Ventriculocisternostomia de Torkildsen no tratamento do hidrocefalo não comunicante: resultados em 67 casos

Sixty-seven cases of non-communicating hydrocephalus treated according to the Torkildsen's procedure are reported. The spinal fluid blockage was caused in 55 cases by supratentorial and in 10 cases by infratentorial tumors; in the remaining cases the spinal fluid interruption was due to non-tumoral causes. Ventriculography was the most important examination performed as far as the local diagnosis was concerned. 15 patients in this series disclosed lethal complications with signs of brain stem lesions. Patient survival was 3.9 years with variation ranging from 1 to 9 years. The following conclusions were drawn: 1) Ventriculocisternostomy is a valious method for the treatment of non-communicating hidrocephalus for it allows a more physiological drainage of the spinal fluid besides favouring the exploration of the posterior fossa in cases of doudtful pre-operative diagnosis. This procedure is of low cost and involves a relatively simple tecnique as compared with other procedures which demand the use of special valves. 2) According to the review of the pertinent literature the best results have been accomplished in cases where there is a non-tumoral aqueduct stenosis as well as in inoperable tumors of the third ventricle. 3) Bilateral drainage is mandatory in cases of bilateral obstruction of Monro's foramina. It has also been indicated in all cases as a precaution due to the possibility of occlusion of one catheter. 4) Ventriculocisternostomy should also be indicated as a prophylactic treatment of non-communicating hydrocephalus in cases of inoperable tumors of the sela or the basal ganglia with compression of the third ventricle but without completly blockage of the ventricle system. 5) Ventriculocisternostomy should be indicated with some reserve in cases of infratentorial tumors as well as in great supratentorial space-occupying lesions. It is however contra-indicated in cases of large tumors and in the inflammatory process involving the posterior fossa. 6) In the present series the obstruction of the draining-system was very uncommon being observed in only three patients. 7) No cases of spinal fluid fistula or meningitis were observed in the present study

Recurrent laryngeal nerve injury

Injury to the recurrent laryngeal nerve is accompanied by a poor functional recovery of the target organ, the larynx. For the patient this means impairments of vocal fold mobility and various kinds of voice disorders. In this thesis, an experimental model in the rat is used to identify the most important pathological factors involved after recurrent laryngeal nerve injury. The results demonstrate that the posterior cricoarytenoid muscle, the only abductor of the vocal fold, recieves dual innervation from both the recurrent laryngeal nerve and the superior laryngeal nerve, a view that is against the classical understanding of laryngeal neuroanatomy. When the recurrent laryngeal nerve is injured, this anatomical relation then serves as a base for collateral reinnervation by competing, intact nerve fibers in the posterior cricoarytenoid muscle. Collateral reinnervation is proposed to be a negative factor for the functional outcome, more important than neuronal death, which was found to be low after recurrent laryngeal nerve injury. Pharmacological treatment with the calcium flow inhibitor nimodipine was shown to improve reinnervation by original recurrent laryngeal nerve fibers in rats. Early clinical data is also presented that indicate a beneficial effect from nimodipine treatment after acute recurrent laryngeal nerve injury, in terms of recovery of vocal fold mobility. Laryngeal electromyography was shown to be a valuable diagnostic and prognostic tool in detecting axonal injury in these patients, which may form an indication for nimodipine treatment

Bronsåldershästarna från Tågaborg i nytt ljus

This paper discusses a Bronze Age hoard, found at Tågaborg in 1895, in the city of Helsingborg. The find is regarded as one of the most important from the Early Bronze Age in Sweden, 1500–1300 BC. It includes two small bronze horse sculptures, four spearheads and three axes made from bronze. In 2002 replicas of the horse figurines were made for exhibition purposes, along with a new examination. It turned out that the bronze horse hoofs were designed as deer hooves. Besides, traces on the preserved head of one of the horse figurines showed signs of fitting for antlers, now lost. Considering these observations, we suggest that the bronze horse sculptures at Tågaborg instead should be interpreted as deer within the Cervidae family. In the article the symbolism of stags versus horses is briefly touched upon and related to rock carvings, miniature wagons and antler deposits (with a ritual intent) in wet land

Bronsåldershästarna från Tågaborg i nytt ljus

This paper discusses a Bronze Age hoard, found at Tågaborg in 1895, in the city of Helsingborg. The find is regarded as one of the most important from the Early Bronze Age in Sweden, 1500–1300 BC. It includes two small bronze horse sculptures, four spearheads and three axes made from bronze. In 2002 replicas of the horse figurines were made for exhibition purposes, along with a new examination. It turned out that the bronze horse hoofs were designed as deer hooves. Besides, traces on the preserved head of one of the horse figurines showed signs of fitting for antlers, now lost. Considering these observations, we suggest that the bronze horse sculptures at Tågaborg instead should be interpreted as deer within the Cervidae family. In the article the symbolism of stags versus horses is briefly touched upon and related to rock carvings, miniature wagons and antler deposits (with a ritual intent) in wet land

Acceptance and Commitment Therapy som stresshanteringsmetod för lärare

Fyrtiosju lärare randomiserades dels till en grupp som fick genomgå Acceptance and Commitment Therapy- Stress Management Intervention (n=24), dels till en kontrollgupp (n=23) i form av väntelista. En matchning genomfördes på det primära utfallsmåttet upplevd stress. Majoriteten av deltagarna var kvinnor, och samtliga arbetade som lärare i Stockholms län. För- och eftermätning genomfördes för samtliga utfallsmått. Interventionen omfattade 12 timmar fördelat på fyra veckor, med hemuppgifter mellan träffarna. Som förväntat visade resultatet signifikant minskad upplevelse av stress för de lärare som genomgått interventionen jämfört med kontrollgruppen. Däremot kunde studien inte påvisa att interventionen hade någon signifikant effekt för generell psykisk hälsa, utmattningssyndrom, krav och kontroll, prestationsbaserad självkänsla samt psykologisk flexibilitet. Diskussionen fokuserade särskilt på resultaten i relation till tidigare studier samt till relevant teori.Forty-seven teachers were randomly allocated to an Acceptance and Commitment Therapy - Stress Management Intervention group (n=24), or a waitlist control group (n=23). The participants were matched on the primary outcome variable, perceived stress. A majority of the participants were women, and all of them worked as teachers in Stockholm County. Outcome variables were recorded before and after the intervention. The intervention lasted for 12 hours spread over four weeks, with homework assignment given between sessions. As hypothesized significant reduction in perceived stress were found following the intervention. On the other hand no significant effects were proved for general mental health, burnout, performance-based self-esteem or psychological flexibility. Discussion mainly focused on the result in relation to earlier studies and relevant theory