Neuronavigation device for stereotaxic external ventricular drainage insertion

Background: The insertion of an external ventricular drainage (EVD) is one of the most frequently used neurosurgical procedures. It is performed to adjust intracranial hypertension in cases of severe craniocerebral injury, acute posthemorrhagic hydrocephalus, meningitis, and oncological diseases related to impaired circulation of cerebrospinal fluid circulation (CSF). Methods: In 2020, three patients with subarachnoid aneurysmal hemorrhage underwent insertion of an EVD navigation percutaneous stereotaxic device. Three cases introduced. Results: In all cases, satisfactory EVD functioning was noted during the surgery and during the early postoperative period. The EVD insertion procedure took an average of 10 min. The EVD insertion route calculations using the software took about 5–15 min. No cases showed any infection, hemorrhagic complications, or EVD dysfunction. According to the control brain computed tomography data, the catheter position was satisfactory and corresponded to the target coordinates in all cases. Conclusion: The use of the device, with its high accuracy and efficiency, can reduce the incidence of unsatisfactory EVD implantation cases in patients with neurosurgical pathology.

The Nursing Diagnosis of risk for pressure ulcer: content validation

Objective: to validate the content of the new nursing diagnosis, termed risk for pressure ulcer. Method: the content validation with a sample made up of 24 nurses who were specialists in skin care from six different hospitals in the South and Southeast of Brazil. Data collection took place electronically, through an instrument constructed using the SurveyMonkey program, containing a title, definition, and 19 risk factors for the nursing diagnosis. The data were analyzed using Fehring's method and descriptive statistics. The project was approved by a Research Ethics Committee. Results: title, definition and seven risk factors were validated as "very important": physical immobilization, pressure, surface friction, shearing forces, skin moisture, alteration in sensation and malnutrition. Among the other risk factors, 11 were validated as "important": dehydration, obesity, anemia, decrease in serum albumin level, prematurity, aging, smoking, edema, impaired circulation, and decrease in oxygenation and in tissue perfusion. The risk factor of hyperthermia was discarded. Conclusion: the content validation of these components of the nursing diagnosis corroborated the importance of the same, being able to facilitate the nurse's clinical reasoning and guiding clinical practice in the preventive care for pressure ulcers.

MOTENA GIBLJIVOST GLASILK - etiologija in simptomi

Paresis or paralysis of one or both vocal cords affects some significant aspects of a human life: breathing, swallowing and speech. The major causes for reduced mobility or even immobility are innervation damage, less often fixation of vocal cord or impaired mobility of crycoarytenoid joint. An injury of the superior or/and inferior laryngeal nerve can be a consequence of different medical procedures, tumor growth, trauma, infection, neurological disorders, radiation exposure, toxic damage, impaired circulation of the area or it is idiopathic. The symptoms are different in the case of unilateral and bilateral paresis of the vocal folds. They also depend on the cause for the impaired mobility. In the patients with unilateral vocal fold paresis, hoarseness and aspiration during swallowing are the leading symptoms. In the bilateral vocal fold paralysis, dyspnea prevails.

LIFESTYLE PECULIARITIES OF YOGA PRACTITIONERS AND NON-PRACTITIONERS

Background. In the modern world, people are short of time for physical and spiritual education, which may lead to major health problems. Due to passive lifestyle, many of them have a poor body composition, impaired circulation and reduced flexibility, which may contribute to physical disorders and susceptibility to chronic diseases (Chen, Tseng, Ting, & Huang, 2007). Hypothesis: lifestyle of yoga practitioners is healthier and health evaluation is better compared to those of non- practitioners. The aims of the research were to asses and compare the features of lifestyle and health evaluation of yoga practitioners and non-practitioners. Methods. The study included middle-aged participants (from 35 to 55 years). A total of 193 people were evaluated, 86 of them were practising yoga. Among these participants, 63 were women, 23 – men. The other 107 did not practise yoga, 58 of them were women, 43 – men. The questionnaire of the lifestyle of Lithuanian adults was used (Grabauskas, Klumbienė, & Petkevičienė, 2011). Results. The analysis of the results confirmed the hypothesis proposed at the beginning of the work. Yoga practitioners’ nutrition, physical activity, addictions and evaluation of their health was better than those of non- practitioners. Conclusion. Yoga practitioners have healthier lifestyle habits, they consume less animal fat, eat more fruits, cereals and cereal-based products. In addition, they are more physically active than non- practitioners, both men and women often exercise alone or in group practice sessions and without yoga they have more kinds of physical activity. A lower prevalence of addictions was observed among them; none of them smoked and they had a lower intake of alcohol beverages compared to yoga non-practitioners. Yoga practitioners are healthier and have a better value of their health and the quality of life.

Impaired tissue integrity, related factors and defining characteristics in persons with vascular ulcers

This transversal study aimed to analyze factors related to, and defining characteristics of, Impaired Tissue Integrity in persons with vascular ulcers, and compare the mean of these factors between the groups presenting different degrees in the severity of tissue compromise. The study was undertaken in February-August 2009, in the municipal health network of Goiânia in the state of Goiás, using interviews, clinical examinations and photographic records of the wounds. For analysis, simple and percentage frequencies and the Student t-test (p<0.05) were used. Five related factors were identified in more than half of the 42 participants: impaired circulation, knowledge deficit, chemical irritants, fluid excess and nutritional factors. Three defining characteristics were identified in all of the participants. There was no difference in the mean of related factors between groups. Impaired Tissue Integrity in persons with vascular ulcers was a phenomenon which demands professional attention extending beyond circulatory impairment. The mean of factors did not indicate greater or lesser severity of the compromising of the tissue integrity.

Vascular Action as the Primary Mechanism of Cognitive Effects of Cholinergic, CNS-Acting Drugs, a Rat phMRI BOLD Study

Concordant results of functional magnetic resonance imaging (fMRI) and behavioral tests prove that some non-blood-brain barrier-penetrating drugs produce robust central nervous system (CNS) effects. The anticholinergic scopolamine interferes with learning when tested in rats, which coincides with a negative blood-oxygen-level-dependent (BOLD) change in the prefrontal cortex (PFC) as demonstrated by fMRI. The peripherally acting butylscopolamine also evokes a learning deficit in a water-labyrinth test and provokes a negative BOLD signal in the PFC. Donepezil—a highly CNS-penetrating Cholinesterase inhibitor—prevents the negative BOLD and cognitive deficits regardless whether the provoking agent is scopolamine or butylscopolamine. Interestingly, the non-BBB-penetrating Cholinesterase inhibitor neostigmine also prevents or substantially inhibits those cognitive and fMRI changes. Intact cerebral blood flow and optimal metabolism are crucial for the normal functioning of neurons and other cells in the brain. Drugs that are not BBB penetrating yet act on the CNS highlight the importance of unimpaired circulation, and point to the cerebral vasculature as a primary target for drug action in diseases where impaired circulation and consequently suboptimal energy metabolism are followed by upstream pathologic events.

Penetrate injuries of colon: Our experience

In attempt to determine the place of primary repair in management of colon injuries, an open, non randomized clinical study was performed. Retrospective (RS) group of 62 patients according to exclusion criteria by Stone (S/F) and Flint (Fl) was managed by one or two stage surgical procedure. Prospective (PR) group of 34 patients was managed using one stage repair non-selectively: two stage procedures were performed in 3 cases of advanced peritonitis and multi-segmental lacerations with impaired circulation of colon. In RS group 36 patients were managed by primary repair and in PR group, 31 were managed by primary repair. Both groups were of similar age/sex. Indexes of trauma severity were similar (TS, ISS, PATI). The latent time was shorter in PR group. Associated injuries to other body regions and abdominal organs were similar in both groups. S/F criteria and Flint grading in both (RS vs. PR) groups were similar. Comparison of attempted and successful primary repairs justifies the more liberal use of primary repair in early management of colon injuries.