Endoscopic Repair of Frontal Sinus Cerebrospinal Fluid Leaks after Firearm Injuries: Report of Two Cases

Objectives To describe two cases of cerebrospinal fluid (CSF) leak repair after gunshot wound to the head.Design Retrospective review of two cases.Settings A large regional tertiary care facility.Participants Two patients with gunshot wounds to the skull base.Main Outcome Measures Preoperative and postoperative physical and radiologic findings.Results Patients in this series underwent endoscopic surgery, debridement, and repair of CSF leaks after gunshot wounds to the head. To date, the patients are without CSF leak.Conclusions Endoscopic closure of anterior skull base CSF leaks in patients with gunshot wounds can be safe and effective. Treatment should be decided by the severity of neurologic deterioration throughout the emergency period and the existence or absence of associated intracranial lesions. Timing for surgery should be decided with great care and with a multidisciplinary approach

To preserve or not to preserve the orbit in paranasal sinus neoplasms : A meta-analysis

Context The effect on survival of orbital evisceration on patients with paranasal sinus neoplasms has not been well established. Objective To review systematically the available literature concerning survival in patients who undergo surgery for paranasal sinus neoplasm with and without preservation of the eye. Data Source A retrospective meta-analysis of English and non-English articles using Medline and the Cochrane database. Eligibility Criteria Studies analyzing 5-year survival rates in patients who had orbital evisceration compared with orbital preservation for the treatment of paranasal sinus neoplasms were included in the final analysis. Data Extraction Independent review by two authors using predefined data fields. Data Synthesis A meta-analysis of four articles involving 443 patients was performed using the DerSimonian-Laird random-effects method. Results Our analysis revealed a total effect size of 0.964 in favor of preservation of the eye; however, these results are not robust, having a true effect size anywhere from 0.785 to 1.142 with a 95% confidence interval. Limitations Only retrospective observational studies were included because a prospective randomized study cannot be performed in this population. Conclusion Our study supports the notion that in select patients preservation of the eye may yield a different outcome when compared with orbital evisceration

Proyecto de construcción de una barda escolar: un dispositivo didáctico interinstitucional para telesecundaria

Presentamos una investigación centrada en el diseño de un Recorrido de Estudio e Investigación (REI), enmarcada en el paradigma del Cuestionamiento del mundo (Chevallard, 2013). Exponemos el trabajo realizado en una escuela telesecundaria de una comunidad rural de México y usamos la noción de inter-institucionalidad para estudiar un problema significativo para la comunidad y el entorno social de la escuela: la construcción de la barda perimetral del edificio escolar. Este problema y su análisis constituyeron elementos clave del diseño metodológico. A través del REI, los estudiantes y la maestra lograron posicionarse y enfrentar la problemática real, desde la escuela. Además, cubrieron contenidos del programa de estudios y recurrieron a un modelo de proporcionalidad directa para abordar tareas tales como evaluar presupuestos, hacer entrevistas, investigar salarios, cantidades, calidades y resistencias de los materiales. Concluimos sobre la necesidad de generar diseños inter-institucionales enmarcados, por ejemplo, en la propuesta teórico-metodológica aquí presentada

Diseño e implementación de prototipo para un carrito de supermercado con capacidad de seguimiento

Los supermercados hoy día no cuentan con la infraestructura necesaria para que personas con discapacidades diferentes puedan realizar sus compras sin ayuda de alguien más

Sistema de Gas Inerte Buque Toledo Spirit

Gas Inerte en Buques Petrolero

Endoscopic Repair of Frontal Sinus Cerebrospinal Fluid Leaks after Firearm Injuries: Report of Two Cases

Objectives To describe two cases of cerebrospinal fluid (CSF) leak repair after gunshot wound to the head.Design Retrospective review of two cases.Settings A large regional tertiary care facility.Participants Two patients with gunshot wounds to the skull base.Main Outcome Measures Preoperative and postoperative physical and radiologic findings.Results Patients in this series underwent endoscopic surgery, debridement, and repair of CSF leaks after gunshot wounds to the head. To date, the patients are without CSF leak.Conclusions Endoscopic closure of anterior skull base CSF leaks in patients with gunshot wounds can be safe and effective. Treatment should be decided by the severity of neurologic deterioration throughout the emergency period and the existence or absence of associated intracranial lesions. Timing for surgery should be decided with great care and with a multidisciplinary approach

Vestibular schwannomas: An understanding of growth should influence management decisions

Background: Treatments for vestibular schwannomas include surgical removal and radiotherapy. Observation is a reasonable alternative, given the slow growth of these tumors. The goal of this study was to determine the 5-year no-growth rate in patients managed initially by observation in attempts to define indications for treatment