci´on de payloads se vio seriamente limitada. Como consecuencia, los atacantes desarrollaron nuevas estrategias para explotar las vulnerabilidades de los procesos remotos. Una de las t´ecnicas m´as importantes es ROP (Return Oriented Programming), la cual permite “reorganizar” el c´odigo del propio proceso que est´a en ejecuci´on para ejecutar lo que ...

  16. Programa de educación para la salud para formar personas ileostomizadas expertas.

    OpenAIRE

    Álvarez Delgado, Cristina

    2017-01-01

    Las personas ileostomizadas sufren, en un breve período de tiempo, cambios físicos y biológicos, que les producen inseguridad, incertidumbre y bajo nivel de autoestima. Estos cambios influyen decisivamente en su calidad de vida, siendo fundamental una buena educación para la adaptación al estoma y lo que conlleva. Está demostrado que la educación grupal es beneficiosa para los pacientes, y que, cuando esta educación se hace de igual a igual (Programa de Paciente Experto), fomenta las conducta...

  17. Los riesgos de Internet. Consejos para su uso seguro. Habilidades necesarias para utilizar Internet

    OpenAIRE

    Marquès Graells, Pere

    2005-01-01

    Internet ofrece infinitas posibilidades, pero también conlleva riesgos para ciertos perfiles de personas. Estos riesgos están relacionados con la información, la comunicación interpersonal, las actividades económicas, el funcionamiento de Internet y las adiciones. Ante estos peligros potenciales, es conveniente adoptar medidas preventivas (decálogo de los derechos de la infancia en Internet, programas de sensibilización para promover el uso seguro y responsable de Internet, etc.) y además, pa...

  18. Software educativo para enfermería

    Directory of Open Access Journals (Sweden)

    Mac Gaul de Jorge, Marcia Ivonne

    2009-01-01

    Full Text Available El presente trabajo relata la experiencia de investigación del proyecto investigación del proyecto Nº 1531 del CIUNSa, "Software Educativo para Enfermería del Adulto". El equipo integra a enfermeras, quienes en el año 2003 elaboraron un material que responde a la realidad epidemiológica de nuestro país, marcadamente diferente a textos clásicos provenientes de otras regiones del mundo. Convencidos que las universidades deben dar respuestas a los problemas regionales, se están desarrollando materiales educativos que, aprovechan las ventajas que la Informática brinda (altamente interactivos y que pueden actualizarse permanentemente. Esta investigación está finalizando su etapa diagnóstica, la cual posee dos objetivos específicos para el desarrollo del producto software: uno tendiente a indagar las competencias de los alumnos de Ciencias de la Salud con relación al uso de materiales educativos informatizados; el otro, modelar el sistema informático del cual serán usuarios los alumnos y docentes, para lo cual se están realizando actividades de Ingeniería de Requerimientos que permitan establecer el contexto en el que se utilizará el software desarrollado. Creemos que el estudio diagnóstico culminado sitúa a nuestros alumnos en la misma sintonía de los desarrolladores. Sus expectativas por un recurso efectivamente didáctico coinciden con nuestras directrices de diseño.

  19. Robot Saltador y Procedimiento para su Control

    OpenAIRE

    Akinfiev, Teodor; Armada, Manuel; Fernández, Roemi; Montes, Héctor

    2005-01-01

    Robot saltador para el movimiento en terrenos con obstáculos, que contiene al menos un resorte (4) con uno de sus extremos unido al cuerpo (1) del robot, y una cadena cinemática entre el motor (5) y el resorte (4) que comprende un cilindro (7) conectado con el eje del motor (5) y una cuerda (8), con uno de sus extremos conectado al cilindro (7) y con el segundo extremo conectado al pie (3). El procedimiento de control se caracteriza porque en el momento en el que el pie (3) pierde el contacto...

  20. Plan de Marketing para Muebles Moncayo

    OpenAIRE

    Foyes Jiménez, Fermín

    2017-01-01

    Treball Final de Màster Interuniversitari en Màrqueting i Investigació de Mercats. Codi: SRB100. Curs: 2016/2017 El proyecto que se describe a continuación consiste en un Plan de Marketing para Muebles Moncayo, empresa de Barcelona dedicada a la comercialización al por menor de muebles de hogar. En la actualidad esta tiene una política de negocio clásica, ya que no tiene definidas las estrategias operativa y de negocio. Dada esta situación, se ha llevado a cabo un análisis de la situación,...

  1. Plan para control de Malaria en Colombia

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    Hernando Rey

    1943-02-01

    Full Text Available Con motivo de la colaboración de la Oficina de Relaciones Interamericanas en la solución de algunos problemas de Higiene pública en Colombia, el Secretario del Ministerio de Trabajo, Higiene y Previsión Social, doctor Alfonso Orozco, me pidió la elaboración de un breve plan para control de Paludismo en Colombia. El Plan fué presentado al Ministerio por una parte y por otra enviado al doctor Mark F. Boyd de la International Health Division de la Fundación Rockefeller.

  2. Una reforma constitucional para la periferia europea

    OpenAIRE

    Gerardo Pissarello

    2011-01-01

    La intempestiva reforma del artículo 135 de la Constitución española puede leerse como una expresión más de la erosión en Europa de los elementos garantistas del constitucionalismo de posguerra. Tanto por su contenido como por el procedimiento empleado para acometerla, su aprobación aparece reñida con principios constitucionales básicos, como el democrático, el del Estado social o el de la autonomía territorial. Asimismo, supone un golpe a la legitimidad global de la Constitución cuya reversi...

  3. Plan digital : estrategias digitales para negocios

    OpenAIRE

    Osorio Sánchez, Alejandra; Lozada Liñán, María Camila

    2016-01-01

    En el presente documento se desarrollará un Plan Digital de Medios con el cuál se pretende impulsar un producto que será lanzado al mercado por la empresa de Nairo Quintana, la cual construye y comercializa bicicleta y accesorios para toda la familia y todo tipo de terreno. El producto innovador que revolucionará la industria, será un casco, cuyo objetivo principal es proporcionar a su portador los más altos niveles de seguridad, diseño y calidad, generando al consumidor experiencias de uso g...

  4. Redes sociales para educomunicadores : recursos y experiencias

    OpenAIRE

    Universitat Autònoma de Barcelona. Máster en Comunicación y Educación (online)

    2013-01-01

    Las redes sociales han sido universalmente acogidas entre los usuarios de internet como una manera comprometerse en eventos, grupos sociales y temas de interés. Estos usuarios han encontrado en las redes un espacio para compartir información, socializar y, en muchos casos, construir verdaderas redes de cooperación y colaboración, un uso que puede ampliarse aún más en la medida en que madure la alfabetización mediática de sus participantes. Este informe muestra las principales redes sociales, ...

  5. Desarrollo de motores stirling para aplicaciones solares

    OpenAIRE

    García Menéndez, David

    2013-01-01

    Los sistemas de conversión termosolar basados en motores Stirling figuran entre las líneas de investigación actuales que pretenden contribuir al uso racional de la energía y al desarrollo sostenible. La presente Tesis Doctoral tiene como objetivo proporcionar criterios de análisis, diseño, fabricación y ensayo útiles para el desarrollo de motores Stirling alimentados con energía solar, a diferentes niveles de salto térmico. La metodología empleada está basada principalmente en técnicas...

  6. Los ritmos como terapia para la impulsividad

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    Mónica Triviño

    2012-10-01

    Full Text Available Investigaciones recientes muestran que el uso de patrones rítmicos facilita la respuesta óptima en el tiempo, por lo que el entrenamiento mediante ritmos podría proponerse como terapia novedosa ante problemas como la impulsividad. Esto podría beneficiar a pacientes con daño prefrontal o personas con trastorno por déficit de atención e hiperactividad (TDAH, que suelen mostrar conductas impulsivas, así como dificultad para estimar el paso del tiempo.

  7. 11 Verduras para Diversificar la Dieta Peruana

    OpenAIRE

    Ugas, Roberto; Loayza, Sara; Chang, Agusto

    2013-01-01

    Los peruanos debemos comer más verduras. Estos alimentos son fuentes esenciales de vitaminas, minerales, antioxidantes y fibra alimentaria y la ciencia muestra día a día su contribución a la prevención de enfermedades. Para tener un estilo de vida saludable es necesario comer diariamente cinco porciones de frutas y verduras y hacer ejercicio físico regularmente. Aquí presentamos una lista corta de once hortalizas de hoja, algunas son yuyos de uso tradicional en el campo peruano, otras son ver...

  8. Factorización para invidentes

    OpenAIRE

    Ramirez, Natalia; García, Carolina; Gutiérrez, Claudia

    2008-01-01

    Planteamos la utilización de la Áreas Mágicas, un material didáctico para la factorización de polinomios que consta de figuras geométricas (cuadrados y rectángulos) de ciertas dimensiones que, dispuestas de la forma correcta, proporcionan al educando la opción de deducir las expresiones utilizadas en los llamados “casos de factorización” sin recurrir a la memorización. Esto facilitaría un aprendizaje significativo de dicha temática sin caer en la rutina de solucionar un gran...

  9. Mobiliario en madera para viviendas sociales

    OpenAIRE

    Russo, Guido

    2017-01-01

    Desde el inicio del trabajo se buscó aplicar los conocimientos sobre las propiedades de la madera de sauce para otorgarle mayor valor, debido a que es un recurso desaprovechado. Además, se intentó responder a las necesidades de los habitantes de viviendas sociales. A partir de esto, se tomaron problemas de los mobiliarios, como el uso intensivo y el desgaste diario, y otros inconvenientes vinculados a la madera, como la tendencia a torcerse y su flexibilidad. Se proyectó una familia...

  10. Mobiliario en madera para viviendas sociales

    OpenAIRE

    Russo, Guido

    2017-01-01

    Desde el inicio del trabajo se buscó aplicar los conocimientos sobre las propiedades de la madera de sauce para otorgarle mayor valor, debido a que es un recurso desaprovechado. Además, se intentó responder a las necesidades de los habitantes de viviendas sociales. A partir de esto, se tomaron problemas de los mobiliarios, como el uso intensivo y el desgaste diario, y otros inconvenientes vinculados a la madera, como la tendencia a torcerse y su flexibilidad. Se proyectó una familia de mue...

  11. Manual de protocolo para empresas hoteleras

    OpenAIRE

    Román-del-Monte, Annabelle Valentina

    2011-01-01

    Este proyecto propone la implementación de un manual de protocolo para empresas hoteleras, especialmente aquellas que reciben clientes pertenecientes al turismo de negocios. Frente a la mayor competencia existente,y en el actual contexto de crisis, las empresas buscan hoy día diferenciarse de las demás a través de la calidad. Una herramienta útil es el “protocolo aplicado a la empresa”. El protocolo anteriormente se entendía como una regla estricta, estrechamente unida al ámbito diplomá...

  12. Manual de accesibilidad universal para hoteles

    OpenAIRE

    SOCYTEC; Paradores de Turismo de España, S.A.

    2007-01-01

    El Manual de Accesibilidad Universal para Hoteles, realizado conjuntamente por Paradores de Turismo de España y el Real Patronato sobre Discapacidad, se estructura tomando como base la secuencia común de movimientos de cualquier persona usuaria de un establecimiento hotelero: comenzando desde el acceso exterior –aparcamiento, entrada al edificio– y primer contacto –vestíbulo, recepción–, pasando por el resto de zonas comunes –salones, zonas de restauración, espac...

  13. ESPECIFICANDO FORMALMENTE TOPOLOGIAS PARA REDES EM CHIP

    OpenAIRE

    Santos, Eliselma Vieira dos; Ramos, Karla Darlene Nepomuceno

    2012-01-01

    Este artigo trata da utilização de métodos formais na especificação de topologias para redes em chip. As redes em chip apresentam similaridades com as redes tradicionais, entretanto, por estarem inseridas em sistemas embarcados apresentam características mais restritivas do ponto de vista de espaço, consumo de energia e latência. A topologia descreve o fluxo de dados através da rede e a estrutura física de como os dispositivos estão conectados, bem como, pode determinar o grau de escalabilid...

  14. Notas para los Colaboradores del Index Botanicorum

    Directory of Open Access Journals (Sweden)

    Verdoorn Frans

    1946-12-01

    Full Text Available EL INDEX BOTANICORUM: -Al discutir la necesidad de un diccionario biográfico de los botánicos del mundo y de todos los tiempos. JAMES BRITTEN (J. Bot. 39: 394. 1901 afirma: “Este formaría un compendio manual y útil no solamente de biografías botánicas sino de investigación botánica y sería de valor incalculable para el historiador y el estudiante” En el siguiente artículo se habla de las pautas que deben seguir los colaboradores del Index Botanicarum al escribir en dicho diccionario.

  15. Para no olvidar el comentario de texto.

    Directory of Open Access Journals (Sweden)

    Rúben López.

    2004-03-01

    Full Text Available ¿Qué es comentar?El Diccionario de la Real Academia Española enuncia que la noción de “comentario” tiene tres sentidos: 1 Escrito que sirve de explicación de una obra, para que se entienda más fácilmente. 2 Juicio, parecer, mención o consideración que se hace, oralmente o por escrito, acerca de una persona o cosa. 3 Título que se da a algunas historias escritas en estilo conciso.

  16. Educar para a literacia : perspectivas e desafios

    OpenAIRE

    Azevedo, Fernando José Fraga de

    2011-01-01

    Comunicação proferida na abertura do "VII Encontro de Educação : Numeracia e Literacia em Educação" Esta conferência aborda as principais perspectivas e desafios com que nos confrontamos quando abordamos o conceito de literacia. Assume-se que a aprendizagem da literacia é um direito da pessoa e que o conceito incorpora, no seu espectro semântico, processos de transformação social e política, muito para além da mera aprendizagem e domínio das técnicas de leitura e de escrita.

  17. Herramienta para la Deteccion de Retinoblastoma

    OpenAIRE

    Vargas-Cuentas , Natalia Indira; Roman-Gonzalez , Avid

    2015-01-01

    International audience; El retinoblastoma, es un tumor que se presenta en la retina de las personas, especialmente en los niños. Una detección temprana del mismo, podría ser muy útil y salvar la vida del niño. Es en ese sentido, que el presente trabajo propone una herramienta sencilla para la detección de retinoblastoma analizando fotografías tomadas con flash en las cuales, en el ojo del niño se puede detectar la presencia de leucoria. Esta detección se realiza utilizando las funciones de de...

  18. Razonamiento algebraico elemental: propuestas para el aula

    Directory of Open Access Journals (Sweden)

    Walter F. Castro G

    2014-09-01

    Full Text Available En este artículo se aborda el problema de la enseñanza de álgebra en la escuela primaria. Se discute lo que se entiende como “early álgebra” y se presentan varios enfoques sobre la introducción del álgebra en la escuela elemental. En correspondencia con los enfoques, se discuten tanto algunas tareas de razonamiento algebraico elemental que pueden ser implantadas en el aula, como algunas de las características algebraicas atribuidas. Finalmente, se presenta una propuesta para asignar niveles o grados de algebrización a algunas tareas.

  19. Convénceme para leer

    OpenAIRE

    Hernanz Vicente, Marina

    2014-01-01

    La animación a la lectura debe fomentarse desde los primeros años de vida del niño, en el ámbito familiar y promoverla en el ámbito escolar de forma sistematizada. En el ámbito educativo, que es el que compete a este trabajo, debemos tener en cuenta el progreso de los alumnos en la lectura y la importancia de una motivación adecuada. Es importante que los alumnos desarrollen un gusto por la lectura, un gusto que se verá reflejado en la cantidad de libros que lean y en su capacidad para com...

  20. Interfaz gráfica para Csound

    OpenAIRE

    Iniesta Serrano, Alberto

    2016-01-01

    Esta memoria documenta la creación de una interfaz gráfica para Csound. Csound es un programa que, mediante órdenes en formato texto compila módulos software que generan o modifican tramas de audio. Mediante el lenguaje Csound se puede crear casi cualquier generador o procesador de sonido imaginable. Esta potencia se evidencia en la vasta colección de instrumentos Csound presentes en Internet. Se ha creado una aplicación gráfica personalizable y atractiva que controla Csound mediante su AP...

  1. ¡CAPACITAR! ¿PARA QUÉ?

    OpenAIRE

    Domingo Tapia Avilés; Jannina Soto Calle

    2013-01-01

    Según el Diccionario de la Real Academia Española capacitar es “Hacer a alguien apto, habilitarlo para algo”, por tanto, lo que persigue el proyecto Influencia de la capacitación especializada en el rendimiento de los empleados de la Universidad Laica Vicente Rocafuerte de  Guayaquil, es brindar a los miembros del personal que labora en ella, y en otras instituciones y empresas, las aptitudes y habilidades que lo vuelvan competentes en el desempeño de sus funciones. Con este fin, se busca imp...

  2. Protocolo accesible para personas con discapacidad

    OpenAIRE

    Flujas, M. J.

    2006-01-01

    La mayor participación de las personas con discapacidad en la vida social exige adaptar el protocolo a sus necesidades específicas. Con ese fin, la Fundación ONCE ha publicado este libro que, lejos de presentarse como una guía de ‘protocolo diferenciado’ para personas con discapacidad, intenta orientar sobre las mejores maneras de que los actos públicos sean abiertos a toda la ciudadanía. La autora, que trabaja como responsable de protocolo en la ONCE, analiza las implicaciones espaciales, co...

  3. Nuevos retos para un museo nacional

    OpenAIRE

    Sanz, Carmen

    2007-01-01

    La larga historia del Museo Nacional de Ciencias Naturales hace que estas líneas se dediquen a la reflexión sobre su papel actual y las posibilidades futuras como institución museística y su clasificación como Museo Nacional. Conviene, pues, hacer un breve recordatorio de la definición de Museo, de las funciones que la legislación española le otorga, para ahondar en ese concepto de Nacional, que lo diferencia y destaca en el panorama de los Museos Estatales.

  4. Arquitectura empresarial para corresponsales no bancarios

    OpenAIRE

    Palacino Díaz, Alejandro; Rodríguez de Silvestre, Carlos Eduardo

    2011-01-01

    La arquitectura empresarial permite alinear el desarrollo tecnológico de una organización con su visión y estrategia. El presente trabajo de grado propone una solución tecnológica al procesamiento transaccional de CNB para entidades financieras en Colombia, mitigando riesgos de operación y reduciendo los limites impuestos por el manejo del efectivo en poblaciones remotas, enmarcada dentro de TOGAF como marco de referencia de arquitectura empresarial. El desarrollo de la arquitectura parte de ...

  5. ESTRATEGIA INTEGRAL PARA PyMES INNOVADORAS

    Directory of Open Access Journals (Sweden)

    Jairo Sanchez Quintero

    2003-07-01

    Full Text Available La administración y la planeación prospectivas, La planeación estratégica y la logística englobanlas necesidades de direccionamiento estratégico de las empresas a nivel mundial. Estos tres elementos  actúan como un trípode. Es decir, si falta uno de ellos no podrá haber estabilidad. La prospectiva aporta el análisis y construcción de escenarios futuros además del análisis de actores. La planeación estratégica (unida a la prospectiva permite el análisis de las variables internas y externas para formular los propósitos (misión, visión, objetivos y metas, las estrategias, los planes de acción y los indicadores de desempeño y logro, tanto para la empresa en su totalidad como para cada área de la misma en particular. Finalmente, la logística permite agregar valor e integrar los procesos transversales de la empresa, ya que se ocupa del mejoramiento de actividades desde la compra de materias primas o insumos hasta la distribución y el servicio al cliente en actividades de postventa. En este artículo, se presentan los hallazgos centrales de la investigación exploratoria sobre planeación prospectiva, estratégica y logística. Dicho estudio se concentra en una muestra de 29 empresas del sector de alimentos de Bogotá (19 empresas de lácteos y 10 de conservas y aplican una metodología de estudio de caso e Investigación y acción a cuatro empresas. El análisis de esta muestra empresarial y la revisión Bibliográfica realizada sentaron las bases para el diseño de la guía y la herramienta de mejora continua en estrategia, que forma parte de la caja de herramientas, fruto del trabajo del grupo PyMES, EAN durante el último año.

  6. Directrices para el tratamiento de úlcera venosa

    OpenAIRE

    Guimarães Barbosa, J.A.; Nogueira Campos, L.M.

    2010-01-01

    Se trata de la revisión de publicaciones sobre úlceras de etiología venosa. Considerando la alta incidencia y lo mucho que prevalecen las úlceras venosas, así como las interferencias que las mismas causan en la vida de los pacientes, y la variedad de conductas utilizadas para el tratamiento de las mismas, este estudio se propone actualizar las directrices sobre el tratamiento de las úlceras venosas. Los trabajos analizados demuestran que a pesar de los avances de las investigaciones, todavía ...

  7. PARA EVITAR LA CONTAMINACIÓN AMBIENTAL

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    F Pachón

    2005-01-01

    Full Text Available El presente artículo se enmarca dentro de la caracterización del sistema de producción bovina del municipio de Utica (Cundinamarca y dentro de los problemas más importantes que lo afectan. Como resultado, el estudio identificó la escasez de alimento de buena calidad en épocas secas como la principal limitante del productor bovino del municipio. Aprovechando una ventaja presente en la zona, como es la elaboración de panela (proceso a través del cual resultan algunos subproductos, como bagazo y melote, que pueden ser utilizados como alternativa alimenticia para los bovinos en cualquier época del año, se planteó un experimento en el que se elaboraron bloques multinutricionales con base en dichos subproductos. El experimento se adelantó en una finca de un productor y se utilizaron 57 novillos cebús con edades entre los 11 y los 24 meses y pesos entre los 124 y los 463 kilogramos. Los animales se dividieron dos grupos que se mantuvieron en pasturas no manejadas. Al grupo experimental se le ofrecieron adicionalmente bloques multinutricionales. Los animales fueron examinados para comprobar su estado fisiológico, con el fin de determinar posibles inconvenientes sanitarios que pudieran afectar el ensayo. Se realizaron pesajes para medir las ganancias de peso en los dos grupos. Los resultados mostraron promedios de ganancias diarias de peso similares a Pr < 5%, donde fueron ligeramente superiores las del grupo alimentado con los bloques multinutricionales (0,848 vs. 0,769 kg animal/día. Los aportes más importantes del experimento fueron, primero, brindar una opción para que el productor pueda alimentar a sus animales en épocas de escasez y evitar que tenga que venderlos a bajos precios. El segundo aporte fue abrir la posibilidad de usar los productos de la elaboración de la panela, que en muchas ocasiones se convierten en desechos que no son usados y que contaminan las fuentes de agua, de una forma económicamente viable.

  8. Misi Baby Spa - Un Mundo para Bebes

    OpenAIRE

    2012-01-01

    Misi Baby Spa es un lugar privilegiado concebido y diseñado especialmente para mamás, papás y bebés. Busca fortalecer el vínculo afectivo entre el núcleo familiar con herramientas como la lúdica, la música y el agua. Aliado con grandes marcas representativas del sector y encadenado a la marca Misi brindará un gran respaldo y garantía de servicio a sus clientes. Hombres y mujeres de clase media alta y alta interesados en el cuidado de y desarrollo de sus hijos, obtendrán en ...

  9. Finanzas Modernas para los Mercados Latinoamericanos

    OpenAIRE

    Hernández Ramírez, Manrique

    2013-01-01

    En este artículo se detalla la evolución de la teoría financieramoderna y se mencionan las universidades, mediosde publicación, autores y países que lideran este tipode investigación. También se lleva a cabo un examen de losprogramas de finanzas de las mejores escuelas de negociosa nivel mundial, para lograr establecer un panorama clarode los tópicos más relevantes. Por medio de la investigaciónbibliográfica se busca exponer el progreso que ha presentadoel campo de las finanzas a la luz de la...

  10. Rúbrica para co-autoevaluación

    OpenAIRE

    Gómez Bravo, Alfonso

    2016-01-01

    Rúbrica para la evaluación cooperativa (alumnos y profesor/a) de cualquier defensa acerca de un trabajo realizado cooperativamente sobre un tema o materia en particular. Departamento de Ciencias de los Materiales e Ingeniería Metalúrgica, Expresión Gráfica en la Ingeniería, Ingeniería Cartográfica, Geodesia y Fotogrametría, Ingeniería Mecánica e Ingeniería de los Procesos de Fabricación

  11. Actividades para ilustrar el pensamiento lateral

    OpenAIRE

    Torres, German

    2006-01-01

    La actividad matemática tiene por objeto ayudar a mejorar la forma de pensar, de pensar matemáticamente. El pensamiento tradicional permite refinar los modelos y comprobar su validez, pero para conseguir un uso óptimo de la nueva información hemos de crear nuevos modelos, escapando a la influencia monopolizadora de los ya existentes. La función del pensamiento lateral, complementario del pensamiento lógico (vertical), es la reestructuración de esos modelos y la creación de otros nuevos. La pr...

  12. Ciencia y conciencia para la Universidad

    OpenAIRE

    Galeano Prieto, Javier; García Villaluenga, Juan Pedro

    2012-01-01

    La sociedad actual a pesar de ser probablemente la más tecnificada de los últimos tiempos presenta muchas carencias en el conocimiento de nuestra historia científica, así como en la actitud crítica ante los avances y descubrimientos científicos. En este trabajo presentamos la asignatura Ciencia y Conciencia. Esta asignatura pretende crear una actitud crítica ante la ciencia, su historia y descubrimientos. Para ello, utilizamos TICs que son de acceso libre y que permiten que los estudiantes di...

  13. REISADO CARETA: brincadeira para louvar Santo Reis

    OpenAIRE

    PALOMA SÁ DE CASTRO CORNELIO

    2009-01-01

    Análise do folguedo Reisado Careta, com música, dança, canto e poesia; realizado por agricultores da região do Médio Itapecuru, sertão leste do Maranhão, especialmente na cidade de Caxias. O Reisado Careta é uma festa para louvar Santo Reis e acontece em forma de jornada que simboliza o caminho feito pelos Três Reis do Oriente desde a noite do dia 25 de dezembro, data do nascimento de Cristo Jesus até o dia 06 de janeiro, quando os Reis chegaram a Belém. As personagens represen...

  14. Plataforma web para el estudio de odontogramas

    OpenAIRE

    Portela García-Miguel, Santiago

    2013-01-01

    Memoria de TFC consistente en el diseño y prototipado de un portal web para facilitar a estudiantes de odontología la práctica de diagnóstico mediante odontogramas. Memòria de TFC consistent en el disseny i prototipat d'un portal web per facilitar a estudiants d'odontologia la pràctica de diagnòstic mitjançant odontogrames. Bachelor thesis for the Telecommunication technologies program on Telematics.

  15. Modelo alternativo para la sostenibilidad empresarial

    Directory of Open Access Journals (Sweden)

    Fausto O. Maussa Pérez

    2010-12-01

    Full Text Available Cerca de 11.000 empresas se liquidaron en todo el país durante los primeros cuatro años de la década de 1990. En este artículo se busca establecer, mediante un estudio cualitativo que emplea el método de caso, que existen alternativas para las empresas que salen de un proceso de liquidación o reestructuración: ese modelo sería la autogestión. Además, se describe un caso donde se muestran las principales características culturales, administrativas y de gestión que tienen las organizaciones autogestionadas. A partir del diagnóstico de los elementos esenciales de estas empresas, se caracterizaron varios casos de estudio: Cales y Derivados de La Sierra S.A. CALDESA; Laminados y Derivados, Layder (casos se presenta como ejemplo; Minera Las Brisas; Cooperativa Los Guaduales, en Antioquia; Artgrancol y Calzado La Corona, en Bogotá. La constitución de las empresas autogestionadas por los trabajadores representa una oportunidad para la conservación de unidades productivas, las cuales generan empleo y contribuyen a mejorar la calidad de vida de esos trabajadores y la de sus familias.

  16. FUNDAMENTOS COGNITIVOS PARA O ENSINO DA LEITURA

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    Lucilene Bender de Sousa

    2010-01-01

    Full Text Available Neste artigo, revisamos alguns fundamentos teóricos para o ensino da leitura baseados em recentes estudos das neurociências e ciências cognitivas. A leitura, enquanto processo cognitivo, deve ser compreendida em todos os seus níveis de processamento para que o ensino possa identificar e atender às necessidades do aluno. Primeiramente, abordamos o processamento da leitura do nível mais básico, a decodificação, ao nível mais avançado, a compreensão. Em seguida, exploramos funções cognitivas que não são exclusivas da leitura, a memória, a emoção e a aprendizagem. Por fim, propomos uma visão integrada desses processos, considerando a intrínseca relação entre língua, cognição e cultura, a qual permeia todas as nossas atividades, destacando o papel da cultura e da educação no desenvolvimento cognitivo.

  17. Sistema integral para viviendas unifamiliares -SIVIM-

    Directory of Open Access Journals (Sweden)

    Drágula, Josef

    1984-07-01

    Full Text Available The Integral System for Multi-family Housing —SIVIM— is a proposition combining a structural solution and a functional one. In the first, techniques developed in civil construction for reinforced concrete technology are incorporated in the production of buildings. The second one proposes a spatial solution appropriate to the users’ requirements. Thus, with this proposition, the aims of constructing mass, low-cost housing are maintained in countries with tropical climatesEl Sistema Integral para Viviendas Multifamiliares —SIVIM— es una proposición que combina una solución estructural y una solución funcional. En la primera, se incorporan técnicas desarrolladas en la construcción civil, para la tecnología del hormigón armado, a la producción de edificaciones. La segunda, propone una solución espacial apropiada a los requerimientos de los usuarios. Se mantiene así con esta proposición, las metas de la construcción masiva y del bajo costo de la vivienda en países de clima tropical

  18. Una matriz de contabilidad social para Asturias

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    Margarita Argüelles

    2003-01-01

    Full Text Available Una Matriz de Contabilidad Social es un sistema integrado de cuentas que presenta en un cuadro de doble entrada todas las transacciones que tienen lugar en una economía entre sectores productivos, factores de producción, sectores institucionales y resto del mundo. En comparación con una Tabla Input-Output, ofrece una mayor cantidad de información y presenta de forma plena el proceso circular de la renta, captando con mayor precisión los efectos de cambios exógenos. Una de las principales utilidades de una Matriz de Contabilidad Social es servir como base de datos para el desarrollo y aplicación de un modelo de equilibrio general computable. Este es, precisamente, el objetivo último que se persigue con la elaboración de la Matriz de Contabilidad Social de la economía asturiana que aquí se presenta. Esta Matriz ha sido construida con datos procedentes de las Cuentas Regionales de Asturias correspondientes al año 1995 y su estructura se ha adaptado a su futura utilización como base de datos para el modelo que se pretende aplicar en esta economía regional.

  19. Heidegger para a Bioética

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    Julio Cabrera

    2014-01-01

    Full Text Available Dentro del actual panorama de crisis global, se intenta poner en discusión la propuesta del filósofo Martin Heidegger, que puede modificar la formulación de una buena parte de las cuestiones bioéticas. El filósofo presenta una nueva noción de lo humano, no solo como “persona” o “agente racional”. Según el concepto del Dasein, la modernidad fue construida en torno a tres ideas: el sujeto como centro y fundamento, la ciencia como criterio único de verdad en el progreso y su consecuente tecnificación del mundo; habría que liberar un espacio para otro tipo de creación que no excluya la técnica, pero que tampoco la exalte hasta el punto de que lo demás desaparezca. Heidegger puede ser extremadamente instigante en cuanto a la distinción salud-enfermedad y problemas como la medicalización, en el intento de obtener una noción existencial de estos conceptos, superando su visión metafísica tradicional. La salud entonces deja de ser un acontecimiento objetivo para transformarse en un proyecto existencial.

  20. UMA NOVA PRIMAVERA PARA A IGREJA

    Directory of Open Access Journals (Sweden)

    Marcelo Barros

    2003-01-01

    Full Text Available Nos últimos anos, as Igrejas cristãs vivem um tempo especial de abertura espiritual e humana. Tudo começou por um profundo diálogo com a humanidade. No caso das Igrejas evangélicas e ortodoxas, reunidas no Conselho Mundial de Igrejas, a sua assembléia geral teve como tema “Faço novas todas as coisas” (Ap 21,5. No caso da Igreja Católica, como mandou o Concílio Vaticano II, ela tem procurado renovar “até costumes veneráveis e ancestrais” para adequar-se à humanidade de hoje. Todos, tanto as pessoas favoráveis a este processo, como as que não concordam, percebem a vitalidade espiritual e o empenho com que toda a Igreja, fieís e pastores, confronta sua vida com o Evangelho de Jesus Cristo e se empenha na missão de testemunhar não a si mesma, mas o Reino de Deus. Nos meios de comunicação, entre as pessoas que são para a humanidade referência de autoridade ética e promotores de solidariedade e da paz estão muitos bispos e pastores dos países pobres do mundo.

  1. Adolfo Celi, um olhar para dois mundos

    Directory of Open Access Journals (Sweden)

    Alessandra Vanucci

    2002-11-01

    Full Text Available O ensaio resgata a vivência brasileira de Adolfo Celi, ator e diretor italiano ativo em cinema e teatro (1922-1986, inserido no laboratório paulista da renovação, na década de 1950. Sua atuação impôs, no palco, o legado texto-cêntrico de Sílvio d'Amico e a utopia do ator plástico de Copeau e, na tela, a estética neo-realista associada a uma atuação fortemente marcada pelo ideário teatral moderno. As intuições, a herança, as oportunidades e as invenções perdidas desta experiência transcultural sugerem um quadro de realização somente parcial do projeto modernizador. Ao entrar na década de 60, é a sensação de ter esgotado um ciclo existencial que fornece a Celi um válido álibi para o retorno. Álibi (1969, seu terceiro e último filme como diretor, realizado na Itália com Gassmann e Lucignani, é um testemunho de vida e memórias, de raiva e de saudade do Brasil; e um precioso guia para entender sua extraordinária ‘aventura americana’.

  2. Yúmari / Tutuburi: danzar para no morir

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    Ángel Acuña Delgado

    2010-01-01

    Full Text Available Los rarámuri, habitantes de la sierra Tarahumara, al norte de México, tienen en su diversidad dancística una de sus más genuinas formas de expresión y comunicación, danza orientada tanto hacia el culto divino como hacia las relaciones humanas. Apoyado en los datos obtenidos durante los once meses de trabajo de campo entre 2001 y 2005 en varias comunidades rarámuris de la Alta y Baja Tarahumara, centraremos aquí la atención en el yúmari / tutuburi, ritual festivo a la vez que modalidad de danza desarrollada en su transcurso. Tras las referencias históricas iniciales, se describe a continuación el proceso festivo en general y la danza en particular identificada como yúmari / tutuburi; para situarnos finalmente en torno al sentido, tanto en un plano funcional como estructural. Con todo ello destacaremos la importancia que esta manifestación cultural posee para seguir siendo rarámuri dentro del contexto actual.

  3. EDUCACIÓN PARA EL CONSUMO

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    J. L. Castillejo

    2011-01-01

    Full Text Available El consumo es un fenómeno de gran peso en la vida actual de los países desarrollados y también de los que están en vías de desarrollo, sinónimo de felicidad y de estatus personal. Por todo ello el consumo merece ser objeto de la educación. En la educación para el consumo resulta clave la implicación familia- escuela, puesto que los padres marcan las primeras pautas en este terreno, junto al contexto social y los medios de comunicación. La educación para el consumo implica información, capacidad de análisis crítica de las situaciones y sensibilidad respecto a las consecuencias del consumo desmedido, que pone en peligro la supervivencia misma del planeta. El consumo se enfrenta así con la escala de valores que la educación debe defender.

  4. Tratamiento acortado estrictamente supervisado para tuberculosis pulmonar

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    Alvarez-Gordillo Guadalupe del Carmen

    1998-01-01

    Full Text Available Objetivo. Evaluar la posibilidad de aplicar el tratamiento acortado estrictamente supervisado (TAES en el Programa de Control de la Tuberculosis en Chiapas, México. Material y métodos. Se evaluó la eficacia y la eficiencia del tratamiento en una cohorte de pacientes con tuberculosis pulmonar confirmada por baciloscopía, que ingresaron a tratamiento con esquemas de autoadministración semisupervisión y estricta supervisión, de enero a junio de 1996. Resultados. La eficacia fue de 90.9. 97.7 y 100% para los esquemas de tratamiento autoadministrado, semisupervisado y TAES, respectivamente, mientras que la eficiencia fue de 68.1. 77.6 y 88.5% en el mismo orden. Conclusiones. Para la salud pública el TAES demostró ser la actividad más importante en el control de la tuberculosis, al elevar las tasas de curación y disminuir, por lo tanto, las fuentes de transmisión de la enfermedad.

  5. Un modelo SETAR para el PIB colombiano

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    Vivas Lorena

    2010-08-01

    Full Text Available En este artículo se estudia el comportamiento de la tasa de crecimiento del PIB colombiano entre 1982-2008 a partir de un modelo SETAR (Self-Exciting Threshold Autoregressive, empleando la metodología propuesta por Tsay (1989 y Tong (1990 para la detección de no linealidades relacionadas con la existencia de regímenes cambiantes. Adicionalmente, se comparan los pronósticos generados con los obtenidos en un modelo autorregresivo lineal para diferentes horizontes de predicción, empleando funciones de pérdida simétricas. Los resultados muestran evidencia empírica de que existe no linealidad de umbral en la serie asociada a las altas o bajas tasas de crecimiento registradas por su rezago anual (permaneciendo más tiempo en el régimen de tasas de crecimiento más elevadas y que el desempeño de los pronósticos del modelo SETAR parece no mejorar con respecto al modelo base.

  6. para el mejoramiento de sus propiedades

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    Kelly Gallego

    2006-01-01

    Full Text Available El polipropileno (PP presenta baja resistencia al impacto a bajas temperaturas y es muy sensible a la degradación térmica. De otro lado, el polietilentereftalato (PET es un polímero muy higroscópico. Uno de los caminos para superar estos inconvenientes consiste en mezclar ambos polímeros logrando su compatibilidad mediante la inserción de grupos funcionales polares en el PP. En la presente investigación se estudió el efecto de la inserción de anhídrido maleico en el PP reciclado para la obtención de una mezcla con PET reciclado. El grado de inserción se cuanti- ficó mediante el índice de carbonilo utilizando espectrofotometría infrarroja con transformadas de Fourier, FTIR. Las mezclas de PP injertado y no injertado con PET reciclado fueron preparadas por reometría de torque y su compatibilidad se analizó por microscopía electrónica, SEM y calorimetría diferencial de barrido, DSC. Se midieron también algunas propiedades de las mezclas como dureza y absorción de agua. Se concluyó que la mejor compatibilidad se presentó en las mezclas preparadas con PP injertado.

  7. importancia para la enseñanza

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    Concepción González Rodríguez

    2014-01-01

    Full Text Available En este trabajo se realiza una revisión histórica, de aquellos estudios/experiencias relacionados con los procesos de fotosíntesis y respiración que contribuyeron a la desestimación de la “teoría del humus” como modelo de nutrición vegetal. También se incluyen aquellos problemas que preocupaban a los investigadores en ese marco histórico. Se pondrá especial énfasis en la evolución de la formulación de “la fotosíntesis”, ya que en dicho conocimiento se localizó “la clave” que otorgó a los vegetales una importancia vital para la supervivencia de la vida en nuestro planeta. La evolución del conocimiento en ese campo, permitió pasar de un modelo de nutrición vegetal centrado únicamente en el nivel organismo, a la elaboración y aceptación del modelo actual que contempla la nutrición en tres niveles: organismo, celular y ecosistema. Finalmente se muestra la importancia que esta revisión histórica tiene para la enseñanza de este tema.

  8. para cemento pórtland I

    Directory of Open Access Journals (Sweden)

    OLGA ISABEL RESTREPO BAENA

    2007-01-01

    Full Text Available En esta investigación se usaron minerales de origen colombiano tal y como son producidos en sus respectivas minas. Se experimentó con la fluorita (Santander, el feldespato (Antioquia y el manganeso (Antioquia en cantidades del 0,0%, 0,2%, 0,5%, 1,0%, 1,5% y 2,0%. Se aplicaron varias técnicas como difracción de rayos X, fluorescencia de rayos x, microscopía electrónica de barrido y microscopía óptica para caracterizar los materiales utilizados y análisis térmico diferencial para determinar la temperatura de clinkerización y se evaluó mineralógicamente el clínker obtenido. Se encontró que el mejor resultado se logró con la adición de 0,5% de la fluorita al permitir la mayor formación de alita y la disminución en el contenido de cal libre. El feldespato y el manganeso (braunita utilizados no tuvieron un comportamiento apropiado.

  9. O preparo para o trabalho de risco

    Directory of Open Access Journals (Sweden)

    Yone Caldas Silva

    Full Text Available A autora focaliza a importância da preparação psicológica e profissional dos trabalhadores, para enfrentarem os riscos do trabalho, no cenário atual de mudanças nas organizações. Considerando a literatura científica internacional, apresenta dados de sua experiência pessoal. A partir do diagnóstico organizacional, sob a coordenação da Assessoria em Segurança, Saúde e Meio Ambiente, da Refinaria Duque de Caxias, (RJ , da qual era consultora, foi aplicada uma metodologia baseada na autonomia de ação de grupos de empregados, incluindo decisões na aplicação de recursos. Como resultados, são evidenciados a dinamização da estrutura organizacional, mudanças nas condições de trabalho, diminuição significativa nos índices e na gravidade dos acidentes, maior capacitação psicológica e profissional para o trabalho de equipe e o desenvolvimento de aptidão gerencial. Conclui, focalizando o importante papel das instituições vinculadas à segurança, saúde e meio-ambiente, indicando a necessidade de serem implementadas pesquisas de novas metodologias concernentes aos aspectos psicológicos do trabalho.

  10. Construyendo nuestra felicidad para ayudar a construirla

    Directory of Open Access Journals (Sweden)

    María Rosario Fernández Domínguez

    2009-01-01

    Full Text Available A lo largo de este trabajo se ofrece una visión de la felicidad y del bienestar como un proceso, como algo a construir a través de una dinámica de desarrollo y crecimiento personal que conduzca, a través del autoconocimiento, a ser más equilibrados, serenos y capaces de disfrutar de lo que hacemos y de lo que vivimos. Analizamos qué es para nosotros la felicidad, insistiendo en que ésta no consiste en tenerlo todo, o en no tener problemas ni dificultades, que, en definitiva, no reside en el exterior sino que está en nuestro interior, resaltando que es posible conquistarla. Situándonos en la perspectiva de la psicología humanista, la conectamos con la psicología positiva, cuyos orígenes se remontan a aquella, y hacemos una breve revisión del concepto de felicidad a través de diferentes autores, representantes de la psicología humanista. Finalmente, terminamos centrándonos en la perspectiva de Personalidad y Relaciones Humanas (PRH, muy cercana a la visión rogeriana. Para Personalidad y Relaciones Humanas la felicidad se puede ir conquistando poco a poco, estando muy ligada a un proceso de crecimiento interior que conduzca a la persona a ser cada vez más ella misma, desplegando todas sus potencialidades, a no vivir pendiente del éxito social o del parecer, a lograr tener el poder sobre su propia vida, sintiéndose cada vez más libre de las ataduras externas e internas; al sentido de la propia existencia, etc. Por ello, analizamos también en qué consiste crecer y qué es lo que favorece y dificulta este proceso de crecimiento interior. Situados en esta perspectiva, defendemos que la felicidad y el optimismo ante la vida es algo que no se adquiere porque sí, o sólo porque queremos. Requiere de un profundo y prolongado trabajo interior, para conocer nuestras potencialidades y límites y poder actualizarlas y ayudar a que crezcan en nuestra vida y relaciones. Pero, para crecer en libertad, alegría, optimismo, capacidad de amar

  11. Centro para reuniones, en Karpfenberg, Estiria (Austria

    Directory of Open Access Journals (Sweden)

    Windbrechtinger, W.

    1965-03-01

    Full Text Available The building bas two wings. One of them has two storeys, and a semibasement, and is used as offices. The other wing has a single floor level, and constitutes the Meeting Hall. On entering there is a kind of forecourt, and behind the meeting hall there is a further court, which on special occasions could also be utilized for large meetings. Amusement rooms for television and card and other games are provided in the semibasement: also a photographic laboratory, games stores, washing and boiler room. The ground floor contains the municipal library, a number of offices (an insurance company, the workers' chamber, and the association of nature's friends and rooms for the meetings of political organisations. On the second floor the syndicates have their offices, which include board room, a teaching room, three rooms for guests, the doorman's living quarters, and the necessary services. Finally, the meeting hall section involves a vestibule, the hall itself with accommodation for 300 people, a stage, cafeteria, kitchen, and other auxiliary facilities. The design of this building is rational and straightforward, and is pleasantly in keeping with the surrounding buildings and landscape.El edificio consta de dos alas: una, con dos plantas—destinadas a oficinas—y semisótano; y otra, de una sola planta, en la que está situada la sala de reuniones. Visto el conjunto desde la entrada, aparece una especie de patio delantero, dejando, detrás de la sala, un segundo patio, susceptible de ser utilizado en casos especiales, tales como grandes reuniones, etc. El semisótano agrupa las salas de esparcimiento—juego, televisión, trabajos para entretenimiento—, laboratorio fotográfico y cámara oscura, locales para guardar los utensilios de deporte, aseos, almacén y cuarto de la calefacción. La planta baja contiene la biblioteca municipal, varias oficinas— de una sociedad de seguros, de la cámara de trabajadores, de la asociación de amigos de la

  12. Estrategia para elevar la motivación laboral; factor imprescindible para mejorar nuestra productividad.

    Directory of Open Access Journals (Sweden)

    Reina de los Ángeles Carballé Piñón

    2015-12-01

    Full Text Available Este trabajo "Estrategia para elevar la motivación laboral; factor imprescindible para mejorar nuestra productividad" resulta de la investigación realizada para tesis de maestría; se realizó el estudio de 2 entidades, nos permitió conocer las principales posiciones que sobre motivación existen, factores que la influencian, cómo incide en el desempeño laboral y que acciones diseñar para elevarla. Las 2 entidades seleccionadas, claves en el desempeño empresarial son un centro de interfase y un centro generador de conocimientos, nuestro objetivo principal es sugerir propuestas que eleven la motivación de los trabajadores del CIGET(centro de interfase y la Universidad de Sancti Spíritus(centro generador de conocimientos por desempeñar una mejor labor y lograr así aumento de la eficacia, eficiencia y productividad; este se concreta específicamente en determinar qué factores ocasionan desmotivación en los trabajadores del CIGET y la Universidad, identificar aquellos factores que realmente motivan a estas personas, de manera individual como colectivamente y trazar una estrategia con el objetivo de elevar la motivación de los trabajadores hacia la actividad que realizan y dotar a estos de herramientas para la identificación de actitudes positivas o negativas en el ámbito laboral y cómo potenciarlas o minimizarlas según sea el caso.

  13. Generalized deformed para-Bose oscillator and nonlinear algebras

    International Nuclear Information System (INIS)

    Ha Huy Bang.

    1995-10-01

    Generalized deformed commutation relations for a single mode para-Bose oscillator and for a system of two para-Bose oscillators are constructed. It turns out that generalized deformed para-Bose oscillators are not, in general, exactly independent. Furthermore, we also discuss about the Fock space corresponding to generalized deformed para-Bose oscillators. Finally, we show how SU(2) and SU(1,1) generators can be constructed in terms of generalized deformed para-Bose creation and annihilation operators. The algebras SU(2) and SU(1,1) of generalized deformed oscillators are the special cases of generalized deformed para-Bose oscillators algebras but, interestingly, they have the same form. (author). 23 refs

  14. Puente mixto para ferrocarril y carretera

    Directory of Open Access Journals (Sweden)

    Harris, P. C.

    1963-10-01

    Full Text Available This new bridge, known as the West Branch, spans the course of a river, and has a double function and two superimposed decks. One of these carries the road, and the other lower one, the railway line. It has been constructed by the Dept. of Public Works of California. The structure consists of four main spans resting on reinforced concrete piles, of great height. Four rectangular holes run down their centres. The decks consist of a continuous metal framework, made up of heavy elements, some of them weighing up to 56 tons each, was assembled in the workshop in separate sections. These were then transported to the site, to be integrated within the whole structure. In the final assembly high tensile steel bolts were employed. As the piles are very high, they are of varying cross section, according to the height. The concreting was done by means of sliding formwork, and this was sufficiently wide to ensure that the concrete was at least four hours old when the formwork passed beyond its level. To carry out these operations an auxiliary tower was built up. which supported the framework carrying the concreting tub and its pouring mechanism. From this main tub the concrete was poured into others, which placed it into the various parts of the formwork. The operation of the concrete elevator, whose motive power was provided by of the plant at ground level, was controlled by telephone between the operator of the power plant and the person responsible for distributing the concrete on the top platform. To provide the finish of the surfaces left by the sliding formwork, another platform was installed, working at a level below the lower edge of the formwork, and a similar arrangement was adopted with respect to the inner formwork for the four hollows running inside the piles.El nuevo puente, llamado West Branch, que salva el profundo cauce de un río, tiene una doble finalidad y dos tableros superpuestos: uno para carretera en la parte superior y otro para una

  15. QRLabel y Blackbird: 2 aplicaciones accesibles para Android

    OpenAIRE

    Mercade Aguila, Gisela

    2012-01-01

    El objetivo de este proyecto es el de realizar dos aplicaciones para dispositivos móviles con sistema operativo Android. Estas aplicaciones están ideadas para ser usadas por una persona invidente o con deficiencias visuales. El transcurso del desarrollo de cada aplicacion sirve para conocer y experimentar con diferentes herramientas que dispone este sistema operativo, y de este modo estudiar sus ventajas y limitaciones. Se presentan dispositivos y prototipos de dispositivos diseñados exclusiv...

  16. Preparar para el futuro: el rol del educador

    Directory of Open Access Journals (Sweden)

    Myrna A. Cuevas Ruiz

    2000-12-01

    Full Text Available El artículo aborda el problema de la educación a la luz de las esperanzas y exigencias que se le plantean y de sus posibilidades reales para responder a los retos. En este marco, ubica la figura del educador, las cualidades que deben caracterizarlo para responder a las demandas de los retos educativos y los requerimientos que, en el contexto de la profesión docente, deben satisfacerse para impulsar los cambios.

  17. Plan de marketing para un vivero de planta ornamental

    OpenAIRE

    MARCH CUBERTORET, PAULA

    2017-01-01

    [ES] Se ha realizado un plan de marketing de un vivero de planta ornamental interior en Petrés (Valencia), así como un estudio de mercado para analizar las necesidades del consumidor y proponer mejorar el posicionamiento de la empresa para finalmente aumentar las ventas de sus productos. March Cubertoret, P. (2017). Plan de marketing para un vivero de planta ornamental. http://hdl.handle.net/10251/92819 TFGM

  18. Plan de marketing para la herramienta de inteligencia artificial Parlakuy

    OpenAIRE

    Farro Flores, César Augusto; Gonzales Gaspar, Juan Francisco

    2017-01-01

    Parlakuy es una empresa tecnológica en formación dedicada a utilizar herramientas de inteligencia artificial, específicamente machine learning, en las redes sociales. Tiene por objetivo ayudar a resolver las necesidades de las empresas y personas para que puedan entender a sus clientes en redes sociales, identificar temas importantes para su estudio y tomar acciones preventivas ante un suceso o acontecimiento en tiempo real. Para esto crea la herramienta Parlakuy, que tiene el mismo nombre...

  19. Salud global 2035: implicaciones para México

    Directory of Open Access Journals (Sweden)

    Naomi Beyeler

    2015-09-01

    Full Text Available En noviembre de 2014, la Secretaría de Salud de México fue sede de una mesa redonda con miembros de la Comisión de The Lancet para la Inversión en Salud (CIS para analizar el informe de esta misma comisión titulado Salud global 2035 y sus posibles implicaciones para el mejoramiento de la salud pública...

  20. Contabilidade ambiental o passaporte para a competitividade

    Directory of Open Access Journals (Sweden)

    Maria Elisabeth Pereira Kraemer

    2002-03-01

    Full Text Available Como todos os problemas ambientais provocaram grandes danos irreversíveis, que incidiram e incidem agora em todos os países subdesenvolvidos e desenvolvidos, nasce, então, como necessidade imperiosa, introduzir nos nossos sistemas econômicos a Contabilidade Ambiental, pois as organizações, até alguns anos atrás, preocupavam-se apenas com a eficiência dos sistemas produtivos. Chegamos a "era da revolução ambiental", e o ambiente não somente aparece como um conjunto de problemas relativos ao controle da contaminação, mas representa um custo no crescimento econômico. Neste sentido, o contador precisa de uma formação que se estenda além dos limites das técnicas e dos procedimentos. É necessário acrescentar o registro contábil do meio ambiente, dada a velocidade de sua afetação e a influência do mundo atual na utilização e disposição dos recursos naturais. Deve ser considerado como um dos princípios contábeis, onde é um desafio para a contabilidade. Precisa ser considerada como uma ciência contábil integrada, pois com a ciência ecológica e outras ciências são responsáveis pela natureza onde devem ser aplicados critérios de proteção ambiental, demonstrando que os recursos naturais constituem nosso principal capital. Partindo dessa premissa é que este trabalho está enfocando os seguintes tópicos: Responsabilidade Social da Empresa; A Empresa e o Meio Ambiente; Gestão Ambiental; Sistema de Gestão Ambiental; Ações para Preservar o Meio Ambiente - O Protocolo Verde, A Contabilidade, Custos Ambientais, Ativo Ambiental, Passivo Ambiental, Patrimônio Ambiental, Contabilidade Ambiental e Contabilidade Ambiental - o Passaporte para a Competitividade.

  1. Nave para Volkswagen en Ravenna, Italia

    Directory of Open Access Journals (Sweden)

    Epaminonda, Ceccarelli

    1965-09-01

    Full Text Available This factory hall is meant to house an exhibition, workshops, stores and offices of the Italian subsidiary of the Volkswagen firm. It is sited in an urbanized, but not yet built up, area. Its ground area is 54 by 38 m. Part of the frontage, about 36 m, is set back 8 m with respect to the remaining 18 m; the latter correspond to the part of the building occupied by the exhibition hall. As the ground is weak, it has been necessary to use piles to support the foundations. The structure is metallic, and the enclosing walls and roof consist of prefabricated panels and metals sheets. The roof contains a special chamber, where the air conditioning ducts and other services are housed. Great care has been taken over the colour patterns, both inside and outside. The type of structure and use of prefabricated panels has greatly lowered the overall cost of the building. All the foundation elements have been suitable waterproofed.Esta nave industrial está destinada a albergar los servicios de exposición, talleres, depósito y oficinas para la empresa concesionaria, en Italia, de la marca de automóviles Volkswagen. Se halla situada en una zona urbanizada, pero sin edificar, y tiene 54x38 m en planta. Parte de la fachada principal—unos 36 m—está retranqueada 8 m respecto de la alineación; los 18 m restantes corresponden al salón de exposiciones. Como el terreno es de escasa capacidad de sustentación, ha sido necesario el empleo de pilotes en los puntos de apoyo. La estructura resistente es metálica y se ha cerrado y cubierto con paneles prefabricados y placas metálicas. Los forjados de cubierta tienen una cámara que permite la colocación de conductos para el acondicionamiento. Se han cuidado mucho los colores para la estructura vista y paramentos interiores. La disposición de la estructura y el empleo de paneles prefabricados han permitido obtener costos muy favorables. Todas las partes de la infraestructura han sido debidamente

  2. FACTIBILIDAD PARA IMPLEMENTAR PLANTA PROCESADORA Y

    Directory of Open Access Journals (Sweden)

    Yesenia Johana Márquez Bravo

    2017-06-01

    Full Text Available Con el propósito de conocer la factibilidad de mercadeo, técnico, económico y financiero para implementar una planta procesadora y comercializadora de café en el marco administrativo de la Asociación 24 de Agosto; organización dedicada a la compra y venta de este grano, se desarrolló un estudio de mercado, mediante encuestas dirigidas a una muestra de la población económicamente activa de los cantones Portoviejo, Manta, Chone y 24 de mayo, pertenecientes a la provincia de Manabí; además, se realizó la observación in situ para identificar la competencia actual del café procesado, la disponibilidad de materia prima, la oferta y demanda, el proceso y la tecnología necesaria para la elaboración del café soluble, la eficiencia y capacidad técnico-financiera, y expectativas del consumidor. Con los datos obtenidos se determinó la inversión requerida, estimada en $307.871,75, la cual incluye el costo de infraestructura y capital de trabajo, financiado un 86,78% mediante préstamo y el 13,22% restante con capital propio, la planta tendrá 115 200 kilogramos en capacidad de procesamiento, tiempo de recuperación de la inversión estimado en 3 año con una tasa del 21,33%. En conclusión, los resultados del estudio técnico, económico y de mercado, donde se observa una tasa de consumo del 88%, con preferencia en la presentación soluble (96% y frecuencia de compra mensual del 68%, demuestran viabilidad de inversión en la planta procesadora de café; además de tener el potencial como fuente generadora de empleo, apoyo a la economía local, crecimiento agroindustrial y cambio de la matriz productiva.

  3. Perfil UML para el desarrollo de aplicaciones WAP

    OpenAIRE

    Soto, Ricardo; Cámara Joui, Mauricio

    2005-01-01

    UML (Unified Modeling Language) es el lenguaje de modelado más utilizado para especificar y documentar sistemas informáticos. Sin embargo, UML es un lenguaje de propósito general, por lo cual muchas veces prescinde de elementos para modelar y representar conceptos concretos de dominios más específicos. Como solución, OMG (Object Managament Group) creó los perfiles, un mecanismo proporcionado para extender la sintaxis y semántica de UML para poder expresar conceptos más específicos de determin...

  4. Caso para diagnóstico

    Directory of Open Access Journals (Sweden)

    Souza Fernanda H. M. de

    2006-01-01

    Full Text Available Pseudoxantoma elástico perfurante periumbilical é distúrbio adquirido do tecido elástico, que acomete mulheres multíparas. Apresenta-se um caso dessa condição em mulher de 74 anos (G10, P10 mostrando placa amarelada de aspecto reticular com áreas constituídas por pápulas eritêmato-ceratósicas. A histologia demonstra derme reticular com fibras conjuntivas basofílicas e irregulares, além de área de hiperplasia epidérmica, com eliminação de fibras elásticas através de canal repleto de ceratina.

  5. PARA UMA ÉTICA DA SUSTENTABILIDADE

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    Élio Estanislau Gasda

    2010-01-01

    Full Text Available Convocar a ética para o debate sobre a sustentabilidade significa integrá-la na reflexão sobre a forma de pensar e orientar nosso estar no mundo e dirigir a atenção aos fins. A dimensão ética é tão importante quanto os componentes técnicos e políticos de um ideal de sustentabilidade. Neste sentido, o ponto de vista da ética sofreu uma evolução teórica nas considerações e nos enfoques sobre o desenvolvimento humano, começando pela mudança que significou a passagem de uma ética da assistência a uma ética do desenvolvimento econômico.

  6. Accesibilidad digital para usuarios con limitaciones visuales

    Directory of Open Access Journals (Sweden)

    Toledo, Gabriela Alejandra

    2013-04-01

    Full Text Available El presente trabajo persigue como objetivos: recapitular y analizar los principios básicos de diseño para el desarrollo de tecnologías inclusivas; evaluar ventajas y desventajas en el uso del programa lector de pantalla (JAWS al acceder a entornos comunicacionales, desde las variables de navegabilidad, interoperabilidad, usabilidad y colaboración en la cognición; derivar sugerencias acerca del diseño de entornos de aprendizaje colaborativo, de modo de lograr una mayor efectividad de esta herramienta digital, aplicada a personas con limitaciones en la visión en diverso grado; redactar un manual complementario de orientaciones que facilite el uso de este instrumento inclusivo, aplicado a entornos de enseñanza/ aprendizaje colaborativo.

  7. Desafios para o crescimento e o emprego

    Directory of Open Access Journals (Sweden)

    CLEMENTE GANZ LÚCIO

    2015-12-01

    Full Text Available resumo A proposta deste texto é mostrar a mudança na dinâmica do mercado de trabalho brasileiro no primeiro semestre de 2015, com aumento do desemprego, informalidade, precarização das condições de trabalho e queda da renda, movimentos opostos aos observados na última década. Também indica políticas e medidas a serem tomadas visando reverter esse quadro, considerando a necessidade de articular uma trajetória de transição para o crescimento econômico, orientada pelo fortalecimento do mercado interno de consumo, pelo investimento e incremento e partilha da produtividade.

  8. Cuatro preguntas para iniciarse en cambio organizacional

    Directory of Open Access Journals (Sweden)

    Carlos A. Acosta R.

    2002-01-01

    Full Text Available El presente artículo llega a un concepto sobre el cambio organizacional a partir de las respuestas que ofrece a cuatro preguntas: ¿Qué es lo que cambia en las organizaciones?, ¿Por qué cambian las organizaciones?, ¿Cómo cambian las organizaciones? y -entonces- ¿Qué es el cambio organizacional? Para lograr el propósito se toma como objeto a las organizaciones empresariales y se centra en las dimensiones donde se localizan los cambios, explora lo que algunos autores dicen sobre el cambio, revisa varias propuestas sobre las razones que llevan al cambio en las organizaciones, expone las modalidades en que cambian las organizaciones y, finalmente, como inferencia de lo expuesto, concluye en un concepto de cambio organizacional

  9. La escuela inclusiva: una oportunidad para humanizarnos

    Directory of Open Access Journals (Sweden)

    Miguel López Melero

    2012-01-01

    Full Text Available En este artículo mis reflexiones las centro en el amor y la educación como fundamentos de la escuela inclusiva. Un amor sin adjetivos, basado en el respeto al otro como legítimo otro en la convivencia. Es un modo de vida que se inicia en la confianza desde la edad más temprana. Más aun, el amor es un acto de confianza. La confianza es el fundamento de nuestra convivencia. Los seres humanos nos enfermamos en un ambiente de desconfianza, manipulación e instrumentalización de las relaciones. La ausencia de amor nos deshumaniza. Vivimos en un mundo en el que se habla mucho del amor pero lo negamos, continuamente, en nuestros comportamientos y acciones. Vivimos inmersos en la cultura patriarcal. El amor, en dicha cultura, es considerado como un bien inalcanzable o, acaso, una ilusión o una esperanza. Sin embargo, debemos recuperar la vida matrística de la infancia, viviendo en el amor, amando. Es decir, respetando a las personas como legítimas personas en su diferencia, independientemente del hándicap, del género, de la etnia, religión o procedencia, en la convivencia. Sólo en el respeto y en el reconocimiento de las personas como personas radica el sentido de lo humano. Lo que constituye al ser humano como tal es la dimensión social y no lo genético. La genética es la condición inicial, es un punto de partida, no de llegada. Somos lo que somos gracias a las oportunidades que hemos tenido y no a los genes. Ahora bien, lo más humano del ser humano es desvivirse por otro ser humano y en este desvivir surge el valor ético de la educación. Por tanto, hablar de inclusión es hablar de justicia y, parece lógico, que para construir una sociedad justa sea necesario desarrollar modelos educativos equitativos que afronten con justicia los desequilibrios existentes en la misma. Para ello es imprescindible que los responsables de las políticas educativas, el profesorado y los investigadores contraigamos el compromiso moral de orientar el

  10. Fomento de responsabilidad procreativa para adolescentes

    Directory of Open Access Journals (Sweden)

    Vanegas de Ahogado Blanca Cecilia

    1995-12-01

    Full Text Available

    Se está desarrollando una línea de investigación-Docencia-Extensión que pretende, con medidas de promoción y prevención primaria, fomentar en los adolescentes un manejo responsable de su sexualidad, para contribuir en la disminución del embarazo indeseado y del aborto provocado. El trabajo se inició con un programa de atención individual y de pareja en una importante universidad colombiana; continuó con un programa de educación a grupos, utilizando técnica participativa con juegos de salón, diseñados por las investigadoras, y ha tenido aplicabilidad con estudiantes de nivel secundario, universitario, de postgrado y profesionales en educación continua. Ha sido apoyado por cuatro investigaciones.

  11. Recomendaciones para una lactancia materna exitosa

    OpenAIRE

    María Elena Ortega-Ramírez

    2015-01-01

    La lactancia materna es la única manera de proporcionar los nutrientes ideales para el adecuado crecimiento y desarrollo de los niños y las niñas. Es el único alimento que tiene una influencia biológica y emocional sobre la salud de la madre y su hijo. La lactancia materna protege a los lactantes de enfermedades gracias a sus propiedades antiinfecciosas, además de que es de más fácil digestión por la menor cantidad de caseína. No contiene betalactoglobulina, que es la proteína que más frecuen...

  12. Escuela para señoritas, Inglaterra

    Directory of Open Access Journals (Sweden)

    Stillman y Eastwlck-Field, Arquitectos

    1963-02-01

    Full Text Available The object was to design part of a new building which had been seriously damaged during the war, so that the old and new parts would blend into a pleasant whole, with a capacity for 600 girls. The new designs avoid the glass box style of school buildings, and glass walls have been adopted only on the ground floor, thus giving an impression of light and airiness to what used to be a partial basement. Classrooms have been designed in a simple manner, and give the impression of conventional rooms. Simple lines and materials have been chosen throughout. Strong contrasts in the external finish have been avoided, and colours provide a relaxing background to the intensive activities of the students. A constructional feature is the use of prefabricated concrete joists and supports. Outer walls consist of brick panels filling in the space between the visible concrete framework. Ceilings are of insulating boards, and the floors are covered with linoleum. Special attention has been devoted to the hall. In this case the roof is of white gypsum, and the only features are the grills covering the fluorescent lighting. The walls of this hall are of glass, and are covered with heavy velvet curtains. A balcony with hardwood posts adds a simple and friendly feature to the building. The furniture and drapery have been carefully chosen. Camden school has a rigid tradition of individualism and fine education, and the new building has succeeded in maintaining the exclusive quality of the older parts, as well as offering an overall impression of up to date construction.El problema consistía en proyectar un nuevo núcleo para un edificio que había sido seriamente bombardeado durante la guerra, de tal modo que las partes antiguas y nuevas formasen un conjunto agradable y con capacidad para más de 600 chicas. En la nueva construcción se ha evitado el carácter de «cajas de cristal» de las nuevas escuelas ordinarias y se han empleado muros de cristal solamente en la

  13. PARA UMA ÉTICA DA SUSTENTABILIDADE

    OpenAIRE

    Élio Estanislau Gasda

    2010-01-01

    Convocar a ética para o debate sobre a sustentabilidade significa integrá-la na reflexão sobre a forma de pensar e orientar nosso estar no mundo e dirigir a atenção aos fins. A dimensão ética é tão importante quanto os componentes técnicos e políticos de um ideal de sustentabilidade. Neste sentido, o ponto de vista da ética sofreu uma evolução teórica nas considerações e nos enfoques sobre o desenvolvimento humano, começando pela mudança que significou a passagem de uma ética da assistência a...

  14. Garaje para la Universidad de California

    Directory of Open Access Journals (Sweden)

    Lin, T. Y.

    1964-06-01

    Full Text Available California University has constructed a two storey garage, with a prestressed concrete structure, at Berkeley. A particular feature of this building is that on the roof a soil layer, 0.45 cm in depth, has been laid, on which there is a grass lawn. The structure consists of a framework of beams, of 7.30 m span, in one direction, and 19 m in the other: this being the maximum separation of the columns in one elevation. Consequently the flooring is made of slabs spanning the shorter 7.30 m distance. The roof slab has been prestressed in two mutually perpendicular directions, hence it is practically impossible for it to develop cracks. This arrangement renders the slab watertight and implies a saving in the cost of applying waterproofing treatment. As the building is surrounded on three sides by three contention walls, advantage has been taken of this to transmit to these the horizontal thrusts due to windage and seismic forces. Most of the structural elements, excepting the flooring, have been prestressed and prefabricated at a workshop 80 Km. away from the site. Many of the constructional units have additional reinforcement, which can be post-tensioned after erection at the working site.La Universidad de California ha construido un garaje, de dos plantas, de hormigón pretensado, en Berkeley, que presenta la particularidad de utilizar la parte superior de su cubierta para colocar sobre ella una capa de tierra, de 0,45 metros de espesor, coronada por un manto de césped. La estructura resistente está constituida por un reticulado de vigas formando crujías de 7,30 m de luz y apoyos espaciados a 19 m. Por tanto, las losas que forman los forjados salvan una, luz de 7,30 m, mientras que las vigas forman pórticos de 19 m de luz máxima. La losa de cubierta se ha pretensado en dos direcciones normales entre sí y, como consecuencia de ello, al hallarse debidamente comprimida en el sentido de estas dos direcciones es prácticamente imposible la

  15. NOTAS PARA UMA ECLESIOLOGIA LATINO AMERICANA

    Directory of Open Access Journals (Sweden)

    Jesus Hortal

    1977-01-01

    Full Text Available Como o próprio título que me foi dado sugere, não se trata de algo perfeitamente elaborado, mas de uma série de notas, de pontos que querem provocar uma reflexão ulterior. Por isso, supõem os conceitos eclesiológicos fundamentais e deveriam incentivar a continuidade do pensamento eclesiológico no nosso meio. Por isso também, não me preocupei com a acumulação de bibliografia. Do que se trata não é de repetir o que os outros disseram, mas de abrir pistas para passar além do que já está dito. Daí que o meu pensamento fique, quase por completo, no plano metodológico.

  16. Lógicas para la red

    Directory of Open Access Journals (Sweden)

    Antonia HUERTAS

    2009-09-01

    Full Text Available RESUMEN: Tim Berners-Lee y sus colegas del World Wide Web Consortium (W3C llamaron «Semantic Web» al que sería el siguiente estadio de desarrollo de la red (inevitablemente traducido al castellano como Web Semántica. La idea detrás de esta evolución de la red es extender con metadatos y reglas lógicas la red basada en el lenguaje html, con el objetivo de que la infraestructura resultante permita a las máquinas entender los datos de la red de la misma forma que los entendemos los humanos. Así, añadir lógica a la red permitiría a los ordenadores tomar decisiones, hacer inferencias y responder preguntas. En este texto se pretende revisar las lógicas que han sido propuestas para permitir esta nueva web inteligente y repasar las cuestiones teóricas y pragmáticas más importantes de la corta pero intensa historia de las lógicas para la red.ABSTRACT: Tim Berners-Lee and their colleagues of the World Wide Web Consortium (W3C called «Semantic Web» the next development of the Web. The idea behind this evolution of the Web is to extend the present network based on the HTML language with metadata and logical rules, with the aim of the resulting infrastructure allowing machines to understand Web data in the same way that human beings understand them. Thus, adding logic to the Web would allow the computers to take decisions, to do inferences and to answer questions. In this paper it is intended to revise the logics that have been suggested to allow this new intelligent Web and to revise the most important theoretical and pragmatic questions of the short but intense history of logics for the Web.

  17. Para qué sirve una sociología de amor (y para qué no sirve)

    OpenAIRE

    Unás Camelo, Viviam Stella

    2013-01-01

    Estudiar el amor desde la disciplina sociológica sirve para muchas cosas. Alguien que conozco sugirió que sirve no tanto para evitar que te dejen como sí para entender por qué te dejaron. Creo firmemente en ello. Creo también que para nuestro grupo de investigación sociologizar el amor ha supuesto una batalla feroz contra el sentido común. Es esto esperable considerando que sobre el amor, ese desenfrenado, todos y todas parecemos tener algo que decir y algo que defender. Y e...

  18. Algunas consideraciones para la reconstrucción del concepto de contabilidad para el presente siglo

    Directory of Open Access Journals (Sweden)

    Claudia Lucía Niño Galeano

    2003-06-01

    Full Text Available En este artículo se hace una reflexión sobre la posición de la contabilidad en el contexto actual, rescatando de manera general su evolución como disciplina y su transformación permanente. A partir de diversas definiciones sobre contabilidad se intenta resaltar los elementos que la determinan como disciplina y sus contenidos, los cuales deben responder o vincularse aún más con la realidad económica actual, caracterizada por la globalización y el impacto de los mercados financieros internacionales. En este contexto, la contabilidad debe ser flexible, tener la capacidad para responder en forma rápida a los cambios del entorno económico y tener las cualidades necesarias para informar objetivamente a los interesados.

  19. Secadores solares - térmicos para granos y frutas para utilizarlo en zonas remotas

    OpenAIRE

    Delgado, E.; Peralta, J.; Barriga, A.

    2009-01-01

    Los objetivos principales de esta investigación son: • Dar a conocer la ventaja que tiene el uso de la utilización de la energía solar térmica para sistemas de secadores solares en la disminución de la humedad de los producto. • Valorar la importancia de la conservación energética y ambiental a través del uso de energía limpia. • Dar a conocer diseños de sistema de secado solar para alimentos, principalmente granos y frutas acorde a las características del producto, geográficas, técnicas y so...

  20. Technological properties of kaolin from Para; Propriedades tecnologicas do caulin do Para

    Energy Technology Data Exchange (ETDEWEB)

    Hildebrando, E.; Martin-Cortes, G.R.; Esper, F.J.; Wiebeck, H.; Alves Junior, P.; Valenzuela-Diaz, F.R., E-mail: germac@usp.br [Universidade de Sao Paulo (PMT/EP/USP), Sao Paulo, SP (Brazil). Escola Politecnica. Departamento de Engenharia Metalurgica e de Materiais

    2011-07-01

    The NE of the State of Para, is notable for its large reserves of kaolin for paper. Kaolin is a mineral composed of hydrated aluminum silicates such as kaolinite and halloysite. The exploitation of these reserves to generate products with higher commercial value, especially in the industries of adsorbents and catalysts, is what motivates the continuous study of technological properties of the Amazon kaolin's. Thus, this paper presents a technological characterization of a sample of kaolin from Para State by X-ray diffraction, SEM - scanning electron microscopy and infrared spectroscopy. The results of preliminary tests indicate that the sample consists for the most part by kaolinite present in low concentrations of quartz and anatase. (author)