Optimal trajectory of the neuroendoscope for third ventricle pavement access.

Background And Aim: Endoscopic Third Ventriculostomy (ETV) is used to treat hydrocephalus, an abnormal cerebrospinal fluid accumulation in brain ventricles. By defining a new trajectory and entry point interval, we aim to establish a standardized approach for FreeHand ETV, a vital technique when specialized tools are unavailable, or during emergencies.

Methods: 187 MRIs were analyzed, with 30 having hydrocephalus.

Lateral rectus pulley concerning the orbital wall. Area of a stereotyped bony insertion.

Purpose: To examine the lateral rectus muscle pulley and its bony insertion concerning the orbital rim and periorbita.

Design: Prospective. An observational anatomic study.

Stereotactic anatomy of the third ventricle.

Purpose: Endoscopic third ventriculostomy (ETV) is a surgical procedure that can lead to complications and requires detailed preoperative planning. This study aimed to provide a more accurate understanding of the anatomy of the third ventricle and the location of important structures to improve the safety and success of ETV.

Methods: We measured the stereotactic coordinates of six points of interest relative to a predefined stereotactic reference point in 23 cadaver brain hemi-sections, 200 normal brain magnetic resonance imaging (MRI) scans, and 24 hydrocephalic brain MRI scans.

What to expect from primary inferior oblique overaction after esotropia surgery : Primary inferior oblique overaction in esotropia.

Background: Overelevation in adduction is common in patients with primary esotropia. This study evaluates the variation in ocular motility pattern in patients with primary inferior oblique (IO) muscle overaction after esotropia surgery.

Methods: The medical records of consecutive patients who underwent surgery for infantile, partially accommodative, and basic esotropia over eleven years and had at least one year of follow-up were reviewed.

Superior Gluteal Nerve Anatomy and Its Injuries: Aiming for a More Secure Surgical Approach of the Pelvic Region.

Because most of the recognized causes of superior gluteal nerve (SGN) injury are iatrogenic, detailed knowledge of the anatomy of the SGN is crucial to prevent its injury associated with surgical procedures. This study aims to describe the precise location of SGN or its branches at the greater sciatic foramen, measure the distances of these neural structures to palpable bony landmarks, and evaluate the possible correlation between these parameters and pelvis size. Twenty human cadaveric hemipelvises were studied.

Automated macular segmentation can distinguish glaucomatous from compressive optic neuropathy.

Purpose: To compare macular damage in glaucomatous optic neuropathy (GON) and compressive optic neuropathy (CON) and assess its diagnostic accuracy in distinguishing between diseases.

Methods: Observational, cross-sectional, single-center study. Patients with GON, CON, and healthy controls were included according to the eligibility criteria.

Venous malformations: what do phleboliths tell us in the pediatric population?

Purpose: Phleboliths are often observed within Venous malformations (VM) and frequently indicated as cause of morbidity. The aim of this study is to investigate independent risk factors for phleboliths in a pediatric population and to determine if its presence influences clinical management.

Methods: We retrospectively review data from patients diagnosed with VM in a vascular anomalies center during a 5-year period.

Medical Photography Usage Amongst Doctors at a Portuguese Hospital.

Technological advancements in smartphones have made it possible to create high-quality medical photographs, with the potential to revolutionise patient care. To ensure the security of the patient’s data, it is important that medical professionals receive informed consent from the patient, that physical conditions are met to take a photograph, and that these medical images are stored correctly. This study aimed to determine if medical professionals of an academic hospital make use of medical photography, and how the content is obtained, stored, transferred, and used.

Keratoconus enlargement as a predictor of keratoconus progression.

Numerous approaches have been designated to document progression in keratoconus, nevertheless there is no consistent or clear definition of ectasia progression. In this present study, we aim to evaluate Keratoconus Enlargement (KCE) as a parameter to document ectasia progression. We define KCE as an increase of more than 1D in the anterior curvature of non-apical corneal areas.

Neurosurgical anatomy of the floor of the third ventricle and related vascular structures.

Purpose: Anatomical knowledge of the floor of the third ventricle (FTV) is essential in avoiding surgical complications during endoscopic third ventriculostomy. The purpose of this study was to characterize the morphometry of FTV and related arteries, particularly the basilar artery (BA), as well as the factors that influence it.

Methods: Twenty-six formalin-fixed adult brains and two hundred adult brain MRIs were studied focusing on FTV and related arteries.

The Role of Atopy in the Choroidal Profile of Keratoconus Patients.

Purpose: Although classically classified as a non-inflammatory condition, an inflammatory basis for keratoconus (KC) appears to be a growing evidence. Recently, it has been shown that KC patients have an increased choroidal thickness (CT). Among inflammatory disorders, atopy has been associated with KC development; therefore, the aim of this study was to evaluate if the increased CT in patients with KC is related to atopy.

Increased choroidal thickness is not a disease progression marker in keratoconus.

The recent findings of increased Choroidal Thickness (CT) in Keratoconus (KC) patients raised the question of whether CT could be an indicator of progressive KC. To test this hypothesis, we evaluated and compared the choroidal profile in progressive and non-progressive KC. We ran a cross-sectional observational study in 76 patients diagnosed with KC, age 14-30, to assess KC progression.

Prelaminated Supraclavicular Island Flap for Total Ear Reconstruction: A New Technique.

Major ear reconstruction has progressed over the past years with the emergence of new techniques directed mainly to patients without available or usable local skin. However, microsurgical transfer requires specific training and eligible patients. The authors report a successful ear reconstruction with a prelaminated supraclavicular island flap in 3 stages, which may be a valuable resource for selected patients or when microsurgery is not available.

Endovascular Approach Versus Aortobifemoral Bypass Grafting: Outcomes in Extensive Aortoiliac Occlusive Disease.

Objective: Compare technical, clinical, and economic outcomes between endovascular and open approaches in patients with type D aortoiliac occlusive disease according to the TransAtlantic Inter-Society Consensus.

Methods: Patients undergoing revascularization for type D aortoiliac lesions, either endovascular or open surgery approach, from 2 Portuguese institutions between January 2011 and October 2017 were included. The surgical technique was left to the surgeon discretion.

Regulation of murine arthritis by systemic, spinal, and intra-articular adrenoceptors.

Background: The regulation of the immune system by the sympathetic nervous system is allowing the design of novel treatments for inflammatory disorders such as arthritis. In this study, we have analyzed the effects of α- and β-adrenoceptor agonists injected subcutaneously, intrathecally, or intra-articularly in zymosan-induced arthritis.

Methods: Murine arthritis was induced by intra-articular (knee joint) injection of zymosan.

Neurosurgical anatomy of the insular cortex.

Objective: The purpose of this study was to clarify the morphology of the insular cortex focusing not only on the shape of the insula, but also on sulcal and gyral organization.

Patients And Methods: Sixty formalin-fixed adult brain hemispheres had their insula exposed and photographed. The dimensions of each gyrus and sulcus were measured using an image analysis software.

Supraclavicular flap as a salvage procedure in reconstruction of head and neck complex defects.

The supraclavicular island flap (SCIF) is an interesting therapeutic option in head and neck reconstruction. Since popularized by Pallua in the late 90s, several clinical series have been published showing its versatility and usefulness. However, only a few studies have focused on factors associated with complications from SCIF use.

[Referral and coordination of healthcare from primary care to angiology and vascular surgery - a center's experience].

Introduction: Minimally invasive revascularization of the left anterior descending coronary artery has gained popularity. Recently, the emergence of new surgical instruments and the improvement of the technique, allowed its use by routine. Its use in Heart Team allows excellent results.

Morphology and Navigational Landmarks of the Cranio-orbital Foramen in a Portuguese Population.

Purpose: The cranio-orbital and accessory foramina are located in the lateral wall of the orbit and adjacent to the superior orbital fissure. In the literature, there is a lack of consistency concerning the location and morphology of these foramina in different populations. Therefore, considering its clinical importance during orbital surgeries, it was the authors' aim to determine the incidence, location, and number of cranio-orbital and accessory foramina in a Portuguese population and compare the findings with data from other studies.

Doctors' career choices in health systems constrained by national medical exams: A discrete choice experiment.

Previous studies that addressed factors influencing junior doctors' career decisions have failed to consider that the market for medical specialty is regulated and doctors are not always able to pursue their career of choice. There is the concern that the National Medical Exam that doctors have to take in many countries conditions their career choices and is behind the low efficacy of policies for retaining doctors in rural areas. In this paper, we use data from a Discrete Choice Experiment applied to a large sample of Portuguese junior doctors (N = 503) who had already taken their Medical Exam but had not chosen their medical specialty yet.

Migration intentions among Portuguese junior doctors: Results from a survey.

Migration of health personnel during periods of economic crisis represents a challenge for policymakers in origin and destination countries. Portugal is going through a period of economic hardship and much has been speculated about an increase in junior doctors' migration during this period. Using a questionnaire administered to a sample of Portuguese junior doctors who were still in the general residency (1st-year after medical school), we aim at determining the prevalence of migration intentions among Portuguese junior doctors and to identify the most important drivers of career choice for those who are considering emigrating in the near future.

Performance equivalency between computer-based and traditional pen-and-paper assessment: A case study in clinical anatomy.

The time, material, and staff-consuming nature of anatomy's traditional pen-and-paper assessment system, the increase in the number of students enrolling in medical schools and the ever-escalating workload of academic staff have made the use of computer-based assessment (CBA) an attractive proposition. To understand the impact of such shift in the assessment method, an experimental study evaluating its effect on students' performance was designed. Additionally, students' opinions toward CBA were gathered.

Junior doctors' medical specialty and practice location choice: simulating policies to overcome regional inequalities.

There are nowadays over 1 million Portuguese who lack a primary care physician. By applying a discrete choice experiment to a large representative sample of Portuguese junior doctors (N = 503) in 2014, we provide an indication that this shortage may be addressed with a careful policy design that mixes pecuniary and non-pecuniary incentives for these junior physicians. According to our simulations, a policy that includes such incentives may increase uptake of general practitioners (GPs) in rural areas from 18% to 30%.