Cerebrospinal fluid fistula after endoscopic transsphenoidal surgery: experience in a spanish center.

Background: Postoperative cerebrospinal fluid (CSF) fistula is the most serious complication after transsphenoidal surgery.

Objective: To analyze the incidence of CSF fistula after endoscopic transsphenoidal surgery for tumor removal in sellar region; to discuss associated factors and methods used for sellar closure.

Method: Retrospective study of 67 patients (73 surgeries) operated via transsphenoidal endoscopy at Hospital Vall D'Hebron and Hospital Clinic of the Universidad de Barcelona, Spain.

Early graft patency after off-pump and on-pump coronary bypass surgery: a prospective randomized study.

Aims: Uncertainty persists regarding the impact of the off-pump technique on coronary bypass graft patency. The primary objective of this study was to assess coronary artery bypass graft patency in patients randomized to off-pump and on-pump multivessel coronary artery bypass grafting (CABG). Secondary objectives were clinical outcomes and neuropsychological functioning.

NMDA channels together with L-type calcium currents and calcium-activated nonspecific cationic currents are sufficient to generate windup in WDR neurons.

Windup is characterized as a frequency-dependent increase in the number of evoked action potentials in dorsal horn neurons in response to electrical stimulation of afferent C-fibers. This phenomenon was first described in the mid-60s, but the core mechanisms behind it still remain elusive. Several factors affecting its dynamics have been identified, but the distinction between modulating mechanisms from generating mechanisms is not always clear.

Labeling index in pituitary adenomas evaluated by means of MIB-1: is there a prognostic role? A critical review.

Objective: The present article presents an overview of the literature, and analyses the methods and the primary questions related to assessment of proliferation index using the Ki-67/MIB-1 labeling index in pituitary adenomas. Although atypical adenomas are characterized by their atypical morphological features by an elevated mitotic index, a Ki-67 (MIB-1) labeling index greater than 3% and extensive nuclear staining for p53, use of the proliferation index (LI) of pituitary adenomas in assessing the degree of tumor aggressiveness is a controversial topic in the literature, and there are disparate results involving many studies.

Methods: A review of literature was carried out to correlate the role of Ki-67 LI and its correlation with clinical findings, tumor size, invasiveness, recurrence, adenoma subtype, adenoma doubling time, and pituitary carcinomas is addressed.

Slow magic-angle coil spinning: a high-sensitivity and high-resolution NMR strategy for microscopic biological specimens.

High-resolution magic-angle spinning has become a valuable tool to study biologic samples; however, there are only a few high-resolution magic-angle spinning methodologies that have been explored specifically to deal with small semisolid biomaterials such as tissues. Here, we report a novel high-resolution (1)H NMR spectroscopic approach using magic-angle coil spinning. We demonstrate its potential for intact tissues by combining a resonant microcoil with a large-volume commercial magic-angle spinning rotor, where the microcoil offers incredible sensitivity and the large-volume magic-angle spinning rotor provides stable slow magic-angle spinning.

Evaluation of patients with Clinically Unclear Parkinsonian Syndromes submitted to brain SPECT imaging using the technetium-99m labeled tracer TRODAT-1.

Despite its relatively high prevalence Parkinson's Disease (PD) is still misdiagnosed in approximately 25% of cases. In this study our aim was to evaluate patients with Clinically Unclear Parkinsonian Syndromes (CUPS) submitted to brain SPECT imaging using the technetium-99m labeled Dopamine Transporter (DAT) tracer TRODAT-1. We recruited 15 subjects with CUPS and matched them with 13 patients with probable PD and 13 healthy control subjects (HCS).

Degenerative parkinsonism in patients with psychogenic parkinsonism: A dopamine transporter imaging study.

Objectives: To evaluate patients with "clinically established" psychogenic parkinsonism (PsyP) using single-photon emission computer tomography (SPECT) with the technetium-99m labeled tracer TRODAT-1, a dopamine transporter (DAT) ligand, and investigate whether these patients have an underlying degenerative parkinsonism.

Patients And Methods: Five patients with PsyP were assessed using demographic data, standard clinical scales for Parkinson's Disease (PD), and a neuropsychiatric interview. DAT imaging using SPECT with TRODAT-1 was performed, and values for caudate/putamen DAT binding potentials (BP) registered.

PINK1 polymorphism IVS1-7 A-->G, exposure to environmental risk factors and anticipation of disease onset in Brazilian patients with early-onset Parkinson's Disease.

Parkinson's disease (PD) etiology has been attributed both to genetic and environmental factors, although the exact mechanisms of its pathogenesis remains elusive. We investigated Brazilian early-onset PD (EOPD) patients with PINK1 polymorphisms (SNPs) in order to find possible correlations between SNPs, environmental exposure, and disease age of onset. We enrolled 48 patients and 61 controls.

Prevalence of serotypes and antimicrobial resistance of invasive strains of pneumococcus in children: analysis of 9 years.

Objective: To determine the prevalence of serotypes and antimicrobial susceptibility of strains of pneumococcus in children and to evaluate the implications for vaccine formulation.

Methods: Strains of pneumococcus obtained from children admitted with invasive diseases were isolated at Hospital de Clínicas of Universidade Federal de Uberlândia, Uberlândia, Brazil, and sent to Instituto Adolfo Lutz, São Paulo, Brazil, for further identification, serotyping, and determination of antimicrobial susceptibility.

Results: From April 1999 to December 2008, 142 strains of pneumococcus, obtained from children under 5 years of age, were analyzed.

Neurological congenital malformations in a tertiary hospital in south Brazil.

Background: Congenital anomalies are one of the main causes of morbidity and mortality among infants. The involvement of the central nervous system (CNS) occurs in 21% of cases.

Objective: To identify incidence of CNS malformations and associated factors in newborns at a Terciary Hospital of Porto Alegre.

New susceptibility breakpoints in antimicrobial resistance rates of invasive pneumococcal strains.

Objective: To evaluate the impact of new penicillin susceptibility breakpoints on resistance rates of pneumococcal strains collected from children with pneumonia.

Methods: Pneumococcal strains collected from patients admitted with pneumonia were isolated at the clinical analysis lab of Hospital de Clínicas de Uberlândia, Uberlândia, Brazil, and sent to Instituto Adolfo Lutz, São Paulo, Brazil, for further identification, serotyping and determination of antimicrobial susceptibility.

Results: From April 1999 to December 2008, 330 strains of pneumococcus were sent to Instituto Adolfo Lutz; of these, 195 (59%) were collected from patients with pneumonia.

Intracranial and spinal ependymoma: series at Faculdade de Medicina, Universidade de São Paulo.

Objective: Ependymomas are rare intracranial neuroepithelial tumors and the most common location is intramedullary. The aim was to analyze the characteristics of these tumors to determine the patients' overall survival and the likelihood of recurrence.

Method: Data of clinical presentation, tumor location, duration of symptoms, degree of resection and complementary treatment of 34 patients with intracranial ependymoma and 31 with intramedullary ependymoma who underwent surgery in the last ten years were collected and correlated with the recurrence time and overall survival.

[Jefferson scale of physician lifelong learning: translation and adaptation for the portuguese medical population].

The competence and professionalism of doctors depend on the process of Lifelong Learning (LLL). In the Portuguese settings, in which the re-certification of physicians' skills or knowledge is currently not required, the exercise of LLL is left to personal motivation and initiative. The importance of LLL has been highlighted in numerous international recommendations and has already led, in the United States, to the development and validation of a scale for measuring physician LLL - the Jefferson Scale of Physician Life Long Learning (JSPLL).

Developing communication skills in pharmacy: a systematic review of the use of simulated patient methods.

Objective: To review the literature relating to the use of simulated patient methods to enhance communication skills of pharmacists.

Methodology: We searched Embase, Lilacs, Medline, Scielo, and Scopus databases between 1980 and 2008, using "communication skills", "patient counseling" and "pharmacist" as keywords. This search was then further refined by using "simulated patients", "pseudo-customer", "standardized patients", and "mystery shoppers" as additional keywords.

Natural abundance 13C and 15N solid-state NMR analysis of paramagnetic transition-metal cyanide coordination polymers.

The (13)C and (15)N MAS NMR spectra of a series of well-characterized paramagnetic metal cyanide coordination polymers are acquired at natural abundance, without the need for polarization transfer methods such as cross-polarization or INEPT. For systems where the paramagnetic centre is outside of the cyanide framework, well-resolved (13)C and (15)N spectra of cyanide ligands are obtained. Chemical shifts deviate from typical diamagnetic cyanide ranges and depend only partly on the cyanide coordination type, being dominated by their proximity to the paramagnetic center.

Simulation of endoscopic third ventriculostomy in fresh cadaveric specimens.

Objective: The purpose of this research is to describe and analyze the endoscopic anatomy of cerebral ventricles, especially of the lateral ventricle and third ventricle.

Methods: 47 brains of adult human cadavers were studied at the Death Check Unit (DCU) of São Paulo. Age, sex, day and approximate time of death, day and time of study, cause of death, outcome of puncture and number of attempts were recorded.

Germanium-73 NMR of amorphous and crystalline GeO(2).

Ultrahigh-field (73)Ge NMR spectra and DFT calculations of GeO(2) phases reveal distinct parameters for four- and six-coordinate Ge, illustrating the viability of solid-state (73)Ge NMR for structural studies.

Retrocollis, anterocollis or head tremor may predict the spreading of dystonic movements in primary cervical dystonia.

Background And Purpose: Few studies have attempted to develop clinical predictors for cervical dystonia (CD) aiming at progression of the dystonic movement.

Method: We retrospectively evaluated 73 patients with primary CD who underwent treatment with Botulinum toxin type-A (BTX-A). The patients were assembled in two groups according to the spread of dystonia during follow-up: spreading and non-spreading CD.

Olfactory groove meningiomas: approaches and complications.

Olfactory groove meningiomas (OGM) account for 4.5% of all intracranial meningiomas. We report 21 patients with OGMs.

Evaluation of Onyx HD-500 embolic system in the treatment of 84 wide-neck intracranial aneurysms.

Objective: We report our results using Onyx HD-500 (Micro Therapeutics, Inc., Irvine, CA) in the endovascular treatment of wide-neck intracranial aneurysms, which have a high rate of incomplete occlusion and recanalization with platinum coils.

Methods: Sixty-nine patients with 84 aneurysms were treated.

Neuroleptic-induced tardive cervical dystonia: clinical series of 20 patients.

Background: Cervical dystonia (CD) may be classified according to the underlying cause into primary or secondary CD. Previous exposure to neuroleptics is one of the main causes of adult-onset secondary dystonia. There are few reports that characterize the clinical features of primary CD and secondary neuroleptic-induced CD.

Clinical and molecular neuroimaging characteristics of Brazilian patients with Parkinson's disease and mutations in PARK2 or PARK8 genes.

Objective: To describe clinical and neuroimaging (SPECT) characteristics of Brazilian patients with Parkinson's disease (PD) and mutations in PARK2 or PARK8 genes.

Method: A total of 119 patients meeting clinical criteria for PD were evaluated.

Results: Of all patients studied, 13 had mutations in either PARK2 (n=9) or PARK8 genes (n=4).