Barbed versus conventional suture in elective posterior spine surgery.

PURPOSE: Barbed sutures are tissue control devices that can reduce operating room time and costs. We analyzed the utility of barbed sutures in posterior spinal surgery in order to prove non-inferiority to conventional methods for wound closure. METHODS: A cohort of patients undergoing elective posterior spinal surgery in which barbed (prospective) versus conventional sutures (retrospective) were used was analyzed. The primary endpoint was the occurrence of wound healing complications or the need for surgical revision. Secondary endpoints included postoperative stay, readmission rate, and duration and cost of wound closure. RESULT: A total of 483 patients participated in the study, 183 in the Barbed group and 300 in the Conventional group. Wound dehiscence or seroma occurred in 3.8% and 2.7% of the Barbed and Conventional groups, respectively (p = 0.6588). Both superficial (1.6% versus 4.0%, P = 0.2378) and deep infections (2.7% versus 4.7%, p = 0.4124) occurred similarly in both groups. Overall, the rate of re-intervention due to wound healing problems was also similar (4.9% versus 5.3%, p = 0.9906), as well as, total median hospital stay, postoperative stay and 30-day re-admission rates. The average duration of wound closure (1.66 versus 4.16 min per level operated, p < 0.0001) strongly favored the Barbed group. The mean cost of wound closure per patient was higher in the Barbed group (43.23 € versus 22.67 €, p < 0.0001). CONCLUSIONS: In elective posterior spinal procedures, the use of barbed sutures significantly reduced the duration of wound closure. The wound healing process was not hindered and the added cost related to the suture material was small.

Perioperative risk factors for major complications after bone replacement in decompressive craniectomy.

INTRODUCTION: Bone flap replacement after a decompressive craniectomy is a low complexity procedure, but with complications that can negatively impact the patient's outcome. A better knowledge of the risk factors for these complications could reduce their incidence. PATIENTS AND METHODS: A retrospective review of a series of 50 patients who underwent bone replacement after decompressive craniectomy at a tertiary center over a 10-year period was performed. Those clinical variables related to complications after replacement were recorded and their risk factors were analyzed. RESULTS: A total of 18 patients (36%) presented complications after bone flap replacement, of which 10 (55.5%) required a new surgery for their treatment. Most of the replacements (95%) were performed in the first 90 days after the craniectomy, with a tendency to present more complications compared to the subsequent period (37.8% vs 20%, p > 0.05). The most frequent complication was subdural hygroma, which appeared later than infection, the second most frequent complication. The need for ventricular drainage or tracheostomy and the mean time on mechanical ventilation, ICU admission, or waiting until bone replacement were greater in patients who presented post-replacement complications. Previous infections outside the nervous system or the surgical wound was the only risk factor for post-bone flap replacement complications (p = 0.031). CONCLUSIONS: Postoperative complications were recorded in more than a third of the patients who underwent cranial bone flap replacement, and at least half of them required a new surgery. A specific protocol aimed at controlling previous infections could reduce the risk of complications and help establish the optimal time for cranial bone flap replacement.

Predicting histological grade in symptomatic meningioma by an objective estimation of the tumoral surface irregularity.

INTRODUCTION: Predicting the histopathologic grade of meningioma is relevant because local recurrence is significantly greater in WHO grade II-III compared to WHO grade I tumours, which would ideally benefit from a more aggressive surgical strategy. It has been suggested that higher WHO grade tumours are more irregularly-shaped. However, irregularity is a subjective and observer-dependent feature. In this study, the tumour surface irregularity of a large series of meningiomas, measured upon preoperative MRI, is quantified and correlated with the WHO grade. METHODS: Unicentric retrospective observational study of a cohort of symptomatic meningiomas surgically removed in the time period between January 2015 and December 2022. Using specific segmentation software, the Surface Factor (SF) was calculated for each meningioma. SF is an objective parameter that compares the surface of a sphere (minimum surface area for a given volume) with the same volume of the tumour against the actual surface of the tumour. This ratio varies from 0 to 1, being 1 the maximum sphericity. Since irregularly-shaped meningiomas present proportionally greater surface area, the SF tends to decrease as irregularity increases. SF was correlated with WHO grade and its predictive power was estimated with ROC curve analysis. RESULTS: A total of 176 patients (64.7% females) were included in the study; 120 WHO grade I (71.9%), 43 WHO grade II (25.7%) and 4 WHO grade III (2.4%). A statistically significant difference was found between the mean SF of WHO grade I and WHO grade II-III tumours (0.8651 ±â€¯0.049 versus 0.7081 ±â€¯0.105, p < 0.0001). Globally, the SF correctly classified more than 90% of cases (area under ROC curve 0.940) with 93.3% sensibility and 80.9% specificity. A cutoff value of 0.79 yielded the maximum precision, with positive and negative predictive powers of 82.6% and 92.6%, respectively. Multivariate analysis yielded SF as an independent prognostic factor of WHO grade. CONCLUSION: The Surface Factor is an objective and quantitative parameter that helps to identify aggressive meningiomas preoperatively. A cutoff value of 0.79 allowed differentiation between WHO grade I and WHO grade II-III with high precision.

Need for head and neck repositioning to restore electrophysiological signal changes at positioning for cervical myelopathy surgery / Necesidad de recolocación de la cabeza y el cuello para revertir alteraciones neurofisiológicas intraoperatorias en el posicionamiento para cirugía de mielopatía cervical

Objective: To evaluate the incidence of significant intraoperative electrophysiological signal changes during surgical positioning, and to assess the effectiveness of head and neck repositioning on the restoration of signals, among patients undergoing surgery for cervical myelopathy.Material and methods: We used multimodal intraoperative monitoring (somatosensory [SEP] and motor evoked potentials [MEP] and spontaneous electromyography) before and after patients’ positioning in a consecutive cohort of 103 patients operated for symptomatic cervical myelopathy. Significant changes were defined as>50% attenuation in amplitude or>10% increase in latency of SEP, or abolishment or 50–80% attenuation of MEP.Results: Out of 103 patients (34.9% female, median age 54.5 years) 88 underwent laminectomy (85.4%) and 15 (14.6%) anterior approach. At the time of positioning, signal alterations occurred in 44 patients (42.7%), yet only 11 patients (10.7%) showed alarming changes. Immediate neck repositioning of these resulted in complete (n=6) or partial (n=4) restoration of potentials, yielding no postoperative deficits. The patient in which signals could not be restored after repositioning resulted in added postoperative deficit. The accuracy (true positives plus true negatives) of monitoring to detect new neurological deficits was 99.0% (102/103) for the entire cohort, and 100% (11/11) for those showing significant changes at the moment of positioning. Overall, only 1 patient, with non-significant SEP attenuation, experienced a new postoperative deficit, yielding a 0.97% rate of false negatives.Conclusion: Among patients undergoing surgery for cervical myelopathy, 10.7% showed alarming electrophysiological signal changes at the time of positioning. Immediate repositioning of the neck resulted in near always restoration of potentials and avoidance of added neurological damage. Complete or partial restoration of potentials after(AU)

Objetivo: Evaluar la incidencia de alteraciones neurofisiológicas intraoperatorias graves en el momento del posicionamiento del paciente, y la efectividad de la recolocación del cuello para revertir dichos cambios en los pacientes que se intervienen de mielopatía cervical.Material y métodos: Se empleó una monitorización intraoperatoria multimodal (potenciales evocados sensoriales [PES], motores [PEM] y electromiografía) antes y después de colocar al paciente en posición, en una cohorte de 103 pacientes consecutivos operados de mielopatía cervical. Se consideraron cambios significativos (de alarma): una disminución >50% de la amplitud o un aumento >10% de la latencia de los PES, o la abolición o disminución >50-80% en amplitud de los PEM.Resultados: De los 103 pacientes (el 34,9% mujeres, mediana de edad: 54,5 años), a 88 se les realizó laminectomía (85,4%) y a 15 (14,6%) un abordaje anterior. En el momento del posicionamiento, ocurrieron alteraciones de señal en 44 pacientes (42,7%), aunque solo en 11 (10,7%) estas fueron significativas. La recolocación inmediata del cuello consiguió revertir la alteración de señal completa (n=6) o parcialmente (n=4), sin producirse déficits postoperatorios. El paciente en el cual la recolocación no consiguió restaurar los potenciales despertó con déficit neurológico añadido. La precisión (verdaderos positivos+verdaderos negativos) de la monitorización intraoperatoria para detectar déficits postoperatorios fue del 99% (102/103) para la cohorte completa y del 100% (11/11) para el subgrupo con alteraciones significativas. Globalmente, solo un paciente, que mostró cambios no significativos, despertó con nuevo déficit neurológico (0,97% de falsos negativos).Conclusión: El 10,7% de los pacientes intervenidos de mielopatía cervical mostraron cambios neurofisiológicos de alarma en el momento del posicionamiento quirúrgico. La inmediata recolocación del cuello revirtió dichos cambios (completa o parcialmente)(AU)

Need for head and neck repositioning to restore electrophysiological signal changes at positioning for cervical myelopathy surgery.

OBJECTIVE: To evaluate the incidence of significant intraoperative electrophysiological signal changes during surgical positioning, and to assess the effectiveness of head and neck repositioning on the restoration of signals, among patients undergoing surgery for cervical myelopathy. MATERIAL AND METHODS: We used multimodal intraoperative monitoring (somatosensory [SEP] and motor evoked potentials [MEP] and spontaneous electromyography) before and after patients' positioning in a consecutive cohort of 103 patients operated for symptomatic cervical myelopathy. Significant changes were defined as>50% attenuation in amplitude or>10% increase in latency of SEP, or abolishment or 50-80% attenuation of MEP. RESULTS: Out of 103 patients (34.9% female, median age 54.5 years) 88 underwent laminectomy (85.4%) and 15 (14.6%) anterior approach. At the time of positioning, signal alterations occurred in 44 patients (42.7%), yet only 11 patients (10.7%) showed alarming changes. Immediate neck repositioning of these resulted in complete (n=6) or partial (n=4) restoration of potentials, yielding no postoperative deficits. The patient in which signals could not be restored after repositioning resulted in added postoperative deficit. The accuracy (true positives plus true negatives) of monitoring to detect new neurological deficits was 99.0% (102/103) for the entire cohort, and 100% (11/11) for those showing significant changes at the moment of positioning. Overall, only 1 patient, with non-significant SEP attenuation, experienced a new postoperative deficit, yielding a 0.97% rate of false negatives. CONCLUSION: Among patients undergoing surgery for cervical myelopathy, 10.7% showed alarming electrophysiological signal changes at the time of positioning. Immediate repositioning of the neck resulted in near always restoration of potentials and avoidance of added neurological damage. Complete or partial restoration of potentials after repositioning yielded no postoperative deficits.

Primary central nervous system angiosarcoma with recurrent acute subdural hematoma.

Angiosarcoma is an infrequent tumor among sarcomas, especially presenting as a primary tumor within the central nervous system, which can lead to a rapid neurological deterioration and death in few months. We present a 41-year old man with a right frontal enhancing hemorrhagic lesion. Surgery was performed with histopathological findings suggesting a primary central nervous system angiosarcoma. He was discharged uneventfully and received adjuvant chemotherapy and radiotherapy. At 5 months, the follow-up MRI showed two lesions with an acute subdural hematoma, suggesting a relapse. Surgery was again conducted finding tumoral membranes attached to the internal layer of the duramater around the right hemisphere. The patient died a few days later due to the recurrence of the subdural hematoma. This case report illustrates a rare and lethal complication of an unusual tumor. The literature reviewed shows that gross-total resection with adjuvant radiotherapy seems to be the best treatment of choice.

Angiographically occult and spontaneously thrombosed large brain arteriovenous malformation / Malformación arteriovenosa cerebral grande, angiográficamente oculta y espontáneamente trombosada

Treatment for brain arteriovenous malformations (AVM) include combinations of surgery, radiosurgery and embolization. Very rarely, spontaneous obliteration may occur, especially among small lesions with single superficial vein drainage and prior bleeding. We report the case of a large symptomatic AVM, without history of hemorrhage or prior treatment, in which self-obliteration was noted at surgery. Although MRI suggested the presence of an AVM, no evidence of arterial anomaly was observed in the brain angiography. At surgery, a large cortical nidus with tortuous arterial vessels, resembling that of an AVM but without blood flow, was identified. Complete resection was easily performed without relevant bleeding. The histopathologic study confirmed the diagnosis of a thrombosed AVM. Despite the low probability of recanalization, surgical resection of a suspected spontaneously obliterated AVM may be warranted, in order to reach a definitive diagnosis and to avoid the risk of an eventual bleeding, especially among younger patients (AU)

El tratamiento de las malformaciones arteriovenosas (MAV) cerebrales incluye combinaciones de cirugía, radiocirugía y embolización. Muy rara vez, ocurre una obliteración espontánea, fundamentalmente en MAV pequeñas, con drenaje venoso único superficial y antecedente de sangrado previo. Presentamos un caso de MAV sintomática grande, sin sangrado ni tratamientos previos, en la que se constató auto-trombosis espontánea. Aunque las imágenes de resonancia sugerían la presencia de una MAV, la arteriografía no mostró anomalía arterial compatible. En la cirugía se evidenció un nidus cortical con vasos tortuosos, idéntico a una MAV clásica, aunque sin flujo sanguíneo, por lo que pudo resecarse sin dificultad. La anatomía patológica confirmó la presencia de una MAV trombosada. A pesar del relativamente bajo riesgo de recanalización, la cirugía de una posible MAV trombosada puede ser una opción recomendable, con objeto de llegar al diagnóstico definitivo y evitar un eventual riesgo de sangrado, especialmente en personas jóvenes (AU)

Need for head and neck repositioning to restore electrophysiological signal changes at positioning for cervical myelopathy surgery.

OBJECTIVE: To evaluate the incidence of significant intraoperative electrophysiological signal changes during surgical positioning, and to assess the effectiveness of head and neck repositioning on the restoration of signals, among patients undergoing surgery for cervical myelopathy. MATERIAL AND METHODS: We used multimodal intraoperative monitoring (somatosensory [SEP] and motor evoked potentials [MEP] and spontaneous electromyography) before and after patients' positioning in a consecutive cohort of 103 patients operated for symptomatic cervical myelopathy. Significant changes were defined as>50% attenuation in amplitude or>10% increase in latency of SEP, or abolishment or 50-80% attenuation of MEP. RESULTS: Out of 103 patients (34.9% female, median age 54.5 years) 88 underwent laminectomy (85.4%) and 15 (14.6%) anterior approach. At the time of positioning, signal alterations occurred in 44 patients (42.7%), yet only 11 patients (10.7%) showed alarming changes. Immediate neck repositioning of these resulted in complete (n=6) or partial (n=4) restoration of potentials, yielding no postoperative deficits. The patient in which signals could not be restored after repositioning resulted in added postoperative deficit. The accuracy (true positives plus true negatives) of monitoring to detect new neurological deficits was 99.0% (102/103) for the entire cohort, and 100% (11/11) for those showing significant changes at the moment of positioning. Overall, only 1 patient, with non-significant SEP attenuation, experienced a new postoperative deficit, yielding a 0.97% rate of false negatives. CONCLUSION: Among patients undergoing surgery for cervical myelopathy, 10.7% showed alarming electrophysiological signal changes at the time of positioning. Immediate repositioning of the neck resulted in near always restoration of potentials and avoidance of added neurological damage. Complete or partial restoration of potentials after repositioning yielded no postoperative deficits.

Volumetric growth rate of incidental asymptomatic meningiomas: a single-center prospective cohort study.

BACKGROUND: Decision about treatment of incidentally found intracranial meningiomas is controversial and conditioned by the growth potential of these tumors. We aimed to evaluate the growth rate of a cohort of incidentally found asymptomatic meningiomas and to analyze their natural course and the need for eventual treatment. METHODS: A total of 193 patients harboring intracranial meningiomas (85 with 109 incidental and 108 with 112 symptomatic) were included between 2015 and 2019. In the prospective cohort of incidental meningiomas, we measured size at diagnosis, volumetric growth rate (by segmentation software), appearance of symptoms, and need for surgery or radiotherapy. Progression-free survival and risk factors for growth were assessed with Kaplan-Meier survival and Cox regression analyses. RESULTS: Among incidental meningiomas, 94/109 (86.2%) remained untreated during a median follow-up of 49.3 months. Tumor growth was observed in 91 (83.5%) and > 15% growth in 40 (36.7%). Neurological symptoms developed in 1 patient (1.2%). Volume increased an average of 0.51 cm3/year (95% CI, 0.20-0.82). Nine patients were operated (9.2%) and 4 underwent radiotherapy (4.7%). Treatment-related complication rates of incidental and symptomatic meningiomas were 0% and 35.4%, respectively. Persistent neurological defects occurred in 46 (40.7%) of symptomatic versus 2 (2.3%) of incidental meningiomas. Among covariates, only brain edema resulted in an increased risk of significant tumor growth in the female subgroup (Cox regression HR 2.96, 95% CI 1.02-8.61, p = 0.046). Size at diagnosis was significantly greater in the symptomatic meningioma group (37.33 cm3 versus 4.74 cm3, p < 0.001). CONCLUSIONS: Overall, 86% of incidentally found meningiomas remained untreated over the first 4 years of follow-up. The majority grew within the 20% range, yet very few developed symptoms. Treatment-related morbidity was absent in the incidental meningioma group.

Primary central nervous system angiosarcoma with recurrent acute subdural hematoma.

Angiosarcoma is an infrequent tumor among sarcomas, especially presenting as a primary tumor within the central nervous system, which can lead to a rapid neurological deterioration and death in few months. We present a 41-year old man with a right frontal enhancing hemorrhagic lesion. Surgery was performed with histopathological findings suggesting a primary central nervous system angiosarcoma. He was discharged uneventfully and received adjuvant chemotherapy and radiotherapy. At 5 months, the follow-up MRI showed two lesions with an acute subdural hematoma, suggesting a relapse. Surgery was again conducted finding tumoral membranes attached to the internal layer of the duramater around the right hemisphere. The patient died a few days later due to the recurrence of the subdural hematoma. This case report illustrates a rare and lethal complication of an unusual tumor. The literature reviewed shows that gross-total resection with adjuvant radiotherapy seems to be the best treatment of choice.

Drezotomía en el tratamiento del dolor por desaferentización: revisión de resultados y análisis de factores predictores de éxito / DREZotomy in the treatment of deafferentation pain: review of results and analysis of predictive factors for success

Antecedentes y objetivos El tratamiento del dolor por desaferentización mediante drezotomía espinal es una opción terapéutica contrastada en la literatura. En los últimos años, la drezotomía ha visto relegado su empleo a un segundo plano debido a la eclosión de las terapias neuromoduladoras. Los objetivos de este estudio son demostrar que la drezotomía continúa siendo un tratamiento efectivo y seguro, y analizar aquellos factores predictores de éxito. Pacientes y métodos Se realizó un estudio retrospectivo de todos los pacientes tratados en nuestro servicio mediante drezotomía espinal desde 1998 hasta 2018. Se excluyeron los casos de drezotomía bulbar. Se emplearon la escala visual analógica (EVA) y la reducción de la medicación habitual como variables resultado, y se analizaron variables demográficas, clínicas y quirúrgicas como factores predictores de éxito. Resultados Un total de 27 pacientes (51,9% mujeres) de 53,7 años de edad media fueron tratados mediante drezotomía. La etiología principal del dolor fue por avulsión de plexo braquial (55,6%) seguida de causa tumoral (18,5%). El tiempo medio de evolución del dolor fue de 8,4 años con una intensidad media de 8,7 según la EVA, pese a que el 63% de los pacientes habían recibido tratamiento neuroestimulador previo. Durante el postoperatorio inmediato un 77,8% de los pacientes presentaron una reducción del 50% o más en la EVA. Tras un seguimiento medio de 22 meses posdrezotomía, permaneció una reducción de al menos el 50% en la EVA en el 59,3% de los pacientes (reducción media de 4,9 puntos) permitiendo una reducción del tratamiento analgésico habitual en el 70,4% de ellos. La drezotomía en la avulsión de plexo braquial presentó una tasa de éxito (93%) superior al resto de patologías (41,7%) de manera significativa (p = 0,001) (AU)

Background and objectives The treatment of deafferentation pain by spinal DREZotomy is a proven therapeutic option in the literature. In recent years, use of DREZotomy has been relegated to second place due to the emergence of neuromodulation therapies. The objectives of this study are to demonstrate that DREZotomy continues to be an effective and safe treatment and to analyse predictive factors for success. Patients and methods A retrospective study was conducted of all patients treated in our department with spinal DREZotomy from 1998 to 2018. Bulbar DREZotomy procedures were excluded. A visual analogue scale (VAS) and the reduction of routine medication were used as outcome variables. Demographic, clinical and operative variables were analysed as predictive factors for success. Results A total of 27 patients (51.9% female) with a mean age of 53.7 years underwent DREZotomy. The main cause of pain was brachial plexus injury (BPI) (55.6%) followed by neoplasms (18.5%). The mean time of pain evolution was 8.4 years with a mean intensity of 8.7 according to the VAS, even though 63% of the patients had previously received neurostimulation therapy. Favourable outcome (≥ 50% pain reduction in the VAS) was observed in 77.8% of patients during the postoperative period and remained in 59.3% of patients after 22 months average follow-up (mean reduction of 4.9 points). This allowed for a reduction in routine analgesic treatment in 70.4% of them. DREZotomy in BPI-related pain presented a significantly higher success rate (93%) than the other pathologies (41.7%) (p = .001). No association was observed between outcome and age, gender, DREZ technique, duration of pain or previous neurostimulation therapies. There were six neurological complications, four post-operative transient neurological deficits and two permanent deficits (AU)

DREZotomy in the treatment of deafferentation pain: review of results and analysis of predictive factors for success. / Drezotomía en el tratamiento del dolor por desaferentización: revisión de resultados y análisis de factores predictores de éxito.

BACKGROUND AND OBJECTIVES: The treatment of deafferentation pain by spinal DREZotomy is a proven therapeutic option in the literature. In recent years, use of DREZotomy has been relegated to second place due to the emergence of neuromodulation therapies. The objectives of this study are to demonstrate that DREZotomy continues to be an effective and safe treatment and to analyse predictive factors for success. PATIENTS AND METHODS: A retrospective study was conducted of all patients treated in our department with spinal DREZotomy from 1998 to 2018. Bulbar DREZotomy procedures were excluded. A visual analogue scale (VAS) and the reduction of routine medication were used as outcome variables. Demographic, clinical and operative variables were analysed as predictive factors for success. RESULTS: A total of 27 patients (51.9% female) with a mean age of 53.7 years underwent DREZotomy. The main cause of pain was brachial plexus injury (BPI) (55.6%) followed by neoplasms (18.5%). The mean time of pain evolution was 8.4 years with a mean intensity of 8.7 according to the VAS, even though 63% of the patients had previously received neurostimulation therapy. Favourable outcome (≥50% pain reduction in the VAS) was observed in 77.8% of patients during the postoperative period and remained in 59.3% of patients after 22 months average follow-up (mean reduction of 4.9 points). This allowed for a reduction in routine analgesic treatment in 70.4% of them. DREZotomy in BPI-related pain presented a significantly higher success rate (93%) than the other pathologies (41.7%) (p=.001). No association was observed between outcome and age, gender, DREZ technique, duration of pain or previous neurostimulation therapies. There were six neurological complications, four post-operative transient neurological deficits and two permanent deficits. CONCLUSION: Dorsal root entry zone surgery is effective and safe for treating patients with deafferentation pain, especially after brachial plexus injury. It can be considered an alternative treatment after failed neurostimulation techniques for pain control. However, its indication should be considered as the first therapeutic option after medical therapy failure due to its good long-term results.

Igualdade de gênero no corfebol: análise das hashtags no Facebook / Gender equality in korfball: analysis of hashtags on Facebook / Igualdad de género en korfball: análisis de hashtags en Facebook

Objetivo: Analisar de que maneira os usuários do Facebook utilizam a hashtag na organização dos conteúdos relacionados ao corfebol e as questões relacionadas à igualdade de gênero e em quais formatos se dão essas postagens nesta rede social. Metodologia: Buscou-seas hashtags #Korfball #Corfebol #GenderEquality e #MixedGenderSport no Facebook e as mesmas foram analisadas sob a Técnica de Análise de Conteúdo no período de 1 a 15 de agosto de 2019. Resultados e discussão: os resultados geraram duas categorias: hashtags utilizadas na marcação das postagens e conteúdos abordados ­igualdade de gênero. Considerações Finais: Pode-se perceber que o Facebook se mostrou um espaço interessante no que tange à difusão de conteúdos relacionados às questões de gênero e as hashtags neste contexto, foram ressignificadas.

Objective: To analyze how Facebook users use the hashtag in the organization of content related to korfball and issues related to gender equality and in what formats these posts are made on this social network. Methodology: We searched for the hashtags #Korfball #Corfebol #GenderEquality and #MixedGenderSport on Facebook and they were analyzed using the Content Analysis Technique from 1 to 15 August 2019. Results and discussion: the results generated two categories: hashtags used to mark posts and content covered -gender equality. Final Considerations: It can be seen that Facebook has proved to be an interesting space in terms of the dissemination of content related to gender issues and hashtags in this context have been re-signified.

Objetivo: Analizar cómo los usuarios de Facebook utilizan el hashtagen la organización de contenidos relacionados con el korfbal y temas relacionados con la igualdad de género y en qué formatos se realizan estas publicaciones en esta red social. Metodología: Se buscaron los hashtags #Korfball #Corfebol #GenderEquality y #MixedGenderSport en Facebook y se analizaron mediante la Técnica de Análisis de Contenido del 1 al 15 de agosto de 2019. Resultados y discusión: los resultados generaron dos categorías: hashtags utilizados para marcar publicaciones y contenido cubierto -igualdad de género. Consideraciones finales: Se puede apreciar que Facebook ha demostrado ser un espacio interesante en cuanto a la difusión de contenidos relacionados con la temática de género y los hashtags en este contexto han sido resignificados.

Angiographically occult and spontaneously thrombosed large brain arteriovenous malformation.

Treatment for brain arteriovenous malformations (AVM) include combinations of surgery, radiosurgery and embolization. Very rarely, spontaneous obliteration may occur, especially among small lesions with single superficial vein drainage and prior bleeding. We report the case of a large symptomatic AVM, without history of hemorrhage or prior treatment, in which self-obliteration was noted at surgery. Although MRI suggested the presence of an AVM, no evidence of arterial anomaly was observed in the brain angiography. At surgery, a large cortical nidus with tortuous arterial vessels, resembling that of an AVM but without blood flow, was identified. Complete resection was easily performed without relevant bleeding. The histopathologic study confirmed the diagnosis of a thrombosed AVM. Despite the low probability of recanalization, surgical resection of a suspected spontaneously obliterated AVM may be warranted, in order to reach a definitive diagnosis and to avoid the risk of an eventual bleeding, especially among younger patients.

Coesão de grupo no basquetebol: olhares nas categorias de base / Group cohesion in basketball: a look at the base categories

O presente estudo teve como objetivo investigar o nível de coesão de grupo em atletas de Basquetebol de categorias de base, comparando os níveis de coesão de grupo no início (abril de 2018) e no final (novembro de 2018) da temporada. Participaram do estudo 26 atletas com idade entre 13 e 15 anos. O instrumento utilizado foi o Questionário de Ambiente de Grupo ­ QEG. Os resultados demonstraram que os atletas de Basquetebol investigados apresentaram elevados escores nas dimensões relacionadas à tarefa, com maiores escores para dimensão AI-T (Atração Individual para o Grupo-Tarefa), independentemente de a análise ser no início ou no final da temporada. Assim, pode-se considerar que os atletas investigados neste estudo apresentaram coesão em prol da tarefa, o que é considerado adequado para o desempenho esportivo.

This study aimed at investigating the level of group cohesion in basketball athletes in base categories, comparing group cohesion levels at the beginning (April 2018) and at the end (November 2018) of the season. A total of 26 athletes aged 13 to 15 years old participated in the study. The instrument used was the Group Environment Questionnaire - QEG. The results showed that the investigated basketball athletes presented high scores on the task-related dimensions, with higher scores for the IA-T dimension (Individual Attraction for the Task Group) regardless of whether the analysis was at the beginning or at the end of the season. Thus, it can be considered that the athletes investigated in this study presented cohesion in favor of the task, which is considered adequate for the sport performance.

Estado de humor de atletas da base de uma equipe de basquetebol / Mood State of athletes from the base of a basketball team / Estado del ánimo de deportistas desde la base de un equipo de baloncesto

O presente estudo investigou o estado de humor de atletas de Basquetebol das categorias de base de um Clube, comparando o estado de humor no início e no final da temporada de 2018. Participaram 26 atletas, voluntários, do sexo masculino, federados, com idades entre 13 e 15 anos. Os atletas responderam a Escala de Humor de Brunel - BRUMS. Os resultados demonstraram que os atletas apresentaram um estado de humor positivo, pois tanto no início quanto no final da temporada a subescala Vigor obteve os maiores escores. Em relação as comparações entre o início e o final da temporada, os atletas aumentaram os escores das subescalas Vigor e Tensão, além de diminuírem os escores da subescala Fadiga. Pode-se concluir que durante a temporada de 2018 os atletas foram capazes de manter o estado de humor positivo, com valores de Vigor superiores aos demais fatores, o que é caracterizado como ideal para o rendimento esportivo.

The present study investigated the mood states of Basketball athletes from the base categories of a Club, comparing mood states at the beginning and end of the 2018 season. Twenty-six athletes, male volunteers, with ages between 13 and 15 years. The athletes responded to Brunel's Humor Scale - BRUMS. The results showed that the athletes presented a positive state of mood, both at the beginning and at the end of the 2018 season, because the Vigor factor presented the highest scores at the two moments of collect. In addition, the Vigor factor increased its score throughout the season, and the Fatigue factor decreased. It can be concluded that during the 2018 season athletes were able to maintain a positive mood, with Vigor values higher than the other factors, which is characterized as ideal for sports performance.

El presente estudio investigó los estados de humor de jugadores de baloncesto de las categorías básicas de un club, comparando los estados de humor al principio y al final de la temporada 2018. Veintiséis hombres, federados, hombres, Entre 13 y 15 años. Los jugadores respondieron a la Escala de Humor de Brunel - BRUMS. Los resultados mostraron que los jugadores presentaron un estado de humor positivo, tanto al principio como al final de la temporada 2018, porque el factor Vigor presentó las puntuaciones más altas en los dos momentos de la recolección. Además, el factor Vigor aumentó su puntaje durante la temporada, y el factor Fadiga disminuyó. Se puede concluir que durante la temporada 2018, los jugadores pudieron mantener un estado de humor positivo, con valores de Vigor superiores a los otros factores, lo que se caracteriza por ser ideal para el rendimiento deportivo.

Estado de Humor em atletas de categoria de base da modalidade Basquetebol / Mood State of base Basketball category athletes / Estado de Humor de atletas de categoría de base de la modalidad Baloncesto

O estudo teve o objetivo de investigar o estado de humor de atletas de Basquetebol de um clube da cidade de São Paulo no início e no final da temporada de 2018. Assim, foi utilizada a Escala de Humor de Brunel (BRUMS), aplicada numa amostra composta por 26 atletas (Sub- 13 e Sub-15), voluntários, do sexo masculino, federados, com idades entre 13 e 15 anos. Os resultados demonstraram que os dois grupos apresentaram estado de humor similar no início e final da temporada, com o fator Vigor sendo superior aos demais. Além disso, o Sub-13 au- mentou os escores dos fatores Vigor e Tensão entre o início e o final da temporada, e o Sub-15 diminuiu os escores do fator Fadiga no decorrer da temporada. Pode-se concluir que os atletas apresentaram o perfil de humor denominado de iceberg .

The purpose of this study was to investigate the mood of basketball athletes of a club in the city of Sao Paulo at the beginning and end of the 2018 season. Thus, the Brunel Humor Scale (BRUMS), applied in a sample composed of 26 male and female volunteers (Sub- 13 and Sub-15), aged 13 to 15 years, was used. The results showed that the two groups had similar mood at the beginning and end of the season, with the Vigor factor being higher than the others. In addition, Sub-13 increased Vigor and Tension factor scores between the beginning and the end of the season and Sub-15 decreased Fatigue factor scores throughout the season. It can be concluded that the athletes presented the humor profile called iceberg.

El estudio tuvo el objetivo de investigar el estado de humor de atletas de baloncesto de un club de São Paulo al inicio y al final de la temporada de 2018. Así, se utilizó la Escala de Humor de Brunel (BRUMS), aplicada en una muestra compuesta por una muestra compuesta 26 atletas (Sub-13 y Sub-15), voluntarios, del sexo masculino, federados, con edades entre 13 y 15 años. Los resultados demostraron que los dos grupos de investigación presentaron estado de humor similar al inicio y final de la temporada, con el factor Vigor siendo superior a los demás. Además, el Sub-13 aumentó los escores de los factores Vigor y Tensión entre el inicio y el final de la temporada y el Sub-15 disminuyó los escores del factor Fatiga en el transcurso de la temporada. Se puede concluir que los atletas presentaron el perfil de humor denominado de iceberg.

Imaging and Radiologic-Pathologic Correlation in Granular Cell Astrocytomas: Report of 2 Cases.

BACKGROUND: Granular cell astrocytoma is a rare and aggressive subtype of astrocytoma that is histopathologically well defined in the literature. It is formed by polygonal cells with granular cytoplasm mixed with neoplastic astrocytes and usually a perivascular infiltrate of lymphocytes. Despite its unusual histologic appearance, relevant radiologic features have not yet been described. CASE DESCRIPTION: We report 2 middle-aged patients with neurologic symptoms secondary to a newly diagnosed brain tumor. The absence of central tumor necrosis as well as the presence of an atypical pattern of enhancement and areas of intense diffusion restriction on magnetic resonance imaging in both cases led to the diagnosis of primary central nervous system lymphoma. Histopathologic findings in both tumors showed an aggressive astrocytoma with a prominent granular cell population and perivascular lymphocytic cuffing in tissue, corresponding to a granular cell astrocytoma. Despite the favorable prognostic factors, including World Health Organization grades II and III astrocytomas and IDH mutations, the outcome was poor. CONCLUSIONS: Granular cell astrocytomas can show unusual aggressive radiologic features that do not correspond to their histopathologic grade of malignancy. The presence of perivascular lymphocytic infiltrate may alter the typical radiologic appearance of common astrocytomas.

Dietary Tryptophan Induces Opposite Health-Related Responses in the Senegalese Sole (Solea senegalensis) Reared at Low or High Stocking Densities With Implications in Disease Resistance.

High rearing densities are typical conditions of both inland and onshore intensive aquaculture units. Despite obvious drawbacks, this strategy is nonetheless used to increase production profits. Such conditions inflict stress on fish, reducing their ability to cope with disease, bringing producers to adopt therapeutic strategies. In an attempt to overcome deleterious effects of chronic stress, Senegalese sole, Solea senegalensis, held at low (LD) or high density (HD) were fed tryptophan-supplemented diets with final tryptophan content at two (TRP2) or four times (TRP4) the requirement level, as well as a control and non-supplemented diet (CTRL) for 38 days. Fish were sampled at the end of the feeding trial for evaluation of their immune status, and mortalities were recorded following intra-peritoneal infection with Photobacterium damselae subsp. piscicida. Blood was collected for analysis of the hematological profile and innate immune parameters in plasma. Pituitary and hypothalamus were sampled for the assessment of neuro-endocrine-related gene expression. During the feeding trial, fish fed TRP4 and held at LD conditions presented higher mortalities, whereas fish kept at HD seemed to benefit from this dietary treatment, as disease resistance increased over that of CTRL-fed fish. In accordance, cortisol level tended to be higher in fish fed both supplemented diets at LD compared to fish fed CTRL, but was lower in fish fed TRP4 than in those fed TRP2 under HD condition. Together with lower mRNA levels of proopiomelanocortin observed with both supplementation levels, these results suggest that higher levels of tryptophan might counteract stress-induced cortisol production, thereby rendering fish better prepared to cope with disease. Data regarding sole immune status showed no clear effects of tryptophan on leucocyte numbers, but TRP4-fed fish displayed inhibited alternative complement activity (ACH50) when held at LD, as opposed to their HD counterparts whose ACH50 was higher than that of CTRL-fed fish. In conclusion, while dietary tryptophan supplementation might have harmful effects in control fish, it might prove to be a promising strategy to overcome chronic stress-induced disease susceptibility in farmed Senegalese sole.

Psicologia do esporte no Brasil: conceituação e o estado da arte / Psychology of sport in Brazil: conceptualization and the state of the art / Psicología del deporte en Brasil: conceptualización y el estado del arte

O objetivo do presente estudo foi conceituar e delimitar áreas de atuação na Psicologia do Esporte no Brasil e apresentar a evolução da área até o momento atual. Para isso, este estudo visou a refletir sobre a temática, pautando-se na revisão de estudos clássicos e contemporâ-neos, nacionais e internacionais. Nessa perspectiva, optou-se por apresentar estudos que fa-zem parte do estado da arte da Psicologia do Esporte e que se encontrassem publicados entre 1980 e 2017. Assim, pode-se concluir que a Psicologia do Esporte é uma área interdisciplinar que surgiu em função do diálogo de diferentes áreas, como a Psicologia e a Educação Física. Além disso, cabe ressaltar que é uma área em que oProfissional deEducação Físicae o Psi-cólogo podem atuar em conjunto e com profissionais de outras áreas.

The objective of the present study was toconceptualize and delimit areas of practice in Sport Psychology in Brazil and present the evolution of the area up to the present moment. For this, this study aimed to weave on the theme, based on the review of classic and contemporary studies, national and international. From this perspective, it was decided to present studies that are part of the state of the art of Sports Psychology and that were published between 1980 and 2017. Thus, it can be concluded that the Psychology of Sport is an interdisciplinary area, which arose as a function of the conversation of different areas, such as Psychology and Phys-ical Education. In addition, it should be noted that this is an area where the Physical Educa-tion Professional and the Psychologist can work together with other areas.

El objetivo del presente estudio fue conceptuar y delimitar áreas de actuación en la Psicologíadel Deporte en Brasil y presentar la evolución del área hasta el momento actual. Para ello, este estudio visó tejer sobre la temática, pautándose en la revisión de estudios clásicos y contem-poráneos, nacionales e internacionales. En esa perspectiva, se optó por presentar estudios que forman parte del estado del arte de la Psicología del Deporte y que se encontraran publicados entre 1980 y 2017. Así, se puede concluir que la Psicología del Deporte es un área interdisci-plinaria, la cual surgió en función de la conversación de diferentes áreas, como la Psicología y la Educación Física. Además, cabe resaltar que es un área en que el Profesional de Educación Física y el Psicólogo pueden actuar en conjunto con otras áreas.