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Results in Journal MedNEXT Journal of Medical and Health Sciences: 44

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Vidanapathirana J, Wijewardana D
MedNEXT Journal of Medical and Health Sciences pp 77-79; https://doi.org/10.34256/mdnt21312

Abstract:
The National Strategic Plan (2020-2024) of the National Cancer Control Programme, Sri Lanka directed the establishment of island wide Cancer Early Detection Centers (CEDC) in all provincial hospitals, aiming to avoid some of the delays for diagnosis of cancer patients in all age groups in Sri Lanka. These one-stop centers provide cancer diagnosis to detect, confirm and refer without long a referral pathway to a treatment center. The services provided these centers are consult a doctor to discuss cancer related issues, identify and education on risk factors and obtain guidance on the need to screen and prevent common and preventable cancers including individual counseling for risk factor reduction and post diagnosis. Further, it facilitates screening for Breast Cancer which includes clinical-breast examination, ultrasound scanning and mammography depending on the clinical assessment. The clinical oral examination for all high-risk target groups and educated on self-mouth examination. Screening for cervical cancer for necessary women via pap test and the HPV DNA test is carried out depending on the clinical assessment. These centers provide fast track method for early detection of cancers.
Esther Maciel Jacobson, Durval Ribas Filho
MedNEXT Journal of Medical and Health Sciences pp 69-76; https://doi.org/10.34256/mdnt21311

Abstract:
Celiac disease (CD) is an autoimmune disease. Whoever has it cannot eat foods that have gluten in their composition. The only treatment available is a diet in which all products containing gluten are removed from the dietary routine of patients with CD, which requires that their patients have determination. It is of utmost importance that the maximum amount of information is provided to the patient, so that the patient has a wide awareness of the conditions and limitations to be respected, as well as of the possible harmful changes to health caused by the non-adherence of the gluten-free diet.
Natália Cíntia de Oliveira, Gleice Kelly de Sousa, Durval Ribas Filho
MedNEXT Journal of Medical and Health Sciences pp 63-68; https://doi.org/10.34256/mdnt21310

Abstract:
The ketogenic diet (KD), a restrictive diet, is mainly characterized by high-fat content, low or no carbohydrate content, and low or normal protein content. This review aimed to address the main syndromes or diseases in which the therapeutic use of KD can be beneficial. One of the main clinical indications of KD has been, for some time, in the treatment of epilepsy refractory to the use of medications, with satisfactory results in the control of seizures. Recently, studies have addressed the metabolism of ketone bodies caused by KD, in the adjuvant treatment of tumors and endocrine disorders, such as diabetes and obesity, with promising results. In this work, the therapeutic aspect of KD was analyzed, as an aid in the control of pre-existing diseases, and that being a very restrictive diet with controversial effects, its use may be limited and it is not advisable to maintain it for long periods or without the proper follow-up.
Mariana De Almeida Lima, Manoel De Almeida Lima, Vitor Bottós da Silva, Dorival Scantamburlo Júnior, Marcio Cesar Reino Gaggini
MedNEXT Journal of Medical and Health Sciences pp 56-62; https://doi.org/10.34256/mdnt2139

Abstract:
Introduction: The new coronavirus (SARS-CoV-2), has infected more than 23 million individuals to date and has resulted in more than 800,000 deaths worldwide. The rapid spread of SARS-CoV-2 and its variants requires the urgent development of accurate diagnostic methods, effective treatments, and vaccines. The recommendations are also related to the Expert Consensus for Clinical Management of Covid-19, at the headquarters of the Pan American Health Organization / World Health Organization (PAHO / WHO) in Brasilia (Brazil). Objective: To gather the main pathophysiological considerations of COVID-19, as well as the actions of investigation, management, and adoption of preventive measures against the complications caused by SARS-CoV-2 in the emergency of hospitals. Methods: This study followed an integrative review model based on the systematic review model. The search for the articles occurred in the databases WHO, PAHO, Ministry of Health, PubMed, Embase, Ovid, Cochrane Library, and Google Scholar. The quality of the studies was based on the GRADE instrument. The risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 58 clinical studies were recruited and submitted to eligibility analysis and, after that, 26 studies were selected, including official public health guidelines and regulations. To the published articles, studies of high to medium quality and with risks of bias were selected that do not compromise the scientific basis of the studies. Based on the main literary findings, as well as the main public health guidelines published in the world, patients with COVID-19 may present respiratory syndromes very similar to the common influenza virus (influenza), being a challenge for early detection during screening. in emergency departments. According to the official health agencies of Brazil (Ministry of Health) and the world (WHO/PAHO) and their regulations, it was defined that the clinical criteria for hospital discharge should take into account the improvement of the clinical picture, the absence of tachydyspnea and hypoxia, the absence of O2 supplementation for at least 24 hours, hemodynamic stability, good oral acceptance and absence of fever.
Mariana Tolentino Chaves, Ana Paula Tolentino Chaves
MedNEXT Journal of Medical and Health Sciences pp 26-31; https://doi.org/10.34256/mdnt2135

Abstract:
Introduction: In the scenario of chronic non-communicable diseases, obesity stands out as a multifactorial disease that can cause several public health problems. Currently, about 30% of the world's population is overweight or obese. Estimates suggest that the prevalence of severe obesity in 2030 will be 11%, approximately twice the current prevalence. By 2025, Brazil will be in fifth place in the world ranking, with an estimated 18.0 million people. The appearance of the new coronavirus (SARS-CoV-2), which causes the disease COVID-19, has worsened the comorbidities of obesity. Objective: to explore, through a concise systematic review, the main metabolic and immunological relationships in obesity, especially in the presence of COVID-19. Methods: The present study followed a concise systematic review model (PRISMA). The search strategy was carried out in the databases PubMed, Embase, Ovid and Cochrane Library, Web Of Science, and Scopus. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results: A total of 76 studies were found that were submitted to the eligibility analysis, and, after that, 15 studies of high to medium quality and with risks of bias were selected that do not compromise the scientific basis of the studies, we found that obesity is an important predictor of worsening SARS-CoV-2 pathology. There are a complex interaction between multiple metabolic, immunological and inflammatory factors that result in meta-inflammation. It has been shown that obesity causes dysfunction in the immune system, increasing susceptibility to infections and death from sepsis, and increased oxidative stress in the body. SARS-CoV-2 amplifies the inflammatory response, enabling greater propensity to alveolar thrombotic microangiopathy and pulmonary thromboembolism. Meta-inflammation and insulin resistance with hyperinsulinemia is the main baseline changes in obesity. Conclusion: In the COVID-19 scenario, obesity is an important predictor of the worsening of SARS-CoV-2 pathology, mainly due to the worsening of metainflammation.
Marcelo Henrique Batista Santos, Priscilla Janaína De Lima Borelli Bovo, Henrique Esteves Magalhães, Luciano Rodrigues Neves, Elias Naim Kassis
MedNEXT Journal of Medical and Health Sciences pp 50-55; https://doi.org/10.34256/mdnt2138

Abstract:
Introduction: The success of dental implants is due to their ability to osseointegrate, with direct contact of the implant surface with the bone, without the interposition of fibrous tissue. Because many patients do not receive implant treatments because they do not have adequate or sufficient bone height, the development of shorter implants could meet the needs of these patients. Objective: To carry out a brief systematic review to present the state of the art of using short implants. Methods: The present study followed a concise systematic review model. The search was carried out in the PubMed, Embase, Ovid, Cochrane Library, Web Of Science, and Scopus databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results: Short implants are an increasingly common alternative to other surgical techniques in areas where bone availability is reduced. Despite the advantages they offer, a variety of biological repercussions have been described in the literature that can even lead to their loss. Conclusion: The studies analyzed showed that short implants are a reliable, safe, and practical alternative to be used in situations with reduced bone height. They do not present bone loss or resorption over the years, nor the risk of fracture or any damage to patients, as long as they have an adequate design, correct technique, and meticulous planning.
Taís Da Silva Lima, Lara Biliato Alves, Fábio Pereira Linhares de Castro
MedNEXT Journal of Medical and Health Sciences pp 20-25; https://doi.org/10.34256/mdnt2134

Abstract:
Introduction: In the scenario of endodontic treatment, fracture of the instrument complicates the endodontic procedure by obstructing debridement, delaying the completion of treatment, and affecting the patient's dental experience. When a file fractures during root canal treatment, several treatment options are available. Fractured endodontic instruments inhibit optimal cleaning and filling of root canals. Objective: To carry out a brief systematic review study to present the main clinical outcomes of different types of techniques for removing fragments of endodontic instruments in root canals. Methods: The rules of the Systematic Review-PRISMA Platform were followed. The research was carried out from November 2020 to January 2021 and developed based on Scopus, PubMed, and SCIENCE DIRECT. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results: A total of 132 articles were found involving the removal of fragments of endodontic instruments. A total of 80 articles were evaluated in full and 30 were included and evaluated in the present study. It has been found that the probability of successful removal of a fractured instrument is reported to range from 53 to 95%, with more than 80% of fractured instruments being removed by the use of ultrasound. Also, long fragments (0.4 mm) can adsorb ultrasonic energy and hinder its loosening. Nickel-titanium (NiTi) instruments with their pseudo-elasticity, especially the newly developed heat-treated NiTi instruments are more ductile and flexible compared to conventional NiTi2. Conclusion: Fractured instruments can be removed by a variety of methods, such as good ultrasonic tips, microtubule devices, and hemostatic pliers/forceps. Removing a fractured file is associated with considerable risk, and therefore the fragment must be circumvented. A cost-benefit analysis of the treatment should be considered before selecting a definitive treatment for the patient.
Cátia Irene Duarte Valente, Elaine Cristina Silva dos Reis, Durval Ribas Filho
MedNEXT Journal of Medical and Health Sciences pp 32-41; https://doi.org/10.34256/mdnt2136

Abstract:
The present study seeks to discuss the incidence of a stress fracture in not athletes. This type of pathology occurs as a result of a repetitive number of movements in a given region, fatigue and muscle imbalance are the main responsible for these fractures, which mainly affect runners and military, groups that are more susceptible to a large amount of impact In practice, and has been increasing in non-athletes. To do so, it reviews the literature based on the first descriptions of the stress fracture, the causes of this type of occurrence, the results on the patient's body, and the modes of treatment and recovery. The objective of this study is to review the literature currently available to aggregate the most relevant information regarding this pathology.
Henrique Esteves Magalhães, Priscilla Janaína De Lima Borelli Bovo, Luciano Rodrigues Neves, Marcelo Henrique Batista Santos, Rogério Luiz De Araújo Vian, Elias Naim Kassis, Álvaro José Cicareli
MedNEXT Journal of Medical and Health Sciences pp 42-49; https://doi.org/10.34256/mdnt2137

Abstract:
Introduction: In the dental implant scenario, the rehabilitation of the maxilla severely reabsorbed with endosseous implants remains a challenge. There are less aggressive alternatives, including short implants, inclined implants, and especially zygomatic (ZI) implants. In cases where the height and width of the residual bone do not allow the placement of conventional dental implants, the ZI can be considered. Objective: Conducted a concise systematic review to analyze the main literary findings on the use of the zygomatic implant as an important alternative for a dental implant, to present the state of the art to the dental community. Methods: The present study followed a concise systematic review model. The search was carried out in the PubMed, Embase, Ovid, Cochrane Library, Web Of Science, and Scopus databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: Zygomatic implants appear to be a consolidated therapeutic option for significantly atrophic maxilla, offering a promising alternative to costly heavy bone graft techniques, fewer complications, less time for rehabilitation, less required prosthodontic work, and significantly higher survival rates. Thus, the zygomatic implant is revolutionizing the implant procedure in the posterior atrophic maxilla, eliminating the complications of bone augmentation and sinus elevation, with delayed healing, showing better clinical results compared to the bone graft, pointing to a possible gold standard for a dental implant.
Michelle Silva Rocha, Durval Ribas Filho
MedNEXT Journal of Medical and Health Sciences pp 6-12; https://doi.org/10.34256/mdnt2132

Abstract:
Nutrology based on the analysis of benefits and harms generated by the ingestion of nutrients and assessing individual organic needs promotes the maintenance of health and the reduction of disease risk, as well as the treatment of manifestations of deficiency or excess. Obesity is defined by a body mass index greater than 30 kg/m². Its manifestation is the sum of genetic and environmental factors, this through sedentary lifestyle and caloric intake greater than energy consumption. There are many ways to deal with obesity, from behavioral changes such as a balanced diet and physical exercises, pharmacological and even surgical measures of different modalities, with Roux-en-Y gastric bypass surgery being the most used technique in Brazil. The most common postoperative nutritional deficiencies are iron, protein, calcium, folate, thiamine, zinc, copper, and vitamins D, B12, A, C, and K. In this case, we present the importance of nutrology in monitoring patients after bariatric surgery. This research made use of a bibliographic survey, giving priority to articles dated from the last 5 years, using the databases Lilacs, Medline, bireme, where articles, dissertations, and theses were consulted, in search of the following keywords, obesity, bariatric surgery, and nutritional deficiency, post-bariatric feeding.
Luciana Fortes Tosto Dias, Eduardo Costa Figueiredo Passos, Álvaro José Cicareli
MedNEXT Journal of Medical and Health Sciences pp 13-19; https://doi.org/10.34256/mdnt2133

Abstract:
Introduction: In the scenario of extraction associated with immediate implantation in the aesthetic area, tooth extraction is common in the daily clinical practice of the dentist, with the main causes of caries, periodontal disease, and coronal-radicular fractures. All extractions must be performed with precise indication, given defined prosthetic planning, thus avoiding an imbalance in the occlusion, swallowing, and aesthetics of the patient. Objective: To carry out a systematic review on the main approaches to extraction associated with immediate implantation in the aesthetic area. Methods: Followed a systematic review model (PRISMA). The search strategy was carried out in the PubMed, Embase, Ovid, Cochrane Library, Web Of Science, and Scopus databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results: A total of 134 studies were found that were submitted to the eligibility analysis and, after that, 41 studies of high to medium quality and with risks of bias were selected that do not compromise the scientific basis of the studies. According to the main literary findings, the use of the technique of installing immediate implants, after extraction, requires planning and care in the management of soft tissues, to correct aesthetic sequelae. The use of precise and minimally traumatic techniques enabled satisfactory and functional aesthetic results, as well as improving the patient's aesthetics and self-esteem. Conclusion: The immediate implant placement procedure after tooth extraction preserves bone height and thickness, reduces treatment time and cost, in addition to maintaining the gingival architecture, being important for the aesthetic success of future prosthetic rehabilitation. Also, it presents success rates comparable to implants in fully healed edges, the extraction must be done in a minimally traumatic way, to preserve the maximum bone tissue. The horizontal defects present after the installation of the immediate implant (gaps), if they are less than or equal to 3mm, will heal with complete bone filling. However, if they are larger than 3mm, bone graft material and/or membrane should be used so that there is bone healing.
Moniele Matos Cadamuro, Durval Ribas Filho
MedNEXT Journal of Medical and Health Sciences pp 1-5; https://doi.org/10.34256/mdnt2131

Abstract:
Introduction: In the scenario of vitamin D deficiency, this incident is prevalent and with risks to public health in the world, reaching approximately 90% of individuals. Hypovitaminosis D can cause, mainly in the elderly, lower bone mineral density, fractures, muscle weakness, falls, and acute respiratory infection. Objective: To evaluate the main clinical results on vitamin D levels in the elderly, as well as to analyze which daily or weekly dose of vitamin D is most effective in the elderly in reducing the number of falls and fractures. Methods: The present study developed a systematic review, addressing randomized clinical studies, diverse clinical studies, systematic reviews, meta-analysis, and the latest international consensus, following the rules of PRISMA. Results and Conclusion: A total of 152 articles were found involving the dosage and the impact of vitamin D in the elderly. In total, 72 articles were evaluated in full and 30 were included. According to the main literary findings, vitamin D deficiency implies problems with mineralization and bone mineral density, causing fractures and an increase in the number of elderly falls. In this sense, SBEM recommends maintaining vitamin D concentrations above 30 ng/mL. Also, vitamin D deficiency points to the occurrence of neurological diseases such as cognitive decline, risk of Alzheimer's disease, and depression. In the current scenario of the pandemic, vitamin D points as an important modulator of the immune system, and its deficiency promotes the unregulated release of cytokines, leading to complications in patients with COVID-19.
Augusto de Almeida Segundo Neto, Leandro Diniz Soares, Durval Ribas Filho
MedNEXT Journal of Medical and Health Sciences pp 71-76; https://doi.org/10.34256/mdnt21211

Abstract:
Autism Spectrum Disorder (ASD) refers to an alteration in neurological development typified by deficits in social communication, as well as in restricted and repetitive patterns of behavior, interests, or activities, varying in a continuum demarcated by the severity levels of their symptomatic pictures. It is estimated that about 45 to 90% of children with ASD have deficiencies in their eating habits, which may include atypical eating patterns and persistent practices of food selectivity, thus limiting the diet of these subjects. Given this context, the present study has the central objective of discussing, through the bibliographic review, the implications resulting from selectivity and eating behaviors in children with an autism spectrum disorder. It is, therefore, a descriptive study with a qualitative approach, organized from a natural perspective, emphasizing in a contextualized and judicious way the analyzed theme. Literary findings suggest that the conduct of food selectivity is significant for both family members, through high levels of stress; as, and above all, for children with ASD, since they will be more likely to develop gastrointestinal disorders, low quality of life, reduced levels of nutrients necessary for their proper development and scurvy when compared to those with typical neurodevelopment. In this sense, it appears that recognition of the different clinical and behavioral patterns manifested in children with ASD through food selectivity, is an important issue for family members and professionals in their diverse clinical practices, considering that the recognition of these patterns will be immeasurable utility in the development of adequate and early treatment strategies.
Mariana Tolentino Chaves, Ana Paula Tolentino Chaves
MedNEXT Journal of Medical and Health Sciences pp 87-93; https://doi.org/10.34256/mdnt21213

Abstract:
Introduction: In the scenario of chronic non-communicable diseases, obesity stands out as a multifactorial disease that can cause several public health problems. Currently, about 30% of the world's population is overweight or obese. Estimates suggest that the prevalence of severe obesity in 2030 will be 11%, approximately twice the current prevalence. By 2025, Brazil will be in fifth place in the world ranking, with an estimated 18.0 million people. The appearance of the new coronavirus (SARS-CoV-2), which causes the disease COVID-19, has worsened the comorbidities of obesity. Objective: to explore, through a concise systematic review, the main metabolic and immunological relationships in obesity, especially in the presence of COVID-19. Methods: The present study followed a concise systematic review model (PRISMA). The search strategy was carried out in the databases PubMed, Embase, Ovid and Cochrane Library, Web of Science, and Scopus. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results: A total of 76 studies were found that were submitted to the eligibility analysis, and, after that, 15 studies of high to medium quality and with risks of bias were selected that do not compromise the scientific basis of the studies, we found that obesity is an important predictor of worsening SARS-CoV-2 pathology. There is a complex interaction between multiple metabolic, immunological and inflammatory factors that result in meta-inflammation. It has been shown that obesity causes dysfunction in the immune system, increasing susceptibility to infections and death from sepsis, and increased oxidative stress in the body. SARS-CoV-2 amplifies the inflammatory response, enabling greater propensity to alveolar thrombotic microangiopathy and pulmonary thromboembolism. Meta-inflammation and insulin resistance with hyperinsulinemia is the main baseline changes in obesity. Conclusion: In the COVID-19 scenario, obesity is an important predictor of the worsening of SARS-CoV-2 pathology, mainly due to the worsening of met inflammation.
Hayslan Theobaldo Boemer, Ana Valéria Garcia Ramirez, Durval Ribas Filho
MedNEXT Journal of Medical and Health Sciences pp 77-86; https://doi.org/10.34256/mdnt21212

Abstract:
Crohn's disease (CD) is an inflammatory, chronic and progressive disease that affects the digestive tract. Despite optimized drug therapy, the risk of multiple surgical interventions over the years is high, leading the patient to develop short bowel syndrome (SBS). Thus, adequate management in the postoperative period directly interferes with the long-term prognosis. Initially, most of these patients, due to hydro electrolytic disorders and absorptive incapacity inherent in SBS, will need parenteral nutritional support. According to the patient's residual digestive profile and according to nutritional management (oral, enteral, and/or parenteral), the intestine will evolve in its adaptive capacity. During this period, control agents are used for motility and intestinal secretion and, if necessary, GLP-2 agonists (intestinotrophic). In cases refractory to these treatments, we can still indicate surgical procedures to control motility, increasing intestinal length, and, finally, transplantation. CD is recurrent, and patients with SBS need a multidisciplinary approach with continuous monitoring to provide better intestinal rehabilitation and consequent quality of life.
, Ana Valéria Garcia Ramirez, Durval Ribas Filho
MedNEXT Journal of Medical and Health Sciences pp 54-66; https://doi.org/10.34256/mdnt2129

Abstract:
Introduction: Hypovitaminosis D is highly prevalent and constitutes a public health problem worldwide. It can affect more than 90% of individuals, depending on the population studied. Objective: To make a broad analysis of the world literature to compose the State of the Art on serum vitamin D levels and its adequate supplementation, to prevent and mitigate various diseases, based on randomized clinical studies, analysis, and latest international conferences and consensus. Methods: The present study followed a literary review of randomized clinical studies, meta-analysis, and the latest international consensus. Cochrane instrument was adopted to assess the quality of the included studies between 2015 and 2020. Major considerations and conclusion: Laboratory evaluation should be performed by measuring 25(OH)D, and the main groups of individuals at risk for vitamin D deficiency are the elderly, patients with osteoporosis, history of falls and fractures, obese, pregnant women, and infants. For patients with osteoporosis and increased risk of fractures, recommended that concentrations of 25(OH)D remain above 30 ng/mL for full benefits on the prevention of secondary hyperparathyroidism, decreased risk of falls. Special considerations must have taken to pregnant women and infants, in patients with chronic renal failure, obese patients, and those undergoing bariatric surgery. Several clinical studies and current meta-analysis have shown significant results with vitamin D supplementation in cardiovascular complications, diabetes, cancer, autoimmune diseases, cognitive function, among others, with doses above 30 ng/mL, reaching up to 70 ng/mL, and maintaining serum dosage at 50 ng/mL.
Fábio Renato Braga Marcato, Juliana Caroline Ferreira de Gois Marcato, , Elias Naim Kassis
MedNEXT Journal of Medical and Health Sciences pp 27-33; https://doi.org/10.34256/mdnt2125

Abstract:
The most common bone disorder found by implant dentists is osteoporosis, which is a systemic skeletal disorder associated with aging, which is characterized by loss of bone mass, making bones fragile and more susceptible to fractures. The World Health Organization has defined osteoporosis as a bone mineral density level greater than 2.5 standard deviations below the mean of young normal women. After 60 years of age, a third of the population have this disorder, it occurs twice as often in women than in men. It is estimated that 1.3 million fractures and 133,000 all hip fractures occur every year as a result of osteoporosis. The aim of this study was to discuss aspects of the pharmacological action of Bisphosphonates (BP) and their influence on the bone tissue when associated with treatment with dental implants. There are several types of treatments which prevent or prevent the progression of osteoporosis. So, BP, such as alendronate, are inhibitors of bone resorption. Act as controlling the development of osteoporosis by increasing the process of bone density and decrease its reabsorption, often acting as supporting the process of osseointegration of dental implants.
Henrique Esteves Magalhães, Priscilla Janaína De Lima Borelli Bovo, Luciano Rodrigues Neves, Marcelo Henrique Batista Santos, Rogério Luiz De Araújo Vian, , Elias Naim Kassis
MedNEXT Journal of Medical and Health Sciences pp 42-48; https://doi.org/10.34256/mdnt2127

Abstract:
Introduction: In recent years, procedures with the use of dental implants have increased worldwide, reaching approximately one million dental implants per year. In recent years, a platelet concentrate called FRP (fibrin-rich plasma) has been the subject of clinical studies. Associated with this, the biomaterial Bio-Oss® (Geistlich), as it is biodegradable, biocompatible, non-toxic, and has low immunogenicity, and bio stimulators can act in the regeneration of bone tissue, as it establishes with the cells the appropriate biological niche (favorable microenvironment) for bone growth. Objective: Therefore, the present study aimed to evaluate, through a brief systematic review, the results that involve bone formation for dental implantation, with the use of biomaterials such as fibrin-rich plasma and Bio-Oss®. Methods: The model used for the review was PRISMA. Was used databases such as Scopus, Scielo, Lilacs, Google Scholar, PubMed. Results: Fibrin-rich plasma (FRP) as an autologous biomaterial for use in oral and maxillofacial surgery presents most leukocytes, platelets, and growth factors, forming a fibrin matrix, with three-dimensional architecture. The Bio-Oss® biomaterial (Geistlich), as it is biodegradable, biocompatible, non-toxic, and has low immunogenicity and bio stimulators can act in the regeneration of bone tissue, since it establishes with the adenomatous mesenchymal stem cells the appropriate biological niche for bone growth and, thus, allowing the dental implant to be as effective as possible. Conclusion: The use of FRP associated with Bio-Oss® seems to illustrate high success rates with minimal costs, which may reduce the amount of bone graft needed to fill the sinus cavity, reducing the costs of the procedure.
Carlos Fernando Almeida da Silva, Tayná Toder Santos, , Elias Naim Kassis
MedNEXT Journal of Medical and Health Sciences pp 34-41; https://doi.org/10.34256/mdnt2126

Abstract:
Introduction: When a dental element is lost in the posterior region of the maxilla, there is natural reabsorption of the alveolar process and at the same time there will be pneumatization of the maxillary sinus. It will increase its volume towards the place where the roots existed and this will often make it difficult or impossible to restore implants in place. For this reason, the procedure for elevating the floor of the maxillary sinus or short implants should be performed when possible. In this context, allogeneic, xenogenous, and alloplastic bone grafts are an alternative for the treatment of bone defects in the jaws, since they avoid the need for a second surgical access. However, due to the need for processing to eliminate antigenic components, these grafts are only osteoconductive with a lower bone formation potential compared to autogenous bone grafts. Also, in this context, in the last 20 years, platelet concentrates have been proposed as regenerative materials in tissue regeneration procedures. Among the platelet concentrates proposed in the literature, PRP and FRP are found to act as autogenous platelet aggregates with osteoinductive properties. Objective: The present study aimed to conduct a wide literature review on maxillary sinus surgery using fibrin-rich plasma. Methods: Experimental and clinical studies (case reports, retrospective, prospective and randomized) with qualitative and/or quantitative analysis were included. Results: The total of 48 articles were found involving Maxillary sinus surgery, Fibrin-rich plasma, and Biomaterials, of which 22 were selected to compose the present study. Conclusion: Based on the literary findings, it was shown that the FRP is favorable for bone formation processes for dental implants, especially when combined with xenografts.
Gilberto Campos Guimarães Filho, Maria Emília Figueiredo Teixeira, , Patrícia Maluf Cury, Giancarlo Lucchetti
MedNEXT Journal of Medical and Health Sciences pp 49-53; https://doi.org/10.34256/mdnt2128

Abstract:
The new coronavirus (SARS-CoV-2), whose disease is COVID-19, in March 2020, spread around the world. To minimize the deleterious effects of emotional vulnerability, many strategies are in use worldwide, such as support groups, online courses, use of social networks, web meetings, yoga practice, meditation, and other contemplative religious and spiritual activities. Religious and spiritual beliefs have been used to deal with tough situations and, through scientific literature is still not so clear about the role of spirituality and religiosity (S/R) in physical and mental health during the pandemic. Therefore, this article proposes a discussion about the physiopathological mechanisms of COVID-19 and how S/R could be useful in this context. In this sense, religious faith can be a powerful resource for good health and well-being with a positive impact verified in mental health outcomes it is plausible to suggest that S/R should be an important tool in minimizing the population suffering at this moment. Spiritual care has long been recognized as one of the domains of quality palliative care, but every health care professional is ultimately responsible for ensuring spiritual care to deal with spiritual distress and improve quality of life in the scenarios inherent to COVID-19.
Kamilla Carneiro Agreli, , Elias Naim Kassis
MedNEXT Journal of Medical and Health Sciences pp 10-16; https://doi.org/10.34256/mdnt2122

Abstract:
Introduction: Dental implant procedures have increased worldwide, reaching approximately one million dental implants per year. The optimization of faster and more accurate techniques by dentists and postoperative surgeons with better results and quality of life stimulated the development of numerous software and hardware for performing computer-guided surgeries, so-called virtual surgeries (VS). Objective: to present, through a systematic review, the main considerations of virtual surgery in dentistry and their respective advantages, disadvantages, and limitations. Methods: The model used for the review was PRISMA. We used databases such as Scielo, Lilacs, Google Scholar, PubMed. Major findings: In the scenario of VS in dentistry, advances in technology have contributed to the improvement of the models, since there was only the direct molding technique to obtain patient models, with the positioning of implants not very favorable in terms aesthetics. The information that is acquired in the 3D reconstructions allows us to determine the quantity and quality of the available bone and also allows the simulation of the installation of the implants in a virtual environment. This provides predictability of techniques and difficulties that can be encountered during surgical intervention, reducing the time and the possibility of errors, allowing the overall reduction of oral rehabilitation costs. Conclusion: Preoperative virtual planning and reconstruction of the mandible guided by dental implants through preoperative designs provide high success rates for the implant and dental rehabilitation, benefiting also prosthetic restorations supported by fixed implants. Still, the concept of using personalized implants with the help of 3D virtual treatment planning, stereolithographic models, and computer-assisted design greatly improves the mandibular restoration and helps to obtain a good facial profile, aesthetic and dental rehabilitation, avoiding complications with the grafts autologous.
Leandro Reis Woitas, José Wilson Ribas,
MedNEXT Journal of Medical and Health Sciences pp 1-9; https://doi.org/10.34256/mdnt2121

Abstract:
Introduction: Vitamin D (VD) deficiency (serum 25-hydroxyvitamin D (25 (OH) D) <50 nmol/L or 20 ng/mL) is more common than is thought in the majority of the world population. In this context, athletes have the same predisposition to low levels of vitamin D, with the majority of their concentrations below 20 ng/mL in a wide variety of sports, especially in the winter months. RV is also essential in extra-skeletal functions, including skeletal muscle growth, immune and cardiopulmonary functions, and inflammatory modulation, which influence athletic performance. Vitamin D can also interact with extra-skeletal tissues to modulate injury recovery and also influence the risk of infection. Objective: Performed a wide analysis of the world literature to compose the State of the Art on the main effects of vitamin D supplementation on the performance of athletes through randomized clinical studies, meta-analysis, and the latest international conferences and consensus. Methods: The present study followed a broad literature review of randomized clinical studies, meta-analysis, and the latest international consensus. The Cochrane instrument was adopted to assess the quality of the studies. Main findings and conclusion: One of the main aspects that must be taken into account is important evidence that suggests that free (bioavailable) 25(OH)D may be a better marker of vitamin D status. Many researchers do not take into account that athletes may need a greater supply of vitamin D to meet the requirements of muscle metabolism due to the potential routes of vitamin D use. A significant debate seems to be needed to determine and standardize the classification of vitamin D deficiency. There are still information gaps on the correlation between vitamin D supplementation and athletes' exercise performance. However, because vitamin D induces myogenesis and muscle protein synthesis, causing an increase in the percentage of rapidly contracting muscle cells, and because vitamin D receptors (VDR) play a significant role in muscle regeneration after injury, supplementation in athletes is recommended.
Cátia Irene Duarte Valente, Elaine Cristina Silva dos Reis, , Durval Ribas Filho
MedNEXT Journal of Medical and Health Sciences pp 21-26; https://doi.org/10.34256/mdnt2124

Abstract:
One of the main factors for the increase in the incidence of skin cancer in Brazil today is exposure to solar radiation. The main means of prevention is through photoprotection, together with factors such as solar incidence in the region, the habits of the population, and the skin phototype. The relationship between photoprotection and vitamin D is fundamental for patient orientation since photoprotection is a practice widely used today for all people, both those who have already suffered some type of skin cancer and others who are at greater risk or not. to develop it. On the other hand, some studies suggest that the photoprotection of the skin would jeopardize the development of Vitamin D, which may cause its deficiency, and may subject patients to future changes in bone mineralization, increasing the risk of bone deformities and fractures since the vitamin D is essential for bone tissue and its production is stimulated by skin exposure to ultraviolet B radiation (UVB), with natural sources limited through the diet. The discussion about the relationship between photoprotection and vitamin D is essential to establish the right conditions for each patient.
Patrícia da Silva, Thaís De Oliveira Nacanishi, Camila Barbosa da Silva, , Patrícia Garani Fernandes
MedNEXT Journal of Medical and Health Sciences pp 17-20; https://doi.org/10.34256/mdnt2123

Abstract:
Periimplantitis is an inflammatory reaction associated with the loss of bone support around the implant, and its main pathological agent is the accumulation of biofilm. The diagnosis is made through radiographic exams, depth of probe, and verification of bone loss, and if the patient presents bleeding and changes in the tissues around the implant, he may already be in the infectious process of periimplantitis. Despite so many treatments offered for peri-implanted, further studies are needed on some aspects of their effectiveness.
Maria Luiza Raduan Meinberg, Ana Cristyna Saad Murad, Isabela Daher Anbar, João Pedro Daher Anbar, Thiago Melo Ignácio Dos Santos,
MedNEXT Journal of Medical and Health Sciences, Volume 2, pp 59-65; https://doi.org/10.34256/mdnt21111

Abstract:
Introduction: Cancer is the main public health problem in the world and is already among the top four causes of death before the age of 70 in most countries. In this context, the interest in quality in the care of cancer services is evident. Because of this, several techniques and methods for this measurement are beginning to emerge, but so far there is no valid and reliable methodological strategy of consensus among researchers, except for the HUMAS and QUALISUS (Brazil) scale. Objective: To present the main strategies and criteria to propose a standard model for the validation of humanized care of oncological individuals from Brazil to the world, based on HUMAS international and QUALISUS in Brazil. Methods: The present study followed a review model of the main national and international public health legislation from Brazil (QUALISUS), WHO (World Health Organization), Health Professional Humanization Scale (HUMAS), and scientific articles. Results: Due to the automation of care, the concept of humanization of care has been increasingly discussed in the scientific literature. Respect for the patient's dignity, uniqueness, individuality, and humanity, as well as adequate working conditions and sufficient human and material resources, are the key elements of the humanization of care that were highlighted in this study's proposal. The factors that can contribute the most to the humanization process are the affection in the service, the friendliness and the smile, and the ones that can make it more difficult are the bad mood, the noise, and the punctual non-attendance. Conclusion: This study presented the main strategies and criteria to propose a standard model for the validation of humanized care of oncological individuals from Brazil to the world, strongly pointing out that hospital humanization must be experienced and felt by all who work in the hospital and need to reflect on the care offered to clients and their families.
Fernando Zanatta Junior, Hugo Guerra Rozani, João Gustavo Lima De Castro Paro, João Pedro Pataro Domingos, Mateus Moreno Landin, , Ana Valéria Garcia Ramirez, Durval Ribas Filho
MedNEXT Journal of Medical and Health Sciences, Volume 2, pp 19-23; https://doi.org/10.34256/mdnt2114

Abstract:
In a modern world, where day-to-day worry and stress prevails, along with an ever-increasing workday, care with diet is often overlooked and, combined with a sedentary lifestyle, increases obesity rates in all the world. The purpose of this work is to analyze society's view about the treatment of obesity with medications, comparing it with the treatment of other diseases, such as high blood pressure and diabetes. Through a questionnaire, on the internet, carried out from July to September 2020, with 14 multiple-choice questions answered by 520 people, 91.7% of the participants answered that obesity is a disease, however, 47.3% of people still think that the use of drugs for their treatment is not necessary and only 37.7% believe in the effectiveness of such a method. In addition, 26.2% believe that all obese people eat a high amount of food and practice little physical activity. As for the comparison with other diseases, 33.3% of the respondents believe that diabetes should be treated with medication and obesity should not, and 32.3% believe that hypertension should use this method and obesity should not. With such results, it was concluded that the society's view is still quite stigmatized regarding the treatment of obesity by drugs, which implies prejudice and the difficulty in adhering to this method by obese people and, with this, is the difficulty in reducing the rates obesity and all comorbidities related to it.
Julia Teles Triglia Pinto, Ana Carolina Tomasella Auad, Gabrielle Menegucci, Marília Gabriela Palácio Galbiatti, Ana Paula Oliveira Matsuda, Gabriela Mascaroz Giometti Heredia, Renan Reverete de Araújo, Airton José Mendes,
MedNEXT Journal of Medical and Health Sciences, Volume 2, pp 35-41; https://doi.org/10.34256/mdnt2117

Abstract:
Objective: To report a case of vertical herpetic meningoencephalitis. Results: The involvement of the central nervous system (CNS) in infection by HSV (herpes simplex virus), HSV-1 or HSV-2, causes an acute inflammatory process in the brain parenchyma, leading to herpetic encephalitis. It is a feared form of the disease due to its severity and its high rate of morbidity and mortality. Its rapid fatal progression can be prevented from early suspicion and treatment, which is essential when taking into account their neurological sequelae since survivors have motor sequelae, behavioral disorders, or epilepsy. The present work reports the case of a newborn male with spontaneous vaginal delivery who, at 19 days of age, started to experience fever, irritability, difficulty in eating, spasms, tremors of the upper limbs, deviation of the eyes, and seizures of difficult to control, together with CFE and serological changes, in addition to imaging tests compatible with herpetic meningoencephalitis, progressing with a very serious evolution despite the institution of specific treatment for CNS herpetic infection, evolving with important neurological sequelae. Conclusion: The sequels resulting from herpetic encephalitis not properly diagnosed, or even late, leads from severe neurological damage to death. Therefore, it is extremely important to start empirical treatment with antiviral drugs to reduce the sequelae mentioned above.
Maria Christiane Valéria Braga Braile-Sternieri, , Victor Rodrigues Ribeiro Ferreira, Eliana Migliorini Mustafa, Sofia Braile Sabino, Giovanni Braile Sternieri, Luiza Braile Verdi, Cibele Olegário Vianna Queiroz, Bethina Canaroli Sbardellini
MedNEXT Journal of Medical and Health Sciences, Volume 2, pp 31-34; https://doi.org/10.34256/mdnt2116

Abstract:
COVID-19 disease is associated with a high inflammatory load that can induce vascular inflammation, myocarditis, and cardiac arrhythmias. Mortality from COVID-19 disease in 2019 is strongly associated with cardiovascular disease, diabetes, and hypertension. These disorders share the underlying pathophysiology related to the renin-angiotensin system (SARS). Cardiovascular disease and SARS pharmacological inhibition increase ACE2 levels, which can increase coronavirus virulence in the lung and heart. On the other hand, there is evidence that coronavirus infection can decrease ACE2, leading to toxic over-accumulation of angiotensin II, which induces acute respiratory distress syndrome and fulminant myocarditis. In addition, there is scientific evidence that SARS-CoV-2 can bind chemically to the heme group of hemoglobin and thus cause the release of iron ions (Fe2+ and Fe3+) that can damage tissues, including the lungs and heart. Another important information is that the heme group is produced by mitochondria and, in this case, the oral or intramuscular use of Coenzyme Q10 (ubiquinone) is strongly recommended, as it stimulates the increase in mitochondrial production. Therefore, the use of chelators of iron ions is notorious, as well as the administration of Coenzyme Q10 as a treatment for patients infected with SARS-CoV-2.
Sule Mb, Sa’Idu Sa, Ma’Aji Sm, Danfulani M, Yunusa Gh, Umar Au, Gele Ih
MedNEXT Journal of Medical and Health Sciences, Volume 2, pp 1-5; https://doi.org/10.34256/mdnt2111

Abstract:
Unicornuate uterus is a form of uterine anomalies which arise from failure of development and fusion of the Mullerian ducts, and accounts for about 2.4-13% of all Mullerian anomalies. This is a 30-year-old housewife referred for hysterosalpingography (HSG) on account of secondary infertility. The patient also had history of recurrent abortion in the first trimester. The HSG showed an ellipsoidal or Banana shaped uterus in the left lateral pelvic cavity with prominent left fallopian tube that showed peri-fimbrial spillage of contrast medium with non-demonstration of a communicating rudimentary horn. She also had a pelvic ultrasound that showed an empty uterus with a right hypoechoic solid area most likely the right rudimentary horn. We report the radiologic features of Unicornuate uterus due to its rare nature and peculiar presentation
Ana Luísa Arantes Pagano, Gabriela Bueno Araújo, Gabriela Spolon Freitas, Rafaela Garcia Lopes, Raquel Gouveia Azevedo, Roberta Dermínio Borges, Ana Valéria Garcia Ramirez, , Durval Ribas Filho
MedNEXT Journal of Medical and Health Sciences, Volume 2, pp 66-72; https://doi.org/10.34256/mdnt21112

Abstract:
Introduction: The concept of body image is defined as the subjective image about the forms and characteristics of the body itself, which integrates physical, mental, and emotional levels about this perception. Excessive concern with weight and body shape and the divinization of exaggerated thinness can lead to eating disorders, which are characterized as psychiatric diseases defined by changes in eating behavior, which mainly affects women, being a source of physical and psychological damage. One of the most common disorders is anorexia nervosa (AN). Objective: To analyze the body perception and anorexic behavior of students at a medical school in the interior of São Paulo. Methods: This is an observational, qualitative study to assess the body perception and anorexic behavior of university students at a medical school in the city of Catanduva-SP. The sample consisted of 141 students. To assess the perception of body image, the Kakeshita silhouette scale, and a visual analog scale were used. For the evaluation of the subjective component of the body image, a virtual questionnaire was applied by Google Forms on the evaluated components. The assessment of nutritional status considered the classification of the body mass index and the EAT-26 test. For statistical analysis, the Wilcoxon non-parametric test was used. Results: The students had an average age of 21.34 years ± 2.2 and an average height of 1.64 meters. The average of the real Body Mass Index (BMI) was 22.08 Kg/m², the perception of BMI was 26.40 Kg/m² and the desired BMI was 22.93 Kg/m², the last two being different statistically from the first. As for EAT-26, 73 students obtained a score greater than or equal to 21, which is considered a risky behavior for the development of AN. Conclusion: Most students have an altered perception of their body image since the perception of BMI is higher than the real BMI. In addition, it was noted, from the positive EAT-26, the existence of a high-risk behavior index for anorexia nervosa in the women in the sample. Thus, it is necessary to investigate the causes of the divergence between reality and looking at oneself in order to prevent such changes from becoming eating disorders.
Olavo Ferreira Lopes Anjo, Otávio Barcelos Domingues, Yuri Belinelli Bono Macedo, Gustavo Pataro, Floriano Alteia Costa, Mateus Calori De Sousa, Durval Ribas Filho, Ana Valéria Garcia Ramirez,
MedNEXT Journal of Medical and Health Sciences, Volume 2, pp 53-58; https://doi.org/10.34256/mdnt21110

Abstract:
Magnesium is an important nutrient for the organism present in several enzymatic reactions. The reduced daily intake of this mineral (below 310 to 320 mg, for women, and 400 to 420 mg, for men) is associated with several chronic diseases. Thus, based on the hypothesis that medical students have a deficient intake of the mineral, this study sought to examine the intake of macronutrients by medical students at a college in the northwest of São Paulo and their thinking about the importance of the presence of the mineral of the diet. This research is a cross-sectional quali-quantitative study. The data used were obtained through a virtual questionnaire that contained several questions to identify gender, the notion of the importance of correct magnesium intake and the frequency of food consumption. The questionnaire was made available to academics between July and August 2020. The responses to the questionnaire were validated only after acceptance of the informed consent form. Thus, 147 responses were validated, with 92 responses from women and 55 from men. Then, from the amounts of magnesium present in food and the minimum and maximum frequencies of magnesium intake by students, the minimum (male 133.2 mg and female 128.5 mg) and maximum (male 232, 8 and female 229.5) of the daily magnesium intake by the students analyzed and their respective standard deviations, using these data, the Figure of the normal distribution for each type of daily average intake was plotted. Also, an opinion was obtained about the importance of magnesium intake on a scale of 1 to 5 (1 being irrelevant and 5 essential) and, from these data, it was observed that those who considered magnesium intake to be irrelevant (3 responses) presented a minimum and a maximum average (57.03 mg / day and 149.4 mg/day, respectively) of daily mineral intake below the 64 that considered it essential (140.06 mg/day and 238 mg / day) day, respectively). Finally, it is noted that the consumption of both sexes of the interviewees is close and both the maximum mean daily magnesium intake resides below the recommended amounts for daily consumption - mainly individuals of the sex but culino, who have a recommended intake value higher daily dose (400 to 420 mg/day) than females (300 to 310 mg). Thus, this data supports the initial hypothesis of the existence of a deficient daily consumption of magnesium by medical students, also, it can be related to a lower importance attributed to the presence of magnesium in the diet to a lower average daily intake.
Cibele Alexandra Ferro, Manuela Guedes Pereira, Maria Júlia Busnardo Aguena, Vítor Afonso Favaretto, , Ana Valéria Garcia Ramirez, Durval Ribas Filho
MedNEXT Journal of Medical and Health Sciences, Volume 2, pp 73-79; https://doi.org/10.34256/mdnt21113

Abstract:
Introduction: According to data provided by the World Health Organization (WHO), 5,941,223 confirmed cases and 366,601 deaths had already been reported by May 31, 2020. Higher rates of infection, hospitalization, submission to the Intensive Care Units, and fatalities were attributed to obese patients. Objective: To gather the available data on obesity and SARS-CoV-2 infection. The study specifically covers combined pathophysiology and prognosis and will be updated until September 2020. Methods: This is a literature review study with a narrative-descriptive approach. The search was carried out in September 2020, with the totality of articles from that same year, when the pandemic of the new coronavirus was declared by the World Health Organization. Results: The search on the data platform resulted in 121 articles, of which 86 were classified as reviews and 35, systematic reviews, totaling 18 reviews and 7 systematic reviews at the end, with a total value of 16 articles with sufficient quality. Obesity is associated with increased severity of COVID-19 in the infected individual with this disease, due to the chronic inflammatory process, with high levels of pro-inflammatory leptin and a lower concentration of anti-inflammatory adiponectin, which causes a response delayed and inferior immune system. Conclusion: Individuals with this association have an easier time in the formation of possible clots, due to chronic inflammation and impaired fibrinolysis, which qualifies them as individuals of significant thrombogenic risk. Thus, individuals with obesity are an important risk group when considering its association with the disease of the new coronavirus.
Gislaine Cristina Dos Santos Silva Souza, , Elias Naim Kassis, Postgraduate In Dentistry Post Graduate And Continuing Education (Unipos)
MedNEXT Journal of Medical and Health Sciences, Volume 2, pp 13-18; https://doi.org/10.34256/mdnt2113

Abstract:
Introduction: In recent years, mesenchymal stem cells derived from dental tissue have gained popularity for applications in tissue engineering and regenerative medicine. Objective: To present the main considerations about stem cells of primary teeth, as well as the importance of their clinical application. Methods: Experimental and clinical studies were included (case reports, retrospective, prospective and randomized studies), following the rules of systematic review-PRISMA. The search strategy was performed on Medline / Pubmed, Web Of Science, ScienceDirect Journals (Elsevier), Cochrane Library, Harvard Library, Scopus, and OneFile (Gale). Major findings and Conclusion: Dental pulp stem cells from primary teeth have very promising properties and potential for bone TE; however, based on these findings and the well-known restrictions in stem cell research, it may be beneficial to at least standardize the methods currently used in animal models based on the bone defect to heal, in order to achieve a higher level of reliability results, enabling safe clinical use.
Matheus Marquez Cruvinel Santos, Flávio Barros Da Silva, , Elias Naim Kassis
MedNEXT Journal of Medical and Health Sciences, Volume 2, pp 24-30; https://doi.org/10.34256/mdnt2115

Abstract:
The most common bone disorder found by implant dentists is osteoporosis, which is a systemic skeletal disorder associated with aging, which is characterized by loss of bone mass, making bones fragile and more susceptible to fractures. The World Health Organisation has defined osteoporosis as a bone mineral density level greater than 2.5 standard deviations below the mean of young normal women. After 60 years of age, a third of the population have this disorder, it occurs twice as often in women than in men. It is estimated that 1.3 million fractures and 133,000 all hip fractures occur every year as a result of osteoporosis. This study aimed to discuss aspects of the pharmacological action of Bisphosphonates (BP) and their influence on the bone tissue when associated with treatment with dental implants. There are several types of treatments that prevent or prevent the progression of osteoporosis. So, BP, such as alendronate, are inhibitors of bone resorption. Act as controlling the development of osteoporosis by increasing the process of bone density and decrease its reabsorption, often acting as supporting the process of osseointegration of dental implants.
Caroline Araújo Gonçalves, Base Hospital Of Sao Jose Do Rio Preto/sp Dermatology Service, Carlos Roberto Antônio, Idiberto José Zotarelli-Filho, Sao Jose Do Rio Preto Zotarelli-Filho Scientific Work
MedNEXT Journal of Medical and Health Sciences, Volume 2, pp 6-12; https://doi.org/10.34256/mdnt2112

Abstract:
Introduction: Breast cancer is the most frequently detected cancer in women worldwide, its metastasis is responsible for 90% of deaths. Breast carcinoma is the most common cancer in women worldwide and the most common cause of deaths associated with malignancies. Hyaluronic acid (HA) is the main molecule binding to CD44 and has proved to be a significant ally in the development of nanotransporters that demonstrate preferential accumulation of tumors and increased cellular uptake. Objective: Carry out a systematic review of the main treatments to reduce or prevent the proliferation of breast cancer. Methods: A total of 59 articles have found and after the selection process 20 articles have included and discussed in this study. PUBMED, EMBASE, OVID, AND COCHRANE LIBRARY databases were searched. Results: cationic liposomes containing the conjugate hyaluronic acid-dioleoylphosphatidylethanolamine (HA-DOPE) mediated good transfection in cell lines that express CD44 in culture. Still, other results suggested that the formulation of lapatinib (LPT) coated with HA increases the activity of LPT against triple-negative breast cancer. In addition, compared to free doxorubicin (DOX), superior in vivo antitumor efficacy of modified carbon spots (HA HA-CD) and (p-CBA-DOX) was observed in heterotopic and orthotopic 4T1 cell tumor models. In addition, hematological and biochemical analysis of blood showed that HA-CD and p-CBA-DOX did not induce noticeable toxicity, which further confirmed the good biocompatibility of HA-CD and p-CBA-DOX. Also, it was found that CD44v expression can negatively influence HA uptake and, instead, when cells expressed mainly CD44s, a positive correlation between expression and uptake was observed. Other findings point to the potential clinical utility of recombinant human proteoglycan 4 (rhPRG4) as a therapeutic treatment for invasive and metastatic breast cancer. Conclusion: The development of nanopharmaceuticals delivery systems are able to control the development of tumors and represent a promising strategy to overcome issues related to the non-specific effects of conventional anticancer therapies.
Sâmara Fernandes Santos Martins, Juliany Medeiros Santos, Bianca Caroline Alvim Tomaz, Jaques Waisberg,
MedNEXT Journal of Medical and Health Sciences, Volume 2, pp 48-52; https://doi.org/10.34256/mdnt2119

Abstract:
Background: Granular Cell Tumors (GCT) are rare benign neoplasms with an estimated prevalence of 0,4% in retrospective series. About 8% of GCT are located in the gastrointestinal tract, having the esophagus as the main affected area. Malignancy was reported in 2-4% of cases and there are no well established treatment protocols. Case summary: It was present an oligo-symptomatic female patient with diagnosis of GCT presented on the endoscopy. Complementary investigation was based on endoscopic ultrasound (EUS). The treatment consisted of mucosectomy and endoscopic variceal ligation, evolving with a favorable outcome. Conclusion: Despite disagreement on protocols for treatment of GCT, mucosectomy appears to be an effective option.
Sara Cordoni, Yagnaseni Bhattacharya, Vamsidhar Vallamkondu, Kim W Ah-See, Muhammad Shakeel
MedNEXT Journal of Medical and Health Sciences, Volume 2, pp 42-47; https://doi.org/10.34256/mdnt2118

Abstract:
Introduction: Parotidectomy carries a risk of postoperative complications including facial nerve palsy and Frey’s syndrome. Less attention, however, has been given to the management of the greater auricular nerve (GAN) during parotidectomy. Providing sensory supply to the auricle, the greater auricular nerve is often sacrificed for access to the parotid gland during surgery. This results in anaesthesia and paraesthesia of the ear lobe and significant patient morbidity. Aim: To review the electronically available documentation of post-parotidectomy ear lobe numbness in our follow-up clinic letters of the past 20 years. Methods: For this retrospective case series our departmental database of over 850 patients undergoing parotidectomy was used as the primary data source. The information collected from electronic records included documentation of intraoperative details, post-operative recovery and incidence of ear lobe numbness post-operatively. The current study was completed between October and November 2020. SPSS and Excel were used for data collection and analysis. Results: The incidence of ear lobe numbness was found to be higher in the patient cohort whose posterior branch of the GAN had been sacrificed during surgery (58% compared to 46%). This agrees with the published literature that preservation of the posterior branch of the GAN decreases the post-operative sensory deficit to the auricle. However, this audit was limited by the incomplete recording of GAN sacrifice intra-operatively and post-operative GAN dysfunction. Discussion: As any tissue removed, added or altered in surgery requires accurate record-keeping, the outcome of the greater auricular nerve during parotidectomy should always be included in the operation notes. A proforma made available within the department may allow for a standardised recording of recognised complications.
Louise Mcmurran, Usman Rasul, Seok Jun Jeong, Vamsidhar Vallamkondu, Muhammad Shakeel
MedNEXT Journal of Medical and Health Sciences, Volume 1, pp 24-28; https://doi.org/10.34256/mdnt2015

Abstract:
A 73-year-old Chinese origin woman presented with a right neck swelling associated with recent swallowing issues and hoarseness. She had an apparent goitre and a right posterior neck swelling. An ultrasound guided fine needle aspiration demonstrated papillary thyroid carcinoma in both thyroid lobes and right neck lymphadenopathy. While awaiting total thyroidectomy and neck dissection she presented with haemoptysis. She was found to have an exophytic mass in right pyriform fossa. The CT scan confirmed an intralaryngeal extension of the thyroid mass via thyroid cartilage and metastatic disease in the lung. Unexpectedly histology showed that the tissue from the right pyriform fossa was squamous cell carcinoma and papillary carcinoma in the thyroid was confirmed. She had synchronous cancers in the thyroid and hypopharynx. Synchronous tumours are a big challenge to diagnose and to treat. In her case the CT scan was misleading. We discuss this unusual presentation of synchronous head and neck cancers and difficulty in managing them.
Mohammad Hasan, Leanne Duff, Sara Katharine Drever, Andrea Chapman, Muhammad Shakeel
MedNEXT Journal of Medical and Health Sciences, Volume 1, pp 19-23; https://doi.org/10.34256/mdnt2014

Abstract:
Testicular tumours are one of the most prevalent cancers in young males. Teratoma is one type of testicular tumour, which carries a good prognosis if treated appropriately. We describe a case of a 37 year old man, diagnosed with testicular non-seminomatous germ cell tumour in 2005. He underwent left orchidectomy and radical chemotherapy with Bleomycin, Etoposide and Cisplatin. He had involved retroperitoneal lymph nodes at the time of diagnosis and underwent retroperitoneal lymphadenectomy in 2007. He made a good recovery but presented with a left neck lump in 2009, the appearance of which suggested differentiated teratoma on fine needle aspiration cytology. The neck lump was excised without any complications and histology confirmed the mass to be mature teratoma with no undifferentiated elements. He has remained disease free since then and remains under oncological surveillance, in keeping with current protocols.
Rodolfo De Souza Melo, Mariana Tolentino Chaves, Renan De Souza Melo,
MedNEXT Journal of Medical and Health Sciences, Volume 1, pp 29-34; https://doi.org/10.34256/mdnt2016

Abstract:
Objective: To carry out an epidemiological analysis characterizing the type and location of the injury, severity based on recovery time, game position, and injury for hours of exposure. Methods: Data collection was carried out in the sub 15, sub 17, and sub 20 categories and verified records made by the medical team of the club, which was trained to use the F-MARC form (a form of the medical research center of the International Football Federation - FIFA) at the beginning of the season. To perform the data analysis, the GraphPad Prism software was used. All variables were analyzed using the Kolmogorov-Smirnov test. Results: In relation to the 129 athletes monitored during the season, 62 athletes presented some injury during the season, presenting 42.2 injuries for every 1000 hours of play, the Sub 15 category was the one with the highest incidence of injury, followed by the Sub17 and U20. The average time of leave after injury was 3.65 ± 4.2 weeks, the Defenders were the ones with the highest injury rate. There were 27 articular injuries (43.54%), 25 muscle injuries (40.32%), 9 bone injuries (15.41%), and one pathological injury (1.61%), and the most affected regions were ankle and knee. Conclusion: It is concluded that the moment of the game is the moment when the greatest number of injuries occurs, having a greater incidence in the athletes of the category Sub 15, the Defenders suffered more injuries and the Lower Limbs were more affected, mainly by articular traumas.
Fergus Cooper, Hassan Baig, Panagiotis Asimakopoulos, Kim W Ah-See, Muhammad Shakeel
MedNEXT Journal of Medical and Health Sciences, Volume 1, pp 15-18; https://doi.org/10.34256/mdnt2013

Abstract:
The patients suspected to have cancer in the head and neck region including pharynx and larynx undergo biopsy of the suspicious lesion under general anaesthetic. This is a long established practice but lately, biopsy of such lesions under local anaesthetic in the outpatient setting is promoted. During the current COVID-19 pandemic our access to operating theatre is significantly reduced. We have, therefore, modified our practice to allow us to carry out such biopsies under local anaesthetic in the outpatient setting. We share our experience with 20 patients who successfully underwent this procedure. The patients reported no side effects and were happy to avoid undergoing a general anaesthetic and its associated risks. We would encourage colleagues in other units to consider this option when dealing with such patients.
Usa Retired Professor
MedNEXT Journal of Medical and Health Sciences, Volume 1, pp 1-7; https://doi.org/10.34256/mdnt2011

Abstract:
COVID-19 coronavirus infection, despite its high contagiousness and rapid spread, is not accompanied by the development of the disease in most infected people. The main cause of clinical manifestations of this infection is inflammation of the lung tissue, which affects the same parts of the organ as bacterial forms of pneumonia, accompanied by identical functional disorders. Functional disorders are caused by inflammatory transformation of tissues, not by the pathogen itself, and are manifested not so much in lung ventilation as in the effect through the pulmonary vessels on the blood circulation of the entire body. Most patients actually cope with the disease on their own, as there are no effective treatment methods yet. However, when the disease has a rapid and progressive course, pathogenetic methods are needed to really help patients, which can help the body adapt and avoid critical situations.
Ana Luiza Vaqueiro Ramos, Anna Julia Coutinho, Anna Julia Lemos De Moura, Bárbara Beatriz Michelini, Daniel Martinez, Natalia SanMiguel, Idiberto Jose Zotarelli-Filho, Ana Valéria Garcia Ramirez, Durval Ribas Filho
MedNEXT Journal of Medical and Health Sciences, Volume 1, pp 8-14; https://doi.org/10.34256/mdnt2012

Abstract:
Chronobiology is the process that studies the biological rhythms of living beings, in which each organism has its own biological clock. Sleep is a state of unconsciousness, characterized by the active inhibitory process, and that has an important relationship with feeding, mainly due to the possibility of sleep privation increasing starvation through hormonal regulation. In addition, starvation can lead to obesity, contributing to the risk factors for chronic non-communicable diseases, such as high blood pressure, hypercholesterolemia, diabetes mellitus, cardiovascular diseases, and some forms of cancer. The cycle of bad sleep may cause direct health problems, such as the diseases mentioned above; and indirect, may result in traffic accidents, unemployment, and difficulties in interpersonal relationships, with the possibility of progressing to anxiety disorders. This study aims to analyze whether there is a relationship between healthy eating and the standard of sleep quality, providing better performance of daily activities. For this study, the 133 participants answered 3 feeding records and, later, questionnaires on sleep quality (Pittsburgh Sleep Quality Index) in three moments. Considering the three questionnaires, there were no significant differences obtained by calculating the statistical tests, however, the analysis of the gross medians with the proposed score showed a strict relationship between sleep and food. In addition to the relationship between food and sleep quality, other factors such as stress and anxiety can contribute to hormonal dysregulation, thus changing the pattern of sleep quality of individuals.
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