PEDIATRIC HEAD TRAUMA: A DESCRIPTION OF CAUSES, NEUROLOGICAL MORBIDITY AND INPATIENT MORTALITY IN A REFERENCE CENTER IN NORTHEASTERN, BRAZIL

The socioeconomic impact of children with sequelae of head trauma is an important public health concern. This retrospective study assessed the causes, the neurological morbidity and the mortality of pediatric head injury during the hospital stays in a referral center in northeastern Brazil. A random sample of 282 medical records of pediatric head trauma cases from a twelve-month period was examined. Patient characteristics, mechanisms of trauma and imaging results were retrieved, and the occurrence of motor deficits, language impairment, cerebrospinal fluid leak seizures or death was assessed during the whole hospital stays. The most affected age range was that of infants (41.5%), the most frequent reported cause was fall (76.5%) and most children were victims of mild brain injury (96%). A total of 11.7% of the computerized tomography examinations showed traumatic injuries, with fractures in 43.6% of them. Thirteen children presented with the above-mentioned endpoints of morbidity and mortality. Seizure (n=9) was the most frequent one. The age range with the highest incidence was also that of infants (n=6). For the same endpoints, the clinical morbid-mortality was 4.6% for the wholes series and 44,4% for moderate and severe trauma. The mortality rate at the end of the period of hospitalization was 1.1%. According to the data from the present study, falls were the main reported cause of pediatric head trauma. A total of 4.6% of victims presented with neurological endpoints of morbid-mortality during the hospital stay and seizure was the most frequent one

DURAÇÃO DO PERCURSO PRÉ-HOSPITALAR DE VÍTIMAS DE ACIDENTE VASCULAR ENCEFÁLICO EM UM SERVIÇO DE EMERGÊNCIA DA REDE SUS - BAHIA

Objetivo: Verificar o tempo decorrido na fase pré-hospitalar do atendimento do AVE isquêmico. Metodologia: Estudo transversal retrospectivo e observacional. A amostra foi composta por pacientes atendidos em urgência em uma unidade do SUSBA em 2011 e 2013. Resultados: Um aumento significativo na proporção de vítimas adimitidas nas primeiras 24h após início das manifestações foi observada: de 48% a 58,4% (p=0,022), e uma tendência não-significativa ao aumento no número de admissões na janela terapêutica de 4h30min. Houve ainda crescimento do número total de adultos atendidos por manifestações suspeitas de AVE: de 1095 para 1230. Conclusão: Uma maior proporção das vítimas chega à emergência em até 24h. Grande parte dos candidatos à trombólise parece ser perdida no percurso pré- hospitalar. Houve acréscimo no número de atendimentos por AVE em fase aguda estimado em aproximadamente 12%, o que pode ter sido intensificado pelo fato de se tratar de uma unidade recentemente implantada

Aspectos anatomopatológicos do paciente portador de Pneumonia: Anatomopathological aspects of the patient with Pneumonia

A pneumonia condiz a uma condensação inflamatória aguda dos alvéolos e/ou infiltração tecidual intersticial pulmonar que resulta da ação de células inflamatórias em resposta a injúrias de um determinado agente microbiano. A patologia conforme o local de aquisição, o padrão de comprometimento, o agente etiológico são determinantes para o quadro clínico, lesões e achados radiográficos. O seguinte artigo objetivou descrever através da revisão bibliográfica, os aspectos gerais da pneumonia com foco em abordar os aspectos anatomopatológicos desta enfermidade. Trata-se  de  um  estudo qualitativo  de  revisão  narrativa,  elaborado  para  abordar  sobre os aspectos anatomopatológicos do paciente portador de pneumonia.  É composta por uma análise ampla da literatura, e com uma metodologia rigorosa e replicável ao nível de reprodução de dados e questões quantitativas para resoluções específicas.  Conforme as informações disponíveis na literatura, elucida-se que os pulmões contam com um aparato de mecanismos de defesa. Mas, mediante injúrias e agentes agressores geram um desequilíbrios e posteriormente originam condições que favorecem doenças respiratórias. A pneumonia possui vários agentes etiológicos, e de acordo com este, distintos padrões de acometimento pulmonar e achados radiográficos irão se manifestar

Production of He-4 and (4) in Pb-Pb collisions at root(NN)-N-S=2.76 TeV at the LHC

Results on the production of He-4 and (4) nuclei in Pb-Pb collisions at root(NN)-N-S = 2.76 TeV in the rapidity range vertical bar y vertical bar <1, using the ALICE detector, are presented in this paper. The rapidity densities corresponding to 0-10% central events are found to be dN/dy4(He) = (0.8 +/- 0.4 (stat) +/- 0.3 (syst)) x 10(-6) and dN/dy4 = (1.1 +/- 0.4 (stat) +/- 0.2 (syst)) x 10(-6), respectively. This is in agreement with the statistical thermal model expectation assuming the same chemical freeze-out temperature (T-chem = 156 MeV) as for light hadrons. The measured ratio of (4)/He-4 is 1.4 +/- 0.8 (stat) +/- 0.5 (syst). (C) 2018 Published by Elsevier B.V.Peer reviewe

A multi-country test of brief reappraisal interventions on emotions during the COVID-19 pandemic.

The COVID-19 pandemic has increased negative emotions and decreased positive emotions globally. Left unchecked, these emotional changes might have a wide array of adverse impacts. To reduce negative emotions and increase positive emotions, we tested the effectiveness of reappraisal, an emotion-regulation strategy that modifies how one thinks about a situation. Participants from 87 countries and regions (n = 21,644) were randomly assigned to one of two brief reappraisal interventions (reconstrual or repurposing) or one of two control conditions (active or passive). Results revealed that both reappraisal interventions (vesus both control conditions) consistently reduced negative emotions and increased positive emotions across different measures. Reconstrual and repurposing interventions had similar effects. Importantly, planned exploratory analyses indicated that reappraisal interventions did not reduce intentions to practice preventive health behaviours. The findings demonstrate the viability of creating scalable, low-cost interventions for use around the world

Towards a functional anatomy of the white matter of the human brain : A STUDY ON FIBER DISSECTION AND ELECTRICAL STIMULATION OF LANGUAGE PATHWAYS

La connaissance de la forme et de la fonction des faisceaux d'association aide à la modélisation des réseaux cognitifs, sert au développement d'abords neurochirurgicaux et à l'interprétation de la neuro-imagerie. Nous avons employé une approche hybride anatomique et neurophysiologique dont l'objectif principal a été la caractérisation des sous-parties du complexe faisceau longitudinal supérieur / faisceau arqué (FLS/FA) et de leur participation dans les fonctions langagières articulatoire, phonologique et sémantique. Soixante-huit hémisphères cérébraux ont été préparés par une variante de la technique de dissection de fibres connue sous le nom de méthode de Klingler. En parallèle, nous avons étudié les cartographies fonctionnelles électriques de quatorze patients opérés en condition éveillée pour des tumeurs cérébrales dans le carrefour temporo-pariétal de l'hémisphère dominant. En se basant sur nos constatations en laboratoire, sur la neuro-imagerie et sur la littérature disponible, nous avons procédé à la mise en corrélation des manifestations cliniques provoquées par la stimulation électrique et la topographie des faisceaux d'association. Les préparations anatomiques ont permis d'étudier l'organisation tridimensionnelle de la substance blanche hémisphérique, de réaliser la première description par dissection de fibres du faisceau longitudinal moyen et de caractériser trois composants du FLS/FA : le majeur, le ventral et l'arqué. L'existence d'un composant dorsal le long du bord supérieur de l'hémisphère, hypothèse basée sur l'anatomie du primate non humain et sur la neuro-imagerie, n'a pas été confirmée. L'anatomie fonctionnelle du lobule pariétal inférieur a été revisitée ainsi que celle des voies de substance blanche à l'intérieur. La variabilité interindividuelle dans la distribution des aires fonctionnelles a été évidente, surtout pour le langage. Ces aires ont servi à délimiter la résection tumorale, à savoir : le cortex sensitif primaire, en avant ; l'aire de Wernicke, en inféro-latéral ; et les voies de substance blanche du FLS/FA en profondeur. A ce niveau, l'observation des manifestations cliniques induites par la perturbation électrique ont permis de conclure que le composant ventral operculaire du FLS/FA joue un rôle dans la fonction articulatoire et que le composant arqué, plus profond, est impliqué dans la fonction phonologique. L'exploration fonctionnelle n'a pas fourni d'argument en faveur d'une participation de ce complexe associatif dans le traitement sémantique, une hypothèse de la littérature basée sur la neuro-imagerie uniquement. Ces constatations peuvent avoir des implications importantes, tant dans la pratique clinique que dans la recherche fondamentale, notamment en ce qui concerne la modélisation des bases neurales du langage.The knowledge of the form and function of fiber pathways supports the modeling of cognitive networks, the development of neurosurgical approaches and the interpretation of neuroimaging. We used a hybrid anatomical and neurophysiological methodology whose main objective was to characterize the subunits of the complex comprised of the Superior Longitudinal and the Arcuate Fasciculus (SLF/AF) as well as their participation in the articulatory, phonological and semantic language functions. Sixty-eight cerebral hemispheres were prepared using a variant of the fiber dissection technique known as the Klingler's method. In parallel, we studied the electrical functional maps of fourteen patients operated on using a sleep-awake-sleep technique for brain tumors of the temporo-parietal junction in the dominant hemisphere. Based on our laboratory and neuroimaging findings, as well as on the available literature, we conducted a correlation of clinical manifestations caused by the electrical stimulation and the topography of the association bundles. The anatomical preparations allowed us to detail the three-dimensional organization of hemispheric white matter, to perform the first description of the Middle Longitudinal Fasciculus using fiber dissection, and to characterize three of the four components of the SLF: the major, the ventral and the arcuate. The existence of a dorsal component along the superior edge of the hemisphere was not confirmed by our findings, a hypothesis in the literature that was based on the anatomy of the nonhuman primate and on previous studies on neuroimaging. The functional anatomy of the inferior parietal lobule was revisited as well as the pathways of white matter in its depth. The inter-individual variability in the distribution of eloquent areas was evident, especially for language. These areas were used to delineate the tumor resection, namely: the primary sensory cortex, anteriorly; the Wernicke's area, inferiorly and laterally, and the white matter pathways from the SLF/AF in the white matter. At this level, the observation of the clinical manifestations in connection with the electrical disturbance caused by the cerebral stimulation allowed us to conclude that the ventral opercular component of the SLF has a role in the articulatory function and the deeper arcuate component is involved in the phonological function. The functional mapping does not provide any argument for a participation of this association complex in the treatment of semantics, an assumption in the literature that was based only on neuroimaging. These findings may have important implications, both in clinical practice and in fundamental research, including for modeling the neural basis of language

Characterization of limbic system connectivity through fiber dissection and diffusion imaging techniques

This is the final version of the following article : Characterization of limbic system connectivity through fiber dissection and diffusion imaging techniques, which has been published in final form at https://www.lestudium-ias.com/content/characterization-limbic-system-connectivity-through-fiber-dissection-and-diffusion-imaging-0International audienceAlthough cortical elements of the limbic system are quite well defined, the underlying white matter pathways are not well detailed. This project aimed to better describe white matter tracts of the limbic system using both fiber dissection, and in and ex vivo Diffusion Weighted Imaging (DWI) techniques. In vivo data (from DWI and neuropsychological evaluations) were obtained from healthy subjects aged 82 and over previously enrolled in the FIBRATLAS project funded by the French Research Agency and run in the host laboratory. Correlations between neuropsychological and white matter characteristics on DWI were examined in this group to infer function of the limbic white matter tracts. Ex vivo data from the FIBRATLAS project database and from the Tours Body Donation Program were examined. The brains were extracted and used to study the anatomy of the limbic white matter tracts employing both DWI and fiber dissection according to a variant of the Klingler’s method

Vers une anatomie fonctionnelle de la substance blanche cérébrale chez l'homme (Étude par dissection de fibres et électrostimulation des voies du langage)

La connaissance de la forme et de la fonction des faisceaux d'association aide à la modélisation des réseaux cognitifs, sert au développement d'abords neurochirurgicaux et à l'interprétation de la neuro-imagerie. Nous avons employé une approche hybride anatomique et neurophysiologique dont l'objectif principal a été la caractérisation des sous-parties du complexe faisceau longitudinal supérieur / faisceau arqué (FLS/FA) et de leur participation dans les fonctions langagières articulatoire, phonologique et sémantique. Soixante-huit hémisphères cérébraux ont été préparés par une variante de la technique de dissection de fibres connue sous le nom de méthode de Klingler. En parallèle, nous avons étudié les cartographies fonctionnelles électriques de quatorze patients opérés en condition éveillée pour des tumeurs cérébrales dans le carrefour temporo-pariétal de l'hémisphère dominant. En se basant sur nos constatations en laboratoire, sur la neuro-imagerie et sur la littérature disponible, nous avons procédé à la mise en corrélation des manifestations cliniques provoquées par la stimulation électrique et la topographie des faisceaux d'association. Les préparations anatomiques ont permis d'étudier l'organisation tridimensionnelle de la substance blanche hémisphérique, de réaliser la première description par dissection de fibres du faisceau longitudinal moyen et de caractériser trois composants du FLS/FA : le majeur, le ventral et l'arqué. L'existence d'un composant dorsal le long du bord supérieur de l'hémisphère, hypothèse basée sur l'anatomie du primate non humain et sur la neuro-imagerie, n'a pas été confirmée. L'anatomie fonctionnelle du lobule pariétal inférieur a été revisitée ainsi que celle des voies de substance blanche à l'intérieur. La variabilité interindividuelle dans la distribution des aires fonctionnelles a été évidente, surtout pour le langage. Ces aires ont servi à délimiter la résection tumorale, à savoir : le cortex sensitif primaire, en avant ; l'aire de Wernicke, en inféro-latéral ; et les voies de substance blanche du FLS/FA en profondeur. A ce niveau, l'observation des manifestations cliniques induites par la perturbation électrique ont permis de conclure que le composant ventral operculaire du FLS/FA joue un rôle dans la fonction articulatoire et que le composant arqué, plus profond, est impliqué dans la fonction phonologique. L'exploration fonctionnelle n'a pas fourni d'argument en faveur d'une participation de ce complexe associatif dans le traitement sémantique, une hypothèse de la littérature basée sur la neuro-imagerie uniquement. Ces constatations peuvent avoir des implications importantes, tant dans la pratique clinique que dans la recherche fondamentale, notamment en ce qui concerne la modélisation des bases neurales du langage.The knowledge of the form and function of fiber pathways supports the modeling of cognitive networks, the development of neurosurgical approaches and the interpretation of neuroimaging. We used a hybrid anatomical and neurophysiological methodology whose main objective was to characterize the subunits of the complex comprised of the Superior Longitudinal and the Arcuate Fasciculus (SLF/AF) as well as their participation in the articulatory, phonological and semantic language functions. Sixty-eight cerebral hemispheres were prepared using a variant of the fiber dissection technique known as the Klingler's method. In parallel, we studied the electrical functional maps of fourteen patients operated on using a sleep-awake-sleep technique for brain tumors of the temporo-parietal junction in the dominant hemisphere. Based on our laboratory and neuroimaging findings, as well as on the available literature, we conducted a correlation of clinical manifestations caused by the electrical stimulation and the topography of the association bundles. The anatomical preparations allowed us to detail the three-dimensional organization of hemispheric white matter, to perform the first description of the Middle Longitudinal Fasciculus using fiber dissection, and to characterize three of the four components of the SLF: the major, the ventral and the arcuate. The existence of a dorsal component along the superior edge of the hemisphere was not confirmed by our findings, a hypothesis in the literature that was based on the anatomy of the nonhuman primate and on previous studies on neuroimaging. The functional anatomy of the inferior parietal lobule was revisited as well as the pathways of white matter in its depth. The inter-individual variability in the distribution of eloquent areas was evident, especially for language. These areas were used to delineate the tumor resection, namely: the primary sensory cortex, anteriorly; the Wernicke's area, inferiorly and laterally, and the white matter pathways from the SLF/AF in the white matter. At this level, the observation of the clinical manifestations in connection with the electrical disturbance caused by the cerebral stimulation allowed us to conclude that the ventral opercular component of the SLF has a role in the articulatory function and the deeper arcuate component is involved in the phonological function. The functional mapping does not provide any argument for a participation of this association complex in the treatment of semantics, an assumption in the literature that was based only on neuroimaging. These findings may have important implications, both in clinical practice and in fundamental research, including for modeling the neural basis of language.MONTPELLIER-BU Sciences (341722106) / SudocSudocFranceF