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A Burning Issue on Oral Mucosal Diseases: Case Series with Review 关于口腔黏膜疾病的热点问题:病例系列与回顾
Pub Date : 2024-07-27 DOI: 10.9734/jammr/2024/v36i85528
Durba Roychowdhury, Rudra Prasad Chatterjee, S. Mahmud, Sudeshna Bagchi, Arunit Chatterjee
Oral Lichenoid Reaction (OLR) is a chronic inflammatory lesion of the oral mucosa that occurs as an allergic response to certain dental materials, medications and systemic diseases. The frequency of OLR in the general population has been documented to be very less. The clinical and histological features of OLR closely resemble those of Oral Lichen Planus (OLP), making it challenging to distinguish between the two clinically. OLRs might have a higher malignant potential than OLP. The diagnosis and treatment of OLR is very crucial as misdiagnosis may result in detrimental effects on the biophysical health of the patient. Here, we present case series of two patients who presented with amalgam restorations and burning sensation on the buccal mucosa while consumption of hot and spicy food. An immunohistopathological evaluation confirmed the diagnosis as Oral Lichenoid Reaction. Elimination of causative factors remain the mainstay of treatment which markedly reduces the sufferings of the patient with a commendable result.
口腔类苔藓样反应(OLR)是口腔黏膜的一种慢性炎症病变,是对某些牙科材料、药物和全身性疾病的过敏反应。据记载,OLR 在普通人群中的发病率非常低。OLR 的临床和组织学特征与口腔扁平苔藓(OLP)非常相似,因此在临床上很难将两者区分开来。与 OLP 相比,OLR 的恶变可能性更高。口腔扁平苔藓的诊断和治疗非常关键,因为误诊可能会对患者的生物物理健康造成不利影响。在此,我们介绍了两名患者的病例系列,他们都有汞合金修复体,并且在进食辛辣食物时出现颊粘膜烧灼感。经免疫组织病理学评估,确诊为口腔扁平苔藓样反应。消除致病因素仍是治疗的主要方法,这明显减轻了患者的痛苦,效果值得称赞。
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引用次数: 0
Myocardial Infarction: Causes, Symptoms, and Emergency Response 心肌梗塞:原因、症状和应急措施
Pub Date : 2024-07-26 DOI: 10.9734/jammr/2024/v36i85527
Shazain Khan, Raheel Chaudhry, Arhum Mahmood, M. Masmoum, Shaf A. Altaf, M. S. S. Mirza
Myocardial infarction (MI), often known as a heart attack, is a severe form of coronary artery disease that causes myocardial damage or necrosis as a result of persistent ischemia. Hypertension, atherosclerosis, diabetes, hyperlipidemia, smoking, lack of physical activity, and obesity are all significant risk factors. Recognizing symptoms such as chest pain, shortness of breath, heavy perspiration, and nausea is crucial for timely treatment. Advances in high-sensitivity troponin tests, coronary angiography, percutaneous coronary intervention (PCI), and pharmaceutical therapies, such as antiplatelet medications, beta-blockers, and statins, have all improved patient outcomes. The reduction of MI morbidity and mortality is contingent on early detection, prompt intervention, and ongoing care. This comprehensive study underlines the need to identify MI symptoms early and call emergency medical services to improve patient outcomes. Emerging medicines and future tactics in MI therapy, including novel antiplatelet agents and precision medicine approaches, hold promise for enhancing patient care.
心肌梗死(MI)通常被称为心脏病发作,是一种严重的冠状动脉疾病,由于持续缺血而导致心肌损伤或坏死。高血压、动脉粥样硬化、糖尿病、高脂血症、吸烟、缺乏运动和肥胖都是重要的危险因素。识别胸痛、气短、大汗淋漓和恶心等症状对于及时治疗至关重要。高敏肌钙蛋白检测、冠状动脉造影术、经皮冠状动脉介入治疗(PCI)以及抗血小板药物、β-受体阻滞剂和他汀类药物等药物疗法的进步都改善了患者的预后。降低心肌梗死的发病率和死亡率取决于早期发现、及时干预和持续护理。这项综合研究强调了及早发现心肌梗死症状并呼叫急救服务以改善患者预后的必要性。心肌梗死治疗方面的新兴药物和未来策略,包括新型抗血小板药物和精准医疗方法,都为改善患者护理带来了希望。
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引用次数: 0
Tooth Discoloration Induced by Calcium Silicate-based Sealers 硅酸钙封闭剂引起的牙齿变色
Pub Date : 2024-07-25 DOI: 10.9734/jammr/2024/v36i85526
David Saldanha de Brito Alencar, Larissa Carvalho Novaes Batista, Jaqueline Martins Crivelari, Andre Luiz Almeida de Abreu, Anna Carolina Neves Leutz, Arian Braido, Leandro Ferreira Frade Soares, Bruno Martini Guimarães, M. Marciano
Aims: The propose of this study was to evaluate, using spectrophotometric analysis, the change in tooth color induced by different calcium silicate-based sealers over the period of 24 hours and 30 days. Methodology: Sixty bovine teeth were sectioned in enamel-dentin blocks. They were filled with AH Plus Bioceramic, AH Plus Jet, Bio-C Sealer and BioRoot RCS and sealed with composite. Triple antibiotic paste and unfilled samples were positive and negative control groups, respectively. Specimens were stored in separate flasks immersed in tap water at 37ºC with ambient light block out. Spectrophotometric analysis for color assessment was performed at different periods, before filling, 24 hours, and 30 days after filling. Luminosity (L) and color change ( ) were calculated. The statistical analysis was performed by using ANOVA and Tukey’s test (P < 0.05). Results: All calcium silicate-based sealers exhibited high color alteration after the evaluated period of 30 days and showed statistically significant difference values of  in relation with the negative control in the period of 30 days (P < 0.05). Luminosity was not affected in comparison with negative control, in both evaluated periods (P < 0.05). Conclusion: All tested sealers showed certain levels of tooth discoloration. Calcium silicate-based sealers (AH Plus Bioceramic, Bio-C Sealer, and BioRoot RCS) presented discoloration exceeding acceptable values within a 30-day follow-up. Notwithstanding, these alterations were imperceptible to the human eye.
目的:本研究旨在使用分光光度分析法评估不同硅酸钙封闭剂在 24 小时和 30 天内引起的牙齿颜色变化。研究方法将 60 颗牛牙切成釉质牙本质块。用 AH Plus Bioceramic、AH Plus Jet、Bio-C Sealer 和 BioRoot RCS 填充,然后用复合材料密封。三重抗生素糊剂和未填充样本分别为阳性对照组和阴性对照组。试样被分别保存在不同的烧瓶中,烧瓶浸泡在自来水中,温度为 37ºC,并遮光。在填充前、填充后 24 小时和 30 天的不同时期进行分光光度分析,以评估颜色。计算光度(L)和颜色变化( )。统计分析采用方差分析和 Tukey 检验(P < 0.05)。结果在 30 天的评估期后,所有硅酸钙封闭剂都表现出较高的颜色变化,与阴性对照组相比,30 天内的差异值具有统计学意义(P < 0.05)。与阴性对照相比,亮度在两个评估期内均未受到影响(P < 0.05)。结论所有测试过的封闭剂都会造成一定程度的牙齿变色。硅酸钙封闭剂(AH Plus Bioceramic、Bio-C Sealer 和 BioRoot RCS)在 30 天的随访中出现的变色超过了可接受值。尽管如此,人眼仍无法察觉这些变化。
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引用次数: 0
Effectiveness and Safety of Tapentadol in Managing Diabetic Neuropathic Pain: A Systematic Review 他喷他多治疗糖尿病神经病理性疼痛的有效性和安全性:系统性综述
Pub Date : 2024-07-24 DOI: 10.9734/jammr/2024/v36i85524
Kirolos Alqus Sela Youssef Khalifa
Introduction: Tapentadol, a μ-opioid agonist and norepinephrine reuptake inhibitor is an effective medication for a wide variety of chronic pain conditions, including back pain, cancer-related pain, and arthritic pain. More recently, tapentadol extended-release has been demonstrated to be effective in the management of painful diabetic neuropathy, an often debilitating condition affecting approximately one-third of all patients with diabetes. Aim of the Study: To identify the efficacy of Tapentadol in the management of patients with Diabetic Neuropathic Pain and to compare the safety of Tapentadol with other drugs used in the management of diabetic neuropathy. Materials and Methods: Up to March 2023, PubMed, Cochrane CENTRAL, Web of Science, and Scopus were searched for potentially relevant studies that met the inclusion criteria. We adhered to PRISMA checklist items for reporting systematic reviews. Results: Three studies included 731 patients suffering from Diabetic polyneuropathy with a mean age of 60.9 years and a mean follow-up duration of 9.3 weeks. The mean difference between the Tapentadol and placebo is 0.97(95% CI [0.59, 1.34]) with the results in favour of Tapentadol with a total sample of 374 patients in the Tapentadol group and 357 patients in the Placebo group. Conclusion: Despite the efficacy of Tapentadol in PDN, the toxicity profile and higher incidence of withdrawal rate should give attention away its use in future research.
简介他喷他多是μ-阿片受体激动剂和去甲肾上腺素再摄取抑制剂,是治疗各种慢性疼痛的有效药物,包括背痛、癌症相关疼痛和关节炎疼痛。最近,他喷他多缓释剂被证明可有效治疗糖尿病神经病变疼痛,这种病变通常会使人衰弱,约三分之一的糖尿病患者会受到影响。研究目的确定他喷他多在治疗糖尿病神经病理性疼痛患者中的疗效,并比较他喷他多与其他用于治疗糖尿病神经病变药物的安全性。材料与方法:截至 2023 年 3 月,我们在 PubMed、Cochrane CENTRAL、Web of Science 和 Scopus 上检索了符合纳入标准的潜在相关研究。我们遵照 PRISMA 检查单项目报告系统性综述。结果三项研究共纳入了 731 名糖尿病多发性神经病患者,他们的平均年龄为 60.9 岁,平均随访时间为 9.3 周。他喷他多与安慰剂的平均差异为 0.97(95% CI [0.59,1.34]),结果有利于他喷他多,他喷他多组共有 374 名患者,安慰剂组共有 357 名患者。结论尽管他喷他多对 PDN 有疗效,但其毒性特征和较高的停药率应在未来的研究中引起重视。
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引用次数: 0
PTSD Treatment: An Inquiry into the Promising Potential of Psilocybin 创伤后应激障碍治疗:对迷幻药潜力的探索
Pub Date : 2024-07-24 DOI: 10.9734/jammr/2024/v36i85525
I. Folorunsho, N. M. Harry, Chukwubueze Obiajunwa, Oluwatosin Arubuolawe, A. K. Busari, Chidalu N Ibeneme, Gibson Anugwom
Post-Traumatic Stress Disorder (PTSD) is a debilitating mental health condition that can occur after experiencing or witnessing a traumatic event. The impact of PTSD extends beyond the individual, affecting families, communities, and society as a whole. This study aims to investigate the potential of psilocybin as a treatment for PTSD. Psilocybin, after being metabolized to psilocin, binds to various serotonergic receptors to exert some major effects such as a reduction in negative mood and an increase in optimism, enhanced ability for introspection and perceptual changes, a reduction in amygdala reactivity during emotion processing, and—as has been found in animal studies—an extinction of the fear response and increased hippocampal neurogenesis. However, psychedelics such as psilocybin may lead to brief episodes of nausea, vomiting, and physical discomfort. This study indicated that there is an urgent need for innovative therapies that could enhance the effectiveness of PTSD treatments. As this review highlights, psilocybin and some other psychedelics offer prospects for an additional method of treating PTSD. They have the potential to directly address PTSD symptoms and can also be used as an adjunct to psychotherapy.
创伤后应激障碍(PTSD)是一种使人衰弱的精神疾病,在经历或目睹创伤事件后可能发生。创伤后应激障碍的影响超出个人范围,会影响家庭、社区和整个社会。本研究旨在探讨迷幻药治疗创伤后应激障碍的潜力。迷幻药在代谢为迷幻素后,会与各种血清素能受体结合,产生一些主要作用,如减少负面情绪,增加乐观情绪,增强内省能力和知觉变化,减少情绪处理过程中杏仁核的反应性,以及动物实验中发现的恐惧反应消失和海马神经元生成增加等。然而,迷幻剂(如迷幻药)可能会导致短暂的恶心、呕吐和身体不适。这项研究表明,目前迫切需要能够提高创伤后应激障碍治疗效果的创新疗法。正如本综述所强调的,迷幻药和其他一些迷幻剂为治疗创伤后应激障碍提供了新的方法。它们有可能直接解决创伤后应激障碍的症状,也可以作为心理疗法的辅助手段。
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引用次数: 0
Using Prostate-specific Antigen to Predict Gleason Scores in African Men Seeking Urological Services at a Referral Hospital in Kisumu, Kenya 利用前列腺特异性抗原预测在肯尼亚基苏木一家转诊医院寻求泌尿科服务的非洲男性的格里森评分
Pub Date : 2024-07-23 DOI: 10.9734/jammr/2024/v36i85521
Vincent Musungu, Domnic Marera, W. Oyieko, Wilbroda Makunda, Benard Siwa
Background: Men are more likely to develop prostate lesions like benign prostatic hypertrophy and prostate cancer as they age. Prostate specific antigen (PSA), which is secreted in large quantities above normal levels of 0–4 ng/ml by cells of the prostate gland in benign prostate hypertrophy (BPH) or prostate cancer (Pca), is a biological marker for the diagnosis of prostate cancer; hence, early diagnosis using PSA facilitates disease detection; the higher the level of PSA, the higher the chance of having prostate cancer (Negahdary et al., 2020; Zhang & Sun, 2018). The Gleason scale is used to grade patients with prostate cancer and determine their risk of the disease progressing. Is it possible to predict the Gleason scores of people with prostate cancer based on their PSA levels? The primary goal of the current study was to establish a correlation between the patient's PSA level and the associated Gleason scores at the time of prostate biopsy at Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH). Methods: The study utilized a cross-sectional retrospective that focused on patient reports with prostate histology who had a PSA between 2017 and 2022 when they requested a biopsy. The majority of the examined histology reports that did not include a PSA level and thus were disregarded. There were 80 sample reports as a result of this exclusion. Results: According to the study, 36 (45%) of the patients whose prostate tissues were examined had prostate cancer. The majority of 24 (66.7%) patients who had PSA values more than 50 ng/ml when they were first diagnosed with prostate cancer were classified as Gleason 7/Group 2 or higher. The study sought to determine whether PSA levels and Gleason scores were correlated. Gleason scores and PSA levels have a statistically significant positive correlation (p = 0.004, r = 0.474). The majority of patients, 55 (65%), who had high PSA values (>4 ng/ml), were between the ages of 60 and 79. These patients were followed by those who were >80 years old at 15 (18.75%) and those who were 50 to 59 years old at 10 (10%). Age and PSA levels were shown to have a statistically significant positive Pearson correlation (r = 0.236, p = 0.035, 95% CI). Conclusions: Gleason scores rise with increasing PSA levels. Age and PSA level have a positive correlation.
背景:随着年龄的增长,男性更容易患上良性前列腺肥大和前列腺癌等前列腺疾病。良性前列腺肥大(BPH)或前列腺癌(Pca)患者的前列腺细胞会大量分泌前列腺特异性抗原(PSA),超过 0-4 纳克/毫升的正常水平,是诊断前列腺癌的生物标志物;因此,使用 PSA 进行早期诊断有助于疾病的发现;PSA 水平越高,患前列腺癌的几率越大(Negahdary 等人,2020 年;张和孙,2018 年)。格里森评分法用于对前列腺癌患者进行分级,并确定其疾病进展的风险。是否有可能根据前列腺癌患者的 PSA 水平预测其格里森评分?本研究的主要目的是在 Jaramogi Oginga Odinga 教学与转诊医院(JOOTRH)进行前列腺活检时,建立患者 PSA 水平与相关格里森评分之间的相关性。研究方法该研究采用横断面回顾性研究,重点关注2017年至2022年期间要求进行活检时PSA为前列腺组织学检查的患者报告。大部分受检组织学报告未包含 PSA 水平,因此不予考虑。因此排除了 80 份样本报告。研究结果研究显示,在接受前列腺组织检查的患者中,有 36 人(45%)患有前列腺癌。在 24 名(66.7%)首次诊断为前列腺癌时 PSA 值超过 50 纳克/毫升的患者中,大多数被归类为 Gleason 7/Group 2 或更高。该研究试图确定 PSA 水平和 Gleason 评分是否相关。Gleason 评分和 PSA 水平在统计学上具有显著的正相关性(p = 0.004,r = 0.474)。PSA 值较高(>4 纳克/毫升)的患者有 55 人(65%),年龄大多在 60 岁至 79 岁之间。其次是年龄大于 80 岁的 15 人(18.75%)和 50 至 59 岁的 10 人(10%)。研究显示,年龄与 PSA 水平之间存在统计学意义上显著的正皮尔逊相关性(r = 0.236,p = 0.035,95% CI)。结论Gleason评分随着PSA水平的升高而升高。年龄与 PSA 水平呈正相关。
{"title":"Using Prostate-specific Antigen to Predict Gleason Scores in African Men Seeking Urological Services at a Referral Hospital in Kisumu, Kenya","authors":"Vincent Musungu, Domnic Marera, W. Oyieko, Wilbroda Makunda, Benard Siwa","doi":"10.9734/jammr/2024/v36i85521","DOIUrl":"https://doi.org/10.9734/jammr/2024/v36i85521","url":null,"abstract":"Background: Men are more likely to develop prostate lesions like benign prostatic hypertrophy and prostate cancer as they age. Prostate specific antigen (PSA), which is secreted in large quantities above normal levels of 0–4 ng/ml by cells of the prostate gland in benign prostate hypertrophy (BPH) or prostate cancer (Pca), is a biological marker for the diagnosis of prostate cancer; hence, early diagnosis using PSA facilitates disease detection; the higher the level of PSA, the higher the chance of having prostate cancer (Negahdary et al., 2020; Zhang & Sun, 2018). The Gleason scale is used to grade patients with prostate cancer and determine their risk of the disease progressing. Is it possible to predict the Gleason scores of people with prostate cancer based on their PSA levels? The primary goal of the current study was to establish a correlation between the patient's PSA level and the associated Gleason scores at the time of prostate biopsy at Jaramogi Oginga Odinga Teaching and Referral Hospital (JOOTRH). \u0000Methods: The study utilized a cross-sectional retrospective that focused on patient reports with prostate histology who had a PSA between 2017 and 2022 when they requested a biopsy. The majority of the examined histology reports that did not include a PSA level and thus were disregarded. There were 80 sample reports as a result of this exclusion. \u0000Results: According to the study, 36 (45%) of the patients whose prostate tissues were examined had prostate cancer. The majority of 24 (66.7%) patients who had PSA values more than 50 ng/ml when they were first diagnosed with prostate cancer were classified as Gleason 7/Group 2 or higher. The study sought to determine whether PSA levels and Gleason scores were correlated. Gleason scores and PSA levels have a statistically significant positive correlation (p = 0.004, r = 0.474). The majority of patients, 55 (65%), who had high PSA values (>4 ng/ml), were between the ages of 60 and 79. These patients were followed by those who were >80 years old at 15 (18.75%) and those who were 50 to 59 years old at 10 (10%). Age and PSA levels were shown to have a statistically significant positive Pearson correlation (r = 0.236, p = 0.035, 95% CI). \u0000Conclusions: Gleason scores rise with increasing PSA levels. Age and PSA level have a positive correlation.","PeriodicalId":506708,"journal":{"name":"Journal of Advances in Medicine and Medical Research","volume":"53 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141813322","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}
引用次数: 0
Efficacy of Smartphone Applications in Hypertension Management: A Systematic Review 智能手机应用在高血压管理中的功效:系统回顾
Pub Date : 2024-07-23 DOI: 10.9734/jammr/2024/v36i85522
Shaheen Sultana, Kayode Aguda, Adetola G Mowo-wale, Regina Azipu, Chiedozie Steven Nzotta, S. Alzaki, Marian Obi, Onyinye Ezewudo, Abdelhay Hassan Taha Mohamed, Shwetha Gopal, Tope Mwuese Anyiman, N. G. Obiefuna, Efi Uyoyou Winners, Omolola Okunromade, Prince Agbakahi, Jovita Echere
Background: Hypertension is a global health challenge, affecting over a billion individuals worldwide. Despite the availability of effective treatments, control rates remain suboptimal. Emerging technologies, such as smartphone applications, offer new avenues to enhance hypertension management. This systematic review aims to evaluate the effectiveness of smartphone applications in hypertension management. Methods: To provide a comprehensive overview of the current evidence, we systematically searched PubMed, EMBASE, and the Cochrane Library for both randomized controlled trials (RCTs) and non-randomized clinical trials that examined the use of smartphone applications in hypertension management. Our search included all relevant studies published until June 2023. Studies were selected based on predefined criteria relating to study design, patient population, intervention type, and outcome measures. Data were extracted and analyzed by two independent reviewers. The primary outcome of interest was blood pressure control, while secondary outcomes included medication adherence and health-related knowledge. Results: From our systematic search, a total of 11 RCTs involving 1,685 participants met our inclusion criteria and were included in the review. The smartphone-based interventions varied widely across studies, ranging from simple text reminders to comprehensive digital therapeutics systems, and including education-based applications, self-monitoring programs, and telemonitoring systems. Collectively, these interventions demonstrated significant improvements in blood pressure control in the intervention groups compared to the standard care. Additionally, they showed increased medication adherence and enhanced health-related knowledge, suggesting potential benefits beyond blood pressure control. Conclusion: The reviewed studies suggest that smartphone applications may provide a beneficial tool for managing hypertension. They show improvements in blood pressure control, medication adherence, and health-related knowledge. These findings underline the potential of digital health interventions to address a global health concern. Nevertheless, further robust, well-designed RCTs are needed to corroborate these findings and explore the long-term effectiveness, sustainability, and cost-effectiveness of smartphone applications in hypertension management. With the rapid advancement in technology, the role of digital health in hypertension management is likely to become even more critical and complex, making this an area of crucial importance for future research.
背景:高血压是一项全球性的健康挑战,影响着全球十多亿人。尽管有有效的治疗方法,但控制率仍不理想。智能手机应用等新兴技术为加强高血压管理提供了新途径。本系统综述旨在评估智能手机应用在高血压管理中的有效性。方法:为了对现有证据进行全面概述,我们系统地检索了 PubMed、EMBASE 和 Cochrane 图书馆中研究智能手机应用在高血压管理中应用的随机对照试验 (RCT) 和非随机临床试验。我们的搜索包括截至 2023 年 6 月发表的所有相关研究。我们根据预先设定的研究设计、患者人群、干预类型和结果测量标准对研究进行了筛选。数据由两名独立审稿人进行提取和分析。研究的主要结果是血压控制,次要结果包括用药依从性和健康相关知识。结果:通过系统性检索,共有 11 项 RCT(涉及 1,685 名参与者)符合我们的纳入标准,并被纳入综述。各项研究中基于智能手机的干预措施差别很大,从简单的文本提醒到全面的数字治疗系统,包括基于教育的应用程序、自我监测程序和远程监测系统。总体而言,与标准护理相比,这些干预措施显著改善了干预组的血压控制。此外,干预组还提高了用药依从性并增强了健康相关知识,这表明其潜在益处超出了血压控制范围。结论综述研究表明,智能手机应用软件可为高血压管理提供有益的工具。这些研究显示,智能手机应用在血压控制、坚持用药和健康相关知识方面都有所改善。这些发现强调了数字健康干预措施在解决全球健康问题方面的潜力。尽管如此,还需要进一步开展稳健、设计良好的 RCT 研究来证实这些发现,并探索智能手机应用在高血压管理中的长期有效性、可持续性和成本效益。随着技术的飞速发展,数字医疗在高血压管理中的作用可能会变得更加关键和复杂,这也是未来研究的一个至关重要的领域。
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引用次数: 0
A Systematic Review on Prototheca spp. Infections in the Human Central Nervous System and Evaluation of Therapeutic Drug Approaches 关于人类中枢神经系统中原生动物感染的系统性综述以及治疗药物方法的评估
Pub Date : 2024-07-23 DOI: 10.9734/jammr/2024/v36i85523
A. Norberg, Paulo Roberto Blanco Moreira Norberg, Fernanda Castro Manhães, B. M. Mangiavacchi, Ligia Cordeiro Matos Faial, Ivy de Campos, Renato Mataveli Ferreira Filho, Alcemar Antônio Lopes de Matos, Kelen Salaroli Viana, Júlio Cesar dos Santos Boechat, Juliana Toledo Campos Arêas
Background and Aim: Prototheca is a genus of unicellular, non-photosynthetic microalgae found in diverse environments, including water, soil, and the intestinal microbiota of animals and humans. They are the only algae pathogenic to humans. Infections of the Central Nervous System (CNS) by Prototheca spp. are rare but severe. This research aims to systematically review the pathogenic potential of Prototheca spp. as CNS infectious agents in humans, identify underlying conditions that contribute to disease development, and evaluate the most suitable drug therapy alternatives for this clinical condition. Methods: A systematic review was conducted using PubMed, SciELO, and Google Scholar databases. Search terms included "Prototheca," "Central Nervous System," "meningitis," "encephalitis," "meningoencephalitis," and "brain." Manuscripts published in English, Portuguese, Spanish, and Russian from 1981 to 2024 were reviewed. Results: The review identified 15 case reports of CNS infections by Prototheca spp. described in 14 scientific articles. Three species were implicated: Prototheca wickerhamii, Prototheca zopfii, and Prototheca trispora, with Prototheca wickerhamii being the most prevalent (66.6%). Only four patients were immunocompromised. A significant association was found between hydrocephalus in children and vulnerability to CNS protothecosis, accounting for 20% of cases. All fatal cases occurred in immunocompromised patients. Resistance profile analysis showed 88.9% susceptibility to amphotericin B and susceptibility to two triazoles (voriconazole and isavuconazole) that cross the blood-brain barrier. Conclusion: Immunodeficiency is not a prerequisite for susceptibility to CNS infections by Prototheca spp., but it predicts an unfavorable prognosis. The most promising treatments are combinations of amphotericin B with tetracyclines or isavuconazole. Dosage adjustments are necessary due to the toxicity of long-term algicidal antifungal treatments, posing a challenge in managing drug therapy.
背景和目的:原生藻是一种单细胞、非光合微藻,存在于水、土壤、动物和人类肠道微生物群等多种环境中。它们是唯一对人类致病的藻类。中枢神经系统(CNS)受原壶藻属感染的情况非常罕见,但却很严重。本研究旨在系统回顾原生藻类作为中枢神经系统感染病原体对人类的致病性,找出导致疾病发展的潜在因素,并评估最适合这一临床症状的药物疗法。方法:使用 PubMed、SciELO 和 Google Scholar 数据库进行系统性综述。搜索关键词包括 "原虫"、"中枢神经系统"、"脑膜炎"、"脑炎"、"脑膜脑炎 "和 "大脑"。对 1981 年至 2024 年用英语、葡萄牙语、西班牙语和俄语发表的文章进行了审查。结果:审查发现了 14 篇科学文章中描述的 15 例原虫感染中枢神经系统的病例报告。其中涉及三个物种:柳叶原神马属、佐菲原神马属和三孢原神马属,其中柳叶原神马属最常见(66.6%)。只有四名患者免疫力低下。研究发现,儿童脑积水与中枢神经系统原壶菌病的易感性之间存在明显联系,占病例总数的20%。所有死亡病例均发生在免疫力低下的患者身上。耐药性分析表明,88.9%的患者对两性霉素B敏感,并对可穿过血脑屏障的两种三唑类药物(伏立康唑和异武康唑)敏感。结论:免疫缺陷并不是原壶菌属中枢神经系统感染的先决条件,但它预示着不利的预后。最有希望的治疗方法是将两性霉素 B 与四环素类药物或异戊唑联合使用。由于长期的杀菌抗真菌治疗会产生毒性,因此有必要调整剂量,这给药物治疗的管理带来了挑战。
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引用次数: 0
Bulk Fill Composite Resin for Non-carious Cervical Lesions: A 24-Month Randomized Clinical Study 用于非龋性宫颈病变的团状填充复合树脂:为期 24 个月的随机临床研究
Pub Date : 2024-07-20 DOI: 10.9734/jammr/2024/v36i75520
R. Vanolli, A. M. Cavazzini, Gabriela Spanholi Tamagno, Poliana Maria de Faveri Cardoso, Júlio Katuhide Ueda, Veridiana Camilotti
Objective: To clinically evaluate for 24 months the restorations of caries-free cervical lesions (CFCL) made with bulk-fill composite resin.  Materials and Methods: Sixty CFCL were selected and divided into two experimental groups: Filtek Z350 (control with conventional composite resin) and Filtek BF (Bulk Fill composite resin). The restorations were evaluated according to the USPHS criteria - marginal adaptation, anatomic form, marginal discoloration, caries formation, postoperative sensitivity, and retention - at the following periods: initial, 7, 30, 180, and 720 days. The results were statistically analyzed using the Friedman ANOVA test (p < 0.05) followed by the Durbin-Conover post-test (p < 0.05). For intra-group analysis, the Wilcoxon non-parametric test was used (p < 0.05). Results: Significant differences were observed between the groups, with Bulk Fill resin showing superior clinical performance in terms of marginal adaptation, restoration discoloration, anatomic form, and especially dentin sensitivity. Regarding caries formation and retention, both groups presented similar results. Conclusion: Bulk-fill composite resins demonstrated superiority in various USPHS criteria in the treatment of caries-free cervical lesions, proving to be a promising material for this treatment context.
目的对使用大量填充复合树脂制作的无龋牙颈部病变(CFCL)修复体进行为期 24 个月的临床评估。 材料与方法:选取 60 个无龋牙颈部病变,分为两个实验组:Filtek Z350(使用传统复合树脂的对照组)和 Filtek BF(大量填充复合树脂)。根据美国牙科医师协会(USPHS)的标准(边缘适应性、解剖形态、边缘变色、龋齿形成、术后敏感性和保持力),在初始、7、30、180 和 720 天对修复体进行评估。结果采用弗里德曼方差分析(Friedman ANOVA)进行统计分析(P < 0.05),然后进行杜宾-康诺弗后检验(P < 0.05)。组内分析采用 Wilcoxon 非参数检验(P < 0.05)。结果显示各组之间存在显著差异,Bulk Fill 树脂在边缘适应性、修复体变色、解剖形态,尤其是牙本质敏感性方面的临床表现更胜一筹。在龋齿形成和固位方面,两组结果相似。结论在治疗无龋牙颈部病变时,团状填充复合树脂在美国牙科医师协会(USPHS)的各种标准中都表现出了优越性,证明它是一种很有前途的治疗材料。
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引用次数: 0
Protocol for a Randomized Clinical Trial of Oculomotor Exercises Added to Treatment for Temporomandibular Disorders 在颞下颌关节紊乱症治疗中加入眼球运动锻炼的随机临床试验方案
Pub Date : 2024-07-16 DOI: 10.9734/jammr/2024/v36i75518
Letícia Neves Mode, Cindy Mozer Nakamura, T. Cunha, Fernanda Cardoso Nakamoto, M. Leonardis, Cid André Fidelis de Paula Gomes, F. Politti, D. Biasotto-Gonzalez
Objective: To evaluate the effect of adding oculomotor exercises to the treatment of Temporomandibular Disorder (TMD) on pain intensity, range of mandibular movement, TMD severity, and ocular convergence insufficiency (CI), immediately, 3 months, and 6 months after treatment. Study Design: Controlled and randomized clinical trial included blinded evaluators and participants. Methodology: Individuals aged 18–45 years diagnosed with TMD and convergence insufficiency. Intervention: Two groups: the experimental group (EG) and the control group (CG) groups will receive 12 treatment sessions. Main outcome measures: pain intensity, range of mandibular movement, convergence insufficiency, and severity of TMD during follow-up immediately after treatment, 3 and 6 months. Analysis: The statistical analysis will use linear mixed models based on the intention to treat. The significance level will be set at 5%. Results: This is a preliminary protocol; results will be available once the study is completed. It is expected relevant patient clinical improvement results. Conclusion: It will be possible to determine the effects of adding oculomotor exercises in the treatment of TMD. Implications for Practice: If successful, the protocol could be integrated into clinical practice as an adjunct to conventional therapy for TMD, expanding the therapeutic options available to healthcare professionals and patients.
目的评估在治疗颞下颌关节紊乱症(TMD)的过程中加入眼部运动锻炼对治疗后即刻、3 个月和 6 个月的疼痛强度、下颌骨活动范围、TMD 严重程度和眼球辐辏不全(CI)的影响。研究设计:对照和随机临床试验,评估者和参与者均为盲人。研究方法:年龄在 18-45 岁之间、被诊断患有 TMD 和辐辏功能障碍的患者。干预:两组:实验组(EG)和对照组(CG)将接受 12 次治疗。主要结果测量:治疗后3个月和6个月随访期间的疼痛强度、下颌骨活动范围、辐辏不足和TMD严重程度。分析:统计分析将采用基于意向治疗的线性混合模型。显著性水平设定为 5%。结果:本研究为初步方案,研究完成后将公布结果。预计会有相关的患者临床改善结果。结论:可以确定在治疗 TMD 时增加眼球运动锻炼的效果。对实践的意义:如果成功,该方案可作为 TMD 传统疗法的辅助疗法纳入临床实践,从而扩大医护人员和患者的治疗选择范围。
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