Gender Differences in Cerebral Aneurysm Location

Background and Purpose: A limited number of studies consisting predominantly of ruptured aneurysms have looked at differences in anatomical distribution of aneurysms between male and females. Unlike all other causes of stroke, subarachnoid hemorrhages (SAH) occur more often in women and are thought to be a result of both hormonal influences and variation in wall shear stress. This paper retrospectively looks at a cohort of largely unruptured intracranial aneurysms to determine if there exists a gender discrepancy in the anatomic distribution of cerebral aneurysms. Methods: A retrospective review of consecutive patients with ruptured and unruptured intradural saccular cerebral aneurysms treated endovascularly was performed. Results: Six hundred eighty-two aneurysms were treated. Seventy-two percentage of the patients were women and 27% of patients presented with SAH. Among women, most aneurysms were located along the ICA (54%) while men the ACA (29%, compared to 15% in women), a discrepancy evident in both unruptured and ruptured groups. Females tended to present later in life (59 vs. 55 years), with multiple aneurysms (11 vs. 6% in men), and with SAH (28 vs. 23% in men) – the majority of these ruptured aneurysms were located at the ICA (42%), while men at the ACA (47%). Additionally, the majority (68%) of ruptured ICA aneurysms were PCOM. Conclusion: Understanding the natural history of aneurysms is imperative in treating incidentally found aneurysms. Significant differences exist between the genders in relation to aneurysm location, the most pronounced at the ICA and ACA. Previously described hormonal and hemodynamic theories behind cerebral aneurysm pathogenesis seem like plausible reasons to explain these differences

Initial Experience with Neuroform EZ in the Treatment of Wide-neck Cerebral Aneurysms

PurposeStent-assisted coiling allows embolization and parent vessel reconstruction of wide-necked intracranial aneurysms. The Neuroform EZ (Boston Scientific, Fremont, CA, U.S.A.) stent delivery system offers deployment of a Neuroform stent with fewer steps and improved operator control. Initial experience, technical considerations, and treatment outcomes using the Neuroform EZ stent delivery system in combination with coil embolization are reported.Materials and MethodsSeventeen consecutive patients harboring 21 wide-necked saccular cerebral aneurysms were treated with stent reconstruction. Twenty aneurysms were unruptured; one was treated within 24 hours of diagnosis of rupture. Twenty aneurysms were located in the anterior circulation; one was in the posterior circulation. Immediate and six-month post-treatment angiography and clinical assessment were performed.ResultsIn all cases, the stents were delivered and positioned without difficulty in deployment. Technical complications occurred in 4 patients, but none were directly related to the stent delivery system. On immediate post-treatment angiography, 5 of 21 aneurysms showed complete occlusion, 5 of 21 showed residual neck, and 11 of 21 showed residual contrast filling of the aneurysm sac. At six month follow-up, all 17 patients were clinically stable. Angiography of 18 of the aneurysms showed total occlusion in 12, residual neck in 3, and residual aneurysm filling in 3. Retreatment was performed in the three with residual aneurysm.ConclusionThe Neuroform EZ stent system offers improved anchoring and support in stent delivery, which is particularly useful when multiple stents are overlapped to further protect the parent vessel and increase flow diversion away from the aneurysm sac. The only significant problem encountered was coil prolapse, which could be treated with a second stent when necessary. The ease of deployment improves upon the already clinically successful Neuroform design

O Conceito de Brasilidade nos produtos moveleiros: O diferencial competitivo que falta

O presente artigo tem como objetivo refletir a respeito de um tema antigo e que vem ganhando grande importância ultimamente junto à produção industrial e cultural nacional – em especial ao design de móveis – como fator de diferencial competitivo: A Brasilidade. E propor a Etnografia como um método de levantamento e analise de dados qualitativos que, por sua característica, possibilita o desvelamento de informações que servirão de inspirações para um projeto de design com uma identidade brasileira

Protestos de Junho 2013 no Brasil: novos repertórios de confronto / The June 2013 Protests in Brazil: new confrontation repertoire

O presente artigo visa delimitar os novos repertórios de confronto experimentados nos ciclos de protestos de Junho de 2013 no Brasil. Para isso, traçamos um resgate dos repertórios tradicionais utilizados nos três movimentos de massa ocorridos anteriormente: a Passeata dos Cem Mil, Diretas Já, e Fora Collor. A apropriação das novas tecnologias informacionais pelos mais diversos atores sociais tem produzido grande quantidade de material fotográfico e audiovisual, o que nos estimulou a utilizar da webnografia como aparato metodológico, e experimentar criticamente como instrumentos de pré-seleção de imagens e vídeos os mais básicos aplicativos encontrados na internet, os sites de busca e as redes sociais. Para facilitar a compreensão e enriquecer nossas análises dividimos estes repertórios em três categorias: os repertórios de ruptura, violência e convenção. Delineamos as inovações e adaptações dos novos repertórios, para compreender dentro das abordagens da psicologia social, as formas que o ativismo político nacional está traçando atualmente

Aneurysm Coil Embolization Using a 1.5-Fr Distal Outer Diameter Microcatheter

The current assortment of microcatheters widely used for aneurysm coil embolization may not be well suited for several anatomic variants, including excessive vascular tortuosity and small aneurysms less than 3 mm. Longer microcatheters designed with a smaller caliber that can accommodate and deliver coils may be of use in these situations. This case series and literature review illustrates the advantages and limitations of the Marathon microcatheter (Covidien, Irvine, CA, USA) when used for coil embolization of cerebral aneurysms. Despite some technical compromises including the distal marker, length, and the risk of buckling, the Marathon microcatheter was able to adequately deliver coils to achieve satisfactory occlusion of cerebral aneurysms. We found unique advantages with regards to length and smaller distal outer diameter (OD). These results may serve as a guide for the further development of a microcatheter used for coil embolization that has the features of a smaller distal OD and longer length

Evaluation of time-resolved whole brain flat panel detector perfusion imaging using RAPID ANGIO in patients with acute stroke: comparison with CT perfusion imaging.

BACKGROUND In contrast to conventional CT perfusion (CTP) imaging, flat panel detector CT perfusion (FD-CTP) imaging can be acquired directly in the angiosuite. OBJECTIVE To evaluate time-resolved whole brain FD-CTP imaging and assess clinically important qualitative and quantitative perfusion parameters in correlation with previously acquired conventional CTP using the new RAPID for ANGIO software. METHODS We included patients with internal carotid artery occlusions and M1 or M2 occlusions from six centers. All patients underwent mechanical thrombectomy (MT) with preinterventional conventional CTP and FD-CTP imaging. Quantitative performance was determined by comparing volumes of infarct core, penumbral tissue, and mismatch. Eligibility for MT according to the perfusion imaging criteria of DEFUSE 3 was determined for each case from both conventional CTP and FD-CTP imaging. RESULTS A total of 20 patients were included in the final analysis. Conventional relative cerebral blood flow (rCBF) 6 s versus FD-CTP Tmax >6 s and CTP mismatch versus FD-CTP mismatch showed more variability (R2=0.57, and R2=0.33, respectively). Based on FD-CTP, 16/20 (80%) patients met the inclusion criteria for MT according to the DEFUSE 3 perfusion criteria, in contrast to 18/20 (90%) patients based on conventional CTP. The vessel occlusion could be correctly extrapolated from the hypoperfusion in 18/20 cases (90%). CONCLUSIONS In our multicenter study, time-resolved whole brain FD-CTP was technically feasible, and qualitative and quantitative perfusion results correlated with those obtained with conventional CTP

A COMUNICAÇÃO PÓS-VENDA COMO INFLUÊNCIA NA FIDELIZAÇÃO DO CLIENTE: UM ESTUDO DE CASO NA "EMPRESA A" SITUADA NA ZONA SUL DO ESTADO DE SÃO PAULO

No presente trabalho, são descritas algumas ferrramentas importantes para a fidelização do cliente em relação à qualidade dos produtos/serviços, visando a comunicação pós-venda pode contribuir com esta fidelização. Logo, têm-se como objetivos mostrar como a comunicação pós-venda, a venda e o marketing influenciam na eficiência, tanto da empresa como na decisão de compra dos consumidores. A metodologia usada foi desenvolvida por meio de pesquisas bibliográficas; e um estudo de caso na Empresa A, onde os resultados foram analisados por meio de gráficos de acordo com o volume de vendas entre os anos 2009z 2013. Ficou claro que há uma forte tendência da incorporação da comunicação pós-venda em suas estratégias para obter resultados. Diante disto é possível conluir que os benefícios dessas estratégias dependerão diretamente dos esforços e, recursos que as empresas estão dispostas a investir.Palavras-chave: Fidelização; Cliente; Comunicação; Pós-venda

Objective Assessment of Arterial Steal Phenomenon in Direct Carotid Cavernous Fistula Using 2D Parametric Parenchymal Blood Flow Analysis

The aim of the study is to evaluate the hemodynamic changes and the parenchymal perfusion associated with carotid cavernous fistulas before and after embolization using two-dimensional (2D) parenchymal blood flow analysis. A 15-year-old boy presented with 2-month history of progressive right eye proptosis, chemosis, and diplopia after a motor vehicle accident. Intracranial liquid embolization using Onyx-18 through the inferior petrosal approach was done with balloon protection at the opening of the fistula in the internal carotid artery, resulting in complete occlusion of the fistula. Parenchymal blood flow analysis was done before and immediately after embolization. 2D parametric parenchymal blood flow analysis is newly introduced software that can provide data cannot be conveyed by conventional digital subtraction angiography alone. The software allows for objective assessment of the arterial steal and the parenchymal perfusion both pre, and post-embolization. Pre-embolization assessment may influence the therapeutic decision, while post-embolization assessment can evaluate the treatment efficacy

A educação física e a prevenção da obesidade infantil no ensino fundamental II

O estudo objetivou identificar a visão do profissional de Educação Física na prevenção da obesidade em crianças do ensino fundamental ll. Foi um estudo descritivo, transversal, e com abordagem qualitativa, realizado em duas escolas do Ceará, com 20 profissionais de Educação Física atuantes na área. Utilizou-se um questionário contendo 4 questões relacionadas ao papel do educador e sua contribuição na conscientização da obesidade junto aos seus alunos. Os resultados mostraram que 85% dos voluntários consideraram importante sua participação na elaboração do PPP da escola. 90% dos entrevistados vêem os temas transversais como algo que vem a favorecer suas aulas, devendo fazer parte do conteúdo das aulas. Para 85% dos professores, as aulas de educação física são um momento oportuno para abordar e conscientizar seus alunos sobre a obesidade. 85% dos educadores afirmaram ser capazes de intervir diante da problemática. Os profissionais gostariam de participar mais efetivamente na elaboração do PPP de suas escolas, e consideram importante a utilização de temas transversais, sendo possível integrá-los as aulas. Os educadores consideram-se capazes de intervir influenciando no comportamento e nos hábitos de vida dos seus alunos

A Naïve Bayes model based on overlapping groups for link prediction in online social networks

Link prediction in online social networks is useful in numerous applications, mainly for recommendation. Recently, different approaches have considered friendship groups information for increasing the link prediction accuracy. Nevertheless, these approaches do not consider the different roles that common neighbors may play in the different overlapping groups that they belong to. In this paper, we propose a new approach that uses overlapping groups structural information for building a naïve Bayes model. From this proposal, we show three different measures derived from the common neighbors. We perform experiments for both unsupervised and supervised link prediction strategies considering the link imbalance problem. We compare sixteen measures in four well-known online social networks: Flickr, LiveJournal, Orkut and Youtube. Results show that our proposals help to improve the link prediction accuracy.São Paulo Research Foundation (FAPESP) (grants: 2013/12191-5, 2011/21880-3, 2011/23689-9 and 2011/22749-8