Pub Date : 2024-03-13DOI: 10.9734/jammr/2024/v36i45401
Basma I. Fehil, Ahmed I. Yassin, Heba A. Mahmoud, Sabiha E. Hedya
Cisplatin (CP) is an important platinum-based chemotherapy agent widely used to treat solid tumors. However, nephrotoxicity is the main limiting adverse effect in 25%–35% of patients treated with even a single dose of CP. This study aimed to evaluate the role of liraglutide (LIRA) and alfacalcidol (ALFA), each of them alone and in combination, in prevention of CP-induced nephrotoxicity. Forty male albino mice were divided into five groups including normal control group and groups CP, CP with LIRA, CP with ALFA, or CP with LIRA and ALFA. Nephrotoxicity was induced by single intraperitoneal injection of CP in a dose 12mg/kg. LIRA and/or ALFA treatment was started 5 days before induction of nephrotoxicity and continued till the end of experiment. Kidney function tests, oxidative stress and ferroptosis parameters were assessed. Histopathological and immunohistochemical examination were performed on kidney tissues. Both LIRA and ALFA monotherapy resulted in a significant improvement in kidney function tests, increased antioxidant levels, inhibition of ferroptosis and improved histopathological findings. LIRA showed more improvement compared to ALFA and their combination showed better results than each one alone. In conclusion, LIRA and ALFA either alone or in combination, represent a promising preventive modality for amelioration of CP-induced nephrotoxicity.
{"title":"The Renoprotective Effects of Liraglutide and Alfacalcidol against Cisplatin Induced Nephrotoxicity in Mice","authors":"Basma I. Fehil, Ahmed I. Yassin, Heba A. Mahmoud, Sabiha E. Hedya","doi":"10.9734/jammr/2024/v36i45401","DOIUrl":"https://doi.org/10.9734/jammr/2024/v36i45401","url":null,"abstract":"Cisplatin (CP) is an important platinum-based chemotherapy agent widely used to treat solid tumors. However, nephrotoxicity is the main limiting adverse effect in 25%–35% of patients treated with even a single dose of CP. This study aimed to evaluate the role of liraglutide (LIRA) and alfacalcidol (ALFA), each of them alone and in combination, in prevention of CP-induced nephrotoxicity. Forty male albino mice were divided into five groups including normal control group and groups CP, CP with LIRA, CP with ALFA, or CP with LIRA and ALFA. Nephrotoxicity was induced by single intraperitoneal injection of CP in a dose 12mg/kg. LIRA and/or ALFA treatment was started 5 days before induction of nephrotoxicity and continued till the end of experiment. Kidney function tests, oxidative stress and ferroptosis parameters were assessed. Histopathological and immunohistochemical examination were performed on kidney tissues. Both LIRA and ALFA monotherapy resulted in a significant improvement in kidney function tests, increased antioxidant levels, inhibition of ferroptosis and improved histopathological findings. LIRA showed more improvement compared to ALFA and their combination showed better results than each one alone. In conclusion, LIRA and ALFA either alone or in combination, represent a promising preventive modality for amelioration of CP-induced nephrotoxicity.","PeriodicalId":14869,"journal":{"name":"Journal of Advances in Medicine and Medical Research","volume":"24 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140244809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-13DOI: 10.9734/jammr/2024/v36i45402
Abinaya, Kumar A, Sinha R, Singh A
Hypoplastic acute leukemia (HAL), also known as smoldering leukemia, is a form of atypical leukemia. It is a rare entity and currently defined as having cellularity of < 20% in bone marrow with >20% blasts at presentation. Hypocellular acute myeloid leukemia are more frequent than hypocellular variant of acute lymphoid leukemia. Although cases of hypoplastic acute myeloid in children and younger age group have been reported in literature, they are extremely rare. These cases pose a diagnostic challenge to the hematopathologist and treating physician, as hematological features of hypoplastic acute myeloid leuckemia (AML), hypocellular myelodysplastic syndrome and aplastic anemia are similar. Therefore, it is crucial to distinguish between these diseases as treatment modalities are different for each entity. Very few reported cases are available in literature. Hereby, we report this case of hypocellular AML-M0 in a 16-years-old Indian boy.
{"title":"Diagnostic Challenging Case of Hypoplastic Acute Myeloid Leukemia with Literature Review","authors":"Abinaya, Kumar A, Sinha R, Singh A","doi":"10.9734/jammr/2024/v36i45402","DOIUrl":"https://doi.org/10.9734/jammr/2024/v36i45402","url":null,"abstract":"Hypoplastic acute leukemia (HAL), also known as smoldering leukemia, is a form of atypical leukemia. It is a rare entity and currently defined as having cellularity of < 20% in bone marrow with >20% blasts at presentation. Hypocellular acute myeloid leukemia are more frequent than hypocellular variant of acute lymphoid leukemia. Although cases of hypoplastic acute myeloid in children and younger age group have been reported in literature, they are extremely rare. These cases pose a diagnostic challenge to the hematopathologist and treating physician, as hematological features of hypoplastic acute myeloid leuckemia (AML), hypocellular myelodysplastic syndrome and aplastic anemia are similar. Therefore, it is crucial to distinguish between these diseases as treatment modalities are different for each entity. Very few reported cases are available in literature. Hereby, we report this case of hypocellular AML-M0 in a 16-years-old Indian boy.","PeriodicalId":14869,"journal":{"name":"Journal of Advances in Medicine and Medical Research","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140246153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-11DOI: 10.9734/jammr/2024/v36i45399
Thiago Augusto Ferreira dos Anjos, A. M. Monteiro, Raquel Gomes da Silva, Kézia Dias Lopes, Lucrécia Aline Cabral Formigosa, Luciana Ferreira dos Santos, Patrícia Santos Martins, Marcela Raíssa Asevedo Dergan
Introduction: Breast cancer is a public health problem, characterized by an uncontrolled growth of malignant cells in breast tissue and the most common type of cancer among women, representing one of the main causes of death in the world. Objective: To carry out an epidemiological profile and trend of breast cancer in the municipalities of Belém and Ananindeua, state of Pará, Amazonia. Methods: This is an ecological, time-series, retrospective, descriptive, quantitative and analytical study, where data were collected from the Population-Based Cancer Registry/State Department of Public Health of the State of Pará in partnership with the Ophir Loyola Hospital (RCBP/SESPA/HOL). Results: The sociodemographic profile, the variable married (marital status) had the highest number of cases and percentage in 1712 (37%), followed by data without information 1214 (26%), followed by the single variable with 1079 (23%). In addition, the brown race was in first place with 1627 (35%) total cases, in schooling the data without information had the highest quantity in 1638 (35%), followed by high school (Old High School) in 1172 (25%). In tumor morphology, infiltrating ductal carcinoma was significant in 3309 (71%), followed by carcinoma without other specifications (NOS) with 284 (6%), in third place malignant neoplasm in 245 (5%). Regarding topography, in the total number of cases, breast was in first place with 2779 (60%), then the upper outer quadrant of the breast in 727 (16%), in third place invasive lesion of the breast 515 (11%), while in the two municipalities Belém had higher cases 3872, compared to Ananindeua 787. Conclusion: The data presented, as well as the epidemiological indicators of breast cancer, such as the trend of the disease, the coefficients of determination, correlation and mortality, were significant, thus elucidating a public health problem, since the epidemiological panorama in the cities of Belém and Ananindeua is increasing.
{"title":"Epidemiological Profile and Trends of Breast Cancer in the Municipalities of Belém and Ananindeua, Pará State, Amazon","authors":"Thiago Augusto Ferreira dos Anjos, A. M. Monteiro, Raquel Gomes da Silva, Kézia Dias Lopes, Lucrécia Aline Cabral Formigosa, Luciana Ferreira dos Santos, Patrícia Santos Martins, Marcela Raíssa Asevedo Dergan","doi":"10.9734/jammr/2024/v36i45399","DOIUrl":"https://doi.org/10.9734/jammr/2024/v36i45399","url":null,"abstract":"Introduction: Breast cancer is a public health problem, characterized by an uncontrolled growth of malignant cells in breast tissue and the most common type of cancer among women, representing one of the main causes of death in the world.\u0000Objective: To carry out an epidemiological profile and trend of breast cancer in the municipalities of Belém and Ananindeua, state of Pará, Amazonia.\u0000Methods: This is an ecological, time-series, retrospective, descriptive, quantitative and analytical study, where data were collected from the Population-Based Cancer Registry/State Department of Public Health of the State of Pará in partnership with the Ophir Loyola Hospital (RCBP/SESPA/HOL).\u0000Results: The sociodemographic profile, the variable married (marital status) had the highest number of cases and percentage in 1712 (37%), followed by data without information 1214 (26%), followed by the single variable with 1079 (23%). In addition, the brown race was in first place with 1627 (35%) total cases, in schooling the data without information had the highest quantity in 1638 (35%), followed by high school (Old High School) in 1172 (25%). In tumor morphology, infiltrating ductal carcinoma was significant in 3309 (71%), followed by carcinoma without other specifications (NOS) with 284 (6%), in third place malignant neoplasm in 245 (5%). Regarding topography, in the total number of cases, breast was in first place with 2779 (60%), then the upper outer quadrant of the breast in 727 (16%), in third place invasive lesion of the breast 515 (11%), while in the two municipalities Belém had higher cases 3872, compared to Ananindeua 787. \u0000Conclusion: The data presented, as well as the epidemiological indicators of breast cancer, such as the trend of the disease, the coefficients of determination, correlation and mortality, were significant, thus elucidating a public health problem, since the epidemiological panorama in the cities of Belém and Ananindeua is increasing.","PeriodicalId":14869,"journal":{"name":"Journal of Advances in Medicine and Medical Research","volume":"28 16","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140253843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-11DOI: 10.9734/jammr/2024/v36i45400
Mário Jorge Augusto de Andrade, Marilia Oliveira Coelho Dutra Leal, C. Jodas, Renato Assis Machado, A. Bachesk, R. G. Teixeira
Background and Aims: Medication-related osteonecrosis of the jaws (MRONJ) is a significant and potentially debilitating side effect caused by antiresorptive and antiangiogenic drugs, which can lead to bone exposure in the oral cavity. However, the management of this condition remains controversial, with adjuvant therapies being employed despite limited scientific evidence. This systematic review aimed to identify effective therapeutic procedures for treating MRONJ. Methodology: A literature search was conducted without any temporal limitations. The PRISMA protocol was followed. To identify relevant studies, we developed electronic search strategies for various bibliographic databases, as Cochrane, Embase, PubMed, Scopus, and Web of Science. It was conducted a comprehensive analysis of 30 studies involving 2,079 patients from 35 countries to evaluate the effectiveness of various treatment approaches for MRONJ. Results: The systematic review revealed that long-term use of Zoledronic acid for approximately 452.04 months (±27.41; 12-102) exposed many patients (n=772) to the risk of MRONJ. Similarly, Alendronate use for approximately 104.4 months (±60.16; 6-180) also posed a risk, affecting 650 patients, while Pamidronate use for about 20.74 months (±4.94; 6-96) was associated with MRONJ risk in 121 patients. Among the treatment approaches, conservative surgical management was the most frequently employed (27.92%), followed by local debridement (13.57%) and conservative treatment (11.21%). Treatment complications were observed in 13.03% of cases, with the most frequent complications being resistant or worsening clinical stage of osteonecrosis, followed by incomplete mucosal healing or dehiscence and mental nerve injury. Conclusion: While conservative surgical management, local debridement, and conservative treatment are commonly utilized approaches, the treatment of MRONJ lacks a standardized consensus due to the scarcity of scientific evidence. Further research and comprehensive studies are imperative to establish effective therapeutic strategies for managing this condition.
{"title":"Evaluation of Various Therapeutic Approaches in Treating Medication-related Osteonecrosis of the Jaw: A Systematic Review","authors":"Mário Jorge Augusto de Andrade, Marilia Oliveira Coelho Dutra Leal, C. Jodas, Renato Assis Machado, A. Bachesk, R. G. Teixeira","doi":"10.9734/jammr/2024/v36i45400","DOIUrl":"https://doi.org/10.9734/jammr/2024/v36i45400","url":null,"abstract":"Background and Aims: Medication-related osteonecrosis of the jaws (MRONJ) is a significant and potentially debilitating side effect caused by antiresorptive and antiangiogenic drugs, which can lead to bone exposure in the oral cavity. However, the management of this condition remains controversial, with adjuvant therapies being employed despite limited scientific evidence. This systematic review aimed to identify effective therapeutic procedures for treating MRONJ. \u0000Methodology: A literature search was conducted without any temporal limitations. The PRISMA protocol was followed. To identify relevant studies, we developed electronic search strategies for various bibliographic databases, as Cochrane, Embase, PubMed, Scopus, and Web of Science. It was conducted a comprehensive analysis of 30 studies involving 2,079 patients from 35 countries to evaluate the effectiveness of various treatment approaches for MRONJ. \u0000Results: The systematic review revealed that long-term use of Zoledronic acid for approximately 452.04 months (±27.41; 12-102) exposed many patients (n=772) to the risk of MRONJ. Similarly, Alendronate use for approximately 104.4 months (±60.16; 6-180) also posed a risk, affecting 650 patients, while Pamidronate use for about 20.74 months (±4.94; 6-96) was associated with MRONJ risk in 121 patients. Among the treatment approaches, conservative surgical management was the most frequently employed (27.92%), followed by local debridement (13.57%) and conservative treatment (11.21%). Treatment complications were observed in 13.03% of cases, with the most frequent complications being resistant or worsening clinical stage of osteonecrosis, followed by incomplete mucosal healing or dehiscence and mental nerve injury. \u0000Conclusion: While conservative surgical management, local debridement, and conservative treatment are commonly utilized approaches, the treatment of MRONJ lacks a standardized consensus due to the scarcity of scientific evidence. Further research and comprehensive studies are imperative to establish effective therapeutic strategies for managing this condition.","PeriodicalId":14869,"journal":{"name":"Journal of Advances in Medicine and Medical Research","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140252470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-09DOI: 10.9734/jammr/2024/v36i45398
Roberto Puertas Garcia, Fernanda Pirossi Brodt, Carolyne Martins De Marchi, Paulo Roxo Barja, A. Dória, Gisele Rosada Dônola Furtado, Michelle Fechine Costa, J. Paterno
Cutaneous ageing is a natural process associated with advancing age, potentially resulting in negative consequences on individuals' self-esteem. The primary manifestations of this process are the emergence of wrinkles, spots, dehydration, sagging, and loss of tissue vitality. In recent years, there has been a significant increase in the pursuit of more natural treatments for facial rejuvenation. In this context, using ALB-Gel and i-PRF stands out as a biological and autologous material. Materials and Methods: The measurement of the dermis using a 16 MHz ultrasound device and photographic documentation allowed for evaluating the technique's efficacy in reducing signs of ageing and nasolabial fold depth. The clinical study was conducted with 13 female participants aged 35 to 55 who underwent a session of ALB-Gel and i-PRF application in the right hemiface nasolabial fold region and i-PRF in the left hemiface. A paired t-test with a significance level of 5% was used in the statistical analysis. The scores on the Self-Perception Index were also statistically assessed using the Wilcoxon test at 5% to verify significant improvement. Additionally, new frontal and profile D and E photos were taken and compared with the initial images. Results: For the right hemiface nasolabial fold, a P < 0.0074 was observed to compare initial and final signs; for the left hemiface, a P < 0.1259 was obtained. These statistical results evidence a significant increase in dermal thickness in the right hemiface nasolabial fold (D) region after intradermal application of ALB-Gel and i-PRF; in the left hemiface nasolabial fold (E) region, treated only with i-PRF, no significant change in dermal thickness was observed. The statistical analysis conducted for the Self-Perception Index revealed a P < 0.0001, indicating a highly significant improvement in participant perception post-treatment. Conclusion: The intradermal application of ALB-Gel and i-PRF in a single session significantly increased dermal thickness, indicating this is a simple and low-cost alternative for dermal restructuring.
{"title":"Comparative Study on the Efficacy of Injectable Platelet Rich Fibrin (i-PRF) and Albumin Gel (ALB-Gel) in Facial Rejuvenation: A Clinical Ultrasonographic Evaluation","authors":"Roberto Puertas Garcia, Fernanda Pirossi Brodt, Carolyne Martins De Marchi, Paulo Roxo Barja, A. Dória, Gisele Rosada Dônola Furtado, Michelle Fechine Costa, J. Paterno","doi":"10.9734/jammr/2024/v36i45398","DOIUrl":"https://doi.org/10.9734/jammr/2024/v36i45398","url":null,"abstract":"Cutaneous ageing is a natural process associated with advancing age, potentially resulting in negative consequences on individuals' self-esteem. The primary manifestations of this process are the emergence of wrinkles, spots, dehydration, sagging, and loss of tissue vitality. In recent years, there has been a significant increase in the pursuit of more natural treatments for facial rejuvenation. In this context, using ALB-Gel and i-PRF stands out as a biological and autologous material.\u0000Materials and Methods: The measurement of the dermis using a 16 MHz ultrasound device and photographic documentation allowed for evaluating the technique's efficacy in reducing signs of ageing and nasolabial fold depth. The clinical study was conducted with 13 female participants aged 35 to 55 who underwent a session of ALB-Gel and i-PRF application in the right hemiface nasolabial fold region and i-PRF in the left hemiface. A paired t-test with a significance level of 5% was used in the statistical analysis. The scores on the Self-Perception Index were also statistically assessed using the Wilcoxon test at 5% to verify significant improvement. Additionally, new frontal and profile D and E photos were taken and compared with the initial images.\u0000Results: For the right hemiface nasolabial fold, a P < 0.0074 was observed to compare initial and final signs; for the left hemiface, a P < 0.1259 was obtained. These statistical results evidence a significant increase in dermal thickness in the right hemiface nasolabial fold (D) region after intradermal application of ALB-Gel and i-PRF; in the left hemiface nasolabial fold (E) region, treated only with i-PRF, no significant change in dermal thickness was observed. The statistical analysis conducted for the Self-Perception Index revealed a P < 0.0001, indicating a highly significant improvement in participant perception post-treatment.\u0000Conclusion: The intradermal application of ALB-Gel and i-PRF in a single session significantly increased dermal thickness, indicating this is a simple and low-cost alternative for dermal restructuring.","PeriodicalId":14869,"journal":{"name":"Journal of Advances in Medicine and Medical Research","volume":"247 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140255785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-09DOI: 10.9734/jammr/2024/v36i45397
Evelly Christinne da Silva Moraes, E. F. D. A. Sobrinho, Breno Yanaguibashi Gonçalves, Ryan Jorge Amorim, Glenda Figueira Guimarães, Kelly Cristina Costa Guedes Nascimento, Paulo Armando Rosa Miranda da Silva, Camilla Castilho Maia, Francisco Dias Lucena Neto, Igor Jordan Barbosa Coutinho, Bruno Eduardo da Silva Oliveira, Vitor Hugo Auzier Lima
Introduction: The intravitreal injection has become one of the most frequently performed invasive procedures in ophthalmology in the last few years. The intravitreal therapy with antiangiogenics is considered the first line of treatment for several retinal diseases through the inhibition of messenger RNA synthesis, transcription or direct blockade of action of vascular endothelial growth factor (VEGF). The most commonly used antiangiogenic agents today are: ranibizumab, bevacizumab, aflibercept and faricimab. Triamcinolone, a potent steroid, is also used in refractory cases. According to the Brazilian Retina and Vitreous Society, the pathologies most treated with anti-VEGF were Age-Related Macular Degeneration (AMD), followed by Diabetic Macular Edema (DME) and RVO. Objective: To analyze the epidemiological impact of intravitreal therapy on patients with vitreoretinal diseases treated at the Hospital Universitário Bettina Ferro de Souza in Belém, Pará. Methods: An observational, cross-sectional, descriptive study with a quantitative approach was carried out. The medical records of 419 patients with vitreoretinal disease and indication of intravitreal therapy were analyzed between January 2018 and August 2023 in an Ophthalmological Reference Centre, evaluating visual acuity, sex, origin, age, injected eye, number of injections, substance injected and underlying disease, using the Chi-Square test of independence with the help of Excel (Microsoft Office) and Epi Info programs. Results: Among the 419 patients evaluated and 540 eyes injected, the average age observed was 66.6 years, there was no predominance of sex and the majority of patients came from the State of Pará. Diabetic Macular Edema (DME) was the most prevalent disease, followed by AMD and retinal occlusion. 68.3% at least started treatment and received one or more substances. AMD and DR correspond to 81.6% of injections administered and Ranibizumab is the most used drug, corresponding to 93% of injections. Considering visual acuity, an improvement was evident after therapy. Conclusion: This work reinforced the difficulty in accessing ocular health and availability of intravitreal treatment with antiangiogenic drugs faced by these patients, worsening their visual prognosis. These medications have a high financial cost and a major impact on vitreoretinal diseases, therefore it is necessary to manage these patients, as well as the early diagnosis of different vitreoretinal disorders that can be treated with these medications, allowing the identification of the main etiologies prevalent in the Amazon region and helping to prevent these diseases.
{"title":"Epidemiological Analysis of Patients with Vitreoretinal Diseases Undergoing Intravitreal Therapy at a Referral Hospital in the State of Pará","authors":"Evelly Christinne da Silva Moraes, E. F. D. A. Sobrinho, Breno Yanaguibashi Gonçalves, Ryan Jorge Amorim, Glenda Figueira Guimarães, Kelly Cristina Costa Guedes Nascimento, Paulo Armando Rosa Miranda da Silva, Camilla Castilho Maia, Francisco Dias Lucena Neto, Igor Jordan Barbosa Coutinho, Bruno Eduardo da Silva Oliveira, Vitor Hugo Auzier Lima","doi":"10.9734/jammr/2024/v36i45397","DOIUrl":"https://doi.org/10.9734/jammr/2024/v36i45397","url":null,"abstract":"Introduction: The intravitreal injection has become one of the most frequently performed invasive procedures in ophthalmology in the last few years. The intravitreal therapy with antiangiogenics is considered the first line of treatment for several retinal diseases through the inhibition of messenger RNA synthesis, transcription or direct blockade of action of vascular endothelial growth factor (VEGF). The most commonly used antiangiogenic agents today are: ranibizumab, bevacizumab, aflibercept and faricimab. Triamcinolone, a potent steroid, is also used in refractory cases. According to the Brazilian Retina and Vitreous Society, the pathologies most treated with anti-VEGF were Age-Related Macular Degeneration (AMD), followed by Diabetic Macular Edema (DME) and RVO.\u0000Objective: To analyze the epidemiological impact of intravitreal therapy on patients with vitreoretinal diseases treated at the Hospital Universitário Bettina Ferro de Souza in Belém, Pará.\u0000Methods: An observational, cross-sectional, descriptive study with a quantitative approach was carried out. The medical records of 419 patients with vitreoretinal disease and indication of intravitreal therapy were analyzed between January 2018 and August 2023 in an Ophthalmological Reference Centre, evaluating visual acuity, sex, origin, age, injected eye, number of injections, substance injected and underlying disease, using the Chi-Square test of independence with the help of Excel (Microsoft Office) and Epi Info programs.\u0000Results: Among the 419 patients evaluated and 540 eyes injected, the average age observed was 66.6 years, there was no predominance of sex and the majority of patients came from the State of Pará. Diabetic Macular Edema (DME) was the most prevalent disease, followed by AMD and retinal occlusion. 68.3% at least started treatment and received one or more substances. AMD and DR correspond to 81.6% of injections administered and Ranibizumab is the most used drug, corresponding to 93% of injections. Considering visual acuity, an improvement was evident after therapy.\u0000Conclusion: This work reinforced the difficulty in accessing ocular health and availability of intravitreal treatment with antiangiogenic drugs faced by these patients, worsening their visual prognosis. These medications have a high financial cost and a major impact on vitreoretinal diseases, therefore it is necessary to manage these patients, as well as the early diagnosis of different vitreoretinal disorders that can be treated with these medications, allowing the identification of the main etiologies prevalent in the Amazon region and helping to prevent these diseases.","PeriodicalId":14869,"journal":{"name":"Journal of Advances in Medicine and Medical Research","volume":"158 S328","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140256742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-08DOI: 10.9734/jammr/2024/v36i45396
R. Soomro, A. Khokher, Sadaf Nasir
Background: Assessing the targeted node, a biopsy-proven metastatic node marked with a metallic clip before neoadjuvant chemotherapy along with sentinel node dissection improves the evaluation of pathological response in the axillary nodal basin after systemic treatment as compared to sentinel node dissection with dual tracer alone. Objectives: The objective was to investigate the rate of the clipped node being a sentinel node and the sensitivity of targeted node dissection in detecting residual disease. Methods: A prospective study of biopsy-confirmed breast axillary nodal metastases with a metallic clip placed before initiating systemic therapy. After the therapy, the clip node was identified by ultrasound-guided needle localization and sentinel node biopsy by the dual tracer. At least 3 or more nodes were sent for biopsy. Nodal metastasis was confirmed by frozen section biopsy and complete axillary dissection was done even if micro-metastatic disease was detected. Results: Of 120 patients enrolled in the study, 60(50%) patients had residual axillary nodal disease after neoadjuvant chemotherapy. Among 60 patients with positive residual disease clip node was positive for metastasis in all node-positive patients 60 (100%). Among these 60 patients with residual disease in 42 (70%) cases clipped nodes and sentinel nodes were alike/same, whereas the remaining 18 (30%) patients with residual disease clipped nodes were not sentinel nodes. In the 10/18 case, the sentinel node was also positive on biopsy or complete axillary clearance but in 8/18(13%) nodes that were clipped but not sentinel nodes clip node was only positive node, but the sentinel node was negative on frozen well as on complete axillary clearance. This emphasizes the importance of clipped node removal/assessment after neoadjuvant surgery without which we can miss about 13% of positive axillary disease. Conclusion: Marking nodes (metallic clip) with biopsy-confirmed metastatic disease allows for selective removal and improves pathologic evaluation for the residual nodal disease after chemotherapy.
{"title":"Implementation of Targeted Axillary Node Assessment Following Neoadjuvant Therapy for Node-positive Breast Cancer Patients Improves Axillary Disease Detection","authors":"R. Soomro, A. Khokher, Sadaf Nasir","doi":"10.9734/jammr/2024/v36i45396","DOIUrl":"https://doi.org/10.9734/jammr/2024/v36i45396","url":null,"abstract":"Background: Assessing the targeted node, a biopsy-proven metastatic node marked with a metallic clip before neoadjuvant chemotherapy along with sentinel node dissection improves the evaluation of pathological response in the axillary nodal basin after systemic treatment as compared to sentinel node dissection with dual tracer alone. \u0000Objectives: The objective was to investigate the rate of the clipped node being a sentinel node and the sensitivity of targeted node dissection in detecting residual disease. \u0000Methods: A prospective study of biopsy-confirmed breast axillary nodal metastases with a metallic clip placed before initiating systemic therapy. After the therapy, the clip node was identified by ultrasound-guided needle localization and sentinel node biopsy by the dual tracer. At least 3 or more nodes were sent for biopsy. Nodal metastasis was confirmed by frozen section biopsy and complete axillary dissection was done even if micro-metastatic disease was detected. \u0000Results: Of 120 patients enrolled in the study, 60(50%) patients had residual axillary nodal disease after neoadjuvant chemotherapy. Among 60 patients with positive residual disease clip node was positive for metastasis in all node-positive patients 60 (100%). Among these 60 patients with residual disease in 42 (70%) cases clipped nodes and sentinel nodes were alike/same, whereas the remaining 18 (30%) patients with residual disease clipped nodes were not sentinel nodes. In the 10/18 case, the sentinel node was also positive on biopsy or complete axillary clearance but in 8/18(13%) nodes that were clipped but not sentinel nodes clip node was only positive node, but the sentinel node was negative on frozen well as on complete axillary clearance. This emphasizes the importance of clipped node removal/assessment after neoadjuvant surgery without which we can miss about 13% of positive axillary disease. \u0000Conclusion: Marking nodes (metallic clip) with biopsy-confirmed metastatic disease allows for selective removal and improves pathologic evaluation for the residual nodal disease after chemotherapy.","PeriodicalId":14869,"journal":{"name":"Journal of Advances in Medicine and Medical Research","volume":"122 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140257208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-07DOI: 10.9734/jammr/2024/v36i45395
Cassia Thaís Iurkiv Zanatta, Poliana Maria de Faveri Cardoso, Veridiana Camilotti, M. J. Mendonça, Júlio Katuhide Ueda
Aims: This study aimed to evaluate the micro-shear bond strength of a self-adhesive versus conventional low-viscosity composite resins adhered to enamel. Study Design: In vitro study. Place and Duration of Study: Dental Clinic of the Western State University of Paraná, between October 2022 and September 2023. Methodology: In this in vitro study, the crowns of ten bovine incisor teeth were separated from the roots and embedded in polyvinyl chloride cylinders with acrylic resin. The teeth were divided into two groups (n=5) according to the type of low-viscosity composite resin used on the enamel, resulting in a total of fifteen specimens: one group with self-adhesive composite resin and another with conventional composite resin. Specimens measuring 3 × 2 mm were prepared with low-viscosity composite resin and applied to the adhesive areas according to their respective groups. The micro-shear test was carried out after 7 days of immersion in distilled water in a universal mechanical testing machine with a 50 kg load cell. The statistical analysis in this study employed the Shapiro-Wilk test to assess data normality. Due to non-normal distribution, the non-parametric Mann-Whitney U test was utilized for group comparisons (p < 0.001). Supplementary analyses were performed using the Dwass-Steel-Critchlow-Fligner (DSCF) test for multiple comparisons (p < 0.001) to detect intergroup differences. Fractures were analyzed using a stereoscopic magnifying glass at 40x magnification. Results: The lowest micro-shear bond strength was observed in the self-adhesive composite resin group, while the highest was observed in the conventional composite resin group. On average, the micro-shear bond strength was higher for the conventional composite resin group compared to the self-adhesive composite resin group (p < 0.001). Most fractures in the conventional composite resin group were mixed, whereas in the Self-Adhesive composite resin group they were predominantly adhesive. Conclusion: Based on this study, it can be concluded that self-adhesive flowable composite resin exhibited lower enamel bond strength values compared to conventional flowable composite resin.
{"title":"Micro-shear Bond Strength of Self-Adhesive Versus Conventional Low-viscosity Composite Resins: In vitro Study","authors":"Cassia Thaís Iurkiv Zanatta, Poliana Maria de Faveri Cardoso, Veridiana Camilotti, M. J. Mendonça, Júlio Katuhide Ueda","doi":"10.9734/jammr/2024/v36i45395","DOIUrl":"https://doi.org/10.9734/jammr/2024/v36i45395","url":null,"abstract":"Aims: This study aimed to evaluate the micro-shear bond strength of a self-adhesive versus conventional low-viscosity composite resins adhered to enamel. \u0000Study Design: In vitro study. \u0000Place and Duration of Study: Dental Clinic of the Western State University of Paraná, between October 2022 and September 2023. \u0000Methodology: In this in vitro study, the crowns of ten bovine incisor teeth were separated from the roots and embedded in polyvinyl chloride cylinders with acrylic resin. The teeth were divided into two groups (n=5) according to the type of low-viscosity composite resin used on the enamel, resulting in a total of fifteen specimens: one group with self-adhesive composite resin and another with conventional composite resin. Specimens measuring 3 × 2 mm were prepared with low-viscosity composite resin and applied to the adhesive areas according to their respective groups. The micro-shear test was carried out after 7 days of immersion in distilled water in a universal mechanical testing machine with a 50 kg load cell. The statistical analysis in this study employed the Shapiro-Wilk test to assess data normality. Due to non-normal distribution, the non-parametric Mann-Whitney U test was utilized for group comparisons (p < 0.001). Supplementary analyses were performed using the Dwass-Steel-Critchlow-Fligner (DSCF) test for multiple comparisons (p < 0.001) to detect intergroup differences. Fractures were analyzed using a stereoscopic magnifying glass at 40x magnification. \u0000Results: The lowest micro-shear bond strength was observed in the self-adhesive composite resin group, while the highest was observed in the conventional composite resin group. On average, the micro-shear bond strength was higher for the conventional composite resin group compared to the self-adhesive composite resin group (p < 0.001). Most fractures in the conventional composite resin group were mixed, whereas in the Self-Adhesive composite resin group they were predominantly adhesive. \u0000Conclusion: Based on this study, it can be concluded that self-adhesive flowable composite resin exhibited lower enamel bond strength values compared to conventional flowable composite resin.","PeriodicalId":14869,"journal":{"name":"Journal of Advances in Medicine and Medical Research","volume":"16 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140260070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-05DOI: 10.9734/jammr/2024/v36i45393
Glenda Figueira Guimarães, José Jesu Sisnando D'Araujo Filho, Raissa Tereza Casseb Oliveira, Evelly Christinne da Silva Moraes, Kelly Cristina Costa Guedes Nascimento, Ryan Jorge Amorim, Pedro Artur Solano Carvalho, Caio Cesar Rodrigues Chaves, Bruno Eduardo da silva Rodrigues, Daniele Salgado de Sousa, Vitor Hugo Auzier Lima
Keratoconus is a progressive non-inflammatory ectatic dystrophy, characterised by thinning and curving of the cornea, with central or paracentral conical protrusion, which occurs due to a biomechanical failure of the corneal stroma that is no longer able to resist the internal and external pressures exerted. The objective of the study was to analyse the positive impact of performing ring implant surgeries on patients on the corneal transplant waiting list, at the Bettina Ferro de Souza University Hospital (HUBFS), in 2023. Of the 87 intrastromal ring implants performed in 2023, 6 patients were excluded due to lack of complete data to carry out the evaluation of this work, using the total number of patients for this research 81 (100%). It was found that 89% of patients showed an improvement in corrected visual acuity after ring implantation, with approximately half reaching 100% of their visual range, providing a visual acuity of 1.0. This study showed that of the 14 patients enrolled for corneal transplantation with keratoconus who also had an indication for ring implantation, only 4 still required corneal transplantation after the procedure. In this sphere, it was evident that the patients had an improvement in visual acuity, symptoms and postponed or canceled the corneal transplant. However, more research is needed in this field, in order to obtain advances that make this procedure even safer, minimizing the risks inherent to its placement, with a view to improving the patient's quality of life.
{"title":"Impact of Ring Implant Surgeries on the Corneal Transplant Queue at a Reference University Hospital in the State of Pará","authors":"Glenda Figueira Guimarães, José Jesu Sisnando D'Araujo Filho, Raissa Tereza Casseb Oliveira, Evelly Christinne da Silva Moraes, Kelly Cristina Costa Guedes Nascimento, Ryan Jorge Amorim, Pedro Artur Solano Carvalho, Caio Cesar Rodrigues Chaves, Bruno Eduardo da silva Rodrigues, Daniele Salgado de Sousa, Vitor Hugo Auzier Lima","doi":"10.9734/jammr/2024/v36i45393","DOIUrl":"https://doi.org/10.9734/jammr/2024/v36i45393","url":null,"abstract":"Keratoconus is a progressive non-inflammatory ectatic dystrophy, characterised by thinning and curving of the cornea, with central or paracentral conical protrusion, which occurs due to a biomechanical failure of the corneal stroma that is no longer able to resist the internal and external pressures exerted. The objective of the study was to analyse the positive impact of performing ring implant surgeries on patients on the corneal transplant waiting list, at the Bettina Ferro de Souza University Hospital (HUBFS), in 2023. Of the 87 intrastromal ring implants performed in 2023, 6 patients were excluded due to lack of complete data to carry out the evaluation of this work, using the total number of patients for this research 81 (100%). It was found that 89% of patients showed an improvement in corrected visual acuity after ring implantation, with approximately half reaching 100% of their visual range, providing a visual acuity of 1.0. This study showed that of the 14 patients enrolled for corneal transplantation with keratoconus who also had an indication for ring implantation, only 4 still required corneal transplantation after the procedure. In this sphere, it was evident that the patients had an improvement in visual acuity, symptoms and postponed or canceled the corneal transplant. However, more research is needed in this field, in order to obtain advances that make this procedure even safer, minimizing the risks inherent to its placement, with a view to improving the patient's quality of life.","PeriodicalId":14869,"journal":{"name":"Journal of Advances in Medicine and Medical Research","volume":"27 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140263612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-05DOI: 10.9734/jammr/2024/v36i35389
J. M. Afolayan, Tokunbo Olajumoke, Babatunde Yusuf
Introduction: This study was undertaken to determine the level of patients’ satisfaction after epidural anaesthesia, without breakthrough pain, in patients scheduled for orthopaedic surgery. Epidural block is one of the regional anaesthesia that can be used in orthopeadic cases with prolonged duration of surgery. Aim and Objectives: To study the intraoperative pain outcome and patients’ satisfaction during epidural anaesthesia with top up doses without breakthrough pain. Methods: A prospective study of patients who underwent orthopaedic procedures under epidural block in the operating rooms of Ekiti State University Teaching Hospital, was carried out. Post-operatively, a proforma was filled for each of the participants to score their satisfaction on a Numerical Rating Scale regarding pain and discomfort during and after epidural anaesthesia and surgery. Other adverse reactions were documented. Patients’ satisfaction score was also documented. Results: A total of 103 patients, with age ranging from 25 to 60 years, were recruited. Majority (102/99%) of the patients had their data well documented while remaining (1/0.9%) patient was excluded from the study for poor documentation. In all, satisfaction with epidural anaesthesia administration was observed in (95/93.1%) whereas (7/6.9%) patients were dissatisfied. Factors associated with dissatisfaction were prolonged onset time (2/1.9%) patients. Breakthrough pain in (1/0.9%) patients. Post-operative nausea and vomiting (PONV) was observed in 1 (0.9%) patient. In addition, (92/90.2%) patients would opt for epidural anaesthesia in future for similar surgery, if situation demands for it, 10 (9.8%) patients would not. Conclusion: The patients receiving epidural anaesthesia, without breakthrough pain, for orthopaedic surgery demonstrated a high rate of patients’ satisfaction.
{"title":"Observational Study on Patients Satisfaction during Epidural Anaesthesia, without Breakthrough Pain, in Patients Scheduled for Orthopaedic Surgery","authors":"J. M. Afolayan, Tokunbo Olajumoke, Babatunde Yusuf","doi":"10.9734/jammr/2024/v36i35389","DOIUrl":"https://doi.org/10.9734/jammr/2024/v36i35389","url":null,"abstract":"Introduction: This study was undertaken to determine the level of patients’ satisfaction after epidural anaesthesia, without breakthrough pain, in patients scheduled for orthopaedic surgery. Epidural block is one of the regional anaesthesia that can be used in orthopeadic cases with prolonged duration of surgery. \u0000Aim and Objectives: To study the intraoperative pain outcome and patients’ satisfaction during epidural anaesthesia with top up doses without breakthrough pain. \u0000Methods: A prospective study of patients who underwent orthopaedic procedures under epidural block in the operating rooms of Ekiti State University Teaching Hospital, was carried out. Post-operatively, a proforma was filled for each of the participants to score their satisfaction on a Numerical Rating Scale regarding pain and discomfort during and after epidural anaesthesia and surgery. Other adverse reactions were documented. Patients’ satisfaction score was also documented. \u0000Results: A total of 103 patients, with age ranging from 25 to 60 years, were recruited. Majority (102/99%) of the patients had their data well documented while remaining (1/0.9%) patient was excluded from the study for poor documentation. In all, satisfaction with epidural anaesthesia administration was observed in (95/93.1%) whereas (7/6.9%) patients were dissatisfied. Factors associated with dissatisfaction were prolonged onset time (2/1.9%) patients. Breakthrough pain in (1/0.9%) patients. Post-operative nausea and vomiting (PONV) was observed in 1 (0.9%) patient. In addition, (92/90.2%) patients would opt for epidural anaesthesia in future for similar surgery, if situation demands for it, 10 (9.8%) patients would not. \u0000Conclusion: The patients receiving epidural anaesthesia, without breakthrough pain, for orthopaedic surgery demonstrated a high rate of patients’ satisfaction.","PeriodicalId":14869,"journal":{"name":"Journal of Advances in Medicine and Medical Research","volume":"21 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140264142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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