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Status Epilepticus in Children: Experience in a Portuguese Tertiary Hospital
Catarina Granjo Morais,Marta João Silva,Teresa Cunha Mota,Ruben Rocha,Augusto Ribeiro 대한소아신경학회 2023 대한소아신경학회지 Vol.31 No.3
Purpose: Status epilepticus (SE) is a life-threatening neurological emergency, frequently diagnosed in pediatric patients. We aimed to characterize our pediatric cases of SE in an 11-year period according to the 2015 International League Against Epilepsy report. Methods: Clinical electronic records were retrospectively reviewed. All pediatric SE cases admitted from January 2010 to December 2020 were included, excluding neonates. SE was considered refractory if it persisted despite the administration of two appropriate antiseizure medications at acceptable doses. Results: We included 102 episodes, 55 (53.9%) in boys. The median age was 2.5 years (interquartile range, 1.3 to 5.0). Most episodes were classified as SE with prominent motor features (92.2%), and the most frequent etiological classification was acute symptomatic cause (84.3%). A benzodiazepine was used as the first-line antiseizure medication in 99 (97%) cases, of which diazepam was preferred (93%). The preferred second-line medication was phenytoin (65.7%). Midazolam was the most frequently responsible for termination of SE when given in a continuous infusion (47%). Episodes of SE were classified as refractory in 81 (79.4%) cases. Episodes of >60 minutes were more frequent in patients diagnosed with epilepsy (P=0.036), focal motor SE (P60 minutes), which reinforces the significance of the underlying neurological disease and semiological standardization in pediatric SE.
Accuracy and Reliability of X-ray Measurements in the Cervical Spine
Catarina Marques,Emma Granström,Anna MacDowall,Nuno Canto Moreira,Martin Skeppholm,Claes Olerud 대한척추외과학회 2020 Asian Spine Journal Vol.14 No.2
Study Design: This study is a post hoc analysis of a multicenter prospective randomized controlled trial which compared artificial disc replacement and anterior cervical discectomy and fusion. Purpose: Useful radiographic parameters for assessing cervical alignment include the Cobb angles, T1 slope (T1S), occipitocervical inclination (OCI), K-line tilt (KLT), and cervical sagittal vertical axis (cSVA). This study aimed to determine measurement accuracy and reliability for these parameters. Overview of Literature: Various authors have assessed repeatability by comparing different methods of measurement, but knowledge of measurement error and minimal detectable change is scarce. Methods: We evaluated 758 lateral cervical radiographs. One medical student and one spine surgeon (i.e., measured ×2 within 4 weeks) independently measured the parameters obtaining 5,850 values. Standard error of measurement (SEm) and minimum detectable change (MDC) were calculated for each parameter. The accuracy and reliability of the Cobb angle measurements were calculated for the different types of angles: cervical lordosis, prosthesis angle, segmental angle with two bone surfaces (SABB), and segmental angle with one bone and one metal surface. Reliability was determined with intraclass correlation coefficient (ICC). Results: SEm was 1.8° and MDC was 5.0° for the Cobb angle, with an intraobserver/interobserver ICC of 0.958/0.886. All the different subtypes of Cobb angles had an ICC higher than 0.950, except SABB (intraobserver/interobserver ICC of 0.922/0.716). The most accurate and reliable measurement was for KLT. Conclusions: This study provides normative data on SEm and MDC for Cobb angles, T1S, KLT, OCI, and cSVA in cervical lateral radiographs. Reliability was excellent for all parameters except SABB (e.g., good).
Diagnosis of Bowel Endometriosis Using Endoscopic Ultrasound-guided Fine Needle Aspiration
Ana Catarina Carvalho,Ricardo Cardoso,Francisco Pires,Sofia Ventura,Francisco Portela,Paula Ministro,Américo Silva 대한소화기학회 2023 대한소화기학회지 Vol.81 No.1
Endometriosis is a relatively common gynecological condition in women of reproductive age. The rectosigmoid region is the most commonly affected segment when the gastrointestinal tract is involved. A differential diagnosis of colorectal neoplasia is difficult because of the similar clinical, endoscopic, and radiology findings. A 42-year-old female presented with abdominal distention and was subsequently diagnosed with a large bowel obstruction in the rectum. A temporary colostomy was performed, and endoscopy revealed a rectal mass obstructing the rectum. The biopsy showed normal mucosa, and it was difficult to exclude rectal malignancies even after the imaging workup. Endoscopic ultrasound demonstrated a hypoechoic lesion below the rectal mucosa, and fine needle aspiration confirmed the diagnosis of bowel endometriosis. Bowel endometriosis is a challenging diagnosis. Endoscopic ultrasound- guided fine-needle aspiration is useful for acquiring adequate samples for histological confirmation and a definitive diagnosis of bowel endometriosis.
Modeling flow instability of an Algerian sand with the dilatancy rule in CASM
Ramos, Catarina,Fonseca, Antonio Viana da,Vaunat, Jean Techno-Press 2015 Geomechanics & engineering Vol.9 No.6
The aim of the present work was the study of instability in a loose sand from Les Dunes beach in Ain Beninan, Algeria, where the Boumerdes earthquake occurred in 2003. This earthquake caused significant structural damages and claimed the lives of many people. Damages caused to infrastructures were strongly related to phenomena of liquefaction. The study was based on the results of two drained and six undrained triaxial tests over a local sand collected in a region where liquefaction occurred. All the tests hereby analyzed followed compression stress-paths in monotonic conditions and the specimens were isotropically consolidated, since the objective was to study the instability due to static loading as part of a more general project, which also included cyclic studies. The instability was modeled with the second-order work increment criterion. The definition of the instability line for Les Dunes sand and its relation with yield surfaces allowed the identification of the region of potential instability and helped in the evaluation of the susceptibility of soils to liquefy under undrained conditions and its modeling. The dilatancy rate was studied in the points where instability began. Some mixed tests were also simulated, starting with drained conditions and then changing to undrained conditions at different time steps.
Environmental Damages in the Atlantic Forest Biome
Michele Santa Catarina Brodt,Melissa Bergmann,Eli Natáli Broman,Gabriela Sanfelice,Juliana Duarte Ferreira,Larissa Lunardi,Alexandre Hüller,Lenice De Carli 강원대학교 산림과학연구소 2018 Journal of Forest Science Vol.34 No.2
We identified the main impacts, drivers, and restoration projects for Atlantic Forest in Northwest of the Rio Grande do Sul State, Brazil. The objective was to analyze the quantity, distribution, and causes of the environmental crimes in 2000-2014. To verify differences between degraded and restored areas, we performed a t-test; ANOVA for the municipalities with more quantity of crimes, simple linear regression analysis for the relationship between sizes of degraded areas and quantity of seedlings planted, and Principal Component Analysis (PCA) for environmental damages categories and population of the municipalities. The main environmental damages found were deforestation outside permanent preservation area (20%) and those related to Permanent Preservation Area (37%). Environmental crimes in these areas fall into two categories: native and exotic vegetation removal (17%), and impediment to natural regeneration (20%). The average size of the degraded areas was 5,359±526 m2, while for restored areas was 3,337±255 m2. The sizes of the degraded fragments were similar among the five municipalities with the higher number of environmental crimes (ANOVA: p>0.05, F=1.24; df=241). The number of seedlings planted was positively related to the sizes of the degraded fragments (p<0.001, R2=0.53). Segregation between the less and the most populous municipalities was found with the PCA analysis along PC1 (51.7%), while PC2 represented 19.2% of the total variation. The most populous municipalities showed the highest number of environmental crimes, and the majority of degraded areas were recovered by planting native seedlings. Atlantic Forest fragments need to be recognized and preserved as an ecosystem with a unique ecological function by the population and public administration.