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Neisseria meningitidis and Streptococcus pneumoniae are the most common pathogens causing cerebrospinal meningitis (CSM) in adults. The mortality rate and the number of complications remain high. In our study, retrospective evaluations were conducted on data concerning 98 adult patients with bacterial cerebrospinal meningitis caused by Neisseria meningitidis (n = 42) and Streptococcus pneumoniae (n = 56), hospitalised at the Regional Specialistic Hospital in Wroclaw (Poland) within the period 1998-2018. Compared to the group infected with S. pneumoniae, patients infected with N. meningitidis were younger and were less often affected by an additional disease burden; they presented more frequently with haemorrhagic rashes. Compared to the S. pneumoniae group, in patients with meningococcal CSM, cytosis in cerebrospinal fluid measuring < 1,000 cells/ mL was less frequent; intravascular coagulation syndrome appeared more frequently; the hospitalisation time was shorter and the rate of mortality was lower. Meningococcal meningitis occurs more frequently among young people with no history of disease. It is characterised by the rapid development of symptoms, which results in earlier diagnosis and more favourable prognosis compared to cases of S. pneumoniae. Irrespective of the pathogen, advanced age and a level of cytosis in cerebrospinal fluid of < 1,000 cells /µl indicate an unfavourable prognosis.
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Meningite Meningocócica , Meningite Pneumocócica , Neisseria meningitidis , Humanos , Polônia , Estudos RetrospectivosRESUMO
PURPOSE: The aim of the article is to present the new hybrid technique for ventriculoatrial shunt implantation. METHODS: Two-and-a-half-year-old boy needed ventriculoatrial shunt implantation due to communicating hydrocephalus and impaired absorptive ability of the peritoneum. Because of a complete occlusion of the right internal jugular vein and critical stenosis of a distal part of the left internal jugular vein, the procedure was performed under fluoroscopy guidance in the catheterisation laboratory equipped with a 3-dimensional single plane angiography machine (Philips Allura--The Netherlands). At the level of critical stenosis of the left jugular vein, it was decided to perform a percutaneous venous balloon angioplasty. This procedure allowed inserting the ventriculoatrial shunt into the right atrium. RESULTS: The whole postoperative period was uneventful. Now, the child is free from symptoms of increased intracranial pressure. The boy has been followed for 9 months. In the control MRI examination, the ventricular system did not change as compared with the previous study. CONCLUSION: The disadvantage of the hemodynamic technique is a higher dose of X-ray irradiation in comparison to other techniques. The hybrid technique should be reserved only to very complicated cases.
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Ventrículos Cerebrais/cirurgia , Derivações do Líquido Cefalorraquidiano/métodos , Hidrocefalia/cirurgia , Cateterismo , Pré-Escolar , Humanos , Hidrocefalia/diagnóstico por imagem , Masculino , Flebografia , Tomografia Computadorizada por Raios XRESUMO
Background/Objectives: SARS-CoV-2 continually mutates, with five identified variants. Many neurological manifestations were observed during the COVID-19 pandemic, with differences between virus variants. The aim of this study is to assess the frequency and characteristics of neurological manifestations during COVID-19 in hospitalized patients over three waves in Poland with comparison and analysis correlation with the course of infection. Methods: This retrospective single-center study included 600 consecutive adults with confirmed COVID-19, hospitalized during 3 waves (pre-Delta, Delta and Omicron) in Poland. Demographic and clinical information and neurological manifestations were collected and compared across three periods. Results: The median age of the study group was 68, lower during the Delta wave. In the Omicron period, the disease severity at admission and inflammatory markers concentration were the lowest. Neurological manifestations were observed in 49%. The most common were altered mentation, headache, myalgia, mood disorder, ischemic stroke and encephalopathy. Smell and taste disturbances (STDs) were less frequent in the Omicron period. Neurological complications were predominant in the pre-Delta and Omicron periods. Ischemic stroke was observed more often in pre-Delta period. Altered mentation was related to higher severity at admission, worse lab test results, higher admission to ICU and mortality, while headache reduced mortality. Pre-existing dementia was related to higher mortality. Conclusions: Neurological manifestations of COVID-19 are frequent, with a lower rate of STDs in the Omicron period and more often cerebrovascular diseases in the pre-Delta period. Headache improves the course of COVID-19, while altered mentation, stroke and neurological comorbidities increase severity and mortality.
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The use of data and algorithms in the social sciences allows for exciting progress, but also poses epistemological challenges. Operations that appear innocent and purely technical may profoundly influence final results. Researchers working with data can make their process less arbitrary and more accountable by making theoretically grounded methodological choices. We apply this approach to the problem of simplifying networks representing ethnographic corpora, in the interest of visual interpretation. Network nodes represent ethnographic codes, and their edges the co-occurrence of codes in a corpus. We introduce and discuss four techniques to simplify such networks and facilitate visual analysis. We show how the mathematical characteristics of each one are aligned with an identifiable approach in sociology or anthropology: structuralism and post-structuralism; identifying the central concepts in a discourse; and discovering hegemonic and counter-hegemonic clusters of meaning. We then provide an example of how the four techniques complement each other in ethnographic analysis.
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High-flow nasal oxygen (HFNO) is recommended as a first-line treatment in patients with acute hypoxemic respiratory failure due to COVID-19. We assessed the effectiveness of HFNO and predictors of failure and death. The medical records of 200 consecutive adult patients treated with HFNO were analysed. Ninety-two patients (46%) were successfully cured, 52 (26%) required noninvasive ventilation, and 61 (30.5%) received intubation. Overall mortality was 40.5%. Risk factors of HFNO ineffectiveness were: SpO2 ≤ 90% with conventional oxygen therapy (HR 0.32, 95% CI 0.19-0.53, p < 0.001), SpO2 ≤ 74% without oxygen therapy (HR 0.44, 95% CI 0.27-0.71, p < 0.001), an age ≥ 60, comorbidities, biomarkers (C-reactive protein, procalcitonin, creatinine, lactate dehydrogenase), duration of symptoms before admission to hospital ≤ 9 days, start of treatment with HFNO ≤ 4 days. The multivariate logistic regression models (age ≥ 60, comorbidities, C-reactive protein concentration and SpO2 with oxygen therapy) revealed a high predictive value of death and HFNO failure (AUC 0.851, sensitivity 0.780, specificity 0.802; AUC 0.800, sensitivity 0.776, specificity 0.739, respectively). HFNO is a safe method for treating acute hypoxemic respiratory failure, with effectiveness reaching nearly 50%. Low values of SpO2 without and during oxygen therapy seem to be good diagnostic tools for predicting death and HFNO failure.
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Vascular and nonvascular plants are affected by environmental factors determining their distribution and shaping their diversity and cover. Despite the cryptogam commonness in Arctic communities, previous studies have often focused on limited number of factors and their impact on only selected species of vascular plants or cryptogams. Our study aimed to investigate in detail the differences in species diversity and cover of cryptogams and vascular plants in the glacier forelands and mature tundra on Svalbard. Furthermore, we determined the biotic and abiotic factors that affected diversity, cover and distribution of cryptogam and vascular plant species. In 2017, we established 201 plots in eight locations (each including habitat type of foreland and mature tundra) and surveyed species abundance, sampled soils and environmental data. Results revealed that diversity and cover of analysed groups differed significantly between locations and habitat types, except for cryptogam cover in mature tundra in terms of location. Distance to the glacier terminus, slope, soil conductivity, nutrient content, and clay content impacted both plant groups' diversity. In contrast, distance to the glacier terminus, nutrient content and soil pH affected their cover. In addition, for cryptogam diversity and cover, foreland location and vascular plant cover were also important, while for vascular plant cover time elapsed after glacier retreat was significant. Distribution of both groups' species in forelands was associated with time elapsed after glacier retreat, soil pH, and nutrient contents. Soil texture and distance to the glacier terminus additionally influenced cryptogam distribution. The positive impact of vascular plants on cryptogam diversity and cover indicates complex relationships between these groups, even in forelands' relatively simple communities. As the cryptogam diversity in the polar areas is high but still largely unknown, future studies on species ecology and climate change impact on vegetation should consider both vascular plants and cryptogams and interactions between these groups.
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Camada de Gelo , Solo , Regiões Árticas , Ecossistema , SvalbardRESUMO
The role of immune dysregulation in the course and prognosis of COVID-19 is not clearly established. In particular, immune status in specific populations such as haematological patients, who have an impaired immunological system, has not been described so far. Here, we performed a comprehensive analysis of peripheral blood lymphocyte subsets in 27 SARS-CoV-2-infected patients, including 16 patients with haematological malignancies. We identified T cell subpopulations, B cells, NK cells and TCR α/ß and É£/Æ-expressing T cells during COVID-19 infection, with significant changes observed in immune profiles during the course of disease, especially in haematological patients. We observed an increase in activated T lymphocytes (CD3+HLA-DR+ and CD3+CD8+HLA-DR+) in the early stages of SARS-CoV-2 infection with a concomitant decrease in the CD4/CD8 ratio in haematological patients compared to non-haematological patients affected by COVID-19. We also found a decrease in É£/Æ T cells in both studied groups of patients, with lower numbers of CD25+ T cells and CD16+CD56+ NK cells in haematological patients compared to non-haematological patients with COVID-19. Our findings demonstrate, for the first time, impaired adaptive immunity in patients with haematological malignancies infected with COVID-19, resulting in impaired cellular immune responses to SARS-CoV-2. This warrants further investigation of this disease group in COVID-19 patient cohorts.
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Recently deglaciated surfaces of glacier forelands are subjected to a variety of biotic and abiotic factors that lead to continuous soil formation. Until now, no attempt has been taken to analyse multiple factors that might affect soil development in the Arctic forelands. The main aim of this research was to determine the factors that influence soil development in the eight forelands of Svalbard. Moreover, the effects of both habitat type (glacier foreland and mature tundra) and geographical location on environmental variables treated as potential factors influencing soil formation were tested. In 2017, at each location a series of 1 m2 plots was established; all 168 plots were investigated in terms of soil properties, spatial data, biological soil crusts (BSCs) properties, percent cover of BSCs and vascular plants. Stepwise multiple linear regression analysis using forward variable selection showed that soil development was significantly associated with six of fifteen analysed factors, i.e. BSC cover, carbon and nitrogen content in BSCs, soil pH, Topographic Wetness Index and foreland location. Two-way analysis of variance followed by Tukey's test revealed significant differences in studied environmental variables between habitat types and studied locations, showing that foreland soils still retain particular initial characters to differentiate them from tundra soil.
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The purpose of the study was to determine the role of land use, seasonality, and hydrometeorological conditions on the relationship between stream water potassium (K+) concentration and discharge during different types of floods-short- and long-duration rainfall floods as well as snowmelt floods on frozen and thawed soils. The research was conducted in small catchments (agricultural, woodland, mixed-use) in the Carpathian Foothills (Poland). In the woodland catchment, lower K+ concentrations were noted for each given specific runoff value for summer rainfall floods versus snowmelt floods (seasonal effect). In the agricultural and mixed-use catchments, the opposite was true due to their greater ability to flush K+ out of the soil in the summer. In the stream draining woodland catchment, higher K+ concentrations occurred during the rising limb than during the falling limb of the hydrograph (clockwise hysteresis) for all flood types, except for snowmelt floods with the ground not frozen. In the agricultural catchment, clockwise hystereses were produced for short- and long-duration rainfall floods caused by high-intensity, high-volume rainfall, while anticlockwise hystereses were produced for short- and long-duration rainfall floods caused by low-intensity, low-volume rainfall as well as during snowmelt floods with the soil frozen and not frozen. In the mixed-use catchment, the hysteresis direction was also affected by different lag times for water reaching stream channels from areas with different land use. K+ hystereses for the woodland catchment were more narrow than those for the agricultural and mixed-use catchments due to a smaller pool of K+ in the woodland catchment. In all streams, the widest hystereses were produced for rainfall floods preceded by a long period without rainfall.
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Infecções por Coronavirus , Coronavirus , Pandemias , Pneumonia Viral , Betacoronavirus , COVID-19 , Teste para COVID-19 , Técnicas de Laboratório Clínico , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/diagnóstico por imagem , Infecções por Coronavirus/epidemiologia , Humanos , SARS-CoV-2Assuntos
Betacoronavirus/isolamento & purificação , Calcinose/diagnóstico por imagem , Infecções por Coronavirus/diagnóstico por imagem , Infecções por Coronavirus/terapia , Pulmão/diagnóstico por imagem , Pneumonia Viral/diagnóstico por imagem , Pneumonia Viral/terapia , COVID-19 , Calcinose/patologia , Infecções por Coronavirus/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/complicações , SARS-CoV-2 , Tomografia Computadorizada por Raios XRESUMO
Our intention was to compare the clinical outcome after surgical treatment of chronic hydrocephalus between patients who were subjected to neuroendoscopic third ventriculostomy and patients who underwent shunt implantation. At the Department of Neurosurgery of the Research Institute of Polish Mothers' Memorial Hospital from 1999 to 2001, 29 children, of an average age of 7 years (+/-7.1 years SD), underwent successful neuroendoscopic procedures, and from 1992 to 1994, 59 children, of an average age of 2 months (+/-1.9 months SD), underwent shunt implantation. The size of the ventricular system was described by the Frontal Horn Index and its change after operative procedures by the ratio of the final to the primary Frontal Horn Index. Head circumference was measured in percentiles according to the Kurniewicz-Witczakowa chart for Polish children. The reduction in head circumference after a neuroendoscopic procedure was, on average, significantly less than after a shunt implantation (0.39 percentiles +/-29.6 SD vs 17.93 percentiles +/-19.93 SD). Concerning the change in ventricular size after a neuroendoscopic procedure, it was noticed that the average ratio of the final to the primary Frontal Horn Index was 0.9. Meanwhile, the same parameter after a shunt implantation was 0.55. Based on the values of the Frontal Horn Indexes, it was observed that the ventricular system in infants after neuroendoscopic procedures was significantly larger than in other age groups (0.7 vs 0.5). After successful neuroendoscopic operations in a group of children suffering from Chiari II malformation, ventricular systems were slightly enlarged. The ratio of the final Frontal Index to the primary Frontal Horn Index was 1.31. In children suffering from chronic hydrocephalus, the average reduction in the size of the ventricular system and the rate of head circumference growth are lower after neuroendoscopic operations than after shunt implantations. Successful neuroendoscopic procedures are characterized by, on average, a higher rate of head circumference growth in infants than in neonates. In addition, the rate of head circumference growth after successful neuroendoscopic procedures could be higher than before the operation, which is clearly visible in children suffering from Chiari II malformation, but it does not mean a constant increase of that parameter during the postoperative period.
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Hidrocefalia/cirurgia , Neuroendoscopia , Terceiro Ventrículo/patologia , Ventriculostomia , Adolescente , Cefalometria , Criança , Pré-Escolar , Doença Crônica , Feminino , Seguimentos , Humanos , Lactente , Recém-Nascido , Masculino , Terceiro Ventrículo/crescimento & desenvolvimento , Terceiro Ventrículo/cirurgia , Resultado do Tratamento , Derivação VentriculoperitonealRESUMO
UNLABELLED: The aim of the paper was to evaluate effectiveness of neuroendoscopic procedures in comparison to complex shunt systems implantation in the treatment of complex compartmentalized hydrocephalus in children. Neuroendoscopic techniques were applied in 47 patients (23 boys, 24 girls aged from 25 days to 18 years, mean age 3 years SD = 4.9 years). The shunt implantation comparison group consisted of 80 patients (47 boys and 33 girls aged from 1 day to 16 years, mean age 0.8 year, SD = 2 years). Every endoscopic procedure was planned individually, in accordance with the patient's type of complex hydrocephalus and level of deformity of his/her ventricular system. In cases of multiloculated hydrocephalus septostomy was generally performed to restore communication between separated parts of the ventricular system. In uniloculated hydrocephalus resulting from the foramen of Monro obliteration, septostomy of pellucid septi was performed to connect the isolated lateral ventricles. In cases of isolated ventricle III the foramen of Monro patency was restored to connect the ventricle with the whole ventricular system. Neuroendoscopic techniques allowed to significantly reduce the number of necessary surgical procedures. Complex hydrocephalus patients treated with the traditional shunt implantation required on the average 7 operations during the whole therapy, as compared to about 2 in those treated by means of neuroendoscopic techniques. An analysis of the number of necessary surgical interventions per year of clinical observation also indicated superiority of neuroendoscopy techniques over shunt implantation (1 vs. 4 operations per year, respectively). Neuroendoscopy allowed to simplify shunt systems in 33 children, i.e. 70.2% of those treated with neuroendoscopic techniques, while in the group treated with traditional methods of shunt implantation only 16 children (16.3%) had a simple shunt system (a shunt with one intraventricular drain). The outcome assessed according to the Glasgow Outcome Scale (GOS 1, 2) in children treated only by shunt implantation was significantly inferior to that in the neuroendoscopy group, both in terms of mortality rate (22.5 and 4.3%, respectively) and postoperative complications present in 42 (52.5%) of shunt implantation cases and 9 (19.1%) of endoscopically treated patients. CONCLUSIONS: Neuroendoscopic techniques allowed to reduce the number of necessary operative procedures, to simplify shunt systems, to improve clinical outcome, and to reduce the risk of complications in the early postoperative period.
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Endoscopia/métodos , Hidrocefalia/cirurgia , Procedimentos Neurocirúrgicos/instrumentação , Adolescente , Derivações do Líquido Cefalorraquidiano , Criança , Pré-Escolar , Feminino , Lateralidade Funcional/fisiologia , Humanos , Hidrocefalia/etiologia , Lactente , Recém-Nascido , Masculino , Complicações Pós-Operatórias/epidemiologiaRESUMO
UNLABELLED: The aim of the study was to compare changes in the head circumference ventricular system size after neuroendoscopic third ventriculostomy with those following shunt implantation in children suffering from chronic hydrocephalus. The data were analysed to establish criteria of success of neuroendoscopic procedures. In the years 1999-2001 neuroendoscopic third ventriculostomy was performed in 59 children at the Neurosurgery Department of the Research Institute of Polish Mothers' Memorial Hospital. However, the sample analysed in the paper consists of 29 children (16 boys, 13 girls aged from 18 days to 18 years, mean age 7.03, SD = 7.11 years) with chronic hydrocephalus successfully treated with neuroendoscopic procedures. The control group consists of 59 children (31 boys, 28 girls) selected out of 80 patients who underwent primary shunt implantation at the same Neurosurgical Department in the years 1992-1994. The control children (aged from 2 weeks to 9 months, mean age 2 months, SD = 1.92 months) did not need shunt revision during the clinical observation period. The ventricular system size was assessed in terms of the Frontal Index, while postoperative changes in the system size were expressed by the ratio of the Final Frontal Index to the Baseline Frontal Index. If the ventricular system size remained the same, the ratio was 1; if its size decreased after surgery, the ratio was less than 1, while any increases in the system size were reflected by a ratio over 1. Moreover, the head circumference (HC) was measured before and after surgery only in infants and neonates with non-communicating hydrocephalus. HC was expressed in centiles using the centile chart developed by Kurniewicz-Witczakowa for various age and sex groups of Polish children. The analysis included also post-surgery changes in HC over the observation period, in terms of the difference between the baseline HC value and HC measurements in relation to the observation period duration. A positive sign of this index evidenced a decrease in the rate of HC enlargement, while a negative sign--an increased rate of HC growth. The mean HC at the end of the observation period was 72.96 centile in the neuroendoscopy group and 52.36 centile in children after shunt implantation. The reduction of head circumference following neuroendoscopic procedures was significantly smaller than that after shunt implantation, as the average decrease in HC after neuroendoscopy was only 0.4 centile as compared to about 18 centiles after shunt implantation. In the neuroendoscopy group a relationship was found between HC and age: in newborns HC was significantly smaller than that in infants (20.25 and 82.55 centiles, respectively). An analysis of HC changes (in centiles) in relation to the time since the surgery in all the children aged under 1 year, successfully treated with neuroendoscopic procedures, indicated no tendency to a steady increase in the rate of HC enlargement, even though in many cases the HC after surgery was larger than that prior to the surgery. As regards changes in the ventricular system size, the average ratio of Final to Baseline Frontal Index was 0.9 in the neuroendoscopy group and 0.5 in the group after shunt implantation. The ventricular system turned out to be significantly larger in infants after neuroendoscopy than in other age groups (the mean Frontal Index values were 0.65 vs. 0.53, respectively). No tendency to constant enlargement of the ventricular system size after neuroendoscopy was found. In children with non-communicating hydrocephalus due to Chiarii II malformation a mild enlargement of the ventricular system was seen after successful neuroscopy (the ratio of the Final to Baseline Frontal Index amounted to 1.3). CONCLUSIONS: The rate of head circumference (HC) enlargement in infants after succeeded neuroendoscopic procedures did not continually increase during the postoperative period, although their HC expressed in centiles could be higher than that before surgery. The average reduction of the ventricular system size was much smaller after neuroendoscopic ventriculostomy than than after shunt implantations. In children with Chiarii II malformation and in infants the ventricle system size may be somewhat increased in comparison to pre-operative levels. However, no tendency to a steady enlargement with time was found either in the HC or in the ventricle system size.
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Cabeça/anatomia & histologia , Hidrocefalia/diagnóstico , Hidrocefalia/cirurgia , Terceiro Ventrículo/anatomia & histologia , Terceiro Ventrículo/cirurgia , Ventriculostomia/instrumentação , Adolescente , Antropometria , Criança , Pré-Escolar , Endoscopia/métodos , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Procedimentos Neurocirúrgicos/instrumentação , Período Pós-Operatório , Índice de Gravidade de DoençaRESUMO
The aim of the study was to evaluate the use of neuroendoscopic techniques (in comparison with other surgical procedures) in the treatment for arachnoid cysts in children. The analysis was performed on results of treatment 22 children with arachnoid cysts submitted to neuroendoscopic procedures. The group consisted of 6 girls and 16 boys, aged from 1 day to 18 years (mean age 5.3 years, SD +/- 5.6). The control group treated with other, non-endoscopic surgical procedures consisted of 61 patients (20 girls and 41 boys aged from 10 days to 17 years, mean age 7 years, SD +/- 6). Criteria of success varied according to the type of surgical treatment. In the case of procedures other than shunt implantation, the treatment was regarded as effective, if there was no need to change the surgical method, while shunt implantation was considered effective, if shunt revision was not necessary. The operative treatment outcome was assessed using the Glasgow Outcome Scale. Post-treatment changes in the clinical state were graded as improvement, no change, or deterioration. In terms of the assumed criteria of success in the treatment for arachnoid cysts, neuroendoscopic procedures and microsurgical cyst excisions were among the most effective methods. As many as 90.9% of neuroendoscopically treated children needed no other operation, in comparison with 92.6% of patients submitted to microsurgical procedures, who needed no change in the operative treatment. In the group of neuroendoscopically treated patients the effectiveness of neuroendoscopic operations varied according to the type of procedure used. Cystocysternostomies or cystoventriculostomies were successful in 100%. The analysis of clinical outcome has shown that deterioration was observed only in 13% of the patients with shunt implantation. Analyzing each type of arachnoid cyst separately, a statistically significant relationship was found between improvement of the clinical state and the use of craniotomy in the surgical treatment for cysts localized in the posterior fossa. Improvement in the case of neuroendoscopically treated children was related to a larger reduction in the cyst size after surgery and to a lower intensity of intraoperative bleeding. Neuroendoscopic techniques allowed to reduce the average period of hospitalization. Neuroendoscopic cystocysternostomy and cystoventriculostomy were the most effective techniques, besides microsurgical excision of arachnoid cysts. Neuroendoscopic treatment efficacy depends on the type of procedure used. The application of neuroendoscopic techniques allows to reduce the period of hospitalization.
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Cistos Aracnóideos/cirurgia , Endoscopia/métodos , Procedimentos Neurocirúrgicos/instrumentação , Adolescente , Cistos Aracnóideos/diagnóstico , Criança , Pré-Escolar , Feminino , Escala de Resultado de Glasgow , Humanos , Lactente , Recém-Nascido , Masculino , Microcirurgia/instrumentação , Microcirurgia/métodosRESUMO
Central nervous system tumour in pregnancy constitutes a serious complication. Considering frequent difficulties in diagnostics and therapy, the aim of the study was to present our experience in management with pregnant women with brain and spinal cord tumours. Between 1988-2000, in The Research Institute Polish Mother's Memorial Hospital in Lodzi, 4 pregnant women had been diagnosed with brain and spinal cord tumours. The incidence of tumours complicating pregnancy was 1/11460. Two patients diagnosed at 29 weeks' gestation, underwent craniotomy and tumour resection during pregnancy. Two other women with central nervous system tumours diagnosed at 39 weeks' gestation, were operated in the postpartum period. The analysis of the postoperative period, gestation and/or postpartum period in all women and well-being of their new-borns confirm undertaken medical decisions.
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Neoplasias Encefálicas , Complicações Neoplásicas na Gravidez , Neoplasias da Medula Espinal , Adulto , Neoplasias Encefálicas/diagnóstico , Neoplasias Encefálicas/cirurgia , Feminino , Humanos , Gravidez , Complicações Neoplásicas na Gravidez/diagnóstico , Complicações Neoplásicas na Gravidez/cirurgia , Resultado da Gravidez , Diagnóstico Pré-Natal , Neoplasias da Medula Espinal/diagnóstico , Neoplasias da Medula Espinal/cirurgia , Fatores de TempoRESUMO
BACKGROUND: This paper is an ethnobotanical review of wild edible plants gathered for consumption from the end of the 18th century to the present day, within the present borders of Poland. METHODS: 42 ethnographic and botanical sources documenting the culinary use of wild plants were analyzed. RESULTS: The use of 112 species (3.7% of the flora) has been recorded. Only half of them have been used since the 1960s. Three species: Cirsium rivulare, Euphorbia peplus and Scirpus sylvaticus have never before been reported as edible by ethnobotanical literature. The list of wild edible plants which are still commonly gathered includes only two green vegetables (Rumex acetosa leaves for soups and Oxalis acetosella as children's snack), 15 folk species of fruits and seeds (Crataegus spp., Corylus avellana, Fagus sylvatica, Fragaria vesca, Malus domestica, Prunus spinosa, Pyrus spp., Rosa canina, Rubus idaeus, Rubus sect. Rubus, Sambucus nigra, Vaccinium myrtillus, V. oxycoccos, V. uliginosum, V. vitis-idaea) and four taxa used for seasoning or as preservatives (Armoracia rusticana root and leaves, Carum carvi seeds, Juniperus communis pseudo-fruits and Quercus spp. leaves). The use of other species is either forgotten or very rare. In the past, several species were used for food in times of scarcity, most commonly Chenopodium album, Urtica dioica, U. urens, Elymus repens, Oxalis acetosella and Cirsium spp., but now the use of wild plants is mainly restricted to raw consumption or making juices, jams, wines and other preserves. The history of the gradual disappearance of the original barszcz, Heracleum sphondylium soup, from Polish cuisine has been researched in detail and two, previously unpublished, instances of its use in the 20th century have been found in the Carpathians. An increase in the culinary use of some wild plants due to media publications can be observed. CONCLUSION: Poland can be characterized as a country where the traditions of culinary use of wild plants became impoverished very early, compared to some parts of southern Europe. The present use of wild plants, even among the oldest generation, has been almost entirely restricted to fruits.
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Etnobotânica , Plantas Comestíveis , Culinária , Etnobotânica/história , História do Século XVII , História do Século XIX , História do Século XX , Humanos , Plantas Comestíveis/classificação , Polônia , Terminologia como AssuntoRESUMO
OBJECTIVE: The authors intended to evaluate the application of neuroendoscopic techniques for the treatment of arachnoid cysts in children and compare it with other operative methods. METHODS: The analysis covered the results of treatment of 44 children with arachnoid cysts who were subjected to neuroendoscopic procedures and 62 patients who underwent other operations. RESULTS: The neuroendoscopic treatment of arachnoid cysts was very effective because of low rate of reoperative treatment (six out of 44 patients), no need to change the operative method (40 effective out of total 44 operative procedures), and low rate of persistent worsening (none of 44 patients worsened). CONCLUSIONS: Summing up all the mentioned aspects of neuroendoscopic techniques, the neuroendoscopic techniques were the most suitable operative procedures in the treatment of arachnoid cysts in the presented group of patients, providing that the connection between the lumen of the arachnoid cyst and the cerebrospinal fluid cisterns was of good quality.
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Cistos Aracnóideos/cirurgia , Neuroendoscopia/métodos , Procedimentos Neurocirúrgicos/métodos , Adolescente , Derivações do Líquido Cefalorraquidiano , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Imageamento por Ressonância Magnética , Masculino , Tomografia Computadorizada por Raios X , Resultado do Tratamento , VentriculostomiaRESUMO
OBJECTIVE: The main object of the work is to assess the suitability of neuroendoscopic techniques for the treatment of complex compartmentalized hydrocephalus. METHODS: For this purpose the authors compared two groups of children treated in the Research Institute of the Polish Mother's Memorial Hospital from March 1997 to January 2002. The first group of 47 children, treated using neuroendoscopic procedures, was compared with the second, which comprised 80 children treated conventionally by complicated shunt implantations. RESULTS: The children treated neuroendoscopically needed on average 1.7660 procedures during the entire therapy, and 1.0232 operations a year. The same parameters in the conventionally-treated group were as follows: the total number of procedures was 7.050, and the rate of reoperation was 3.949 procedures a year. The proportion of patients who suffered from complications connected with operative treatment and who had a bad outcome was higher in the conventionally-treated group than in the neuroendoscopic one.