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Search Results: 1 - 10 of 449869 matches for " Larissa;L?hr Júnior "
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Ictal patterns in children: an illustrated review
Spinosa, M?nica Jaques;Liberalesso, Paulo Breno de Noronha;Mehl, Larissa;Lhr Júnior, Alfredo;
Journal of Epilepsy and Clinical Neurophysiology , 2011, DOI: 10.1590/S1676-26492011000400008
Abstract: detailed knowledge of electroencephalographic patterns accompanying epileptic seizures in children is paramount to the correct identification of epileptic seizures and syndromes. in this article, we present a review of ictal patterns of different seizure types in children, illustrating with examples collected in our video-eeg laboratory at pequeno príncipe hospital.
Challenges in the surgical treatment of epilepsy: hypothalamic hamartoma in infancy - case report
Mehl, Larissa Alessandra;Liberalesso, Paulo Breno Noronha;Spinosa, M?nica Jaques;Machado, Sílvio;Lhr Júnior, Alfredo;
Journal of Epilepsy and Clinical Neurophysiology , 2012, DOI: 10.1590/S1676-26492012000100004
Abstract: introduction: hypothalamic hamartoma is a rare congenital malformation, characterized by epilepsy, especially gelastic seizures, psychomotor developmental delay, mental retardation, behavioral disorders and precocious puberty. epilepsy has early onset and is usually medically refractory. etiology and pathophysiological mechanisms are unclear. the eeg can present disorganization and slowing of background activity and multifocal and/or generalized epileptogenic discharges. objective: to report the difficulties and challenges of neurosurgical treatment of a hypothalamic hamartoma in an infant. case report: infant with seizures since eight months old of age. the neurological investigation revealed a lesion in tuber cinereum suggestive of hamartoma. the epilepsy evolved with resistance to antiepileptic drugs, requiring neurosurgical procedure. the endoscopic resection could not be performed because the hamartoma was firmly attached to the hypothalamus. currently, the child remains with tonic, clonic and atonic seizures. discussion: lesionectomy performed by microsurgery or radiosurgery seems to be the most effective treatment for seizure control in patients with hypothalamic hamartomas who do not respond to clinical treatment. callosotomy may be effective in selected cases, and lobectomy/cortical resections are not related to seizure control. in some patients, particularly in infants, lesionectomy and radiosurgery may be technically unfeasible.
De Morsier syndrome associated with periventricular nodular heterotopia: case reporte
Spinosa, M?nica Jaques;Liberalesso, Paulo Breno Noronha;Vieira, Simone Carreiro;Lhr Júnior, Alfredo;
Arquivos de Neuro-Psiquiatria , 2007, DOI: 10.1590/S0004-282X2007000400029
Abstract: introduction: septo-optic dysplasia (de morsier syndrome) is defined as the association between optic nerve hypoplasia, midline central nervous system malformations and pituitary dysfunction. case report: third child born to nonconsanguineous parents, female, adequate pre-natal medical care, cesarean term delivery due to breech presentation, apgar score 3 at the first minute and 8 at 5 minutes, symptomatic hypoglycemia at 18 hours. neurological follow-up identified a delay in acquisition of motor and language developmental milestones. epileptic generalized seizures began at 12 months and were controlled with phenobarbital. eeg was normal. mri revealed agenesis of the pituitary stalk, hypoplasia of the optic chiasm and periventricular nodular heterotopia. ophthalmologic evaluation showed bilateral optic disk hypoplasia. endocrine function laboratory tests revealed primary hypothyroidism and hyperprolactinemia. conclusion: the relevance of this case report relies on its uniqueness, since periventricular heterotopia had not been described in association with septo-optic dysplasia until 2006.
Estudo comparativo entre a qualidade do sono em crian?as de 7 a 15 anos com epilepsia clinicamente controlada e refratária
Vidotto, Gisele A. Frederich;Liberalesso, Paulo Breno Noronha;Farias, Ant?nio Carlos de;Jurkiewicz, Ari Leon;Zeigelboim, Bianca Simone;Lhr Júnior, Alfredo;
Journal of Epilepsy and Clinical Neurophysiology , 2008, DOI: 10.1590/S1676-26492008000400004
Abstract: introduction: the relationship between epilepsy and sleep has been recognized many years. sleep disturbances and epilepsy are pathological conditions of raise prevalence in the general population, particularly in infancy, childhood and adolescence. the aim of this study was to compare the sleep behavior in children from seven to 15 years-old with controlled epilepsy and refractory epilepsy. methods: the scale "sleep behavior questionnaire", translated and validated for portuguese language, was applied to all patients with controlled epilepsy and refractory epilepsy who attended the pediatric neurology department of hospital pequeno príncipe between april and september 2007. results: the 46 patients were divided into 2 groups, which consisted of 24 with controlled epilepsy (group 1) and 22 with refractory epilepsy (group 2). mann-whitney statistical test was applied and a significant statistical difference (p=0,000) was evidenced between the index of sleep behavior of the two groups, the equality of sleep being considered worse in the patients with refractory epilepsy. conclusion: the data showed the children from seven to 15 years-old with refractory epilepsy have worse quality of sleep than children with controlled epilepsy.
First unprovoked seizure: clinical and electrographic aspects
Vieira, Simone Carreiro;Liberalesso, Paulo Breno Noronha;Spinosa, M?nica Jaques;Ortega, Adriana Banzzatto;Olmos, Alaídes Suzana Fojo;Lhr Júnior, Alfredo;
Journal of Epilepsy and Clinical Neurophysiology , 2006, DOI: 10.1590/S1676-26492006000300004
Abstract: objective: to evaluate classification, eeg tracings and neuroimage following the first episode of unprovoked epileptic seizure in a pediatric population. methods: patients diagnosed with first episode of unprovoked epileptic seizure from may 2000 to may 2005 were included. all subjects were submitted to eeg and cranial ct in the first 72 hours after the event. seizures were classified according to the ilae classification criteria of 1981. results: 387 patients, 214 (55.3%) male, average age 4.2 years. neuropsicomotor development was normal in 315 (81.4%) patients. seizure classification: 167 (43.15%) generalized, tonic-clonic being the most frequent of these (105/62.85%), followed by typical absence (22/13.17%), clonic (20/11.98%), tonic (13/7.78%) and atonic (7/4.19%). focal seizures: 220 (56.85%), complex partial with secondary generalization as the most common of these (81/36.82%). eeg was normal in 208 (53.75%) cases. brain atrophy was the most frequent abnormality on cranial ct. discussion: the majority of the children had normal neurodevelopment after a first unprovoked epileptic seizure. partial seizures were more frequent than generalized seizures. early eeg identifies interictal paroxysms or focal slowing in virtually half the patients.
Interictal electroencephalogram: sensibility in the diagnosis of epileptic seizures in childhood
Rego, Raquel;Liberalesso, Paulo Breno Noronha;Spinosa, M?nica Jaques;Vieira, Simone Carreiro;Olmos, Alaídes S. Fojo;Lhr Júnior, Alfredo;
Journal of Epilepsy and Clinical Neurophysiology , 2007, DOI: 10.1590/S1676-26492007000100005
Abstract: introduction: it is currently estimated that more than 10 million children all over the world have epilepsy and the eeg is the most commonly used diagnostic test in the investigation of these patients. the aim of this study was to analyze the sensibility of the eeg in revealing abnormalities in children with the clinical hypothesis of an epileptic seizure. methods: out of 970 eegs obtained between april 2005 and august 2006 at pequeno príncipe children's hospital, curitiba, pr, brazil, 692 fit the criteria proposed (clinical hypothesis of an epileptic seizure after the evaluation of a pediatric neurologist). all eegs were recorded digitally, with minimal duration of 20 minutes and electrodes positioned according to the international system 10-20. neonates were excluded. results: age ranged from 30 days to 16.5 years (mean of 6.4 years and median of 4.1 years), 403 were female (58.2%). out of the 692 eeg included in the study, 281 (40.6%) yielded abnormal results, 96 (34.2%) with abnormalities of the background activity (disorganization and/or asymmetry) and 185 (65.8%) with epileptiform paroxysms. the sensibility of the eeg was 40.6%. sharpe wave occurred in 77 cases (41.6%), spike in 21 (11.4%), polispike in 14 (7.6%), spike-wave in 17 (9.2%), polispike-wave in 24 (13.0%) and exams with discharges of more than one morphology in 32 (17.3%). conclusion: our data strengthen the concept that even though the diagnosis of epilepsy is clinical and based on the semiological description of the epileptic crisis, the eeg has a good sensibility when properly indicated.
Lissencephaly, abnormal genitalia and refractory epilepsy: case report of XLAG syndrome
Spinosa, M?nica Jaques;Liberalesso, Paulo Breno Noronha;Vieira, Simone Carreiro;Olmos, Alaídes Susana Fojo;Lhr Júnior, Alfredo;
Arquivos de Neuro-Psiquiatria , 2006, DOI: 10.1590/S0004-282X2006000600027
Abstract: introduction: x-linked lissencephaly with ambiguous genitalia (xlag) is a recently described genetic disorder caused by mutation in the aristaless-related homeobox (arx) gene (xp22.13). patients present with lissencephaly, agenesis of the corpus callosum, refractory epilepsy of neonatal onset, acquired microcephaly and male genotype with ambiguous genitalia. case report: second child born to healthy nonconsanguineous parents, presented with seizures within the first hour of life that remained refractory to phenobarbital, phenytoin and midazolam. examination identified microcephaly, axial hypotonia, pyramidal signs and ambiguous genitalia. eeg showed disorganized background activity and seizures starting at the right midtemporal, central and occipital regions. mri showed diffuse pachygyria, moderate thickening of the cortex, enlarged ventricles, agenesis of the corpus callosum and septum pellucidum. karyotype showed a 46,xy genotype. additional findings were hypercalciuria, vesicoureteral reflux, patent ductus arteriosus and chronic diarrhea.
Constituintes químicos das folhas e caule de Croton sellowii (Euphorbiaceae)
Palmeira Júnior, Sebasti?o F.;Alves, Vanessa L.;Moura, Fabyanne S.;Vieira, Larissa F.A.;Conserva, Lucia M.;Lemos, Rosangela P.L.;
Revista Brasileira de Farmacognosia , 2006, DOI: 10.1590/S0102-695X2006000300018
Abstract: this work describes the isolation of terpenoids (sitosterol, stigmasterol, cycloart-25-ene-3b,24b-diol, cycloart-25-ene-3b,24a-diol and betulonic acid), flavonoids (artemetin, crysosplenetin, casticin, penduletin and tiliroside) and phenylpropanoid (threo-7-ethoxy-8-hydroxy-dihydroanol) from the leaves and stems of croton sellowii baill. all isolated compounds are being described for the first time in this species and were identified on basis of the spectral data (ir, uv, and nmr, including apt, dept, cosy, noesy, hmqc and hmbc), and by comparison with literature data.
Interdisciplinary in Promoting Improvements in the Quality of Undergraduate Education in Clinical Nursing  [PDF]
Diana Paula de Souza Rego Pinto Carvalho, Anna Lúcia Dantas, Anna Larissa de de Castro Rego, Gabriela Assun??o da Costa Mafra Souza, Isabelle Campos de Azevedo, Giovanna Karinny Pereira Cruz, Priscila Fernandes Meireles, Allyne Forte Vitor, Maria Lúcia Ivo, Marcos Antonio Ferreira Júnior
Creative Education (CE) , 2015, DOI: 10.4236/ce.2015.617192
Abstract: The university monitoring is an auxiliary activity of educational support offered to students interested in deepening content and solving questions about the topics learned in the classroom, as well as an opportunity for the development in the student-monitor relationship next to the teaching practice. This study aimed to report the experience lived by the student-monitors linked to monitoring project entitled “Interdisciplinary for improving the quality of education: Physiology, Anatomy and Pathology for Clinical Nursing teaching”. It is an experience report experienced by student-monitors linked to the project developed for curriculum component Comprehensive Health Care I, taught in the fifth period of the Undergraduate Nursing course at the Federal University of Rio Grande do Norte, Brazil. This project has four stages: preparation of laboratories and fellows training, construction and application of clinical cases, development of simulations in the laboratory with the students and the final evaluation of the changing process in curriculum practice. The monitoring project has provided contact with a simulation environment for students, for the development of skills and attitudes in solving clinical nursing problems through an innovative approach to integrating disciplinary learning in the classroom and development initiation skills in student-monitors teaching. The approximate relationship with the teacher allows the exchange of knowledge, which makes proactive student-monitor in the very process of teaching and learning, as well as the teacher provides the formation of a more qualified and secure professional for the exercise of appropriate assistance.
The MUC gene family: Their role in diagnosis and early detection of pancreatic cancer
J?rg Ringel, Matthias Lhr
Molecular Cancer , 2003, DOI: 10.1186/1476-4598-2-9
Abstract: Mucins (MUCs) are heavily glycosylated, high molecular weight glycoproteins with an aberrant expression profile in various malignancies.This review considers briefly the potential use of the mucin expression pattern in diagnosis of pancreatic neoplasm. The overview will point out the present knowledge about changes in the mucin gene expression in pancreatic intraepithelial neoplasia (PanINs) as precursor lesions and in pancreatic adenocarcinoma, compared to normal pancreas and chronic pancreatitis and the potential role for differentiating chronic pancreatitis from pancreatic cancer.Furthermore, the potential use of MUCs in the diagnosis and differentiation of intraductal papillary-mucinous neoplasm's (IPMNs) will be discussed.Pancreatic adenocarcinoma is a neoplasm with a relatively high incidence and an extraordinarily poor prognosis [1]. In Western countries, it is the fifth leading cause of cancer deaths and has the lowest 5-year survival rate of any cancer [2]. Despite advances in diagnostic imaging, methods like endoscopic ultrasonography, dualphase spiral computer tomography, magnetic resonance imaging, and endoscopic retrograde cholangiopancreatography, early diagnosis and differentiation between malignant pancreatic tumors and chronic pancreatitis is still a diagnostic problem for clinicians [3].The most commonly used clinical tests for tumor markers are serum-based immunoassays for blood group-related antigens and glycoproteins like CA 19-9, DUPAN2, CA 50, CA 125, and more recently CA 242. In pancreatic cancer, the sensitivity of the CA19-9 serum assay has been shown to range from 69% to 93%, and the specificity varied between 46% and 98% [4,5]. Unfortunately, elevated levels of the CA 19-9 antigen were found in chronic pancreatitis and other cancer conditions [5,6].Antigens such as CA 19-9, CA 50, CA 125, and CA 242 contain oligosaccharide structures present on heavily glycosylated high molecular weight mucins [7]. These molecules are widely synthesized a
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