M. Boumaaz, I. Asfalou, M. Raissouni, A. Benyass, E. Zbir
Middle aortic syndrome (MAS) results from a diffuse narrowing of the distal thoracic or abdominal aorta commonly involving both the visceral and renal arteries. Congenital, acquired, inflammatory, and infectious etiologies have been described. Symptoms occur within the first three decades of life. Revelation modes are dominated by hypertension, lower extremity claudication, and mesenteric ischemia. We herein report a pediatric case of MAS with an original revelation mode that has never been described before in medical literature.
{"title":"Midaortic syndrome and hypertension in childhood revealed by enuresis: a case report","authors":"M. Boumaaz, I. Asfalou, M. Raissouni, A. Benyass, E. Zbir","doi":"10.3823/2577","DOIUrl":"https://doi.org/10.3823/2577","url":null,"abstract":" \u0000 Middle aortic syndrome (MAS) results from a diffuse narrowing of the distal thoracic or abdominal aorta commonly involving both the visceral and renal arteries. Congenital, acquired, inflammatory, and infectious etiologies have been described. Symptoms occur within the first three decades of life. Revelation modes are dominated by hypertension, lower extremity claudication, and mesenteric ischemia. We herein report a pediatric case of MAS with an original revelation mode that has never been described before in medical literature.","PeriodicalId":73409,"journal":{"name":"International archives of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46275174","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}
A. L. Dias, C. Pires, Alvaro Alves dos Santos Neto, B. Oliveira, L. H. S. E. Silva, Thais Loyola da Silva, C. Mainardi, P. S. Franco, Maria Amélia Lopes dos Santos
Background: Vitiligo is an acquired hypomelanosis that affects between 0.5% and 4% of the world population, characterized by distinct acromic macules of various shapes and sizes, and may appear in any region of the skin. Worldwide, there are few publications on vitiligo that address epidemiological characteristics. Thus, the objective was to describe the clinical and epidemiological profile of patients with this condition at the State University of Pará’s Dermatology Clinic, in the city of Belém, Northern of Brazil. Methods and Findings: A cross-sectional descriptive study was performed, in which 180 medical records of patients treated at the State University of Pará’s Dermatology Clinic, from July 2000 to July 2014, were analyzed using a protocol consisting of variables related to the disease. The information obtained was organized in a database and submitted to descriptive and inferential statistical analysis. The study was approved by the ethics and research committee under the number 923.213. A predominance of the female gender (72.2%), of the adult age group (55%) was observed; without relation to family history (46.7%); without progression (58.3%); with a predominant clinical form of vitiligo of the generalized type (67.2%), being the common generalized one with the highest prevalence (57%). The most affected sites were head and neck (27.5%), and upper limbs (25.3%). Conclusions: This study revealed the characteristics of the vitiligo patient residing in the Amazon region, and patients were found to have a generalized clinical form, most of the patients achieved improvement of the lesions with the proposed treatment, and only a minority presented progression of the disease. It is concluded that vitiligo is a disease with great therapeutic difficulty, and it is emphasized the importance of an early diagnosis, since in the early stages is easier to resolve the disease.
{"title":"Clinical and Epidemiological Study of Vitiligo Patients at a Dermatology Service in Northern Brazil","authors":"A. L. Dias, C. Pires, Alvaro Alves dos Santos Neto, B. Oliveira, L. H. S. E. Silva, Thais Loyola da Silva, C. Mainardi, P. S. Franco, Maria Amélia Lopes dos Santos","doi":"10.3823/2576","DOIUrl":"https://doi.org/10.3823/2576","url":null,"abstract":"Background: Vitiligo is an acquired hypomelanosis that affects between 0.5% and 4% of the world population, characterized by distinct acromic macules of various shapes and sizes, and may appear in any region of the skin. Worldwide, there are few publications on vitiligo that address epidemiological characteristics. Thus, the objective was to describe the clinical and epidemiological profile of patients with this condition at the State University of Pará’s Dermatology Clinic, in the city of Belém, Northern of Brazil. \u0000Methods and Findings: A cross-sectional descriptive study was performed, in which 180 medical records of patients treated at the State University of Pará’s Dermatology Clinic, from July 2000 to July 2014, were analyzed using a protocol consisting of variables related to the disease. The information obtained was organized in a database and submitted to descriptive and inferential statistical analysis. The study was approved by the ethics and research committee under the number 923.213. A predominance of the female gender (72.2%), of the adult age group (55%) was observed; without relation to family history (46.7%); without progression (58.3%); with a predominant clinical form of vitiligo of the generalized type (67.2%), being the common generalized one with the highest prevalence (57%). The most affected sites were head and neck (27.5%), and upper limbs (25.3%). \u0000Conclusions: This study revealed the characteristics of the vitiligo patient residing in the Amazon region, and patients were found to have a generalized clinical form, most of the patients achieved improvement of the lesions with the proposed treatment, and only a minority presented progression of the disease. It is concluded that vitiligo is a disease with great therapeutic difficulty, and it is emphasized the importance of an early diagnosis, since in the early stages is easier to resolve the disease.","PeriodicalId":73409,"journal":{"name":"International archives of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47974007","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}
L. Ajonuma, K. Nathaniel, A. Bamiro, S. Makanjuola
Chlamydia trachomatis (C. trachomatis) is an intracellular obligate bacterium. It is the most common cause of pelvic inflammatory disease (PID) amongst a spectrum of diseases. Chlamydia infection is of a major public health concern especially in developing countries. It is estimated that about 600 million people are infected worldwide annually yet its roles in the pathogenesis of gynecological cancers are poorly understood and has not been fully elucidated. An understanding of the mechanisms underlying cancer development following PID due to C. trachomatis will be essential in prevention and providing more rational treatments. This review discusses the mechanisms and sequence of events linking Chlamydial infections to carcinogenesis in the female reproductive organs. Possible links between C. trachomatis infection and cancer development in the female reproductive organs are proposed. C. trachomatis infection as a co factor is also re-examined in light of these possible mechanisms.
{"title":"The role of Chlamydia trachomatis in the pathogenesis of female reproductive organs cancers","authors":"L. Ajonuma, K. Nathaniel, A. Bamiro, S. Makanjuola","doi":"10.3823/2574","DOIUrl":"https://doi.org/10.3823/2574","url":null,"abstract":"Chlamydia trachomatis (C. trachomatis) is an intracellular obligate bacterium. It is the most common cause of pelvic inflammatory disease (PID) amongst a spectrum of diseases. Chlamydia infection is of a major public health concern especially in developing countries. It is estimated that about 600 million people are infected worldwide annually yet its roles in the pathogenesis of gynecological cancers are poorly understood and has not been fully elucidated. An understanding of the mechanisms underlying cancer development following PID due to C. trachomatis will be essential in prevention and providing more rational treatments. This review discusses the mechanisms and sequence of events linking Chlamydial infections to carcinogenesis in the female reproductive organs. Possible links between C. trachomatis infection and cancer development in the female reproductive organs are proposed. C. trachomatis infection as a co factor is also re-examined in light of these possible mechanisms.","PeriodicalId":73409,"journal":{"name":"International archives of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44419808","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}
Objective: To determine face, content, and construct validity, and internal consistency of ROL scale. Methods and Findings: A three-phase study was conducted. First, content analysis of the scale was carried out consulting 10 professional experts. Then, face validity was analyzed with 60 caregivers. Finally, construct validity was evaluated by performing an exploratory factor analysis (EFA) with 110 participants. Internal consistency of ROL scale was also assessed. Face validity of ROL scale reached a high acceptance index in three dimensions: role performance (0.97), role organization (0.98), and response to the role (0.98). Content validity showed coherence, clarity, and relevance of the scale. From factor analysis, three components emerged and were grouped in the same manner for varimax, quartimax, and equimax rotations. Cronbach's alpha was 0.816, which is an acceptable overall value. Conclusion: ROL scale makes objective the concept of role taking in family caregivers of people with chronic disease. It demonstrated to have acceptable reliability, and construct, face, and content validity to be used in the Colombian context. Keywords: Validation Study, Caregivers, Health Transitions, Chronic Disease.
{"title":"Validity and Reliability of the Scale, Role Taking in Caregivers of People with Chronic Disease, ROL","authors":"M. A. Arias, S. Carreño, Lorena Chaparro","doi":"10.3823/2575","DOIUrl":"https://doi.org/10.3823/2575","url":null,"abstract":"Objective: To determine face, content, and construct validity, and internal consistency of ROL scale. \u0000Methods and Findings: A three-phase study was conducted. First, content analysis of the scale was carried out consulting 10 professional experts. Then, face validity was analyzed with 60 caregivers. Finally, construct validity was evaluated by performing an exploratory factor analysis (EFA) with 110 participants. Internal consistency of ROL scale was also assessed. Face validity of ROL scale reached a high acceptance index in three dimensions: role performance (0.97), role organization (0.98), and response to the role (0.98). Content validity showed coherence, clarity, and relevance of the scale. From factor analysis, three components emerged and were grouped in the same manner for varimax, quartimax, and equimax rotations. Cronbach's alpha was 0.816, which is an acceptable overall value. \u0000Conclusion: ROL scale makes objective the concept of role taking in family caregivers of people with chronic disease. It demonstrated to have acceptable reliability, and construct, face, and content validity to be used in the Colombian context. \u0000Keywords: Validation Study, Caregivers, Health Transitions, Chronic Disease.","PeriodicalId":73409,"journal":{"name":"International archives of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48799373","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}
C. Pires, S. Bandeira, Gabriela Ferreira Rocha, Marcella Silva Maia, A. Nascimento, Márcia Moraes dos Prazeres, Suzana Maria Klautau Ferreira, Anderson Phelipe Dias Sabry Azar, Heraldo Hebert Mauro Neto, R. O. Chaves, Adriana Kamilly Leitão Pitman Machado
Background: Caring for leprosy patients requires neurological assessment for prevention of potential physical disabilities. This study focused on the neurological impairment and degree of physical incapacity (DI) at the time of the diagnosis and at discharge of leprosy patients from Dermatology Department of the University of the State of Pará. Methods and findings: It was a cross-sectional, observational study based on the medical records, neurological assessment and DI of 14 patients assisted at a referral service between 2012 and 2016, applying descriptive statistical analysis. At diagnosis were observed patients with decreased abduction forces of the 5th finger (14.28%), extension of hallux and foot dorsiflexion (10.72%); loss of protective sensitivity in the ulnar nerve area (3.57%) and tibial nerve area (25%); 7.15% of thickened ulnar nerve; DI 0 (64.28%) and DI 1 (35.72%). At discharge, 10.72% of the patients showed decreased abduction of the 5th finger, extension of hallux and foot dorsiflexion (14.28%); loss of protective sensitivity just in the tibial nerve area (17.87%); 4.28% of thickened ulnar nerve; DI 0 (78.57%) and DI 1 (21.43%). Conclusions: Therefore, most of the patients had normal neurological assessment and DI 0 at both moments, with reduction of alterations in discharge, except for the fibular nerve. Thus, it is highlighted the primary role of the health team, which constitutes one of the main agents promoters of health education, especially when it comes to preventing disabilities in leprosy.
{"title":"Neurological assessment and degree of disability of leprosy patients: observation at diagnosis and at discharge","authors":"C. Pires, S. Bandeira, Gabriela Ferreira Rocha, Marcella Silva Maia, A. Nascimento, Márcia Moraes dos Prazeres, Suzana Maria Klautau Ferreira, Anderson Phelipe Dias Sabry Azar, Heraldo Hebert Mauro Neto, R. O. Chaves, Adriana Kamilly Leitão Pitman Machado","doi":"10.3823/2573","DOIUrl":"https://doi.org/10.3823/2573","url":null,"abstract":"Background: Caring for leprosy patients requires neurological assessment for prevention of potential physical disabilities. This study focused on the neurological impairment and degree of physical incapacity (DI) at the time of the diagnosis and at discharge of leprosy patients from Dermatology Department of the University of the State of Pará. \u0000Methods and findings: It was a cross-sectional, observational study based on the medical records, neurological assessment and DI of 14 patients assisted at a referral service between 2012 and 2016, applying descriptive statistical analysis. At diagnosis were observed patients with decreased abduction forces of the 5th finger (14.28%), extension of hallux and foot dorsiflexion (10.72%); loss of protective sensitivity in the ulnar nerve area (3.57%) and tibial nerve area (25%); 7.15% of thickened ulnar nerve; DI 0 (64.28%) and DI 1 (35.72%). At discharge, 10.72% of the patients showed decreased abduction of the 5th finger, extension of hallux and foot dorsiflexion (14.28%); loss of protective sensitivity just in the tibial nerve area (17.87%); 4.28% of thickened ulnar nerve; DI 0 (78.57%) and DI 1 (21.43%). \u0000Conclusions: Therefore, most of the patients had normal neurological assessment and DI 0 at both moments, with reduction of alterations in discharge, except for the fibular nerve. Thus, it is highlighted the primary role of the health team, which constitutes one of the main agents promoters of health education, especially when it comes to preventing disabilities in leprosy.","PeriodicalId":73409,"journal":{"name":"International archives of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43991217","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}
I. Ardeleanu, L. Macovei, L. Anghel, Ana Tănasă, M. Balasanian, C. Georgescu
Abstract: Atrial fibrillation (AF) is the most common supraventricular arrhythmia, characterized by an irregular and extremely rapid atrial electrical activation that causes loss of atrial mechanical function and important hemodynamic consequences. AF classification is important in both the therapeutic approach and the prognosis. Several classifications based on the ECG patch, epicardial or endocavitary records have been performed over time, but no classification can take into account all the characteristics of AF and especially associated diseases, which may be both the cause and consequence of arrhythmia. Aim: The aim of the study is to establish the current profile of the patient with atrial fibrillation in the new era of oral anticoagulant therapy and sinus rhythm restoration. Material and methods: The trial was conducted on patients with atrial fibrillation hospitalized between 01.10.2014-31.03.2015 at Institute of Cardiovascular Diseases ”Prof. Dr. G. Georgescu”, Iasi. Patients included in the study were analyzed according to age and sex, criteria for the clinical and paraclinic definition for atrial fibrillation. Results: Atrial fibrillation is an extremely common cardiovascular pathology and is present in about one-third of patients admitted to our clinic. Cardiovascular diseases such as hypertension, ischemic coronary artery disease, and valvulopathy are common in patients with AF. Patients with AF are usually elderly patients with many associated diseases in whom sinus rhythm restoration treatment and anticoagulant therapy are difficult to establish. AF is one of the most common arrhythmias that complicates the evolution of acute myocardial infarction, association between dual antiplatelet therapy and anticoagulation treatment, increasing the risk of bleeding complications. Conclusions: Atrial fibrillation is an extremely common cardiovascular pathology and is present in about one-third of patients admitted to our hospital. The data obtained revealed that this arrhythmia occurs in a small number of cases as the only pathology of the patient, usually associated with numerous comorbidities. Cardiovascular diseases such as hypertension, ischemic coronary artery disease, valvulopathy are common in our practice. Patient with AF is a patient who requires long-term anticoagulant therapy and in whom sinus rhythm recovery therapy is dependent on the precocity of presentation to the physician, as well as on the therapeutic resources of current medicine.
{"title":"The current profile of the patient with atrial fibrillation","authors":"I. Ardeleanu, L. Macovei, L. Anghel, Ana Tănasă, M. Balasanian, C. Georgescu","doi":"10.3823/2572","DOIUrl":"https://doi.org/10.3823/2572","url":null,"abstract":"Abstract: Atrial fibrillation (AF) is the most common supraventricular arrhythmia, characterized by an irregular and extremely rapid atrial electrical activation that causes loss of atrial mechanical function and important hemodynamic consequences. AF classification is important in both the therapeutic approach and the prognosis. Several classifications based on the ECG patch, epicardial or endocavitary records have been performed over time, but no classification can take into account all the characteristics of AF and especially associated diseases, which may be both the cause and consequence of arrhythmia. Aim: The aim of the study is to establish the current profile of the patient with atrial fibrillation in the new era of oral anticoagulant therapy and sinus rhythm restoration. \u0000Material and methods: The trial was conducted on patients with atrial fibrillation hospitalized between 01.10.2014-31.03.2015 at Institute of Cardiovascular Diseases ”Prof. Dr. G. Georgescu”, Iasi. Patients included in the study were analyzed according to age and sex, criteria for the clinical and paraclinic definition for atrial fibrillation. \u0000Results: Atrial fibrillation is an extremely common cardiovascular pathology and is present in about one-third of patients admitted to our clinic. Cardiovascular diseases such as hypertension, ischemic coronary artery disease, and valvulopathy are common in patients with AF. Patients with AF are usually elderly patients with many associated diseases in whom sinus rhythm restoration treatment and anticoagulant therapy are difficult to establish. AF is one of the most common arrhythmias that complicates the evolution of acute myocardial infarction, association between dual antiplatelet therapy and anticoagulation treatment, increasing the risk of bleeding complications. \u0000Conclusions: Atrial fibrillation is an extremely common cardiovascular pathology and is present in about one-third of patients admitted to our hospital. The data obtained revealed that this arrhythmia occurs in a small number of cases as the only pathology of the patient, usually associated with numerous comorbidities. Cardiovascular diseases such as hypertension, ischemic coronary artery disease, valvulopathy are common in our practice. Patient with AF is a patient who requires long-term anticoagulant therapy and in whom sinus rhythm recovery therapy is dependent on the precocity of presentation to the physician, as well as on the therapeutic resources of current medicine.","PeriodicalId":73409,"journal":{"name":"International archives of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49092501","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}
J. Vidal-Alaball, J. M. Peña, Glòria Sauch Valmaña
Background Telemedicine is particularly useful in rural areas where can facilitate access to specialised care in regions far from urban hospitals and can prevent unnecessary travel. The purpose of this research was to evaluate the degree of resolution of an asynchronous teledermatology service in the Bages County, comparing urban and rural primary care centres. Methods and findings A longitudinal descriptive study of referrals from 14 Primary Care Teams to a hospital dermatology service as a result of a previous referral to a teledermatology program was performed, comparing years 2015 and 2016 and urban with rural practices. Both in urban and rural areas there was an increase in referrals to the teledermatology service in 2016 compared to the previous year (12.9% and 0.3% respectively). In the two years analysed, referral rates to the teledermatology service per thousand inhabitants from rural centres was statistically much higher than that of urban centres (p<0.001). The number of referrals to the face-to-face dermatology service after a teledermatology consultation decreased significantly in both urban [OR=0,81 (0,70-0,93) p=0,001] and rural centres [OR=0,64 (0,57-0,72) p<0,001]. Conclusions The asynchronous teledermatology service established in the Bages County increases the resolution of primary care teams as reduces referrals to the face-to-face dermatology service. This effect is more pronounced in rural than in urban areas. Such finding may indicate the need to prioritize telemedicine services in rural primary care practices.
{"title":"Rural-urban differences in the pattern of referrals to an asynchronous teledermatology service","authors":"J. Vidal-Alaball, J. M. Peña, Glòria Sauch Valmaña","doi":"10.3823/2571","DOIUrl":"https://doi.org/10.3823/2571","url":null,"abstract":"Background \u0000Telemedicine is particularly useful in rural areas where can facilitate access to specialised care in regions far from urban hospitals and can prevent unnecessary travel. The purpose of this research was to evaluate the degree of resolution of an asynchronous teledermatology service in the Bages County, comparing urban and rural primary care centres. \u0000Methods and findings \u0000A longitudinal descriptive study of referrals from 14 Primary Care Teams to a hospital dermatology service as a result of a previous referral to a teledermatology program was performed, comparing years 2015 and 2016 and urban with rural practices. \u0000Both in urban and rural areas there was an increase in referrals to the teledermatology service in 2016 compared to the previous year (12.9% and 0.3% respectively). In the two years analysed, referral rates to the teledermatology service per thousand inhabitants from rural centres was statistically much higher than that of urban centres (p<0.001). The number of referrals to the face-to-face dermatology service after a teledermatology consultation decreased significantly in both urban [OR=0,81 (0,70-0,93) p=0,001] and rural centres [OR=0,64 (0,57-0,72) p<0,001]. \u0000Conclusions \u0000The asynchronous teledermatology service established in the Bages County increases the resolution of primary care teams as reduces referrals to the face-to-face dermatology service. This effect is more pronounced in rural than in urban areas. Such finding may indicate the need to prioritize telemedicine services in rural primary care practices.","PeriodicalId":73409,"journal":{"name":"International archives of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46779017","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}
A. Rodrigues, Daniel Macedo do Nascimento, Eduarda de Carvalho Sato, Fernanda de Paula Moreira, Maitê Silva Martins Gadelha, Paula Cíntia Machado Sampaio, Tarsila Stockler Ravaschieri Martinoli, Yan Garcia Lira
Background:Glioblastoma with oligodendroglioma component (GBMO) is a recently classified subtype of glioblastoma, which carries different clinical and prognostic outcomes, being frequently misdiagnosed. Both glioblastoma and GBMO are mainly seen in older ages, such as the 5th and 6th decades of life, being an extremely rare occurrence in children or adolescents and more frequent in male patients. Case report: A 15-year-old girl, presented with history of daily headache, not relieved by painkillers, vomiting, blurred vision and strabismus. Magnetic resonance imaging of the brain revealed expansive tumour on left temporo-occipital lobe. Patient was submitted to intracranial exeresis, along with histopathological examination: glial neoplasm with areas of pleomorphism, hyperchromatism, anaplasia, foci of oligodendroglial component, perinuclear halo and ramified capillaries, resembling oligodendroglioma, necrosis and intense mitotic activity. The immunohistochemical analysis revealed positive Glial Fibrillary Acidic Protein (GFAP), synaptophysin, Ki-67 (MindBomb E3 ubiquitin protein ligase 1 – MIB-1)and hyperexpression of Epidermal Growth Factor Receptor (EGFR), indicating GBMO. Subsequently, Fluorescence in situ Hybridization (FISH) showed 1p/19q codeletion and Isocitrate Dehydrogenase 1 (IDH 1) mutation, suggesting an oligodendroglioma component. Tumour resection was total and symptoms disappeared. Afterwards, she started adjuvant oral chemotherapy with temozolomide. Treatment was completed nine months after the diagnosis, with no greater symptoms or complications and complete remission. Conclusion: GBMO must be considered as a possible diagnosis when confronted with a malignant glioma with oligodendroglial tumour component, independent of age or genre. Necrosis upon histopathological examination has a strong relation to shorter median overall survival. IDH mutation and 1p/19q codeletion should be analyzed by immunohistochemistry. Total tumour resection, with adjuvant treatment (chemotherapy with temozolomide and radiotherapy), increases benefits and improves prognosis.
{"title":"Glioblastoma with Oligodendroglioma Component (GBMO) in an adolescent: a case report","authors":"A. Rodrigues, Daniel Macedo do Nascimento, Eduarda de Carvalho Sato, Fernanda de Paula Moreira, Maitê Silva Martins Gadelha, Paula Cíntia Machado Sampaio, Tarsila Stockler Ravaschieri Martinoli, Yan Garcia Lira","doi":"10.3823/2569","DOIUrl":"https://doi.org/10.3823/2569","url":null,"abstract":"Background:Glioblastoma with oligodendroglioma component (GBMO) is a recently classified subtype of glioblastoma, which carries different clinical and prognostic outcomes, being frequently misdiagnosed. Both glioblastoma and GBMO are mainly seen in older ages, such as the 5th and 6th decades of life, being an extremely rare occurrence in children or adolescents and more frequent in male patients. \u0000Case report: A 15-year-old girl, presented with history of daily headache, not relieved by painkillers, vomiting, blurred vision and strabismus. Magnetic resonance imaging of the brain revealed expansive tumour on left temporo-occipital lobe. Patient was submitted to intracranial exeresis, along with histopathological examination: glial neoplasm with areas of pleomorphism, hyperchromatism, anaplasia, foci of oligodendroglial component, perinuclear halo and ramified capillaries, resembling oligodendroglioma, necrosis and intense mitotic activity. The immunohistochemical analysis revealed positive Glial Fibrillary Acidic Protein (GFAP), synaptophysin, Ki-67 (MindBomb E3 ubiquitin protein ligase 1 – MIB-1)and hyperexpression of Epidermal Growth Factor Receptor (EGFR), indicating GBMO. Subsequently, Fluorescence in situ Hybridization (FISH) showed 1p/19q codeletion and Isocitrate Dehydrogenase 1 (IDH 1) mutation, suggesting an oligodendroglioma component. Tumour resection was total and symptoms disappeared. Afterwards, she started adjuvant oral chemotherapy with temozolomide. Treatment was completed nine months after the diagnosis, with no greater symptoms or complications and complete remission. \u0000Conclusion: GBMO must be considered as a possible diagnosis when confronted with a malignant glioma with oligodendroglial tumour component, independent of age or genre. Necrosis upon histopathological examination has a strong relation to shorter median overall survival. IDH mutation and 1p/19q codeletion should be analyzed by immunohistochemistry. Total tumour resection, with adjuvant treatment (chemotherapy with temozolomide and radiotherapy), increases benefits and improves prognosis.","PeriodicalId":73409,"journal":{"name":"International archives of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41368237","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}
Background: The current study estimated (a) the indirect costs associated with non-fatal disability and premature death across a wide range of diseases and health conditions in Africa in 2015 and (b) the potential savings that could be accrued if countries were to meet the 3 health targets of the substainable development goal (SDG) compared to the costs under the status quo. Methods: This study used the lost output or human capital approach to quantify the gross domestic product (GDP) losses associated with the disability-adjusted-life-years (DALYs) lost due to all causes by age group as well as by country economic classification (Group 1: 10 high/upper-middle income countries; Group 2: 17 lower-middle income countries; and Group 3: 27 low income countries). Results: The expected indirect cost of the 704,765,879 DALYs lost in Africa in 2015 was Int$ 2,983,187,560,197. Of this amount, 25.17%, 57.84% and 16.99% were incurred by the economies of the countries comprising Group 1, Group 2 and Group 3, respectively. Of the total continental indirect cost, 36.9%, 10.5%, 13.7%, 17.0%, 7.6%, 6.8% and 7.5% were associated with people aged 0-4, 5-14, 15-29, 30-49, 50-59, 60-69 and 70 years or older, respectively. Most of the total indirect cost (56.61%) was attributable to maternal conditions, AIDS, tuberculosis (TB), malaria, neglected tropicald diseases (NTDs), non-communicable diseases and traffic injuries. Approximately half (47%) of this cost could be avoided (or saved) every year if the 3 (health) targets of the SDG were fully met. Conclusion: The study estimated the total indirect cost of illness due to all causes by age group and country economic classification. The annual indirect cost is substantial. The findings contained in this paper suggest that health system strengthening should focus on both rich and poor countries, people of all ages and specific disease categories.
{"title":"The Indirect cost of illness in Africa","authors":"J. Kirigia, G. Mwabu","doi":"10.3823/2568","DOIUrl":"https://doi.org/10.3823/2568","url":null,"abstract":"Background: The current study estimated (a) the indirect costs associated with non-fatal disability and premature death across a wide range of diseases and health conditions in Africa in 2015 and (b) the potential savings that could be accrued if countries were to meet the 3 health targets of the substainable development goal (SDG) compared to the costs under the status quo. \u0000Methods: This study used the lost output or human capital approach to quantify the gross domestic product (GDP) losses associated with the disability-adjusted-life-years (DALYs) lost due to all causes by age group as well as by country economic classification (Group 1: 10 high/upper-middle income countries; Group 2: 17 lower-middle income countries; and Group 3: 27 low income countries). \u0000Results: The expected indirect cost of the 704,765,879 DALYs lost in Africa in 2015 was Int$ 2,983,187,560,197. Of this amount, 25.17%, 57.84% and 16.99% were incurred by the economies of the countries comprising Group 1, Group 2 and Group 3, respectively. Of the total continental indirect cost, 36.9%, 10.5%, 13.7%, 17.0%, 7.6%, 6.8% and 7.5% were associated with people aged 0-4, 5-14, 15-29, 30-49, 50-59, 60-69 and 70 years or older, respectively. Most of the total indirect cost (56.61%) was attributable to maternal conditions, AIDS, tuberculosis (TB), malaria, neglected tropicald diseases (NTDs), non-communicable diseases and traffic injuries. Approximately half (47%) of this cost could be avoided (or saved) every year if the 3 (health) targets of the SDG were fully met. \u0000Conclusion: The study estimated the total indirect cost of illness due to all causes by age group and country economic classification. The annual indirect cost is substantial. The findings contained in this paper suggest that health system strengthening should focus on both rich and poor countries, people of all ages and specific disease categories. \u0000 ","PeriodicalId":73409,"journal":{"name":"International archives of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45544396","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}
T. Gomes, J. Matos, J. Vasconcelos, K. Olivieri, W. Brandt, M. Miranda
Aim: The objective of this study was to investigate the performance of experimental resinous adhesives containing different combinations of photoinitiators systems through the bending test. Material and Methods: Resinous adhesive formulations were prepared with monomer mixtures consisting of 50% by mass of bisphenol dimethacrylate glycidyl (BisGMA) and 50% by mass of triethyleneglycol dimethacrylate (TEGDMA). The photoinitiators were used, camphorquinone (CQ) and bis-alkyl phosphinic oxide (BAPO). The co-initiators were diphenyliodonium hexafluorophosphate (DFI) and the amine (dimethylamino methylmethacrylate - DMAEMA) in the 1:1 proportion by mass. The photopolymerizable initiator systems were dissolved in the organic matrix at 0.5% by mass concentrations, creating eight groups (G1- CQ, G2- CQ/amine, G3- CQ/DFI, G4- CQ/amine/DFI, G5- BAPO, G6- BAPO/amine, G7- BAPO/DFI, G8- BAPO/amine/DFI). Samples with 7.0 mm in length, 2.0 mm wide and 1.0 mm height were prepared (n=12). The curing light used was VALO – Ultradent and the curing time was 20 s. The samples were subjected to evaluation of bending test at three points at a speed of 1 mm/min to evaluate the flexural resistance (FR). Results: The results were submitted to analysis of variance with one criterion (p < 0,001) and multiple comparisons were performed using Tukey test. Systems with the photoinitiator BAPO showed higher or equivalent bending values that demonstrated by the conventional system containing CQ/amine. Systems with the DFI had higher flexural values in relation to those demonstrated by systems without the DFI to CQ. Conclusion: The use of systems with alternative photoinitiators and co-initiators allows to obtain superior properties to the conventional system, making these promising systems to act both in isolation as associated with conventional systems.
{"title":"Effect of Different Photoiniciers of Experimental Adhesive Systems on Adhesive Interface Union Resistance","authors":"T. Gomes, J. Matos, J. Vasconcelos, K. Olivieri, W. Brandt, M. Miranda","doi":"10.3823/2567","DOIUrl":"https://doi.org/10.3823/2567","url":null,"abstract":"Aim: The objective of this study was to investigate the performance of experimental resinous adhesives containing different combinations of photoinitiators systems through the bending test. \u0000Material and Methods: Resinous adhesive formulations were prepared with monomer mixtures consisting of 50% by mass of bisphenol dimethacrylate glycidyl (BisGMA) and 50% by mass of triethyleneglycol dimethacrylate (TEGDMA). The photoinitiators were used, camphorquinone (CQ) and bis-alkyl phosphinic oxide (BAPO). The co-initiators were diphenyliodonium hexafluorophosphate (DFI) and the amine (dimethylamino methylmethacrylate - DMAEMA) in the 1:1 proportion by mass. The photopolymerizable initiator systems were dissolved in the organic matrix at 0.5% by mass concentrations, creating eight groups (G1- CQ, G2- CQ/amine, G3- CQ/DFI, G4- CQ/amine/DFI, G5- BAPO, G6- BAPO/amine, G7- BAPO/DFI, G8- BAPO/amine/DFI). Samples with 7.0 mm in length, 2.0 mm wide and 1.0 mm height were prepared (n=12). The curing light used was VALO – Ultradent and the curing time was 20 s. The samples were subjected to evaluation of bending test at three points at a speed of 1 mm/min to evaluate the flexural resistance (FR). \u0000Results: The results were submitted to analysis of variance with one criterion (p < 0,001) and multiple comparisons were performed using Tukey test. Systems with the photoinitiator BAPO showed higher or equivalent bending values that demonstrated by the conventional system containing CQ/amine. Systems with the DFI had higher flexural values in relation to those demonstrated by systems without the DFI to CQ. \u0000Conclusion: The use of systems with alternative photoinitiators and co-initiators allows to obtain superior properties to the conventional system, making these promising systems to act both in isolation as associated with conventional systems.","PeriodicalId":73409,"journal":{"name":"International archives of medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49551413","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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