Proposal of a new method to induce ventricular system dilation to simulate the features of hydrocephalus and provide an anatomical model for neuroendoscopy training.

OBJECTIVE: Create an anatomical model which simulates the real condition of a hydrocephalus and which can be used as a tool in the training of neurosurgeons in neuroendoscopy techniques and anatomical structure study. METHODS: Case-control type study, with an experimental group consisting of ten brains, in which the injection of distilled water was performed; and the control group consisting of three brains with saline solution. Inclusion criteria were brains with no history of contagious diseases or traumatic injury. RESULTS: t student test showed that the relation between frontal horn and internal frontal diameter (FH/ID), with an average of 13 % before the experiment, had a significant difference (t = -3.47, df = 9, p < 0.01) from the relation after the subsequent experiment with an average of 20 %. The Evan's index also showed a significant difference (t = -3.57, df = 9, p < 0.01) with an initial and final average of 12 % and 19 %, respectively. Friedman test showed significant difference of the size of the temporal horn before and after the experiment (f = 8.1, df = 1, p < 0.01), indicating that there was significant increase of the temporal horn. CONCLUSION: The adequate use of the anomalous chemical-physical characteristics of the water molecule may provide a good mechanism to expand the ventricular cavity, in order to create an experimental model of hydrocephalus. The endoscope may be introduced by the usual ways, allowing anatomical observation and simulation of the same tactile sensitivity that one would find during the actual procedure.

Opinion of hypertensive patients on treatment effectiveness and disease-associated risk factors / Opinião de pacientes hipertensos sobre efetividade do tratamento e fatores de risco associados à doença

BACKGROUND AND OBJECTIVES: To determine population knowledge about systemic high blood pressure (SHBP) and to know about hypertensives' opinion of their blood pressure levels and the effectiveness of blood pressure control they perform. METHOD: Cross-sectional study with interviewed volunteersfrom 18 to 65 years of age, excluding pregnant women; patients' subjective opinions about SHBP and treatment effectiveness were addressed, anthropometric measures were collected, and measurement of blood pressure (BP) was performed. All records were included in the research, being stored and analyzed through PAWS Statistics 18 software, using Odds Ratio and Pearson correlation with 95% confidence interval. RESULTS: The sampling comprises 365 patients, 43.8% of males, with 29.6% being hypertensive. According to Pearson correlation, the systolic pressure was related to waist circumference (WC) (0.456), body mass index (BMI) (0.428) and neck circumference (0.326), with diastolic blood pressure (DBP) achieving similar relations but in lesser extent. The most statistically significant relations were between SHBP and diabetes (OR = 7.5), high women waist circumference (OR = 4.5) and BMI ≥ 30 (OR = 3.0). A correlation was found between patients with high systolic and diastolic BP and their opinion that BP was high (OR = 10.2 and 7.2, respectively). There was a relation between being hypertensive and having high systolic or diastolic pressure (OR = 5.4 and 3.5, respectively). When asked about the downsides of long-term SHBP, 20.3% could not inform about theses consequences. CONCLUSION: The authors concluded that antihypertensive therapy in this population does not meet the targets proposed by the VI Brazilian Guidelines on Hypertension.(...)

JUSTIFICATIVA E OBJETIVOS: Mensurar o conhecimento populacional acerca da hipertensão arterial sistêmica (HAS), conhecer a opinião do hipertenso sobre seus níveis tensionais e a eficácia do controle pressórico realizado por eles. MÉTODO: Pesquisa transversal com entrevistados voluntários entre 18 e 65 anos, excluídas gestantes. Abordaram-se opiniões subjetivas do paciente sobre HAS e efetividade do tratamento, colhidas medidas antropométricas e aferição da pressão arterial (PA). Todas as fichas foram incluídas na pesquisa, sendo armazenadas e analisadas no programa PAWS Statistics 18, utilizando-se Odds Ratio e correlação de Pearson com intervalo de confiança de 95%.RESULTADOS: Amostra composta por 365 pacientes, 43,8% do sexo masculino, 29,6% hipertensos. De acordo com a correlação de Pearson, pressão arterial sistólica (PAS) obteve relação com circunferência abdominal (CA) (0,456), índice de massa corpórea (IMC) (0,428) e circunferência do pescoço (0,326),tendo a pressão arterial diastólica (PAD) relações parecidas em menores escalas. As relações mais significantes estatisticamente foram entre HAS e: diabetes (OR = 7,5), CA feminina elevada (OR = 4,5) e IMC ≥ 30 (OR = 3,0). Houve relação entre os pacientes com PAS e PAD elevadas e opinião de achar que a PA está elevada (OR = 10,2 e 7,2, respectivamente). Existiu relação entre ser hipertenso e estar com a PAS ou PAD (OR = 5,4 e 3,5, respectivamente). Quando perguntados sobre os males da HAS em longo prazo, 20,3% não souberam informar tais consequências. CONCLUSÃO: A terapêutica anti-hipertensiva na população estudada está aquém das metas propostas pelas VI Diretrizes de Hipertensão. Os hipertensos em tratamento acreditam que sua PA está elevada antes de aferi-la, o que foi confirmado depois da medição, denotando a insegurança com a terapia e eficácia inadequada do tratamento. (...)