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Role of dynamic computed tomography scans in patients with congenital craniovertebral junction malformations

World Journal of Orthopedics 2017年第3期8卷 271-277页

作者： Otávio Turolo da Silva Enrico Ghizoni Helder Tedeschi andrei fernandes joaquim Department of Neurology Division of Neurosurgical State University of Campinas

AIM To evaluate the role of dynamic computed tomography(CT)scan imaging in diagnosing craniovertebral junction(CVJ)instability in patients with congenital CVJ *** Patients with symptomatic congenital CVJ malformations who underwent posterior fossa decompression and had a preoperative dynamic CT scan in flexion and extended position were included in this *** of the following craniometrical parameters were taken in flexed and extended neck position:Atlanto-dental interval(ADI),distance of the odontoid tip to the Chamberlain’s line,and the clivus-canal angle(CCA).Assessment of the facet joints congruence was also performed in both *** of the values obtained in flexion and extension were compared using a paired Student’s *** A total of ten patients with a mean age of 37.9 years were *** flexion imaging,the mean ADI was1.76 mm,the mean CCA was 125.4°and the mean distance of the odontoid tip to the Chamberlain’s line was+9.62 *** extension,the mean ADI was1.46 mm(P=0.29),the mean CCA was 142.2°(P<0.01)and the mean distance of the odontoid tip to the Chamberlain’s line was+7.11 mm(P<0.05).Four patients(40%)had facetary subluxation demonstrated in dynamic imaging,two of them with mobile subluxation(both underwent CVJ fixation).The other two patients with a fixed subluxation were not initially *** patient with atlantoaxial assimilation and C23 fusion without initial facet subluxation developed a latter CVJ instability diagnosed with a dynamic CT *** with basilar invagination had a lower CCA variation compared to the whole *** Craniometrical parameters,as well as the visualization of the facets location,may change significantly according to the neck *** imaging can provide additional useful information to the diagnosis of CVJ *** studies addressing the relationship between craniometrical changes and neck position are necessary.

关键词： Craniovertebral junction Dynamic imaging Basilar invagination Chiari malformation Treatment

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Extrahepatic right hepatic duct diverticulum: a rare entity

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Hepatobiliary & Pancreatic Diseases International 2010年第2期9卷 213-215页

作者： Eduardo SM fernandes Raquel L Bernardo Moacir M fernandes Rogério MC Araújo Renato Sebbe Asterio Monte JoséF Coelho Antonio AP Souza joaquim Ribeiro Filho Department of General Surgery Section of Hepatobiliary Surgery and TransplantationRio de Janeiro Federal University Department of Digestive Surgery and Gastroenterology Pio XII General Hospital

BACKGROUND:Douglas described choledochal cysts in 1852 and Todani proposed an anatomy-based classification in 1977. The classification is the most extensively used,but does not include some rare *** present a case of hepatic duct diverticulum,one of the variations,and discuss its diagnosis and treatment. METHODS:A 57-year-old woman presented with upper abdominal pain and discomfort associated with nausea and *** was finally diagnosed with cholelithiasis and right hepatic duct diverticulum. RESULT:The patient underwent resection of the hepatic duct diverticulum and cholecystectomy,and was asymptomatic 26 months after surgery. CONCLUSIONS:Hepatic duct diverticulum is a rare form of choledochal cyst,not included in Todani’s classification. Todani’s classification including this and other uncommon variations of choledochal cysts must be *** best diagnostic imaging methods and treatment for choledochal cysts must be defined.

关键词： choledochal cysts hepatic duct diverticulum Todani's classification intrahepatic diverticulum

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Acute cholestatic hepatitis caused by amoxicillin/ clavulanate

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World Journal of Gastroenterology 2013年第46期19卷 8789-8792页

作者： Daniel Oliveira Beraldo Joanderson fernandes Melo Alexandre Vidal Bonfim andrei Alkmim Teixeira Ricardo Alkmim Teixeira André Loyola Duarte Department of Internal Medicine Hospital Renascentista Escola Paulista de Medicina-UNIFESP Nephrology Department Escola Paulista de Medicina-UNIFESP Cardiology Department Cardiology Department Instituto do Cora o-FMUSP Pathology Department Hospital A.C.CamargoSo Paulo

Amoxicillin/clavulanate is a synthetic penicillin that is currently commonly used,especially for the treatment of respiratory and cutaneous *** general,it is a well-tolerated oral ***,amoxicillin/clavulanate can cause adverse effects,mainly cutaneous,gastrointestinal,hepatic and hematologic,in some *** here is a case report of a 63-yearold male patient who developed cholestatic hepatitis after recent use of amoxicillin/*** 6 wk of prolonged use of the drug,he began to show signs of cholestatic icterus and developed severe hyperbilirubinemia(total bilirubin>300 mg/L).Diagnostic investigation was conducted by ultrasonography of the upper abdomen,serum tests for infection history,laboratory screening of autoimmune diseases,nuclear magnetic resonance(NMR)of the abdomen with bile duct-NMR and transcutaneous liver biopsy guided by *** duration of disease was approximately 4 mo,with complete resolution of symptoms and laboratory changes at the end of that time *** treatment was not instituted,only a combination of anti-emetic(metoclopramide)and cholestyramine for pruritus.

关键词： Hepatology Hepatitis Amoxicillin/Clavula-nate Drug reactions Hyperbilirubinemia

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Tracheoesophageal Voice Prosthesis Outcomes:Success or Insucess?

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International Journal of Otolaryngology and Head & Neck Surgery 2014年第1期3卷 14-22页

作者： Sara Cruz Rita Viana Joana Guimaraes Joao fernandes joaquim Castro Silva Eurico Monteiro Servico de Otorrinolaringologia Instituto Portugues de Oncologia Francisco Gentil do PortoPortoPortugal

Introduction: Total laryngectomy/pharingo-laryngectomy is a potentially aggressive surgery for advanced laryngeal/hypopharyngeal carcinomas, which results in important physical and functional changes that compromise some of the most vital functions, including speech communication. For these patients, tracheoesophageal speech is considered to be the gold standard for voice rehabilitation. Objectives: The purpose of the present study was to determinate the success rate of voice prosthesis rehabilitation, voice prosthesis lifetime and the rate of complications, and its related clinicopathologic factors. Material and Methods: Retrospective review of 92 patients who undergone tracheoesophageal puncture (TEP) performed between January 2007 and December 2012 at the Francisco Gentil Portuguese Institute of Oncology of Oporto. Age, primary disease, staging, the extent of surgical resection, radiotherapy treatment, timing of TEP, surgical and prosthesis-related complications were noted. The impact of these clinicpathological factors on functional outcome, complications of TEP and lifetime of prosthetic valves was assessed in univariate analysis. Vocal rehabilitation efficacy with voice prosthesis was assessed with the multidimensional Harrison-Robillard Shultz (HRS) Rating Scale. Lifetime of voice prosthesis and early and late complications were recorded. Results: A total of 83 patients met the study criteria, predominantly males (94%) with a mean age of 63.7 years. 77% of the patients underwent primary and 23% secondary TEP. 68.7% of patients achieved functional tracheoesophageal speech (HRS score ≥ 10), 67.2% had performed primary TEP and 73.7% had performed secondary TEP. The mean device lifetime was 9.8 months for voice prosthesis. Prosthesis-related complications occurred in 81% of the patients and the most common issues were prosthesis leakage (76%) and displacement (22%). The most common surgical-related problem was a large and deep tracheostoma. Conclusions: Our succe

关键词： Laryngeal Cancer Total Laryngectomy Tracheoesophageal Puncture Tracheoesophageal Speech Voice Prosthesis

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Use of antiepileptic drugs in children with brain tumors: A review for acute management

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Journal of Acute Disease 2018年第5期7卷 181-185页

作者： Jennifer Herrera-Bejarano Amit Agrawal Claudia Marcela Navas Valbuena Guru Dutta Satyarthee Chandramouli Balasubramanian andrei F.joaquim George Chater Cure Luis Rafael Moscote-Salazar Physician Universidad del RosarioBogotaColombia Professor of Neurosurgery MM Institute of Medical Sciences&ResearchMaharishi Markandesh(w)ar UniversityMullana-Ambala133-207.HaryanaIndia Physician Universidad Industrial de SantanderUISBucaramangaColombia Assistant Professor of Neurosurgery All India Institute of Medical SciencesNew DelhiIndia Department of Neurosurgery Birmingham Children's HospitalBirminghamUK Department of Neurology Neurosurgery DivisionUniversity of Campinas(UNICAMP)Campinas-SPBrazil Neurosurgeon Clinica General del NorteBarranquillaColombia Neurosurgeon-Critical Care University of CartagenaCartagena de IndiasColombia

Patients with primary or secondary tumors in the central nervous system may have seizures resulting from direct tissue damage,metabolic abnormalities,infection,or toxic side effects of *** pediatric patients,it is more frequent to use drugs to control secondary *** this article,we discuss the main nuances of antiepileptic drugs for the proper management of children with central nervous system tumors.

关键词： Antiepileptic drugs Brain tumors Neuro oncology Seizures

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Preoperative rectal tumor embolization as an adjunctive tool for bloodless abdominoperineal excision:A case report

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World Journal of Clinical Oncology 2020年第12期11卷 1070-1075页

作者： Marley Ribeiro Feitosa Lucas fernandes de Freitas Antonio Balestrim Filho Guilherme Seizem Nakiri Daniel Giansante Abud Ligia Magnani Landell Mariângela Ottoboni Brunaldi Jose joaquim Ribeiro da Rocha Omar Feres Rogério Serafim Parra Department of Surgery and Anatomy Medicine School of Ribeirão PretoUniversity of São PauloRibeirão Preto 14048900São PauloBrazil Department of Internal Medicine Medical School of Ribeirão PretoUniversity of São PauloRibeirão Preto 14048900São PauloBrazil Department of Pathology and Forensic Medicine Medicine School of Ribeirão PretoUniversity of São PauloRibeirão Preto 14048900São PauloBrazil

BACKGROUND Abdominoperineal excision(APE)-related hemorrhage can be challenging due to difficult access to pelvic organs and the risk of massive blood *** objective of the present study was to demonstrate the use of preoperative embolization(PE)as a strategy for blood preservation in a patient with a large low rectal tumor with a high risk of bleeding,scheduled for *** SUMMARY A 56-year-old man presented to our institution with a one-year history of anal bleeding and rectal *** patient was diagnosed with bulky adenocarcinoma limited to the *** the patient refused any clinical treatment,surgery without previous neoadjuvant chemoradiation was *** patient underwent a tumor embolization procedure,two days before surgery performed via the right common femoral *** tumor was successfully devascularized and no major bleeding was noted during *** recovery was uneventful and a one-year follow-up showed no signs of *** Therapeutic tumor embolization may play a role in bloodless surgeries and increase surgical and oncologic *** describe a patient with a bulky low rectal tumor who successfully underwent preoperative embolization and bloodless abdominoperineal resection.

关键词： Rectal neoplasms Proctectomy Bloodless medical and surgical procedures Embolization,therapeutic Colorectal surgery Case report

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Effects of Kenneth Cyclone on Groundnut Crop (Arachis hypogaea L.) in Two Districts of Northern Mozambique

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Journal of Agricultural Science and Technology(B) 2020年第4期10卷 246-254页

作者： Ibraimo Teleha Chabite Ali Magido Florência joaquim Cesário Evódio Armindo Sábado Andate Laboratory of Quality and Food Safety(LQSA) Lúrio Interdisciplinary Study Center(CEIL)Lúrio UniversityStreet No.4250NampulaMozambique HELVETAS Swiss Intercooperation Parque dos ContinuadoresNo.31Nampula OfficeMozambique Researcher and Independent Consultant Muhala ExpansãoStreet No.3NampulaMozambique

In Mozambique,groundnut(Arachis hypogaea L.)in terms of importance is the third crop after maize(Zea mays L.)and cassava(Manihot esculenta).But due to geographical location,the country suffers major impacts of climate change and natural phenomena that also influence the production of this *** recent Kenneth cyclone that has affected Northern Mozambique,Cabo Delgado and Nampula provinces,is an example of such *** study aimed to evaluate the effects of Kenneth cyclone on groundnut cultivation in Eráti and Meconta districts in Nampula *** research used a questionnaire with closed and open questions to collect data from 31 producers and five traders in Eráti and Meconta *** on the data the sum of the overall average production losses between the two districts was approximately 60%,in which Eráti lost 52%and Meconta 67%of the total production expected for *** biggest impact was the loss of unharvested groundnut germination and the deterioration of the groundnut in the field while *** cyclone created appropriate conditions for the proliferation of fungus causing aflatoxin,Aspergillus *** collected for laboratory analysis showed high levels of total aflatoxins,some 269.4 ppb in Meconta and 148.3 ppb in Erá*** purchase price of groundnut in Eráti during this period varied naturally based on product quality,with 0.8 US$/kg of groundnut that looks good quality(without the presence of fungus or mould,insect damage,rotten and germinated nuts)and 0.6 US$/kg for the poor quality(presence of fungus or mould,insect damage,rotten and germinated nuts).Kenneth cyclone affected the expectations of farmers in groundnut yields in the 2018/2019 season.

关键词： Groundnut Kenneth cyclone aflatoxin Mozambique

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