Although most research has focused on adults, studies indicate that children also experience detrimental psychological effects as the result of natural disasters. The purpose of the present study was to determine if the tornado which struck Wichita Falls,, Texas, on April 10, 1979, had any negative effects on the academic performance or social behavior of school children. Three groups of students were studied: (a) victims of the tornado who suffered a significant loss, (b) observers of the disaster who did not suffer a significant loss, and (c) newcomers who arrived after the disaster. Achievement test scores, grades, and attendance over a 4-year period were studied. The overall results do not indicate significant differences among the three groups.

Introdução: No campo do tratamento cirúrgico de Gliomas, tem se observado um interesse crescente no uso de novas tecnologias de suporte como métodos auxiliares na obtenção do equilíbrio entre radicalidade cirúrgica e preservação da funcionalidade cerebral. Na maior parte dos estudos, a localização tumoral tem sido pouco considerada e a real eficácia das tecnologias de suporte ainda está pouco investigada nos gliomas insulares. Objetivos: avaliar a eficácia da fluorescência intraoperatória com 5-ALA, monitorização neurofisiológica, neuronavegação e tractografia no grau de ressecção tumoral (GRT), escores de funcionalidade, sobrevida global e sobrevida livre de progressão em uma coorte retrospectiva de gliomas insulares. Métodos: revisamos todos os casos de tumores insulares operados no Departamento de Neurocirurgia da Universidade de Tübingen - Alemanha, entre maio de 2008 e novembro de 2013. O grau de ressecção foi avaliado por volumetria. Foram utilizados os testes de Mann Whitney, Qui-quadrado e funções de Kaplan Meier para análise do efeito de cada tecnologia nos desfechos primários e secundários. Resultados: 28 casos - 18 homens (64%) e 10 mulheres (36%); idade média 52,5 anos (12 - 59) - foram inclusos para análise. Gliomas de alto grau corresponderam a 20 casos (71%), com 8 lesões de baixo grau (29%). As tecnologias mais utilizadas foram monitorização neurofisiológica (64%) e neuronavegação (68%). 5-ALA foi a única modalidade associada a taxas de ressecção > 90% (p = 0,05). O uso de tractografia determinou melhora no KPS (50% vs 5%, p = 0,02). Houve associação positiva entre o uso de neuronavegação e sobrevida global (23 vs. 27,4 meses, p = 0,03), mas o uso de 5-ALA se associou a piora na sobrevida global (34,8 vs 21,1 meses, p = 0,01) e sobrevida livre de progressão (24,4 vs. 11,8 meses, p = 0,01). Conclusões: Considerando os gliomas insulares, o presente trabalho demonstra pioneiramente que o uso de 5-ALA tem papel na obtenção de maiores taxas de ressecção, ainda que este achado possa estar associado a piora nas sobrevidas global e livre de progressão. Tractografia e neuronavegação parecem desempenhar papel importante no tratamento dos gliomas insulares, na medida em que determinaram melhor sobrevida global e funcionalidade, respectivamente. Estudos prospectivos com uma amostra mais proeminente e análise multivariada permitirão a avaliação do benefício real destas tecnologias de suporte no tratamento dos gliomas insulares / Introduction: In the field of Glioma surgery, there has been an increasing interest in the use of assistive technologies to overcome the difficulty of preserving brain function while improving surgical radicality. In most reports, tumor localization has seldom been considered a variable and the role of intraoperative adjuncts is yet to be determined for gliomas of the insula. Objectives: to evaluate the efficacy of fluorescence-guided resection with 5-ALA, intraoperative neurophysiological monitoring (IOM), neuronavigation, and tractography in the Extent of Resection (EOR), functionality scores, overall survival (OS) and progression-free survival (PFS) in a retrospective cohort of insular gliomas. Methods: we reviewed all cases of insular tumors operated on at the Department of Neurosurgery, University Hospital of Tübingen - Germany, between May 2008 and November 2013. EOR was determined by volumetric analysis. Mann Whitney, Chi-square and Kaplan Meier functions were used for assessment of each technology\'s effect on primary and secondary outcomes. Results: 28 cases (18 men (64%) and 10 women (36%); median age at diagnosis: 52.5 years, range 12 - 59) were considered eligible for analysis. High grade and low grade gliomas accounted for 20 (71%) and 8 (29%) cases, respectively. The most used technologies were IOM (64%) and Neuronavigation (68%). 5-ALA was the only technique associated with EOR > 90% (p = 0.05). Tractography determined improvement in the Karnofsky Performance Scale (50% vs 5% cases improved, p = 0.02). There was a positive association between the use of neuronavigation and overall survival (23 vs. 27.4 months, p = 0.03), but the use of 5-ALA was associated with shorter OS (34.8 vs. 21.1 months, p = 0.01) and PFS (24.4 vs. 11.8, p = 0.01). Conclusions: we demonstrate for the first time that for insular gliomas 5-ALA plays a role in achieving higher EOR, although this technology was associated with poor OS and PFS; Also tractography and neuronavigation can be of great importance in the treatment of insular gliomas as they determined better functionality and overall survival in this study, respectively. Prospective studies with a more prominent sample and proper multivariate analysis will help determine the real benefit of these adjuncts in the setting of insular gliomas

Os relaxantes neuromusculares não despolarizantes são fármacos indispensáveis nos procedimentos cirúrgicos que requerem entubação endotraqueal, visto que diminuem o tônus muscular. Quimicamente são divididos em derivados isoquinolinicos e derivados de esteróides, esses últimos com maior aplicação clinica e comercialização no Brasil. Assim sendo, é importante a validação de métodos analíticos para o controle de qualidade com alternativas confiáveis que garantam sua eficácia e segurança. Os brometos de vecurônio, de pancurônio e de rocurônio são fármacos relaxantes neuromusculares não despolarizantes derivados de esteróides. As propriedades farmacológicas destes fármacos são significativamente diferentes entre si, porém, as propriedades químicas são bastante similares. Na presente pesquisa foram desenvolvidos e validados métodos analíticos de separação (cromatografia líquida de alta eficiência e eletroforese capilar) para cada fármaco. Estes métodos foram aplicados a medicamentos comercializados no Brasil. Para todos os métodos cromatográficos foi utilizada uma coluna amino devido a seu caráter polar. Em função da baixa absorção dos três fármacos na região ultravioleta, os métodos eletroforéticos foram aplicados com detecções indiretas utilizando substâncias cromóforas. Comparando-se as técnicas utilizadas para determinação dos fármacos nos medicamentos isoladamente, não houve diferença significativa com nível de confiança de 95,0%. Nos testes de hipótese aplicados (F-Snedecor e t-Student), não foram observadas diferenças na precisão (variâncias) e no valor encontrado dos fármacos contidos nas amostras estudadas (comparação de duas médias). / The non-depolarizing neuromuscular relaxant drugs are essential in surgical procedures requiring endotracheal intubation, as they decrease muscle tonics. These drugs are chemically divided in isoquinolines derivatives and steroid derivatives, this latter group, with greater clinical application and commercialization in Brazil. Therefore, the study and validation of analytical methods are important for quality control with reliable alternatives to ensure their effectiveness and safety. The vecuronium, pancuronium and rocuronium bromides are steroid derivatives presenting non-depolarizing neuromuscular relaxant action. Pharmacological properties of these drugs differ significantly, however, its chemical properties are quite similar. In this research, analytical separation methods (high performance liquid chromatography and capillary electrophoresis), for each drug, were developed and fully validated. The methods were applied to pharmaceutical formulations commercialized in Brazil. For all chromatographic methods, an amino column was used, due to its polar characteristics. Due to the low absorption of the three drugs in the ultraviolet region, electrophoretic methods has been applied with indirect detection using chromophoric substances. When comparing both techniques used for quantitative determination of these drugs in pharmaceutical products, no significant difference was observed using a confidence level of 95.0%. By applying hypothesis tests (F-Snedecor and t-Student), it was not observed difference in precision (variance) and in the found amount of drugs contained in the selected samples (comparison of two means).

The juvenile justice system is society's response to juvenile misconduct. In spite of numerous federal, state, and local programs, the problem of juvenile delinquency persists. An increasing number of juveniles are being taken into custody and placed in institutional settings. Although juvenile delinquents share a number of common general characteristics (e.g., sex, minority, lower socioeconomic status, a history of school failure), they are not a homogeneous group. Effective educational interventions with delinquent juveniles can meet their unique academic, vocational, and social skills deficits. Handicapped juveniles are disproportionately represented among juvenile correctional facility populations. The identification of handicapped juveniles among delinquent populations is compounded as they share many of the same general characteristics. Federal statutes require individualized educational programs for all handicapped juveniles. This research investigated academic, behavioral, and social competencies of non-handicapped and handicapped adjudicated youth. Specifically, this investigation assessed measures of academic performance, classroom behavior, self-esteem, and social behavior. ANOVA indicated statistically significant differences between non-handicapped, learning disabled, and emotionally/behaviorally disordered adjudicated juveniles in reading achievement, mathematics achievement, and teacher generated measures of classroom behavior.

Os relaxantes neuromusculares não despolarizantes são fármacos indispensáveis nos procedimentos cirúrgicos que requerem entubação endotraqueal, visto que diminuem o tônus muscular. Quimicamente são divididos em derivados isoquinolinicos e derivados de esteróides, esses últimos com maior aplicação clinica e comercialização no Brasil. Assim sendo, é importante a validação de métodos analíticos para o controle de qualidade com alternativas confiáveis que garantam sua eficácia e segurança. Os brometos de vecurônio, de pancurônio e de rocurônio são fármacos relaxantes neuromusculares não despolarizantes derivados de esteróides. As propriedades farmacológicas destes fármacos são significativamente diferentes entre si, porém, as propriedades químicas são bastante similares. Na presente pesquisa foram desenvolvidos e validados métodos analíticos de separação (cromatografia líquida de alta eficiência e eletroforese capilar) para cada fármaco. Estes métodos foram aplicados a medicamentos comercializados no Brasil. Para todos os métodos cromatográficos foi utilizada uma coluna amino devido a seu caráter polar. Em função da baixa absorção dos três fármacos na região ultravioleta, os métodos eletroforéticos foram aplicados com detecções indiretas utilizando substâncias cromóforas. Comparando-se as técnicas utilizadas para determinação dos fármacos nos medicamentos isoladamente, não houve diferença significativa com nível de confiança de 95,0%. Nos testes de hipótese aplicados (F-Snedecor e t-Student), não foram observadas diferenças na precisão (variâncias) e no valor encontrado dos fármacos contidos nas amostras estudadas (comparação de duas médias). / The non-depolarizing neuromuscular relaxant drugs are essential in surgical procedures requiring endotracheal intubation, as they decrease muscle tonics. These drugs are chemically divided in isoquinolines derivatives and steroid derivatives, this latter group, with greater clinical application and commercialization in Brazil. Therefore, the study and validation of analytical methods are important for quality control with reliable alternatives to ensure their effectiveness and safety. The vecuronium, pancuronium and rocuronium bromides are steroid derivatives presenting non-depolarizing neuromuscular relaxant action. Pharmacological properties of these drugs differ significantly, however, its chemical properties are quite similar. In this research, analytical separation methods (high performance liquid chromatography and capillary electrophoresis), for each drug, were developed and fully validated. The methods were applied to pharmaceutical formulations commercialized in Brazil. For all chromatographic methods, an amino column was used, due to its polar characteristics. Due to the low absorption of the three drugs in the ultraviolet region, electrophoretic methods has been applied with indirect detection using chromophoric substances. When comparing both techniques used for quantitative determination of these drugs in pharmaceutical products, no significant difference was observed using a confidence level of 95.0%. By applying hypothesis tests (F-Snedecor and t-Student), it was not observed difference in precision (variance) and in the found amount of drugs contained in the selected samples (comparison of two means).

Hydraulic systems are widely applied in industry for position or force control. However, due to hydraulic system nonlinearities, it is difficult to achieve a precise model valid over a large range of frequencies and movements. The work in this dissertation focuses on a high performance hydraulic test bench which involves three main hydraulic components, i.e. two high performance servovalves, a double rod actuator, and a specific intermediate block connecting the servovalves and actuator. This rig has been designed for testing aerospace or automotive components in real conditions (e.g. wear and ageing effects). The main objectives of this dissertation are first the development of a virtual prototype based on a precise model which is derived from the physical principles and experimental works, and then second the synthesis of several nonlinear control laws of this actuation system in a large operating range with a good robustness to the perturbations. The proposed model based on Bond Graph shows a very good agreement with experimental results not only at low frequencies, but also at high frequencies. Moreover, its performances are improved at high frequencies by introducing the dynamic effects due to the intermediate block. Besides, multivariable and monovariable control strategies, based on respectively the backstepping and the model-free method, are developed and implemented on the test bench. All the control strategies proposed have been validated by simulations and experiments. Results show they lead to better tracking precision and robustness performance compared to the conventional control techniques.

Darbo objektas – žaidybinės veiklos analizė Tikslas – įvertinti ir palyginti 13–14 metų amžiaus jaunųjų Lietuvos tenisininkų (berniukų ir mergaičių) žaidybinės veiklos rodiklius. Uždaviniai 1. Įvertinti ir palyginti 13–14 metų amžiaus Lietuvos jaunųjų tenisininkų berniukų ir mergaičių padavimo efektyvumą. 2. Įvertinti ir palyginti 13–14 metų amžiaus Lietuvos jaunųjų tenisininkų berniukų ir mergaičių padavimo priėmimo stabilumą. 3. Įvertinti ir palyginti 13–14 metų amžiaus Lietuvos jaunųjų tenisininkų berniukų ir mergaičių pasirinktą žaidimo stilių. Tiriamasis klausimas Tenisas žaidžiamas visame pasaulyje, visų amžiaus grupių žmonių poilsio varžybiniais tikslais. Nepaisant pasaulinio teniso populiarumo, fiziniai reikalavimai ir žaidėjo dalyvavimas varžybose dar nėra visiškai aiškūs. Svarbu išanalizuoti varžybinius teniso rodiklius, lemiančius aukštą rezultatą, tikslu suvokti ir išsiaiškinti tarpusavio ryšį tarp žaidybinės veiklos ir žaidėjų charakterių, treniruočių pobūdžio, mitybos bei aplinkos sąlygos intervencijų (Morante&Brotherhood, 2007). Rezultatai: nustatyta, kad padavimo efektyvumas 13-14 metų jaunųjų tenisininkų berniukų buvo geresnis nei to paties amžiaus mergaičių (p<0,05), tačiau padavimo metu dvigubai klydo panašiai abi lytis, ir patikimo skirtumo nebuvo užfiksuota. Vertinant padavimo priėmimo stabilumą, tarp lyčių skirtumo neužfiksuota, tačiau reikšmingas skirtumas stebimas berniukų grupėje ir mergaičių grupėje tarp grąžintų į aikštelę ir negrąžintų... [toliau žr. visą tekstą] / Research object – indexes of tennis performace Research problem. Tennis is played throughout the world by people of all ages and standards on a recreational or competitive basis. Despite the global opulaity of tennis, the physical demands and player performance in competition are not fully understood. A tool is required to analyse competitive tennis for the objective evaluation of matters such as associations between performance and player characteristics, training and nutritional interventions, and environmental conditions. Research aim – to investigate and compare tennis performance indexes between 13-14 yars old Lithuanian young tennis players - boys and girls. Tasks: 1. To investigate and compare tennis serve effectivness between 13-14 years old Lithuanian young tennis boys and girls players. 2. To investigate and compare tennis stability of serve acceptance between 13-14 years old Lithuanian young tennis boys and girls players. 3. To investigate and compare playing style during the match between 13-14 yars old Lithuanian young tennis players girls and boys. Results: it was founded that the serve efficiency of 13-14 years old young tennis boys players was better than girls of the same age (p<0.05). However, during serve, double errors were made similarly by both genders and significant difference was not observed. Assessing the stability of the serve receipt, the differences between gender were not observed, but significant difference was observed among the boys and... [to full text]

Les études conduites au cours de ce travail de thèse ont montré que l’optimisation de la position du cycliste sur son vélo était un élément déterminant de la performance. Nos recherches ont porté sur quatre axes principaux : la conception et la validation d’outils de mesure, l’étude de la position aérodynamique, l’étude de la position assise et enfin l’étude de la position danseuse.L’ensemble des résultats obtenus montrent que la capacité de performance du cycliste peut être améliorée en position aérodynamique en augmentant le ratio entre la puissance mécanique (Pméca) et la surface frontale effective (SCx). Le confort représente également un des principaux facteurs de la performance en contre‑la‑montre (CLM) puisqu’il détermine l’aptitude du cycliste à maintenir sa position au cours du temps. Nos travaux montrent une amélioration du confort avec des semelles orthopédiques, chez les cyclistes affectés par une inégalité de longueur des membres inférieurs (ILMI), liée à une réduction des mouvements du bassin. Une correction orthopédique induit également une augmentation du rendement énergétique (+5,7 %). Ainsi, les cyclistes affectés par une ILMI sont recommandés de la compenser avec des semelles orthopédiques individualisées de façon à améliorer leur performance en CLM. Lors d’une étude préliminaire, nous avons également montré la relation entre les mouvements de la tête et le SCx, c’est pourquoi les cyclistes doivent réduire au maximum ces mouvements afin de minimiser leur SCx et ainsi maximiser leur performance. L’évaluation de la position aérodynamique doit être réalisée en conditions réelles de locomotion, que ce soit pour l’évaluation de S ou de SCx. Le développement de nos deux applications est donc un réel atout pour l’évaluation de la traînée aérodynamique (Ra) de manière individualisée dans les prochaines années puisqu’elles rendent le traitement plus accessible aux entraîneurs. Enfin, bien que nous ayons initié une nouvelle méthodologie d’évaluation de la position aérodynamique en associant numérisation 3D et modélisation numérique de la mécanique des fluides, cette méthode serait plutôt recommandée pour l’individualisation de l’équipement.La position assise peut également être optimisée en augmentant l’indice d’efficacité mécanique (IEM) du cycliste, quel que soit le niveau et le sexe. Cette augmentation de l’IEM passe principalement par une diminution de la force résistante (Fres) dans la phase de montée de la pédale. Malgré tout, le cycliste ne doit pas tirer sur la pédale pour générer un couple propulsif car cette stratégie est contre-productive d’un point de vue énergétique. Il serait intéressant d’étendre notre première étude, établie en laboratoire, sur le terrain pour analyser les adaptations biomécaniques du pédalage des cyclistes aux conditions rencontrées sur le terrain. Les différences observées en laboratoire, sur terrain plat et en montée laissent penser que les cyclistes adaptent leur pédalage selon les conditions dans lesquelles ils évoluent.Enfin, les travaux menés sur la position danseuse montrent que les cyclistes augmentent leur coût mécanique (CM) (+4,3 % en laboratoire vs. +19 % sur le terrain) par rapport à la position assise alors que la consommation d’oxygène reste stable entre les deux positions. Ces pertes mécaniques en position danseuse sont principalement dues à l’augmentation du coefficient de roulement (Cr) due aux oscillations latérales du vélo et donc à la torsion des pneus. Puisque les pertes mécaniques sont plus élevées sur le terrain que sur tapis roulant, d’autres facteurs semblent contribuer à cette différence comme la Ra (~10 W), le matériel utilisé par les cyclistes, le Cr de la route et la technique adoptée. Aussi, la position danseuse induit une augmentation du CM pour maintenir la vitesse de déplacement face aux variations de pente en montée. Les cyclistes sont donc fortement recommandés de réduire l’augmentation du CM en position danseuse comparée à la position assise. / The studies conducted during this PhD research showed that optimizing the position of the cyclist on the bicycle is a key factor influencing cycling performance. Our research focused on four main axes: the design and validation of measurement tools, the study of the aerodynamic position, the study of the seated position and the study of the standing position.All the results showed that the performance capacity of cyclists can be improved in aerodynamic position by increasing the ratio between the mechanical power (PO) and the drag area (ACd). Comfort is also a significant factor in time trial (TT) performance as it determines the ability of the cyclist to maintain position over time. Our works show that comfort can be improved via orthopaedic correction in cyclists affected by lower limb length inequality (LLLI) in the TT position, related to a reduction in pelvis movements. The orthopaedic correction also induces an increase in gross efficiency (+5.7%). Thus, this improvement in comfort could increase the PO and/or the amount of time the aerodynamic position can be maintained during a TT. Therefore, cyclists affected by LLLI should compensate LLLI with individualised foot orthotics to improve their TT performance. In a preliminary study, we also showed that there is a relationship between head movements and ACd. Therefore, cyclists should minimise these movements to minimise their ACd and maximise their performance. Aerodynamic position must be evaluated in real cycling locomotion, whether for the evaluation of A or ACd. We have developed two applications that are a real asset for the dynamic evaluation of aerodynamic drag (Ra) as they make the data analysis more accessible to coaches. Finally, although we have initiated a new method to assess ACd in the aerodynamic position by combining 3D scanning and computational fluid dynamics simulation, this method is also recommended for individualisation of cycling equipment.The seated cycling position can also be optimised by increasing the cyclists’ force effectiveness (FE), regardless of practice level or gender. This increase in FE is mainly due to a decrease in resistive force (Fres) during the upstroke phase of pedalling. Nevertheless, the cyclist should not pull on the pedal to generate propulsive torque because this strategy is counterproductive from an energy point of view. It would be interesting to extend our first study, which was set up in a laboratory, to the field to analyse the biomechanical adaptations of cyclists to the real conditions of locomotion. The differences observed in the laboratory, on level ground and over an uphill grade suggest that cyclists adjust their pedalling technique according to the conditions under which they are performing.Finally, studies of the standing cycling position show that cyclists increase their mechanical cost (MC) (+4.3% in the laboratory vs. +19% in the field) compared to the seated position; however, oxygen consumption was similar between the two positions. These mechanical losses (13 W in the laboratory vs. 49 W in the field) in the standing position are mainly due to increased rolling resistance coefficient (Crr), induced by the lateral sways of the bicycle and therefore torsion of the tyres. Because the observed mechanical losses are higher in the field than on the treadmill, other factors could contribute to this difference, such as Ra (~10 W), the equipment used by cyclists, the Crr of the road surface and the technique adopted. Also, the standing position induces an increase in MC to maintain constant speed when faced with uphill slope variations. Cyclists are therefore strongly recommended to reduce the increase of the MC in standing position compared to the seated position. This reduction in mechanical losses can be achieved by decreasing lateral sways and Ra.

Pas de résumé / No abstract

Introdução: No campo do tratamento cirúrgico de Gliomas, tem se observado um interesse crescente no uso de novas tecnologias de suporte como métodos auxiliares na obtenção do equilíbrio entre radicalidade cirúrgica e preservação da funcionalidade cerebral. Na maior parte dos estudos, a localização tumoral tem sido pouco considerada e a real eficácia das tecnologias de suporte ainda está pouco investigada nos gliomas insulares. Objetivos: avaliar a eficácia da fluorescência intraoperatória com 5-ALA, monitorização neurofisiológica, neuronavegação e tractografia no grau de ressecção tumoral (GRT), escores de funcionalidade, sobrevida global e sobrevida livre de progressão em uma coorte retrospectiva de gliomas insulares. Métodos: revisamos todos os casos de tumores insulares operados no Departamento de Neurocirurgia da Universidade de Tübingen - Alemanha, entre maio de 2008 e novembro de 2013. O grau de ressecção foi avaliado por volumetria. Foram utilizados os testes de Mann Whitney, Qui-quadrado e funções de Kaplan Meier para análise do efeito de cada tecnologia nos desfechos primários e secundários. Resultados: 28 casos - 18 homens (64%) e 10 mulheres (36%); idade média 52,5 anos (12 - 59) - foram inclusos para análise. Gliomas de alto grau corresponderam a 20 casos (71%), com 8 lesões de baixo grau (29%). As tecnologias mais utilizadas foram monitorização neurofisiológica (64%) e neuronavegação (68%). 5-ALA foi a única modalidade associada a taxas de ressecção > 90% (p = 0,05). O uso de tractografia determinou melhora no KPS (50% vs 5%, p = 0,02). Houve associação positiva entre o uso de neuronavegação e sobrevida global (23 vs. 27,4 meses, p = 0,03), mas o uso de 5-ALA se associou a piora na sobrevida global (34,8 vs 21,1 meses, p = 0,01) e sobrevida livre de progressão (24,4 vs. 11,8 meses, p = 0,01). Conclusões: Considerando os gliomas insulares, o presente trabalho demonstra pioneiramente que o uso de 5-ALA tem papel na obtenção de maiores taxas de ressecção, ainda que este achado possa estar associado a piora nas sobrevidas global e livre de progressão. Tractografia e neuronavegação parecem desempenhar papel importante no tratamento dos gliomas insulares, na medida em que determinaram melhor sobrevida global e funcionalidade, respectivamente. Estudos prospectivos com uma amostra mais proeminente e análise multivariada permitirão a avaliação do benefício real destas tecnologias de suporte no tratamento dos gliomas insulares / Introduction: In the field of Glioma surgery, there has been an increasing interest in the use of assistive technologies to overcome the difficulty of preserving brain function while improving surgical radicality. In most reports, tumor localization has seldom been considered a variable and the role of intraoperative adjuncts is yet to be determined for gliomas of the insula. Objectives: to evaluate the efficacy of fluorescence-guided resection with 5-ALA, intraoperative neurophysiological monitoring (IOM), neuronavigation, and tractography in the Extent of Resection (EOR), functionality scores, overall survival (OS) and progression-free survival (PFS) in a retrospective cohort of insular gliomas. Methods: we reviewed all cases of insular tumors operated on at the Department of Neurosurgery, University Hospital of Tübingen - Germany, between May 2008 and November 2013. EOR was determined by volumetric analysis. Mann Whitney, Chi-square and Kaplan Meier functions were used for assessment of each technology\'s effect on primary and secondary outcomes. Results: 28 cases (18 men (64%) and 10 women (36%); median age at diagnosis: 52.5 years, range 12 - 59) were considered eligible for analysis. High grade and low grade gliomas accounted for 20 (71%) and 8 (29%) cases, respectively. The most used technologies were IOM (64%) and Neuronavigation (68%). 5-ALA was the only technique associated with EOR > 90% (p = 0.05). Tractography determined improvement in the Karnofsky Performance Scale (50% vs 5% cases improved, p = 0.02). There was a positive association between the use of neuronavigation and overall survival (23 vs. 27.4 months, p = 0.03), but the use of 5-ALA was associated with shorter OS (34.8 vs. 21.1 months, p = 0.01) and PFS (24.4 vs. 11.8, p = 0.01). Conclusions: we demonstrate for the first time that for insular gliomas 5-ALA plays a role in achieving higher EOR, although this technology was associated with poor OS and PFS; Also tractography and neuronavigation can be of great importance in the treatment of insular gliomas as they determined better functionality and overall survival in this study, respectively. Prospective studies with a more prominent sample and proper multivariate analysis will help determine the real benefit of these adjuncts in the setting of insular gliomas