Use of twist-drill craniostomy with drain in evacuation of chronic subdural hematomas: independent predictors of recurrence

Background  

Recurrence rates after chronic subdural hematoma (CSDH) evacuation with any of actual techniques [twist-drill craniostomy (TDC), burr-hole craniostomy, craniotomy] range from 5% to 30%. Use of drain has improved recurrence rates when used with burr-hole craniostomy. Now, we analyze predictors of recurrence of TDC with drain.     

Noninvasive assessment of portal hypertension in cirrhosis: Liver stiffness and beyond

Liver stiffness measurement(LSM)is a good,but still limited tool to noninvasively assess complications and prognosis in patients with advanced liver disease.This review aims to consider the role of LSM for the diagnosis of portal hypertension-related complications and for assessment of prognosis in cirrhotic patients,and to highlight the drawbacks as well as some alternatives for improving the performance.Hence,this field is far from being closed,and deserves more attention.There is still a place for more carefully designed studies to find new,innovative and reliable approaches.     

Long-Term Corrosion Testing of Zy-4 in a LiOH Solution under High Pressure and Temperature Conditions

The fuel cladding is one of the most important structural components for maintaining the integrity of a fuel channel and for safely exploitation of a nuclear power plant. The corrosion behavior of a fuel cladding material, Zy-4, under high pressure and temperatures conditions, was analyzed in a static isothermal autoclave under simulated primary water conditions—a LiOH solution at 310 °C and 10 MPa for up to 3024 h. After this, the oxides grown on the Zy-4 sample surface were characterized using electrochemical measurements, gravimetric analysis, metallographic analysis, SEM and XPS. The maximum oxide thicknesses evaluated by gravimetric and SEM measurements were in good agreement; both values were around 1.2 µm. The optical light microscopy (OLM) investigations identified the presence of small hydrides uniformly distributed horizontally across the alloy. EIS impedance spectra showed an increase in the oxide impedance for the samples oxidized for a long time. EIS plots has the best fit with an equivalent circuit which illustrated an oxide model that has two oxide layers: an inner oxide layer and outer layer. The EIS results showed that the inner layer was a barrier layer, and the outer layer was a porous layer. Potentiodynamic polarization results demonstrated superior corrosion resistance of the samples tested for longer periods of time. By XPS measurements we identified all five oxidation states of zirconium: Zr⁰ located at 178.5 eV; Zr⁴⁺ at 182.8 eV; and the three suboxides, Zr⁺, Zr²⁺ and Zr³⁺ at 179.7, 180.8 and 181.8 eV, respectively. The determination of Vickers microhardness completed the investigation.     

Stroke Mortality Rates and Trends in Romania, 1994-2017

Background and Aim: Romanian national level stroke mortality data is relatively scarce. The current study investigated stroke mortality rates and trends in Romania. Methods: All individual deaths registered in Romania during 1994-2017 were analyzed using an anonymized database, based on death certificates. Stroke crude mortality rates (CMR) and age-standardized mortality rates (ASMR) were calculated and expressed per 100,000 persons-year. Results: Between 1994 and 2017, 6,281,873 persons died in Romania, stroke being registered as the underlying cause of death in 959,319 cases. The overall stroke CMR was 188.2 (199.3 for women and 176.5 for men). The CMR for hemorrhagic stroke (HEMS) was 32.4 and for ischemic stroke (ISCS) 10.9. There was a significant decrease in stroke ASMR from 344.4 (95% confidence interval [CI] 343.4-345.4) in 1994 to 192.1 (95% CI 191.5-192.7) in 2017, with an annual percent change (APC) of 2.53% per year (95% CI 2.50-2.55, P < .001). Although compared with men, women had higher CMRs, when those rates were age-standardized men had higher ASMR as compared with women. The decline in HEMS ASMR had an APC of 4.65% per year (95% CI 4.59-4.70, P < .001). ISCS ASMR showed an initial increase in ASMR during 1994-2005, with APC 6.39% per year (95% CI 6.09-6.70, P < .001), followed by a significant decrease until 2017, with APC 2.83% per year (95% CI 2.59-3.07, P < .001). Conclusion: There was a significant reduction in stroke ASMR during 1994-2017. The decline was slow until 2002 and became steeper after that, with significant differences in gender analysis.     

Adult onset foveomacular vitelliform dystrophy

We present the case report of a 43 years old patient with adult-onset foveomacular vitelliform dystrophy, a rare disease described for the first time by Gass in 1974. The differential diagnosis was made particularly with Best disease, based on the aspect, the progression of the macular lesions, and the EOG.     

Macular syndrome

The syndrome consists of signs and symptoms associated in a similar clinical picture, yet induced by different causes. The macular syndrome represents a complex of signs (changes in macular architecture) and symptoms associated with central vision disturbances, obviously induced by different causes. Our paper reviews the macula alteration causes, the clinical elements of this dysfunction and the clinical and paraclinical methods of diagnosis in macular diseases.