Leukemia Cutis As the Initial Manifestation of Chronic Lymphocytic Leukemia Progression.

Chronic lymphocytic leukemia (CLL) is a malignant proliferation of monoclonal mature B-cells in peripheral blood. Leukemia cells can commonly spread from the blood to other sites such as the lymph nodes, liver, and spleen. However, contrary to T-cell lymphomas that can involve the skin, CLL metastasis to the skin is unusual and is rarely the first manifestation of systemic disease.

Neuronavigated Ultrasound in Neuro-Oncology: A True Real-Time Intraoperative Image.

Objective: Ultrasound is considered a real-time imaging method in neuro-oncology because of its highly rapid image acquisition time. However, to our knowledge, there are no studies that analyze the additional surgical time that it requires.

Methods: A prospective study of 100 patients who underwent intra-axial brain tumor resection with navigated intraoperative ultrasound.

Middle Cranial Fossa Approach: Anatomical Study on Skull Base Triangles as a Landmark for a Safe Anterior Petrosectomy.

 The Kawase approach provides access to the petroclival and posterior cavernous sinus regions, cerebellopontine angle, and upper basilar artery territory. Nevertheless, it remains one of the most challenging approach for neurosurgeons, due to the considerable related morbidity and mortality. The goal of this study was to evaluate the relationship between anatomical landmarks and their possible variations, and to measure the extension of the Kawase space, to define the reliability of these landmarks while performing an anterior petrosectomy.

Artery of Percheron and Endoscopic Endonasal Surgery: Case Report and Review of the Literature.

Artery of Percheron (AOP) is a rare anatomical variant in which a single perforating artery arising from the P1 segment of the posterior cerebral artery supplies paramedian thalami and rostral midbrain. The occlusion of AOP produces bilateral thalamic ischemia and may be a rare complication in relation to an extended endoscopic endonasal approach. We report the case of a patient who developed AOP damage during endoscopic endonasal surgery (EES); to our knowledge, this complication has been previously reported only in one case, in relation to a second surgery.

Intraoperative Use and Benefits of Tractography in Awake Surgery Patients.

Objective: The present study analyzed the benefits of the use of tractography in the preoperative and intraoperative scenarios.

Methods: We present a prospective cohort study with 2 groups of patients who had undergone awake surgery for brain tumor resection. A control group for which no intraoperative navigated diffusion tensor imaging (DTI) was used (non-DTI group) and the case group (DTI group).

Labor analgesia: a comparative study between combined spinal-epidural anesthesia versus continuous epidural anesthesia.

Background And Objectives: Pain relief during labor is a permanent concern, aiming at the maternal well being, decreasing the stress secondary to pain, and reducing its consequences on the fetus. Several analgesia techniques can be used during labor. The aim of this study was to compare continuous and combined epidural analgesia, both of them using 0.

[Racemic 0.25% bupivacaine and 50% enantiomeric excess (S75-R25) 0.25% bupivacaine associated to fentanyl for labor analgesia with patients ambulation. Comparative study.].

Background And Objectives: Clinical studies with levogyrous enantiomers of local anesthetics have shown better safety due to lower cardiotoxicity. Parturients ambulation during labor may be able to shorten it. This study aimed at comparing anesthetic quality and maternal and fetal repercussions, as well as patients ambulation and spontaneous micturition ability with continuous epidural racemic or 50% enantiomeric excess (S75-R25) 0.

[Comparative study between 0.5% bupivacaine, 0.5% enantiomeric mixture of bupivacaine (S75-R25) and 0.75% ropivacaine, all associated to fentanyl, for epidural cesarean section anesthesia.].

Background And Objectives: Clinical trials with local anesthetic levo-enantiomers have shown higher safety due to lower cardiotoxicity. This study aimed at evaluating quality of anesthesia and maternal/fetal repercussions of 0.5% bupivacaine, enantiomeric 0.

[Evaluation of maternal acid-base status after different doses of spinal sufentanil for cesarean section and its effects on the neonates.].

Background And Objectives: Spinal sufentanil in obstetric anesthesia promotes immediate pain relief, improves anesthesia quality and prolongs postoperative analgesia, its major side effect being respiratory depression. This study aimed at evaluating maternal acid-base status after different doses of spinal sufentanil associated to hyperbaric bupivacaine for cesarean section, and its effects on neonates' vitality.

Methods: Participated in this study 40 full term pregnant women, physical status I (ASA), aged 17 to 35 years, who were submitted to elective cesarean section under spinal anesthesia.