Safety and occlusion rates of surgical treatment of unruptured intracranial aneurysms: a systematic review and meta-analysis of the literature from 1990 to 2011.

BACKGROUND AND PURPOSE: Surgical clipping of unruptured intracranial aneurysms (UIAs) has recently been challenged by the emergence of endovascular treatment. We performed an updated systematic review and meta-analysis on the surgical treatment of UIAs, in an attempt to determine the aneurysm occlusion rates and safety of surgery in the modern era. METHODS: A detailed protocol was developed prior to conducting the review according to the Cochrane Collaboration guidelines. Electronic databases spanning January 1990-April 2011 were searched, complemented by hand searching. Heterogeneity was assessed using I(2), and publication bias with funnel plots. Surgical mortality and morbidity were analysed with weighted random effect models. RESULTS: 60 studies with 9845 patients harbouring 10 845 aneurysms were included. Mortality occurred in 157 patients (1.7%; 99% CI 0.9% to 3.0%; I(2)=82%). Unfavourable outcomes, including death, occurred in 692 patients (6.7%; 99% CI 4.9% to 9.0%; I(2)=85%). Morbidity rates were significantly greater in higher quality studies, and with large or posterior circulation aneurysms. Reported morbidity rates decreased over time. Studies were generally of poor quality; funnel plots showed heterogeneous results and publication bias, and data on aneurysm occlusion rates were scant. CONCLUSIONS: In studies published between 1990 and 2011, clipping of UIAs was associated with 1.7% mortality and 6.7% overall morbidity. The reputed durability of clipping has not been rigorously documented. Due to the quality of the included studies, the available literature cannot properly guide clinical decisions.

On Dichelyne (Cucullanellus) elongatus (Tornquist, 1931) Petter, 1974: South American correlated species (Nematoda, Cucullanidae) and some other helminths of micropogonias furnieri (Desmarest, 1823) (Pisces, Sciaenidae)

Dichelyne (Cucullanellus) elongatus (Tomquist, 1931) Petter, 1974, from Venezuela, of which D.(C.) amaurincai (Freitas, Vicente & Ibáñez, 1969) Petter, 1974 is proposed as a junior synonym, is redescribed and comments on the present status of the remaining species under the group, namely D.(C.) dichelyneformes (Szidat, 1950) Petter, 1974, D.(C.) rodriguesi (Pinto, Fábio & Noronha, 1970) Petter, 1974 and D.(C.) travassosi (Guimarães & Cristofaro, 1974), occuring in South America are made. Dollfusentis chandleri Golvan, 1969 (Acanthocephala, Illiosentidae), Poecilancistrium caryophyllum (Diesing, 1850)(Cestoidea, Otobothriidae) and Callitetrarhynchus gracilis (Rudolphi, 1819)(Cestoidea, Dasyrhynchidae) as well as larval forms of Echinocephalus sp. (Nematoda, Gnathostomatidae) and Contracaecum sp. (Nematoda, Anisakidae) are also reported.

Trypanosoma cruzi: serum antibody reactivity to the parasite antigens in susceptible and resistant mice

The specific antibody responses were compared among susceptible (A/Sn), moderately susceptible (Balb/c) and resistant (C57 BL/lOJ) mice infected with Trypanosoma cruzi (Y strain). Sera obtained during the second week of infection recognized a surface trypomastigote antigen of apparent Mr 80 kDa while displaying complex reactivity to surface epimastigote antigens. Complex trypomastigote antigens recognition was detected around the middle of the third week of infection. No major differences were observed along the infection, among the three strains of mice, neither in the patterns of surface antigen recognition by sera, nor in the titres of antibodies against blood trypomastigotes (lytic antibodies), tissue culture trypomastigotes or epimastigotes. On immunoblot analysis, however, IgG of the resistant strain displayed the most complex array of specificities against both trypo and epimastigote antigens, followed by the susceptible strain. IgM antibodies exhibited a more restricted antigen reactivity, in the three mouse strains studied. Balb/c sera (IgG and IgM) showed the least complex patterns of reactivity to antigens in the range of 30 kDa to 80 kDa. The onset of reactivity in the serum to trypomastigote surface antigens was also dependent on the parasite load to which the experimental animal was subjected.

Itinerari polític i ideològic de Ferran Valls-Taberner : de la República al franquisme (1931-1942)

Ferran Valls-Taberner fou un intel•lectual i polític que va militar a la Lliga Regionalista durant més de vint-i-sis anys i després es va convertir en un ideòleg del franquisme. En aquest treball s'estudien les raons que el van portar a fer aquest canvi a partir dels llibres i articles que va publicar.

Determinantes del crecimiento de las emisiones de gases de efecto invernadero en España (1990-2007)

La evolución de los gases de efecto invernadero en España se está distanciando notablemente del objetivo marcado por el Protocolo de Kyoto. En el presente trabajo se analizan los diferentes factores que han contribuido al importante aumento experimentado en las emisiones de gases de efecto invernadero provenientes del consumo de energía en España en el período 1990-2007. La metodología de descomposición factorial utilizada permite hacer una distribución exacta (sin residuos) de la variación de emisiones en diferentes efectos (efecto carbonización, efecto transformación, efecto intensidad y efecto escala). Los resultados muestran claramente que el efecto escala -la variación en el nivel de producción- ha sido determinante en explicar el aumento de emisiones, mientras que la contribución de los otros efectos, que deberían ser los que cambiaran la tendencia de crecimiento de emisiones, no ha permitido moderar su aumento. Una contribución especialmente negativa es la atribuible al efecto intensidad, que refleja la variación en la intensidad energética final del PIB, ya que incluso habría contribuido a aumentar las emisiones. En sentido opuesto, el efecto transformación, el impacto atribuible a la transformación energética, habría contribuido a moderar el aumento de las emisiones totales. El trabajo discute las implicaciones de los resultados obtenidos.

Intratypic differentiation of polioviruses isolated from suspected cases of poliomyelitis in Brazil during the period of 1990 to 1993

This study analyzed 3129 fecal samples derived from 1626 patients with sudden onset acute flaccid paralysis clinically compatible with poliomyelitis. The samples were collected in the period ranging from January 1990 to September 1993 in all regions of Brazil. Among the 1626 cases studied, 196 had isolation of poliovirus. Nevertheless, it was observed that some factors influenced the isolation rate and the intratypic characterization of these polioviruses. No cases of acute flaccid paralysis has been found to be etiologically related with wild polioviruses.

Immature stages of mosquitoes (Diptera: Culicidae) Collected during the autumn-winter period in Cordoba Province, Argentina

Eggs, immature mosquito collections were made at Cosquin, La Calera ( Chaco phytogeographic region), Villa Allende and Villa del Rosario (Espinal phytogeographic region) during April/September of two consecutive years 1989, 1990. Specific immature habitats in each locality were identified and sampled monthly. Eggs and/or immatures of Aedes albifasciatus, Ae. fluviatilis, Anopheles albitarsis, culex acharistus, Cx. apicinus, Cx. bidens, Cx. coronator, Cx. chidesteri, Cx. dolosus, Cx. maxi, Cx. quinquefasciatus, Cx. saltanensis, Psorophora ciliata and Uranotaenia lowii were collected. Three species (Cx. acharistus, Cx. dolosus and Cx. quinquefasciatus) were collected during the sampling period for all developmental stages. This suggests that immature of these species do not overwinter but continue to develop throughout the cold autumn and winter seasons.

Development of a collection of bacteria causing meningitis in Rio de Janeiro from 1990 to 1991

From March 1990 to December 1992, the National Institute for Quality Control of Health-INCQS Research Collection received 1476 bacterial samples isolated from human cerebrospinal fluid of patients suspect of meningitis in Rio de Janeiro, from the São Sebastião State Institute of Infectious Diseases (IEISS). Neisseria meningitidis was found in most of these materials, followed in smaller number by Haemophilus sp. and Streptococcus pneumoniae. The great majority of N. meningitidis strains was serogroup B, followed by serogroup C and a few strains of serogroup W135. More than 50 of the isolated bacterial agents came from the predominant 0-4 years age group. The majority of the strains were from patients in the region known as "Baixada Fluminense" (Low Lands). The aim of the work presented here is to obtain samples of meningitis cases in at least 70 of the State of Rio de Janeiro and develop a collaborative research between INCQS-FIOCRUZ and the IEISS, in order to set up a collection of strains for future studies. However, despite work being carried out in a rather satisfactory way, difficulties still arise and have to be overcome, to survey data.

Scanning electron microscopic study of Prosorhynchoides arcuatus (Linton, 1990) (Bucephalidae: Digenea)

Prosorhynchoides arcuatus (Linton, 1900) from the intestine of Pomatomus saltator (L.) from the Atlantic coast of the State of Rio de Janeiro is studied by scanning electron microscopy, with detailed description of tegumental spines. Comments on the synonymy of this species with Bucephalopsis callicotyle Kohn, 1962 are made. The tegument of adult P. arcuatus presents scale like and serrated spines and uniciliated sensory papillae, distributed over the body surface and is compared with other digenetic trematodes.

Onchocerciasis in Ecuador: changes in prevalence of ocular lesions in Onchocerca volvulus infected individuals over the period 1980-1990

Trends in prevalence rates of onchocercal ocular lesions were examined over the period 1980 to 1990 using data from two cross-sectional surveys. There was evidence for increasing prevalence of anterior chamber microfilariae, iridocyclitis, optic atrophy, and chorioretinopathy. Large increases in prevalence, in particular, were seen for posterior segment lesions: optic atrophy increased from 2.7% to 6.4% and chorioretinopathy from 8.8% to 35.6%. Greatest increases in these lesions were seen in the Chachi which was attributed to the large increases in prevalence of microfilariae in the anterior chamber particularly in those aged 30 years or greater. The study findings suggest that ocular onchocerciasis is evolving in parallel with the well documented parasitological changes.