[Thrombophilic study in dialysis patients].

Chronic kidney disease is a complex phenotype that results from the association of underlying kidney disease and environmental and genetic factors. In addition to the traditional risk factors, genetic factors are involved in the etiology of renal disease, including single nucleotide polymorphisms which could account for the increased mortality from cardiovascular disease of our hemodialysis patients. The genes that influence the development and rate of progression of kidney disease deserve to be better defined. We have evaluated the alterations of thrombophilia genes in hemodialysis patients and in blood donors and we have compared the results obtained. The objective of the present study is to identify biomarkers of morbidity and mortality, which allow us to identify patients with chronic kidney disease at high risk, thanks to which it is possible to implement accurate therapeutic strategies and preventive strategies that have the objective of intensifying controls in these patients.

[Intoxications in nephrology: clinical cases and local experience in Sciacca Hospital].

Intoxications are a common problem all over the world and cause acid-base balance disturbances, dysionias or acute renal failure; they can develop rapidly leading to severe cellular dysfunction and death. Intoxications and drug overdoses often require the intervention of Nephrologists, for the correction of acidosis, the administration of selective inhibitory enzymes and also hemodialysis treatment. Extracorporeal therapies have been used to remove toxins for over fifty years and have acquired an increasing role, thanks to the use of new treatment modalities in intoxicated patients. In our clinical practice in the Covid period we have found an increase in clinical cases of intoxication with psychiatric drugs, including benzodiazepines, clozapine, lithium, quetiapine and cocaine.

[Urinary tract infections in nephrology: antibiotic therapy in the era of antibiotic resistance].

Urinary tract infections (UTIs) are an emerging health problem. Kidney patients with UTI are at increased risk of antimicrobials resistance (AMR) and bad prognosis. In the nephrological setting, optimizing the management of UTIs is certainly a challenge, but it is indispensable for a favorable clinical outcome and in fighting AMR. When UTIs caused by multidrug-resistant germs are suspected, it is necessary to initiate empirical antibiotic therapy timely, pending microbiological study and bacterial sensitivity. The empirical choice of antibiotic must be based on: guidelines, resistance rates recorded in the region, and knowledge of pharmacokinetic and pharmacodynamic characteristics of the drug, in order to maximize efficacy, reduce adverse effects and minimize AMR development. Recently, the clinical use of old drugs such as colistin has increased, due to the limited circulation of resistant bacterial strains. On the other hand, ceftolozane/tazobactam, ceftazidime/avibactam, cefiderocol, imipenem/cilastatin/relebactam and meropenem-vaborbactam are very promising new antibiotics. Ongoing clinical studies will be able to determine the place for these interesting molecules in the treatment of infections and in fighting AMR.

[GLP-1 receptor agonists in the treatment of diabetes mellitus type 2: cardioprotection, and more!]

Optimal glycemic control in diabetic patients remains a difficult goal to achieve. Hypoglycemia, nausea and weight gain can compromise the patients' adherence to antidiabetic therapy over time. GLP-1 receptor agonists have been shown to improve glycemic control and reduce the incidence of side effects both when used in monotherapy and in combination with other hypoglycemic drugs. The growing interest of nephrologists in GLP-1 receptor agonists derives from numerous studies showing that not only they positively affect traditional cardiovascular risk factors, but also exert a protective effect on renal function regardless of their hypoglycemic effects, thus delaying the development and progression of diabetic nephropathy. The aim of this paper is to review the latest evidence on pharmacokinetics and pharmacodynamics and the direct and indirect mechanisms through which GLP-1 receptor agonists confer nephroprotection, improving the renal outcomes of diabetic patients.

Health-related quality of life (HRQoL) in a population at risk of type 2 diabetes: a cross-sectional study in two Latin American cities.

PURPOSE: The purpose of this study was to describe the health-related quality of life (HRQoL) characteristics in a population at risk of developing type 2 diabetes in Barranquilla and Bogotá, Colombia. METHODS: A cross-sectional study with 1135 participants older than 30 years-of-age recruited in Bogotá D.C., and Barranquilla by cluster sampling in 2018 to 2019. The Finnish Diabetes Risk Score (FINDRISC) was used to detect participants at risk of developing type 2 diabetes (T2D). HRQoL was assessed using the EQ-5D-3L questionnaire. Unadjusted and adjusted logistic regression models were used to calculate odds ratios (OR) and their corresponding 95% confidence intervals CI). RESULTS: Moderate or extreme problems appeared more frequently in the dimensions of Pain/Discomfort (60.8%) and Anxiety/Depression (30.8%). The mean score of the EQ-VAS was 74.3 (± 17.3), significantly larger in the state of complete health (11111) compared with those with problems in more than one of the quality-of-life dimensions. Being female and living in Bogota D.C., were associated with greater odds of reporting problems in the Pain (OR 1.6; 95% CI 1.2-2.2) and Discomfort dimensions (OR 1.6; 95% CI 1.2-2.0) respectively and Anxiety/Depression (OR 1.9; 95% CI 1.3-2.7), (OR 9.1; 95% CI 6.6-12.4), respectively. CONCLUSIONS: As living place and sex were associated with dimensions of Pain/Discomfort and Anxiety/Depression in the HRQoL in people at risk of T2D, greater attention should be paid to these determinants of HRQoL to design and reorient strategies with a territorial and gender perspective to achieve better health outcomes. Diabetes is one of the four non-communicable diseases with increasing prevalence in the world, which has made it a serious public health problem. In Colombia, in 2019 diabetes affected 8.4% of the Colombian adult population and more than one million Colombian adults of this age group have hidden or undetected diabetes. This disease is not only characterized by increased premature mortality, loss of productivity, and economic impact, but it also involves a deterioration in the quality of life of people with diabetes with their respective families. However, very Little is known about health-related quality of life (HRQoL) in a population at risk or with prediabetes. This study has evaluated the quality of life in patients at risk of diabetes and their behavior with some variables as sociodemographic, lifestyle, history, and established their difference in two territories of the Colombian Caribbean. The results of this study indicate that the HRQoL of people at risk of type 2 diabetes is affected by factors such as gender, city, dysglycemia, medication for hypertension and education level. Therefore, greater attention should be paid to these determinants of HRQL to design and implement strategies that reduce this risk of developing type 2 diabetes, prevent prediabetes and improve the quality of life in prediabetic or diabetic patients.

Structural Adaptive, Self-Separating Material for Removing Ibuprofen from Waters and Sewage.

ß-Cyclodextrin nanosponge (ß-CD-M) was used for the adsorption of ibuprofen (IBU) from water and sewage. The obtained material was characterized by scanning electron microscopy (SEM), Fourier transform infrared spectroscopy (FTIR), Brunauer-Emmett-Teller (BET), Barrett-Joyner-Halenda (BJH), Harkins and Jura t-Plot, zeta potential, thermogravimetric analysis (TGA), differential scanning calorimetry (DSC) and elementary analysis (EA). Batch adsorption experiments were employed to investigate the effects of the adsorbent dose, initial IBU concentration, contact time, electrolyte ions and humic acids, and sewage over adsorption efficiency. The experimental isotherms were show off using Langmuir, Freundlich, Hill, Halsey and Sips isotherm models and thermodynamic analysis. The fits of the results were estimated according to the Sips isotherm, with a maximum adsorption capacity of 86.21 mg g-1. The experimental kinetics were studied by pseudo-first-order, pseudo-second-order, Elovich, modified Freundlich, Weber Morris, Bangham's pore diffusion, and liquid film diffusion models. The performed experiments revealed that the adsorption process fits perfectly to the pseudo-second-order model. The Elovich and Freundlich models indicate chemisorption, and the kinetic adsorption model itself is complex. The data obtained throughout the study prove that this nanosponge (NS) is extremely stable, self-separating, and adjusting to the guest structure. It also represents a potential biodegradable adsorbent for the removal IBU from wastewaters.

Factors Associated With Low Physical Activity in Two Latin American Populations at Risk of Developing Type 2 Diabetes: An Exploratory Analysis.

Low level of physical activity is a risk factor for chronic non-communicable diseases. Specifically, people at risk of Type 2 Diabetes (T2D) have shown to benefit from being physically active. The objective of this study was to explore what factors were associated with low physical activity in people at high risk of T2D living in Bogota and Barranquilla, Colombia. Methodology: Cross-sectional study using baseline data from a quasi-experimental clinical trial (PREDICOL Project). The study included 1,135 participants of Bogota and Barranquilla that presented a high risk of developing T2D according to the Finnish Diabetes Risk Score (>12 points) and who underwent an oral glucose tolerance test. The main outcome variable was the level of physical activity assessed by the International Physical Activity Questionnaire. Unadjusted and adjusted logistic regression analysis were used to calculate odds ratios (OR) and the corresponding 95% confidence intervals (CI). Results: In total, 72.5% of the study participants had low level of physical activity. Participants in the age group between 45 and 54 years showed 74% greater odds of having low physical activity compared with the youngest age group (OR 1.74, 95% CI 1.1 -2.8). People living in Barranquilla were eight times more likely to have low physical activity compared with those in Bogotá D.C. (OR 8.1, 95% CI 5.7 to 11.4). Conclusion: A large proportion of the population at risk of developing D2T in two large cities of Colombia have a sedentary lifestyle. Interventions should be designed and implemented in order to increase physical activity in these populations.

[Antifibrotic renal role of mineralcorticoid receptor antagonists].

Cardiovascular and renal diseases are one of the main health problems in all industrialized countries. Their incidence is constantly increasing due to the aging of the population and the greater prevalence of obesity and type 2 diabetes. Clinical evidence suggests that aldosterone and the activation of mineralocorticoid receptors (MR) have a role in the pathophysiology of cardiovascular and renal diseases. Moreover, clinical studies demonstrate the benefits of mineralocorticoid receptor antagonists (MRAs) on mortality and progression of heart and kidney disease. In addition to renal effects on body fluid homeostasis, aldosterone has multiple extrarenal effects including the induction of inflammation, vascular rigidity, collagen formation and stimulation of fibrosis. Given the fundamental role of MR activation in renal and cardiac fibrosis, effective and selective blocking of the signal with MRAs can be used in the clinical practice to prevent or slow down the progression of heart and kidney diseases. The aim of the present work is to review the role of MRAs in light of the new evidence as well as its potential use as an antifibrotic in chronic kidney disease (CKD). The initial clinical results suggest that MRAs are potentially useful in treating patients with chronic kidney disease, particularly in cases of diabetic nephropathy. We don't yet have efficacy and safety data on the progression of kidney disease up to the end stage (ESRD) and filling this gap represents an important target for future trials.

Results of the prophylactic surgery of lumbosacral lipomas 20 years of experience in the Paediatric Neurosurgery Department La Timone Enfants Hospital, Marseille, France.

INTRODUCTION: We conducted a retrospective study of children with lumbosacral lipomas treated in the Department of Pediatric Neurosurgery hospital Timone Enfants in the last 20 years. We selected patients with lipomas of the conus medullaris who underwent preventive surgery. 86 ,4 % of the patients remained asymptomatic during the follow-up. Worse results were observed in children older than one year old at surgery with transitional lipoma, with the conus medullaris was below L5 and when the resection had been partial. In view of the results, the authors recommend the preventive surgery before the first year of life under neurophysiologic monitoring in order to perform a total near-total resection with a neural plate reconstitution.

The role of early intra-operative MRI in partial resection of optic pathway/hypothalamic gliomas in children.

INTRODUCTION: Optic pathway/hypothalamic gliomas (OPHGs) are generally benign but situated in an exquisitely sensitive brain region. They follow an unpredictable course and are usually impossible to resect completely. We present a case series of 10 patients who underwent surgery for OPHGs with the aid of intra-operative MRI (ioMRI). The impact of ioMRI on OPHG resection is presented, and a role for ioMRI in partial resection is discussed. METHODS: Ten patients with OPHGs managed surgically utilising ioMRI at Alder Hey Children's Hospital between 2010 and 2013 were retrospectively identified. Demographic and relevant clinical data were obtained. MRI was used to estimate tumour volume pre-operatively and post-resection. If ioMRI demonstrated that further resection was possible, second-look surgery, at the discretion of the operating surgeon, was performed, followed by post-operative imaging to establish the final status of resection. Tumour volume was estimated for each MR image using the MRIcron software package. RESULTS: Control of tumour progression was achieved in all patients. Seven patients had, on table, second-look surgery with significant further tumour resection following ioMRI without any surgically related mortality or morbidity. The median additional quantity of tumour removed following second-look surgery, as a percentage of the initial total volume, was 27.79% (range 11.2-59.2%). The final tumour volume remaining with second-look surgery was 23.96 vs. 33.21% without (p = 0.1). CONCLUSIONS: OPHGs are technically difficult to resect due to their eloquent location, making them suitable for debulking resection only. IoMRI allows surgical goals to be reassessed intra-operatively following primary resection. Second-look surgery can be performed if possible and necessary and allows significant quantities of extra tumour to be resected safely. Although the clinical significance of additional tumour resection is not yet clear, we suggest that ioMRI is a safe and useful additional tool, to be combined with advanced neuronavigation techniques for partial tumour resection.

Endoscopic Third Ventriculostomy in Children with Myelomeningocele: A Case Series.

Hydrocephalus develops in up to 80-90% of children with myelomeningocele (MM) after closure of the defect. Traditionally, ventriculoperitoneal shunts have been used to manage hydrocephalus in these patients. A role for endoscopic third ventriculostomy (ETV) in MM has provoked much debate, principally due to anatomical variants described, which may complicate the procedure. We present 7 cases of children with MM and hydrocephalus undergoing a total of 10 ETV procedures. All patients demonstrated clinical improvement (in acute/subacute cases) or stabilization (in chronic cases). Three patients requiring a second ETV have shown clinical stability and renewed radiological evidence of functioning ventriculostomies in follow-up since reintervention. ETV can be used, albeit cautiously, in selected cases of hydrocephalus associated with MM. However, the frequency with which anatomical variation is encountered and the difficulty of the assessment of success make the procedure more challenging than usual.

Extradural abscess secondary to Salmonella enteritidis in a child following fronto-orbital facial advancement and remodeling surgery.

Intracranial infections caused by Salmonella are rare. We describe the first case of a child undergoing craniofacial surgery for trigonocephaly and subsequently developing an extradural abscess secondary to likely community-acquired Salmonella enteritidis. He underwent surgical washout but returned to theater for a further 2, alongside a prolonged course of intravenous ciprofloxacin. We observed extensive anterior skull bone loss at 78 days postoperatively. At 1 year 11 months, extensive anterior skull bone remodeling had taken place, and the child is currently well.

MRI findings of intracranial anomalies associated with cephalocele--a case series.

INTRODUCTION: Cephalocele is a relatively rare cranial dysraphism characterised by herniation of intracranial structures through the skull. Surgical management is primarily necessary where a risk of infection through communication of the lesion with the intracranial space exists, a risk of rupture, or for cosmetic purposes. Cephalocele is often associated with venous anomalies such as vertical embryonic positioning of the straight sinus, splitting of the superior sagittal sinus, vein of Galen elongation, along with tenting of the tentorium [Morioka et al. Childs Nerv Syst 25:309-315, 2009] PATIENTS: Here, we report four cases of cephalocele with pre-operative MRI imaging retrospectively studied, demonstrating associated venous anomalies. Three of these patients went on to have uncomplicated, corrective surgery, while one was managed conservatively. RESULTS: All four cases demonstrated the main venous drainage going through a persistent falcine sinus to drain into the superior sagittal sinus. Upward tenting of the tentorium was observed in three cases (cases 1, 3 and 4). Two of our cases demonstrated other venous anomalies frequently reported in the literature, namely splitting of the superior sagittal sinus and absence of the transverse sinus (case 1) and communication of the cephalocele with the superior sagittal sinus and absence of the straight sinus (case 2). CONCLUSION: The association between cephalocele and venous anomalies suggests that pre-operative MRI should be mandatory for a full evaluation of a suspicious midline cranial lesion in order to evaluate the safety of corrective surgery.

Intracystic gadolinium-enhanced MRI in the evaluation of residual giant-cystic craniopharyngiomas in children: report of four cases.

Residual giant-cystic craniopharyngiomas are amenable to intracavitary bleomycin treatment. Radiologic identification of potential cyst leaks is of paramount for treatment decisions. This report describes our experience in the use of intracystic Gadolinium (Gd)-enhanced MR imaging to determine potential communications between the tumoral cysts and other intra-axial spaces in 4 pediatric patients with residual giant-cystic craniopharyngiomas in whom intracavitary bleomycin treatment was planned after the injection of .1-.2 mL of gadopentetate dimeglumine (Gd-DTPA). In three cases no leaks were found. In one case, whose previous water-soluble iodinated contrast-enhanced CT cystography was negative for leaks, intracystic Gd-enhanced MR showed intraventricular Gd enhancement. We conclude that MR imaging after intracystic administration of Gd-based contrast paramagnetic agents is useful in the detection of potential leaks in cases of giant residual craniopharyngiomas.

Saúde, sexualidade e educação sexual em adolescentes do Alto Minho / Health, sexuality and sexual education in adolescents from Alto Minho

A sexualidade como energia indiscutivelmente presente no ser humano, apesenta-se não só como fenómeno físico, mas também como um fenómeno social e psicológico, que deve ser compreendido como universal e situado no âmbito e nas regras da cultura onde vivem os indivíduos (Paiva,1996) A importância da educação sexual é hoje uma realidade aceite e compreendida como fundamental e necessária. É reconhecida a sua importância, quer no âmbito da formação da personalidade, quer do desenvolvimento do indivíduo no seu todo. Deve ser compreendida numa perspetiva holística, no âmbito dos conceitos de Educação e de Saúde, revestindo-se do propósito de educar os adolescentes para a vivência de uma sexualidade saudável, centrando-se no diagnóstico das necessidades dos adolescentes nesta área e apoiando-se na articulação dos diferentes agentes educativos. Tendo por base o referido, o presente estudo tem como objetivo identificar as atitudes conhecimentos e comportamentos sexuais dos adolescentes e observar fatores determinantes dos mesmos, evidenciando o papel relevante da família no processo de educação para a sexualidade. Apresenta-se como estudo de abordagem quantitativa, de carácter descritivo transversal. Os dados foram obtidos através de um questionário de autopreenchimento. A recolha de informação decorreu no período de Maio a Junho de 2012, tendo sido inquiridos para o efeito 360 adolescentes escolarizados com idades compreendidas entre os 15 e 19 anos. As dimensões em análise foram o conhecimento e comportamento na área da sexualidade, as atitudes sexuais e a relação dos adolescentes com os pais. A análise dos resultados quantitativos possibilita identificar que os rapazes apresentam menos conhecimentos corretos que as raparigas, que a idade de iniciação sexual dos adolescentes varia tendo em conta o sexo, por volta dos 14 anos para os rapazes e 16 anos para as raparigas. Permite ainda verificar que os rapazes apresentam-se mais favoráveis ao sexo ocasional e que a perceção das atitudes parentais, nomeadamente na dimensão do Controlo, parece influenciar a iniciação sexual dos adolescentes, assim como a dimensão de amor parece interferir com a posição dos adolescentes face ao sexo ocasional/sexo sem compromisso, verificando-se que os adolescentes que percecionam mais Controlo, por parte dos pais, iniciam as relações sexuais mais tarde, e os adolescentes que percecionam mais amor, não são tão favoráveis ao sexo ocasional / sexo sem compromisso. Estes resultados apresentam-se importantes, na medida em que permitem refletir sobre as práticas na área da educação para a sexualidade junto dos adolescentes, por parte dos vários agentes educativos, promovendo a reflexão conjunta no sentido de definir estratégias articuladas por parte da escola e serviços de saúde, com especial envolvimento da família.

There are no doubts that sexuality is part of human beings' life. It is not only a physical, but also a social and psychological phenomenon that should be simultaneously understood as being dependent on specific contexts, such as individuals' cultural context and inherent rules (Paiva, 1996). Education for sexuality has been increasingly recognised by academics and professionals as critical and necessary to individuals' development, specifically in terms of personality (Frade, Marques, Alverca & Vilar, 2001; GTES, 2005). Education for sexuality is a broader subject and it involves different areas of investigation and participants and/or parties (e.g. school and family). Thus, in order to be fully understood, education for sexuality should be understood in a holistic perspective including Education and Health concepts and the perspective of the different parties involved. Thus, and given the above, this study considers these two areas of investigation and its purpose is twofold. First, the study aims to identify teenagers' knowledge, attitudes, and behaviours with regard to sexuality. Second, the purpose is to determine the influencing factors on teenagers' knowledge, attitudes, and behaviours with regard to sexuality. This study adopts a quantitative research approach. Data was collected through a self-completion questionnaire between May and June 2012 from 360 teenagers, more specifically from secondary school students whose age ranged from 15-19 years old. With regard to students' knowledge, the results indicate that male respondents have less knowledge about "correct practices" than female respondents. In addition, regarding sexual behaviours, male respondents tend to initiate their sexual behaviours earlier than female respondents and they are more favourable (attitudes) to casual sex than female students. Also, the results indicate that teenager' perceptions about their parents' attitudes, especially regarding control and love-related attitudes, seem to be related to teenagers' behaviour in relation to causal sex/sex without commitment. Those students that perceived their parents having more controlling attitudes indicated that they initiated their sexual behaviour later than those who perceived less controlling attitudes. Additionally, those teenagers that perceive more love from their parents were not so favourable to casual sex/sex without commitment as those students that perceived less love from their parents. At a practical level these results are important to those involved in education for sexuality aiming at teenagers as they allow a more thorough evaluation of what is the current situation with regard to teenagers' perceptions, attitudes, and behaviour towards sexuality. In addition, based on these results, future plans and actions could be developed by the different involved parties, namely school, health services and family, with the latter having a key role on education for sexuality. By identifying teenagers' needs and informing them in relation to this issue, education for sexuality can influence them to choose a healthy sexuality in the future.

Fascitis craneal: caso clínico y revisión de la literatura / No disponible

La fascitis craneal es una lesión miofibroblástica benigna infrecuente, de rápido crecimiento, localizada en el cráneo y de aparición preferente en niños durante el primer año de vida. Histológicamente es similar a la fascitis nodular o a la fascitis seudosarcomatosa. Puede mimetizar patologías más agresivas, como histiocitosis o sarcomas, por su rápido crecimiento de forma nodular en el tejido subcutáneo. La resección completa se considera curativa y tiene bajo riesgo de metástasis o de malignización. En el presente trabajo se presenta el caso de un varón de 4 años con fascitis en tejido celular subcutáneo craneal con erosión de la tabla externa y reacción perióstica circundante, respetando las meninges. El objetivo de este trabajo es destacar la ausencia de necesidad de tratamiento adyuvante con radioterapia o quimioterapia. Se lleva a cabo, además, una revisión de la literatura (AU)

Foreign body granuloma secondary to ventriculo-peritoneal shunt: a rare scenario with a new insight.

Ventriculo-peritoneal shunts are used extensively for the management of hydrocephalus and frequently present with complications such as shunt blockage and infection. Cerebrospinal fluid (CSF) eosinophilia and allergic responses to the shunt itself are rare, poorly understood but increasingly recognised complications. Here, the authors describe a child who required multiple shunt revision surgeries due to extensive scalp tenderness overlying the shunt tubing and persistent severe headaches despite having a normal working shunt and no CSF infection or eosinophilia. Histological investigation of excised tissue during the last shunt revision demonstrated fibrosis with scar tissue and chronic inflammatory infiltrate with foreign body giant cells and few abortive granulomata. This was felt to represent a foreign body reaction to the shunt. A hypoallergenic 'extracted' shunt was trialled (extracted Delta® valve and extracted ventricular and peritoneal catheters; Medtronic) and the child has had no further shunt revisions and is currently asymptomatic 1 year after the insertion.

[Cranial fasciitis: a case report and review of the literature]. / Fascitis craneal: caso clínico y revisión de la literatura.

Cranial fasciitis is an uncommon, rapidly-growing, benign, non-tumoural, myofibroblastic lesion of the skull, found mainly among young children in their first year of life. It is histologically similar to nodular fasciitis and pseudosarcomatous fasciitis. It may mimic more aggressive pathologies, such as sarcomatosis or histiocytosis, due to its rapid, nodular growth in subcutaneous tissue. Complete resection is considered curative and, therefore, entails a low risk of metastases or malignant recurrences. We present the clinical, radiological and pathological findings in a 4-year-old boy with cranial fasciitis in the deep, subcutaneous, soft tissue, with erosion of the outer table of the cranium, which also produced periosteal reaction, while respecting the inner table and meninges. The objective of this article is to highlight the absence of radiotherapeutic or chemotherapeutic adjuvant treatment. In addition, an exhaustive review of the literature is also presented.

Endoscopic Third Ventriculostomy Success Score (ETVSS) predicting success in a series of 50 pediatric patients. Are the outcomes of our patients predictable?

PURPOSE: In our series of endoscopic third ventriculostomy (ETV), we sought to establish the relationship between the preoperative prediction using the Endoscopic Third Ventriculostomy Success Score (ETVSS) and the postsurgical success rate. MATERIALS AND METHODS: This descriptive analytical study comprised 50 pediatric patients who underwent 58 ETV procedures between 2003 and 2011. Data regarding clinical, surgical, and radiological findings were obtained from a continuously updated database. For each patient, we calculated the ETVSS, based on the patient's age, hydrocephalus etiology, and presence of a previous shunt. We considered success to be an established or improved clinical state and at least one of the following radiological criteria: (a) reduction in ventricular size or stable ventricles with disappearance of periventricular edema and increased subarachnoid space over cerebral convexities, (b) flow artifact in sagittal T2FSE MR, or (c) bidirectional flow signal in 2D-CPC MR. Statistical significance was set at p < 0.05. Six months was the minimum postoperative follow-up required. RESULTS: The ETV was successful in 29 patients (58 %). Patients aged over 1 year achieved the best results (p < 0.019). For those who underwent successful ETV, the mean ETVSS was 71.03 (95 % CI, 66.23-75.84). In those for whom the ETV was not successful, the mean ETVSS was 60 (95 % CI, 53.09-66.90); (p < 0.007). CONCLUSIONS: The success of ETV in our series could have been predicted by ETVSS. Predictability could help establish stricter surgical selection criteria, thereby obtaining higher success rates, as well as preparing the patients and their families for expected outcomes.

Resposta germinativa de sementes de caroá [Neoglaziovia variegata (Arruda) Mez] / Germinative response of Neoglaziovia variegata (Arruda) Mez seeds

O caroá é uma Bromeliaceae nativa da Caatinga brasileira cujas fibras retiradas das folhas geram trabalho e renda para diversas famílias nordestinas com a fabricação de vários produtos artesanais. A propagação ocorre via sementes, que podem servir como alimento para muitos animais e pássaros. Diante de sua importância econômica regional, a planta do caroá tem sido coletada na caatinga de forma extrativista, já tendo praticamente desaparecido em algumas regiões da Bahia. Objetivou-se, com o desenvolvimento deste trabalho, avaliar o efeito da temperatura e da restrição de água na germinação de sementes de Caroá. A germinabilidade foi avaliada sob as temperaturas de 25, 30, 34 e 37° C, sendo que a temperatura mais favorável à germinação foi utilizada no ensaio seguinte, combinando com diferentes soluções-teste de polietilenoglicol. As maiores taxas de sementes germinadas (> 66 por cento) ocorreram quando as temperaturas do meio eram mais elevadas, sendo que a de 30° C foi a que proporcionou a maior velocidade média de germinação (0,12 dias-1) e índice de velocidade de germinação; por sua vez a germinação decresceu com a diminuição do potencial osmótico do meio. Sob condições de restrição hídrica, as sementes de caroá mostraram capacidade germinativa até o potencial de -0,6 MPa.

Caroá is a native Bromeliaceae of the Brazilian savanna. It generates work and income for many Northeastern families when used as source of fiber for producing craft products. The species can be propagated from seeds and it serves as food for a variety of animals. As a result of its economic importance to the region, the caroá plant has been indiscriminately harvested in the savanna and has practically disappeared in some areas of Bahia State, Brazil. The objective of this research was to study the effect of hydric restriction on the seed germination of caroá, as a proposed means of establishing a cultivation system and more rational production methods. Germination was tested at temperatures of 25, 30, 34 and 37° C, with the optimum temperature for germination used in a subsequent test, combining different test solutions of polyethylene glycol. The highest rates of seed germination (> 66 percent) occurred when the ambient temperature was higher, and 30° C yielded the highest average speed of germination (0.12 day-1) and germination speed index. On the other hand, germination rates decreased as osmotic potential of the environment decreased. Under conditions of hydric restriction, seed germination of caroá showed the potential to reach up to -0.6 MPa.