classification

“Iliosacral bridging” - A new alternative minimal invasive fixation of unstable pelvic ring fractures

Published on: 20th November, 2018

Introduction: Fractures of both the anterior and posterior pelvic ring are common injuries in polytrauma and the elderly that extend beyond those of simple low-impact trauma. While conventional X-rays predominantly show the ventral aspect of the injury, computed tomography often detect additional fractures of the sacrum. A large number of these fractures are B-injuries by AO, mainly compression fractures at an advanced age. In addition, the prevalence of pelvic insufficiency fractures caused by osteoporosis rather than subsequent to an obvious trauma is increasing, with such an injury often associated with pain that impairs mobilization. The standard sacroiliac screw fixation is often characterized by loosening and thus failure of the osteosynthesis especially in osteoporotic bone of elderly patients. Method: A new alternative surgical minimal invasive technique, the “iliosacral bridging”, stabilizes the fractures of the sacrum with an internal fixation from S1 pedicle of the uninjured side to the ilium on the affected side. The combination of this internal fixation with the standard single sacroiliac screw on the injured side allows an immediate full weight bearing and pain free mobilization. We present a case series of 8 patients. Results: The clinical and radiological analysis analogous to the pelvic-outcome-score brought forward that 2 patients showed an excellent and 2 patient a good result. The other 4 patients achieved sufficient results. Conclusions: The “iliosacral bridging” we have introduced in the present study provides evidence of an expected increased stability of the pelvis after B-injuries
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Lecture: “First aid to the population for wounds during accidents, сatastrophes, natural disasters, and terrorist attacks” for Humanitarian and Technical Universities

Published on: 19th July, 2019

OCLC Number/Unique Identifier: 9272394938

1. The concept of wounds. 2. Classification of wounds. 3. Signs of wounds. 4. Factors affecting the course of the wound process. 5. Phases of the wound process. 6. Types of wound healing. 7. Features of wounds in children. 8. First (first emergency) help. 9. Complications of wounds. 10. Specific bite wounds. Notion Treatment. Complications. 11. Snake bites. First aid. 12. Arthropod bites. First aid. Wounds are called traumatic violation of the integrity of the skin or mucous membranes with possible damage to the deeper tissues.
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Economic disparities and suicides: The dynamic panel data analyses of 50 states in the United States

Published on: 16th March, 2021

OCLC Number/Unique Identifier: 8982618746

The economic inequalities associated with suicide risks among 50 states in the United States were identified in this paper to form the dynamic panel data set from 1981 to 2016. The effects of growing income inequalities on suicides in the Unites States were estimated using the Arellano–Bond method. This paper is the first to associate the social inequalities with suicides using the state-level dynamic panel data in America. It is found that the change of unemployment rates significantly and positively impact the changes of the overall suicides rates, female and male suicides rates. The changes of Top 10% income index are uniformly positive to the change of female, male and overall state-level suicide rates. The Gini index has positive correspondence within the overall and female groups, along with the insignificantly vague evidence within the male groups. The potential endogeneity problem inferring from the fixed effect estimation has been also investigated accordingly. JEL Classification: A13, A14, I18. 
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So-called idiopathic scoliosis – disfiguring deformity in children, pain problems in adults. Information about biomechanical etiology, classification and therapy

Published on: 10th March, 2020

OCLC Number/Unique Identifier: 8553234161

In the article presented the etiology of the so-called idiopathic scoliosis (Adolescent Idiopathic Scoliosis [AIS]), new classification, there are given rules of therapy and causal prophylaxis. This knowledge is based on observations from 1984, but essentially from the years 1995 – 2007. In 2001 it was given the first description in classification – “S” scoliosis in 1st group / type and “C” and “S” scoliosis in 2nd A / B group and types, in 2004 “I” scoliosis in 3rd group / type.
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Revisiting childhood pneumonia in low-recourse setting hospitals

Published on: 12th July, 2021

OCLC Number/Unique Identifier: 9137597336

Introduction: Pneumonia, defined as infection of lung parenchyma, is associated with severe complications especially in the very young and old patients. It is the world’s leading cause of childhood mortality. The World Health Organization (WHO) classification and guidelines are commonly used in Sudan in the diagnosis and management of pneumonia patients. This review was the outcome of some researches done in Sudan by the author and his colleagues. Management Systems were evaluated to give complete end to end solutions for serving patients along with their records in hospitals and clinics in Sudan. The objective of the study was: To reflect author experience in management of childhood pneumonia in Sudan and to determine feasible, affordable approach to pneumonia in Sudan. Methodology: Searching through PubMed for the author publication and review of publication by author in Sudan regarding management of pneumonia. Conclusion: Simple tests like chest X-ray, high WBC high-reactive protein, together with high temperature can predict the need for urgent blood culture. Antibiotic treatment for childhood pneumonia weather that recommended by WHO, b-lactam inhibitors or 3rd generation cephalosporin has the same outcome.
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What is new in Hypertension of Mexico 2018? -Impact of the new classification of high blood pressure in adults from American College of Cardiology/American Heart Association (ACC/AHA)

Published on: 7th March, 2018

OCLC Number/Unique Identifier: 7379463999

The new report of American College of Cardiology/American Heart Association task force on Clinical Practice Guidelines for High Blood Pressure in Adults was published online ahead of print November 13, 2017. The new American recommendation was focused on the criteria to define Hypertension. 130/80 mmHg or more is now considered as the new cut off point to define Hypertension. It is not new if we consider cumulative evidence in the las two decades has been broken the idea to consider 140/90 mmHg as the point to start medical actions. Thus, in México with current ACC/AHA definition it is estimated today around 48 million of adult hypertensive population. In the Mexican Institute of Social Security (IMSS) several strategies has been developed to improve prevention as the key action to confront non communicable chronic disease including hypertension. This updated guideline from ACC/AHA is an extraordinary opportunity to reinforce our preventive programs to high blood pressure control. In this brief report we analyze the epidemiological situation in Mexico and its possible consequences of the new criteria for hypertension diagnosis. The main current strategies that are applied into the IMSS to confront cardiovascular risk factors are directed to prevention. The IMSS is prepared to attend situations as the change of criteria diagnoses in Hypertension and new preventive models are in progression.
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Identification and resolution of drug therapy problems among hypertensive patients receiving care in a Nigerian Hospital - A pilot study

Published on: 1st October, 2020

OCLC Number/Unique Identifier: 8677986406

Background: An event involving drug therapy that actually or potentially interfers with the desired health outcomes is known as drug therapy problem. Objective: The study aimed to identify and resolve potential drug related problems encountered among adult hypertensive patients receiving care in a Nigerian Tertiary Hospital. Methods: This was a prospective cross sectional study. The data were collected from the patients’ medical records using the Pharmaceutical Care Network Europe (PCNE) Classification tool Version 6.2 (PCNE, 2010). For each of the 171 medical records, the DTPs experienced within the study period were identified. Data were analyzed using the IBM Statistical Product and Service Solutions (SPSS) for Windows, Version 21.0 (IBM Corp, Version 21.0, and Armonk, NY, USA). Results: Majority of the patients were above 65years of age 64(37.4%), while about half of the patients were females. A total of 644 drug therapy problems were identified. The major cause of DTP was prescribing error 189(29.3). Other causes of drug therapy problem identified in this study were inappropriate drug selection 122(18.9), no indication for drugs 52(8.1), inappropriate drug combination 87(13.6), new indication presented 61(9.5), dose too high 62(9.6), dose too low 44(6.8), wrong drug taken/administered 27(4.2). Majority of the interventions made were accepted 586(91.0%) while only 3(0.5%) of the interventions made were not accepted. Conclusion: This study demonstrates that a pharmacist, with adequate training and support can play a vital role in identifying and resolving drug therapy problems. Also, there is a need for an educational intervention among prescribing physicians to update them regularly on hypertension guidelines.
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Rural adolescent health: Issues, behaviors and self-reported awareness

Published on: 22nd April, 2020

OCLC Number/Unique Identifier: 8582318282

Purpose: The purpose of the study was to examine the health status of rural adolescents and young adults in the United States through a comprehensive review of detailed health information, behavior and health awareness. The disparity in health awareness between rural and non-rural residents compared and evaluated. Methods: Rural-Urban Commuting Area (RUCA) codes were combined with respondent-level data from the Longitudinal Survey of Adolescent to Adult Health (Add Health) to classify individuals as rural/non-rural residents. Health characteristics and perceived health awareness was tested for statistically significant differences using ANOVA. Differences in weight perception accuracy was compared for systematic differences controlling for self-selection into rural areas using a two-stage logistic selection model. Findings: Analysis revealed that rural residents have a higher incidence of major health conditions including epilepsy, high cholesterol, high blood pressure and diabetes. Additionally, they have a higher prevalence of unhealthy behaviors including drinking and drug use. Rural residents are less likely to be insured, but more likely to be overweight or obese. While rural adolescents are more likely to mis-classify their body weight, this misclassification is a result of the higher incidence of overweight rather than the residential location. Conclusion: The higher prevalence of chronic conditions combined with the income and education levels suggests the rural environment is a unique and potentially challenging context for adolescent health. Improving rural adolescent health will require innovative solutions appropriate for rural environments and changes in individual health literacy. Solutions must be multisectoral, engaging education, economic development, and other community perspectives to establish key drivers for health equity.
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Pure Erythroid Leukemia: The Sole Acute Erythroid Leukemia

Published on: 11th July, 2017

OCLC Number/Unique Identifier: 7317598453

Pure Erythroid Leukemia (PEL) is an aggressive and exceedingly rare form of acute leukemia. In the 2008 WHO classification PEL was one of the subtypes of acute erythroid leukemia the other subtype being erythroleukemia (erythroid/ myeloid). In the 2016 WHO classification update, erythroleukemia was merged into myelodysplastic syndrome and PEL now is the only type of acute erythroid leukemia.106 cases of acute myeloid leukemia were diagnosed in 28 months in children’s hospital Lahore and PEL constituted 0.94%. Diagnosis of PEL is made by the bone marrow morphology showing predominant Immature erythroid precursors (proerythroblastic or undifferentiated), Periodic Acid- Schiff staining and immunophenotyping. In PEL no specific genetic mutations have been described but complex karyotypes and TP53 mutations are frequently noted. Future collaborative studies to identify the molecular defects will contribute to the development of targeted therapies that might improve the prognosis.
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The PVSG/WHO versus the Rotterdam European clinical, molecular and pathological diagnostic criteria for the classification of myeloproliferative disorders and myeloproliferative neoplasms (MPD/MPN): From Dameshek to Georgii, Vainchenker and Michiels 1950-2018

Published on: 17th April, 2019

OCLC Number/Unique Identifier: 8164019922

The present article extends the PVSG-WHO criteria into a simplified set of Rotterdam and European Clinical, Molecular and Pathological (RCP/ECMP) criteria to diagnose and classify the myeloproliferative neoplasms (MPNs). The crude WHO criteria still miss the masked and early stages of ET and PV. Bone marrow histology has a near to 100% sensitivity and specificity to distinguish thrombocythemia in BCR/ABL positive CML and ET, and the myelodysplastic syndromes in RARS-T and 5q-minus syndrome from BCR/ABL negative thrombocythemias in myeloproliferative disorders (MPD). The presence of JAK2V617F mutation with increased erythrocytes above 6x1012/L and hematocrit (>0.51 males and >0.48 females) is diagnostic for PV obviating the need of red cell mass measurement. About half of WHO defined ET and PMF and 95% of PV patients are JAK2V617F positive. The combination of molecular marker screening JAK2V617F, JAK2 exon 12, MPL515 and CALR mutations and bone marrow pathology is 100% sensitive and specific for the diagnosis of latent, early and classical ECMP defined MPNs. The translation of WHO defined ET, PV and PMF into ECMP criteria have include the platelet count above 350 x109/l, mutation screening and bone marrow histology as inclusion criteria for thrombocythemia in various MPNs. According to ECMP criteria, ET comprises three distinct phenotypes of true ET, ET with features of early (“forme fruste” PV), and ET with a hypercellular erythrocythemic, megakaryocytic granulocytic myeloproliferation (EMGM or masked PV). The ECMP criteria clearly differentiate early erythrocythemic, prodromal and classical PV from congenital polycythemia and idiopathic or secondary erythrocytosis. The burden of JAK2V617F mutation in heterozygous ET and in homozygous PV is of major clinical and prognostic significance. JAK2 wild type MPL515 mutated normocellular ET and MF lack PV features in blood and bone marrow. JAK2/MPL wild type hypercellular ET associated with primary megakaryocytic granulocytic myeloproliferation (PMGM) is the third distinct CALR mutated MPN. The translation of WHO into ECMP criteria for the classification of MPNs have a major impact on prognosis assessment and best choice for first line non-leukemogenic approach to postpone potential leukemogenic myelopsuppressive agents as long as possible in ET, PV and PMGM patients.
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Drug abuse and its ramifications on skeletal system

Published on: 5th November, 2019

OCLC Number/Unique Identifier: 8330461480

The purpose of this study is to highlight the drug abuse hazards and preventive aspects. From a public health perspective, substance abuse has long been a source of major concern, both for the individual’s health and for wider society as a whole. The UK has the highest rates of recorded illegal drug misuse in the western world. In particular, it has comparatively high rates of heroin and crack cocaine use. Substances that are considered harmful are strictly regulated according to a classification system that takes into account the harms and risks of taking each drug. The adverse effects of drug abuse can be thought of in three parts that together determine the overall harm in taking it. Some addictive substances are more damaging to the skeletal system along with the others. In this review article, an effort has been taken to elaborate the effects of addictive drugs on human highlighting these most problematic substances for bones and also the promising potential prevention aspects of drug abuse.
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Endogenous archeological sciences: Physiology, Neuroscience, Biochemistry, Immunology, Pharmacology, Oncology and Genetics as instrument for a new field of investigation? Modern global aspects for a new discipline

Published on: 14th December, 2018

OCLC Number/Unique Identifier: 7976988064

In this work is analyzed scientific literature involved in human evolution to be used as an archeological Pathway to link different sciences in an overall new discipline. A rational classification of single evidence make possible to better understand under new light some Physiological process. The archeological instrument to be applied in other field like biology or other sciences.
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Impact of mandibular advancement device in quantitative electroencephalogram and sleep quality in mild to severe obstructive sleep apnea

Published on: 30th December, 2020

OCLC Number/Unique Identifier: 8899350400

Sleep related breathing disorders (SRBD) are among seven well-established major categories of sleep disorders defined in the third edition of The International Classification of Sleep Disorders (ICSD-3), and Obstructive Sleep Apnea (OSA) is the most common SRBD [1,2]. Several studies have demonstrated that obstructive sleep apnea treatment increases the quality of life in OSA patients [3-8]. Indeed, excessive daytime sleepiness (EDS), cognitive impairment (e.g., deficits in attention-concentration, memory, dexterity, and creativity), traffic accidents, and deterioration of social activities are frequently reported in untreated patients [9-11]. Furthermore, an increase in cardiovascular morbidities and mortality (systemic hypertension, stroke, cardiac arrhythmias, pulmonary arterial hypertension, heart failure) [12], metabolic dysfunction, cerebrovascular ischemic events and chemical/structural central nervous system cellular injuries (gray/white matter) has been reported in OSA patients [13-17].  Continuous positive airway pressure (CPAP) therapy is considered the gold standard for treatment of moderate-severe OSA, nevertheless there is an increasing body of evidence supporting the usefulness of mandibular advancement devices (MADs) for improving quality of life and respiratory parameters even among patients with a high severity of OSA burden [5,10,18,19]. According to the standard of care of the American Academy of Sleep Medicine (AASM), MADs are indicated for mild to moderate OSA particularly in the context of CPAP intolerance or refusal, surgical contraindication, or the need for a short-term substitute therapy [9,15,20-22]. In Cuba, CPAP machines are not readily available; they are expensive and the majority of OSA patients cannot obtain this mode of therapy. Taking into account this problem, our hypothesis was based in the scientific evidences of MAD effectiveness, considering that low cost MADs could offer a reasonable alternative treatment for patients with OSA where CPAP technology are not handy. In this way our purpose was to assess the efficacy of one of the most simple, low cost, manufactured monoblock MAD models (SAS de Zúrich) in terms of improvements in cerebral function, sleep quality and drowsiness reports in a group of Cuban OSA patients with mild to severe disease. Outcome measures included changes in the brain electrical activity, sleep quality, and respiratory parameters, measured by EEG recording with qEEG analysis and polysomnographic studies correspondingly, which were recorded before and during treatment with an MAD, as well as subjective/objective improvements in daytime alertness. 
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Flow cytometry potential applications in characterizing solid tumors main phenotype, heterogeneity and circulating cells

Published on: 24th August, 2021

OCLC Number/Unique Identifier: 9213084224

Flow cytometry (FCM) is a unique technique that allows rapid quantitative measurement of multiple parameters on a large number of cells at the individual level. FCM is based on immunolabelling with fluorochrome-conjugated antibodies, leading to high sensitivity and precision while time effective sample preparation. FCM can be performed on tissue following enzymatic or mechanical dissociation. The expression of epithelial antigens and cytokeratin isoforms help in distinguishing tumor cells from adjacent epithelial cells and from tumor infiltrating leukocytes. Tumor phenotypes can be characterized on expression intensity, aberrancies and presence of tumor-associated antigens as well as their cell proliferation rate and eventual heteroploidy. FCM can measure quantitative expression of hormone or growth factor receptors, immunoregulatory proteins to guide adjuvant therapy. Expression of adhesion molecules tells on tumor’s capacity for tissue invasion and metastasis seeding. Tumor heterogeneity can be explored quantitatively and rare, potentially emerging, clones with poor prognosis can be detected. FCM is easily applicable on fine needle aspiration and in any tumor related biological fluids. FCM can also be used to detect circulating tumor cells (CTC) to assess metastatic potential at diagnosis or during treatment. Detecting CTC could allow early detection of tumors before they are clinically expressed although some difficulties still need to be solved. It thus appears that FCM should be in the pathologist tool box to improve cancer diagnosis, classification and prognosis evaluation as well as in orientating personalized adjuvant therapy and immunotherapy. More developments are still required to better known tumor phenotypes and their potential invasiveness
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A study to correlate the central corneal thickness to the severity of diabetic retinopathy and HbA1c levels in type 2 diabetes mellitus

Published on: 14th December, 2021

Background: Diabetic retinopathy (DR) is one of the most common causes of preventable blindness. Patients with Diabetes Mellitus (DM) develop not only DR but also corneal endothelial damage leading to anatomical and physiological changes in cornea. Central corneal thickness (CCT) is a key parameter of refractive surgery and Intraocular pressure (IOP) estimation. The role of CCT and higher glycemic index in DR needs to be researched upon.Objectives: To identify the corneal endothelial morphology in patients with type 2 DM, to measure the Central Corneal thickness (CCT) in patients with type 2 Diabetes Mellitus, to assess the relationship of CCT with HbA1C levels in the study group and to correlate the CCT with the severity of Diabetic retinopathy in the study group.Methods: A cross-sectional observational study was conducted between January 2018 and June 2019 in Vydehi Institute of Medical Sciences and Research Centre, Bangalore. The study included 100 subjects with type 2 DM for 5 years or more. Patients with comorbidities that may affect the severity of DR or alter CCT and other corneal endothelial parameters such as glaucoma, previous ocular surgery or trauma, corneal degenerations and dystrophies, chronic kidney disease and Hypertension were excluded. DR was assessed by dilated fundoscopy, fundus photography and optical coherence imaging of the macula and graded as per the Early Treatment of Diabetic Retinopathy Study (ETDRS) classification. CCT and other corneal endothelial parameters were measured through specular microscopy. Relevant blood investigations including blood sugar levels were done for all patients.Statistical analysis: Relationship between CCT and grades of DR and HbA1c levels were established using the Chi-Square test. The level of significance was set at p < 0.05.Results: The mean CCT in patients with no diabetic retinopathy, very mild and mild non-proliferative diabetic retinopathy (NPDR), moderate NPDR, severe and very severe NPDR and PDR was 526.62 ± 8.084 μm, 542.07 ± 8.713 μm, 562.16 ± 8.255 μm, 582.79 ± 7.368 μm and 610.43 ± 18.256 μm respectively. Analysis of the relationship between CCT and severity of DR showed a statistically significant positive correlation between the two parameters (Pearson r = 0.933, p = 0.001). Beyond this, a correlation was found between all the corneal endothelial parameters and severity of DR. Multivariate analysis showed that advanced DR was positively correlated with CV (r  = 0.917) and CCT (r = 0.933); while it was negatively correlated with ECD (r = -0.872) and Hex (r = -0.811). A statistically significant correlation was also found between CCT and HbA1c. Also increasing age, duration of DM and higher glycemic index were positively correlated with severity of DR. Conclusion: This study, by demonstrating a strong correlation between the central corneal thickness to the severity of DR and HbA1c levels emphasizes the importance of evaluation of corneal endothelial morphology in the early screening and diagnosis of microvascular complications of DM.
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A study on the determination of sex using lip print patterns among indigenes of Akwa Ibom State, Nigeria

Published on: 28th January, 2022

OCLC Number/Unique Identifier: 9406521878

The lip print pattern is the characteristic pattern of the wrinkles and grooves present on the labial mucosa. This study evaluated the determination of sex among indigenes of Akwa Ibom State, Nigeria using lip print patterns. 100 subjects (50 males and 50 females), aged 18-25 years participated in the study. With written consent, lip prints were collected from the subjects. Samples were analyzed using Suzuki and Tsuchihashi classification of lip prints. The lip samples were analyzed as a whole and then divided into six portions Right Upper Portions, Middle Upper Portion, Left Upper Portion, Right Lower Portion, Middle Lower Portion and Left Lower Portion and analyzed differently. Data were analyzed using the Chi-square test and T - test analysis. The result shows that the most prevalent lip print in males considering the lip as a whole is Type I (29%) while that of the females is Type I’ (32%). In six portions, there was a significant difference (p < 0.05) between the lip print patterns in male and female subjects in the Right Upper Portion (25.960), Left Upper Portion (15.455) and Middle Left Portion (19.948) suggesting that these portions can be effectively used for sex determination among these indigenes. There was no significant difference (p > 0.05) between the thickness of lip in males and in females but, the lower lip was significantly thicker (p < 0.01) than the upper lip in both gender. Results also showed that the length of lips in males was significantly longer (p < 0.01) than that of females. This study, therefore, concludes that determination of sex among indigenes of Akwa Ibom State using lip length and lip print patterns in specific portions of Right Upper Portion, Left Upper Portion and Middle Left Portion can be effectively done.
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Association between clinical forms of Leprosy and contacts with the vaccination state with BCG in five endemic municipalities in the Brazilian Amazon

Published on: 19th July, 2022

OCLC Number/Unique Identifier: 9575035083

Introduction: The World Health Organization (WHO) strategy for leprosy control from 2021 to 2030 focuses on interrupting transmission, reducing autochthonous cases to zero, and using a safe and effective vaccine and chemoprophylaxis. In 2020, 127,396 new cases were registered in the world, 19,195 new cases in the Americas, and, of these, 17,979 cases in Brazil, about 93.66% of the total in the Americas. Brazil is classified as a country with a high burden of the disease, occupying the 2nd place in the world, behind only India (WHO, 2020). Análise do período de 2010-2015 em publicação recente9, apresenta as seguintes cidades no estado do Pará nas quais se observou maiores taxas de incidência (detecção): Marituba, Belém, Marabá, Parauapebas e Altamira [9]. Material and method: This is an analytical retrospective study carried out in a database - Epi-Info resulting from records of Surveillance and Seroprevalence actions in five endemic municipalities for leprosy located in the Southeast and West of Pará. The following variables were analyzed: age, sex, Clinical Classification, vaccination status with BCG, and the result of the search for IgM antibodies against PGL-1 of Mycobacterium leprae by the “In house” ELISA technique. Results: We evaluated 1551 records examined in the laboratory from 2014 to 2016, which were classified into 123 Multibacillary -MB patients (123/1551 = 7.93%); 71 Paucibacillary-PB patients (71/1551 = 4.57%); 451 Intradomicilliary Consanguineous Contacts - CCOSI (451/1551 = 29.07%) and 906 Non Consanguineous Contacts - CNCOS (906/1551 = 58.41%). 57 MB patients (13.47%), 13 PB patients (3.07%), 133 CCOSI (31.44%) and 220 CNCOS (52.00%) were positive for PGL-1. The correlation of the Classification with the vaccination status showed 57 MB patients without any BCG (57/125 = 45.6%) and only 3 patients with two doses of BCG (3/125 = 2.4%); 17 PB patients without any dose of BCG (17/69 = 24.63%); 80 CCOSI without any BCG (80/455 = 17.58%) and 171 CNCOS (171/906 = 18.87%). The odds ratio (OR) in the analysis between unvaccinated MB patients compared to CCOSI was statistically significant (OR = 14.25; p ˂ 0.0001). The study shows the importance of using the BCG vaccine in healthy contacts of patients with leprosy, as it shows the probability of unvaccinated individuals being 14.25 times more likely to become ill with Multibacillary forms compared to CCOSI. In addition, the BCG vaccine has been in use for 80 years and is the only vaccine that we can use in leprosy control programs. Conclusion: Although the leprosy epidemiological data analyzed recently (2010 - 2015) show a downward trend in the main indicators in Pará, such as the detection of new cases and prevalence, the endemic municipalities are still classified as hyperendemic for the population under 15 years of age and This proves that Surveillance is essential, as well as BCG vaccination according to the Ministry of Health Standards.
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Evaluation of the health of temporomandibular joint – A novel technique

Published on: 23rd July, 2022

Case report: This case report aimed to evaluate temporomandibular joint activity in a patient with the temporomandibular disorder before and after disclusion time reduction (DTR) therapy.Results: Positive changes in joint health were observed in the patient after the DTR treatment. Conclusion: The joint vibration analysis objectively showed significant results with the disclusion-time reduction therapy. The measured parameters were closer to the reference values. Thus, DTR is an effective method to treat TMJ disorders, based on Piper’s classification.
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Cost-analysis comparison of clinical risk assessment with and without ROMA for the management of women with pelvic masses

Published on: 17th August, 2022

Objective: Pelvic masses can be classified as low risk (likely benign) and high risk (likely malignant) based on an initial clinical risk assessment, which involves a detailed history, physical exam, basic laboratory tests, and imaging. In recent years, the Risk of Ovarian Malignancy Algorithm (ROMA), which combines CA125, HE4 and menopausal status, has emerged as a powerful tool in the classification of pelvic masses and triage of patients to either a generalist gynecologist or a gynecologic oncologist for management. The objective of this study was to evaluate whether the use of ROMA, alone or in combination with Initial Clinical Risk Assessment (ICRA), provides cost savings compared to triage based on ICRA alone.Methods: A health-economic decision model was developed to assess clinical and cost differences associated with three different clinical pathways of risk assessment for a pelvic mass: ICRA alone, ROMA alone, or ICRA + ROMA in combination. Using previously reported accuracy rates and patient characteristics from a prospective, multicenter, blinded clinical trial, total healthcare costs were modeled for each clinical pathway using the Medicare 2020 reimbursement rates.Results: A total of 461 patients with pelvic masses were included with 10.4% ultimately diagnosed with epithelial ovarian cancer. Total healthcare costs for patients with benign disease, EOC, or low malignant potential tumors (LMP) (n = 441) triaged using ROMA alone were 3.3% lower than when triaged using ICRA alone. While lab costs increased 55% using ROMA, the use of ROMA alone resulted in a 4% decrease in laparoscopy costs and a 3.1% decrease in laparotomy costs compared with ICRA alone. Similarly, total costs associated with a combination of ICRA + ROMA were 3.9% lower than total costs associated with ICRA alone. The model also predicted a 63% reduction in repeat surgeries resulting from false negative ICRA when using ROMA to triage patients.Conclusion: Triage of women with pelvic masses using the more sensitive ROMA score lowers overall healthcare costs compared to ICRA alone. With fewer false negative results than ICRA alone, the ROMA score improves initial detection of malignancy and reduces second surgical treatments in women with pelvic masses.
Cite this ArticleCrossMarkPublonsHarvard Library HOLLISGrowKudosResearchGateBase SearchOAI PMHAcademic MicrosoftScilitSemantic ScholarUniversite de ParisUW LibrariesSJSU King LibrarySJSU King LibraryNUS LibraryMcGillDET KGL BIBLiOTEKJCU DiscoveryUniversidad De LimaWorldCatVU on WorldCat

Renal neoplasms and computed tomography

Published on: 8th November, 2022

Introduction: In recent years the increased utilization of imaging modalities has led to an accelerated diagnosis of renal masses. Initial diagnoses and staging are commonly done with the abdominal Computed Tomography (CT). This study evaluates the various aspects to consider when utilizing CT scan for the diagnosis of renal masses.Discussion: CT scan is the most important imaging modality to evaluate renal neoplasms. Postcontrast acquisitions can be tailored according to the indication for the study. This alongside various techniques, imaging modalities and classification systems may help differentiate the malignant Renal Cell Carcinoma, from benign or metastatic lesions, lymphomas or renal pseudotumor. Finally CT can also be utilized alongside other tools for staging the tumor. Conclusion: Certain CT imaging features are pertinent to evaluate the malignancy potential of renal lesions. However the CT alone may be inconclusive in diagnosing the majority of renal neoplasms, excluding AML with macroscopic fat. Hence it is recommended that the CT aid additional imaging modalities and tools to reach an accurate diagnosis.
Cite this ArticleCrossMarkPublonsHarvard Library HOLLISGrowKudosResearchGateBase SearchOAI PMHAcademic MicrosoftScilitSemantic ScholarUniversite de ParisUW LibrariesSJSU King LibrarySJSU King LibraryNUS LibraryMcGillDET KGL BIBLiOTEKJCU DiscoveryUniversidad De LimaWorldCatVU on WorldCat
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