Dissecção da artéria carótida interna apresentando-se como cefaléia em salvas

Federal University of São Paulo Department of Neurology and NeurosurgeryHospital Israelita Albert Einstein Critical Care UnitUNIFESP, Department of Neurology and NeurosurgerySciEL

Hippocampal sclerosis and status epilepticus - cause or consequence? A MRI study

Background: Transient imaging abnormalities, including changes on diffusion-weighted imaging (DWI), maybe seen in status epilepticus. These abnormalities can be followed by hippocampal sclerosis. Case report: We report a 15-year-old lady with focal non convulsive status epilepticus (NCSE) and focal slowing on EEG. DWI exhibited abnormal hyperintense signals in bilateral temporal and insular cortices. After 3 weeks, MRI performed a localizated hippocampal atrophy. Conclusion: the MRI findings indicated vasogenic and cytotoxic edema during seizure activity and subsequent loss of brain parenchyma.Fleury Inst, Magnet Resonance Imaging Unit, São Paulo, SP, BrazilUniversidade Federal de São Paulo, Dept Neurol, Div Gen Neurol, São Paulo, SP, BrazilUniversidade Federal de São Paulo, Dept Neurol, Div Gen Neurol, São Paulo, SP, BrazilWeb of Scienc

Differential diffusion effects on buoyancy-driven instabilities of acid-base fronts: The case of a color indicator

Buoyancy-driven hydrodynamic instabilities of acid-base fronts are studied both experimentally and theoretically in the case where an aqueous solution of a strong acid is put above a denser aqueous solution of a color indicator in the gravity field. The neutralization reaction between the acid and the color indicator as well as their differential diffusion modifies the initially stable density profile in the system and can trigger convective motions both above and below the initial contact line. The type of patterns observed as well as their wavelength and the speed of the reaction front are shown to depend on the value of the initial concentrations of the acid and of the color indicator and on their ratio. A reaction-diffusion model based on charge balances and ion pair mobility explains how the instability scenarios change when the concentration of the reactants are varied.Fil: Kuster, S.. Universidad de Buenos Aires. Facultad de Ingeniería. Departamento de Física. Grupo de Medios Porosos; ArgentinaFil: Riolfo, L. A.. Universidad de Buenos Aires. Facultad de Ingeniería. Departamento de Física. Grupo de Medios Porosos; ArgentinaFil: Zalts, Anita. Universidad Nacional de General Sarmiento; ArgentinaFil: El Hasi, C.. Universidad Nacional de General Sarmiento; ArgentinaFil: Almarcha, C.. Université Libre de Bruxelles; BélgicaFil: Trevelyan, P.M.J.. Université Libre de Bruxelles; BélgicaFil: De Wit, A.. Université Libre de Bruxelles; BélgicaFil: D'onofrio, Alejandro Gustavo. Universidad de Buenos Aires. Facultad de Ingeniería. Departamento de Física. Grupo de Medios Porosos; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentin

Performance of four ischemic stroke prognostic scores in a Brazilian population

Objective: Ischemic stroke (IS) prognostic scales may help clinicians in their clinical decisions. This study aimed to assess the performance of four IS prognostic scales in a Brazilian population. Method: We evaluated data of IS patients admitted at Hospital Paulistano, a Joint Commission International certified primary stroke center. In-hospital mortality and modified Rankin score at discharge were defined as the outcome measures. The performance of National Institutes of Health Stroke Scale (NIHSS), Stroke Prognostication Using Age and NIHSS (SPAN-100), Acute Stroke Registry and Analysis of Lausanne (ASTRAL), and Totaled Health Risks in Vascular Events (THRIVE) were compared. Results: Two hundred six patients with a mean +/- SD age of 67.58 +/- 15.5 years, being 55.3% male, were included. The four scales were significantly and independently associated functional outcome. Only THRIVE was associated with in-hospital mortality. With area under the curve THRIVE and NIHSS were the scales with better performance for functional outcome and THRIVE had the best performance for mortality. Conclusion: THRIVE showed the best performance among the four scales, being the only associated with in-hospital mortality.CAPESHosp Paulistano, AMIL, Sao Paulo, SP, BrazilPrograma Integrado AVC PIAVEN, AMIL, Sao Paulo, SP, BrazilFac Med ABC, Dept Neurol, Sao Paulo, SP, BrazilUniv Fed Sao Paulo, Dept Neurol, Sao Paulo, SP, BrazilUniv Fed Minas Gerais, Programa Neurociencias, Belo Horizonte, MG, BrazilUniv Fed Sao Paulo, Dept Neurol, Sao Paulo, SP, BrazilWeb of Scienc

Long-term leukocyte reconstitution in NSG mice transplanted with human cord blood hematopoietic stem and progenitor cells

Abstract Background Humanized mice (hu mice) are based on the transplantation of hematopoietic stem and progenitor cells into immunodeficient mice and have become important pre-clinical models for biomedical research. However, data about their hematopoiesis over time are scarce. We therefore characterized leukocyte reconstitution in NSG mice, which were sublethally irradiated and transplanted with human cord blood-derived CD34+ cells at newborn age, longitudinally in peripheral blood and, for more detailed analyses, cross-sectionally in peripheral blood, spleen and bone marrow at different time points. Results Human cell chimerism and absolute human cell count decreased between week 16 and 24 in the peripheral blood of hu mice, but were stable thereafter as assessed up to 32 weeks. Human cell chimerism in spleen and bone marrow was maintained over time. Notably, human cell chimerism in peripheral blood and spleen as well as bone marrow positively correlated with each other. Percentage of B cells decreased between week 16 and 24, whereas percentage of T cells increased; subsequently, they levelled off with T cells clearly predominating at week 32. Natural killer cells, monocytes and plasmacytoid dendritic cells (DCs) as well as CD1c + and CD141+ myeloid DCs were all present in hu mice. Proliferative responses of splenic T cells to stimulation were preserved over time. Importantly, the percentage of more primitive hematopoietic stem cells (HSCs) in bone marrow was maintained over time. Conclusions Overall, leukocyte reconstitution was maintained up to 32 weeks post-transplantation in our hu NSG model, possibly explained by the maintenance of HSCs in the bone marrow. Notably, we observed great variation in multi-lineage hematopoietic reconstitution in hu mice that needs to be taken into account for the experimental design with hu mice

Self-organisation in LTE networks : an investigation

Mobile telecommunications networks based on Long Term Evolution (LTE) technology promise faster throughput to their users. LTE networks are however susceptible to a phenomenon known as inter-cell interference which can greatly reduce the throughput of the network causing unacceptable degradation of performance for cell edge users. A number of approaches to mitigating or minimising inter-cell interference have been presented in the literature such as randomisation, cancellation and coordination. The possibility of coordination between network nodes in an LTE network is made possible through the introduction of the X2 network link. This thesis explores approaches to reducing the effect of inter-cell interference on the throughput of LTE networks by using the X2 link to coordinate the scheduling of radio resources. Three approaches to the reduction of inter-cell interference were developed. Localised organisation is a centralised scheme in which a scheduler is optimised by a Genetic Algorithm (GA) to reduce interference. Networked organisation makes use of the X2 communications link to enable the network nodes to exchange scheduling information in a way that lowers the level of interference across the whole network. Finally a more distributed and de-centralised approach is taken in which each of the network nodes optimises its own scheduling in coordination with its neighbours. An LTE network simulator was built to allow for experimental comparison between these techniques and a number of existing approaches and to serve as a test bed for future algorithm development. These approaches were found to significantly improve the throughput of the cell edge users who were most affected by intereference. In particular the networked aspect of these approaches yielded the best initial results showing clear improvement over the existing state of the art. The distributed approach shows significant promise given further development.EPSR

Síndrome de Grisel relato de caso e revisão de literatura: follow up de 7 anos de evolução com tratamento incruento: Grisel Syndrome case report and literature review: follow up of 7 years of evolution with incruent treatment

Objetivo: Relatar a eficácia terapêutica do tratamento incruento para um caso de Síndrome de Grisel em paciente de 9 anos. Relato de Caso: Paciente masculino, 16 anos atualmente, deu entrada em nosso serviço com 9 anos de idade, apresentando quadro de cervicalgia de etiologia atraumática, deformidade, limitação da amplitude de movimentos e infecção de vias aéreas superiores (IVAS) três semanas antes do início dos sintomas. Foi tratado como torcicolo espasmódico, com resolução parcial após uso de sintomáticos. Foi submetido a radiografias e tomografia computadorizada (TC) em que foi visualizada subluxação rotatória C1-C2 e à aplicação de halo craniano e tração em centro cirúrgico, no qual se manteve por 15 dias em cadeira de Stagnara com tração progressiva, e, posteriormente, usou um halo vest por 12 semanas. Discussão: Com a terapia incruenta obteve-se redução C1-C2 com índice mensurado no plano coronal e axial de 5 mm. Após 7 anos de seguimento clínico, não foi observada perda funcional ou limitações de quaisquer natureza, parâmetros avaliados por questionários de qualidade de vida e funcionalidade da coluna cervical. Além dos exames de imagem não evidenciarem alterações cervicais importantes. Considerações Finais: Não houve relato do paciente a respeito de episódios de recorrência desde a realização do tratamento proposto. Ficou claro para a equipe deste trabalho o sucesso da abordagem terapêutica conservadora no caso exposto