Delayed cyst formation after radiosurgery for arteriovenous malformation: A case report and critical review.

Background: Stereotactic radiosurgery (SRS) is a validated treatment option for cerebral arteriovenous malformations (AVMs), even if a greater knowledge of its potential delayed complications is still being acquired.

Case Description: A 49-year-old man suffered multiple episodes of cerebral hemorrhage in an approximate 10-year follow-up interval in the context of a left central core AVM with deep venous drainage into the internal cerebral veins (Spetzler Martin Grade 4) despite being treated with gamma knife radiosurgery at two separate timepoints, and with an almost complete obliteration confirmed. Approximately 10 years after the first radiosurgery treatment, he developed severe motor aphasia, Grade 3 right hemiparesis, progressive confusion, and memory deficits.

Trust matters: The Addressing Vaccine Hesitancy in Europe Study.

This article presents the design of a seven-country study focusing on childhood vaccines, Addressing Vaccine Hesitancy in Europe (VAX-TRUST), developed during the COVID-19 pandemic. The study consists of (a) situation analysis of vaccine hesitancy (examination of individual, socio-demographic and macro-level factors of vaccine hesitancy and analysis of media coverage on vaccines and vaccination and (b) participant observation and in-depth interviews of healthcare professionals and vaccine-hesitant parents. These analyses were used to design interventions aimed at increasing awareness on the complexity of vaccine hesitancy among healthcare professionals involved in discussing childhood vaccines with parents.

Primary Central Nervous System Lymphoma Mimicking the Presentation of Pituitary Apoplexy: A Case Report.

Pituitary lymphoma is one of the rare variants of primary central nervous system lymphoma (PCNSL), mostly arising due to the metastatic spread of systemic lymphoma. We report the case of a 69-year-old woman who initially presented to her family physician with a headache but without any other symptoms. The MRI scan revealed a sellar mass consistent with a pituitary macroadenoma.

The distance between the falx cerebri and the corpus callosum in patients with bilateral subdural hematomas: A potential measure of disease severity.

Background: We aimed to assess the usefulness of the falx cerebri and the corpus callosum measurements as imaging markers of the evaluation of patients with bilateral subdural hematomas.

Methods: The anterior-posterior and craniocaudal distances between the falx cerebri (FC) and the corpus callosum (CC) were retrospectively measured in 88 head CT scans from 2018 to 2022 from patients with bilateral subdural hematomas and associated with quantitative data and clinical outcomes. Statistical analysis was performed using multivariate regression and receiver operating characteristic curves.

2,3,5-triphenyl tetrazolium chloride as colorimetric indicator for drug susceptibility testing against nontuberculous mycobacteria.

This study aimed to propose and evaluate a drug susceptibility testing (DST) using the 2,3,5-triphenyl tetrazolium chloride (TTC) as a colorimetric indicator against Mycobacterium abscessus complex (MABC), M. avium complex (MAC), and M. kansasii strains, main nontuberculous mycobacteria (NTM) of clinical relevance.

Spread of Mycobacterium tuberculosis in Southern Brazilian persons deprived of liberty: a molecular epidemiology study.

To evaluate the genetic diversity and clustering rates of M. tuberculosis strains to better understand transmission among persons deprived of liberty (PDL) in Rio Grande do Sul (RS), southern Brazil. This is a cross-sectional study, including strains of M.

The Importance of the Temporary Clip Removal Phase on Exposure to Hypoxia: On-Line Measurement of Temporal Lobe Oxygen Levels During Surgery for Middle Cerebral Artery Aneurysms.

Background: Most studies concerning intraoperative temporary arterial occlusion overlook the period between and after clip placement.

Objective: To analyze the brain tissue oxygen tension through the process by which anterograde arterial blood flow is re-established after temporary clipping (TR).

Methods: In this prospective observational study, patients who presented to surgery for middle cerebral artery aneurysms were continuously monitored with ICM+, to obtain temporal (downstream) PbtO2 levels while M1 segment temporary clips were applied and removed.

Understanding Complaints in the Emergency Department.

The aim of this research is to identify the main determinants of patients' complaints and potential mediators and moderators in this regard. This research shows that complaints can result from a complex set of processes involving direct, mediating, and moderating effects. Interventions aimed at reducing patients' complaints should consider specific patient groups and experiences.

Selection bias in patients proposed for neurosurgical versus endovascular treatment of aneurysms of the posterior communicating artery.

Background: Microsurgical clipping and endovascular coiling are viable treatment options for posterior communicating artery (PComA) aneurysms, but there are still major limitations to evidence-based decisions regarding standard-of-care treatment. In this study, we aimed at assessing potential selection biases that may influence our ability to extract conclusions about the comparative effectiveness or efficacy of the aneurysm treatment.

Objective: To study the patient/aneurysm characteristics as possible biases in the option for endovascular or neurosurgical treatment of PComA aneurysms.

Pulmonary embolism and COVID-19: A comparative analysis of different diagnostic models performance.

Objective: Pulmonary embolism (PE) is a common complication of SARS-CoV-2 infection. Several diagnostic prediction rules based on pretest probability and D-dimer have been validated in non-COVID patients, but it remains unclear if they can be safely applied in COVID-19 patients. We aimed to compare the diagnostic accuracy of the standard approach based on Wells and Geneva scores combined with a standard D-dimer cut-off of 500 ng/mL with three alternative strategies (age-adjusted, YEARS and PEGeD algorithms) in COVID-19 patients.

Effects of Temporary Clipping as an Expression of Circulatory Individuality: Online Measurement of Temporal Lobe Oxygen Levels During Surgery for Middle Cerebral Artery Aneurysms.

Objective: Despite its widespread use, much is left to understand about the repercussions of parent artery temporary clipping in neurosurgery. This study seeks a better comprehension of the subject by aiming at the online measurement of brain tissue oxygen pressure (PO) during such events.

Methods: This was a prospective observational study.

The mediating role of patient satisfaction and perceived quality of healthcare in the emergency department.

The purpose of this research was to identify whether a certain set of drivers of satisfaction/perceived quality of healthcare (PQHC) could indirectly affect patients' confidence/trust in the emergency department (ED).Patients were seen at an ED in the public hospital in Lisbon, Portugal between January and December 2016. Data were collected between May and November 2017, using a questionnaire, by mail or e-mail.

Laboratory diagnosis for Covid-19: A mini-review.

Coronavirus disease (COVID-19) is a pandemic caused by a new coronavirus, called SARS-CoV-2. This disease was first identified in December 2019 and rapidly developed into a challenge to the public health systems around the world. In the absence of a vaccine and specific therapies, disease control and promotion of patient health are strongly dependent on a rapid and accurate diagnosis.

Predictors of Patient Satisfaction and the Perceived Quality of Healthcare in an Emergency Department in Portugal.

Introduction: The predictors of patient satisfaction in emergency medicine (EM) have been widely studied and discussed in the scientific literature; the results vary depending on the specific EM attributes, cultural aspects, researchers' preferences, and approaches. However, it is not clear whether the same predictors of patient satisfaction can contribute to a better-perceived quality of healthcare or whether patients' perceptions form a different attitude toward satisfaction and perceived quality of healthcare. The goal of this study was to identify the key predictors of patient satisfaction and perceived quality of healthcare in the framework of an emergency department (ED).

Evaluation of comprehensive care for older adults in primary care services.

Objective: To evaluate the performance of comprehensive care for older adults in primary care services in the Brazilian Unified Health System in the state of São Paulo, Brazil.

Methods: A total of 157 primary care services from five health regions in midwestern São Paulo responded, from October to December 2014, the pre-validated 2014 questionnaire for primary care services assessment and monitoring. We selected 155 questions, based on national policies and guidelines on this theme.

A wearable approach for intraoperative physiological stress monitoring of multiple cooperative surgeons.

It is known that excessive levels of occupational stress affect professionals' technical and non-technical skills and surgeons are no exception. However, very few studies address this problem in neurosurgeons. A system for monitoring cardiovascular strain and autonomic imbalance during intracranial aneurysm procedures is proposed in order to obtain overall cardiac measures from those procedures.

Efflux Activity Differentially Modulates the Levels of Isoniazid and Rifampicin Resistance among Multidrug Resistant and Monoresistant Mycobacterium tuberculosis Strains.

With the growing body of knowledge on the contribution of efflux activity to drug resistance, increased attention has been given to the use of efflux inhibitors as adjuvants of tuberculosis therapy. Here, we investigated how efflux activity modulates the levels of efflux between monoresistant and multi- and extensively drug resistant (M/XDR) clinical isolates. The strains were characterized by antibiotic susceptibility testing in the presence/absence of efflux inhibitors, molecular typing, and genetic analysis of drug-resistance-associated genes.

Interplay between Mutations and Efflux in Drug Resistant Clinical Isolates of .

Numerous studies show efflux as a universal bacterial mechanism contributing to antibiotic resistance and also that the activity of the antibiotics subject to efflux can be enhanced by the combined use of efflux inhibitors. Nevertheless, the contribution of efflux to the overall drug resistance levels of clinical isolates of is poorly understood and still is ignored by many. Here, we evaluated the contribution of drug efflux plus target-gene mutations to the drug resistance levels in clinical isolates of .

Long-term clinical and radiological follow-up after laminectomy for cervical spondylotic myelopathy.

Background: The role of laminectomy in the surgical treatment of cervical spondylotic myelopathy (CSM) is established even though postoperative cervical sagittal balance changes and a risk for long-term instability have been described. The aim of the present study is to investigate its clinical efficacy and the radiological outcome in the long-term.

Methods: The authors retrospectively reviewed consecutive cases of patients with CSM, who underwent cervical laminectomy between 1995 and 2010 at the Hospital São João (n = 106).

Multidrug-Resistant Mycobacterium tuberculosis of the Latin American Mediterranean Lineage, Wrongly Identified as Mycobacterium pinnipedii (Spoligotype International Type 863 [SIT863]), Causing Active Tuberculosis in South Brazil.

We recently detected the spoligotype patterns of strains of Mycobacterium pinnipedii, a species of the Mycobacterium tuberculosis complex, in sputum samples from nine cases with pulmonary tuberculosis residing in Porto Alegre, South Brazil. Because this species is rarely encountered in humans, we further characterized these nine isolates by additional genotyping techniques, including 24-locus mycobacterial interspersed repetitive-unit-variable-number tandem-repeat (MIRU-VNTR) typing, verification of the loci TbD1, RD9, pks15/1, RD(Rio), and fbpC, the insertion of IS6110 at a site specific to the M. tuberculosis Latin American Mediterranean (LAM) lineage, and whole-genome sequencing.

Mind the Gap: A Semicontinuum Model for Discrete Electrical Propagation in Cardiac Tissue.

Electrical propagation in cardiac tissue is a discrete or discontinuous phenomenon that reflects the complexity of the anatomical structures and their organization in the heart, such as myocytes, gap junctions, microvessels, and extracellular matrix, just to name a few. Discrete models or microscopic and discontinuous models are, so far, the best options to accurately study how structural properties of cardiac tissue influence electrical propagation. These models are, however, inappropriate in the context of large scale simulations, which have been traditionally performed by the use of continuum and macroscopic models, such as the monodomain and the bidomain models.