Stroke Due to Orthognathic Surgery: Case Report of a Rare Complication.

Le Fort I osteotomy is a frequent surgical procedure used in orthognathic surgeries to treat severe malocclusions and is associated with relatively rare surgical complications. Here, the authors report a case of thrombotic ischemic stroke as a result of this procedure, a complication still not described in the literature. A 19-year-old man with class II malocclusion and retrognathia underwent orthognathic surgery for aesthetic purposes.

Transgender people in the nursing discourse: An integrative review.

Objective: To integrate and analyse the literature produced by nurses in terms of care, education and understanding of the reality of transgender (trans) people.

Design: An integrative review methodology guided by the framework proposed by Whittemore and Knafl.

Data Sources: The search strategy was applied in the following databases: Medline, Embase, Scopus, Web of Science and CINAHL, as well as in Biblioteca Virtual de Saúde, during February and March 2021, with no time frame.

Skull osteology of the holotype of the rhynchosaur Hyperodapedon sanjuanensis (Sill, 1970) from the Upper Triassic Ischigualasto Formation of Argentina.

Rhynchosaurs are bulky quadrupedal herbivores that achieved a cosmopolitan distribution during the Middle and Late Triassic. Rhynchosaurids are characterized by a pair of premaxillae modified into an edentulous beak that had a bone-to-bone occlusion with the tips of the dentaries, and a specialized masticatory apparatus composed of groove(s) on the maxilla and ridges(s) on the dentary. The Argentinian fossil record of rhynchosaurs is abundant, but only two nominal species have been named so far.

Enigmatic dinosaur precursors bridge the gap to the origin of Pterosauria.

Pterosaurs were the first vertebrates to evolve powered flight and comprised one of the main evolutionary radiations in terrestrial ecosystems of the Mesozoic era (approximately 252-66 million years ago), but their origin has remained an unresolved enigma in palaeontology since the nineteenth century. These flying reptiles have been hypothesized to be the close relatives of a wide variety of reptilian clades, including dinosaur relatives, and there is still a major morphological gap between those forms and the oldest, unambiguous pterosaurs from the Upper Triassic series. Here, using recent discoveries of well-preserved cranial remains, microcomputed tomography scans of fragile skull bones (jaws, skull roofs and braincases) and reliably associated postcrania, we demonstrate that lagerpetids-a group of cursorial, non-volant dinosaur precursors-are the sister group of pterosaurs, sharing numerous synapomorphies across the entire skeleton.

Alterations in Regional Homogeneity in Patients With Unilateral Chronic Tinnitus.

Chronic subjective tinnitus is a widespread disorder. This perceptual anomaly is assumed to result from a dysbalance of excitatory and inhibitory mechanisms on different levels of the auditory pathways. However, the brain areas involved are still under discussion.

Interspinous process devices for treatment of degenerative lumbar spine stenosis: A systematic review and meta-analysis.

Background: Degenerative lumbar spinal stenosis is a condition related to aging in which structural changes cause narrowing of the central canal and intervertebral foramen. It is currently the leading cause for spinal surgery in patients over 65 years. Interspinous process devices (IPDs) were introduced as a less invasive surgical alternative, but questions regarding safety, efficacy, and cost-effectiveness are still unanswered.

Evolution of gamma knife capsulotomy for intractable obsessive-compulsive disorder.

For more than half a century, stereotactic neurosurgical procedures have been available to treat patients with severe, debilitating symptoms of obsessive-compulsive disorder (OCD) that have proven refractory to extensive, appropriate pharmacological, and psychological treatment. Although reliable predictors of outcome remain elusive, the establishment of narrower selection criteria for neurosurgical candidacy, together with a better understanding of the functional neuroanatomy implicated in OCD, has resulted in improved clinical efficacy for an array of ablative and non-ablative intervention techniques targeting the cingulum, internal capsule, and other limbic regions. It was against this backdrop that gamma knife capsulotomy (GKC) for OCD was developed.

Endoscopic endonasal management of cerebrospinal fluid rhinorrhea after anterior clinoidectomy for aneurysm surgery: changing the paradigm of complication management.

Resection of the anterior clinoid process results in the creation of the clinoid space, an important surgical step in the exposure and clipping of clinoidal and supraclinoidal internal carotid artery aneurysms. Cerebrospinal fluid rhinorrhea is an undesired and potentially serious complication. Conservative measures may be unsuccesful, and there is no consensus on the most appropriate surgical treatment.

Visuospatial Memory Improvement after Gamma Ventral Capsulotomy in Treatment Refractory Obsessive-Compulsive Disorder Patients.

Gamma ventral capsulotomy (GVC) radiosurgery is intended to minimize side effects while maintaining the efficacy of traditional thermocoagulation techniques for the treatment of refractory obsessive-compulsive disorder (OCD). Neuropsychological outcomes are not clear based on previous studies and, therefore, we investigated the effects of GVC on cognitive and motor performance. A double-blind, randomized controlled trial (RCT) was conducted with 16 refractory OCD patients allocated to active treatment (n=8) and sham (n=8) groups.

Gamma ventral capsulotomy for obsessive-compulsive disorder: a randomized clinical trial.

Importance: Select cases of intractable obsessive-compulsive disorder (OCD) have undergone neurosurgical ablation for more than half a century. However, to our knowledge, there have been no randomized clinical trials of such procedures for the treatment of any psychiatric disorder.

Objective: To determine the efficacy and safety of a radiosurgery (gamma ventral capsulotomy [GVC]) for intractable OCD.

Radiofrequency denervation for facet joint low back pain: a systematic review.

Study Design: A systematic review and meta-analysis of randomized controlled trials.

Objective: To assess treatment effects (benefits and harms) of radiofrequency denervation for patients with facet joint-related chronic low back pain.

Summary Of Background Data: There is no consensus regarding the treatment efficacy of facet joint radiofrequency denervation (FJRD) and how it compares with nerve blockades and joint infiltration with anesthetics and/or corticosteroids.

Hoarding symptoms and prediction of poor response to limbic system surgery for treatment-refractory obsessive-compulsive disorder.

Unlabelled: OBJECT.: Recent findings have suggested a correlation between obsessive-compulsive disorder (OCD) symptom dimensions and clinical outcome after limbic system surgery for treatment-refractory patients. Based on previous evidence that the hoarding dimension is associated with worse outcome in conventional treatments, and may have a neural substrate distinct from OCD, the authors examined a large sample of patients undergoing limbic surgery (40 with capsulotomy, 37 with cingulotomy) and investigated if symptom dimensions, in particular hoarding, could influence treatment outcome.

Limbic system surgery for treatment-refractory obsessive-compulsive disorder: a prospective long-term follow-up of 64 patients.

Object: Obsessive-compulsive disorder (OCD) is a common and disabling psychiatric illness, and in a significant proportion of patients with OCD the disease is refractory to conventional pharmacotherapy and psychotherapy. For more than half a century, patients with severe, treatment-resistant OCD have been treated with stereotactic limbic system lesions, including dorsal anterior cingulotomy. The authors present their results describing the efficacy and durability of limbic system surgery for OCD, characterizing a large cohort of patients treated at a single institution with a mean follow-up of more than 5 years.

Anemia in chronic renal disease: evaluation of inflammatory activity on erythropoiesis and iron metabolism in patients not submitted to dialysis treatment.

Background: Inflammatory activity is one of the factors involved in the physiopathology of anemia in patients with chronic kidney disease (CKD). The majority of studies on anemia, inflammation, and disturbances of iron metabolism have focused on patients in end-stage renal failure and dialysis therapy. However, anemia and inflammation are present in patients in previous stages of renal failure.

Minimally invasive computer-assisted stereotactic fenestration of an aqueductal cyst: case report.

Introduction: Current advances in frame modeling and computer software allow stereotactic procedures to be performed with great accuracy and minimal risk of neural tissue or vascular injury.

Case Report: In this report we associate a previously described minimally invasive stereotactic technique with state-of-the-art 3D computer guidance technology to successfully treat a 55-year-old patient with an arachnoidal cyst obstructing the aqueduct of Sylvius. We provide detailed technical information and discuss how this technique deals with previous limitations for stereotactic manipulation of the aqueductal region.

Treatment of resistant obsessive-compulsive disorder with ventral capsular/ventral striatal gamma capsulotomy: a pilot prospective study.

A subgroup of obsessive-compulsive disorder (OCD) patients remains refractory to conventional treatments. For them, a new stereotactic radiosurgery has been recently developed: the ventral capsular/ventral striatal (VC/VS) gamma capsulotomy. The authors aim to report efficacy and adverse events of VC/VS gamma capsulotomy.

[Role of brain single photon emission computed tomography in the diagnosis of distinct forms of presentation of Hashimoto's encephalopathy].

We present the clinical features of five cases of Hashimoto's encephalopathy, all of which showed heterogeneous presentation and normal results on morphological tests except for cerebral single photon emission computed tomography (SPECT), which was decisive in the diagnosis. In addition, we present changes in brain SPECT images and their connection with the clinical and immunological parameters in the patient with the longest-standing Hashimoto's disease that we have seen.

Physiological responses to brain stimulation during limbic surgery: further evidence of anterior cingulate modulation of autonomic arousal.

Background: In view of conflicting neuroimaging results regarding autonomic-specific activity within the anterior cingulate cortex (ACC), we investigated autonomic responses to direct brain stimulation during stereotactic limbic surgery.

Methods: Skin conductance activity and accelerative heart rate responses to multi-voltage stimulation of the ACC (n = 7) and paralimbic subcaudate (n = 5) regions were recorded during bilateral anterior cingulotomy and bilateral subcaudate tractotomy (in patients that had previously received an adequate lesion in the ACC), respectively.

Results: Stimulations in both groups were accompanied by increased autonomic arousal.

Comparative epidemiology of stroke and acute myocardial infarction: the Dijon Vascular project (Diva).

Background: Despite a common pathophysiological mechanism (ie, atherosclerosis) and similar vascular risk factors, few reliable studies have compared the epidemiology of stroke and acute myocardial infarction (AMI).

Methods: All first ever cases of stroke and AMI in Dijon, France (151 846 inhabitants) from 2001 to 2006 were prospectively recorded. The 30 day case fatality rates (CFRs) and vascular risk factors were assessed in both groups.