MedNEXT Journal of Medical and Health Sciences
Latest articles in this journal
MedNEXT Journal of Medical and Health Sciences pp 77-79; doi:10.34256/mdnt21312
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.
MedNEXT Journal of Medical and Health Sciences pp 69-76; doi:10.34256/mdnt21311
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.
MedNEXT Journal of Medical and Health Sciences pp 63-68; doi:10.34256/mdnt21310
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.
MedNEXT Journal of Medical and Health Sciences pp 56-62; doi:10.34256/mdnt2139
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.
MedNEXT Journal of Medical and Health Sciences pp 26-31; doi:10.34256/mdnt2135
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.
MedNEXT Journal of Medical and Health Sciences pp 42-49; doi:10.34256/mdnt2137
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.
MedNEXT Journal of Medical and Health Sciences pp 50-55; doi:10.34256/mdnt2138
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.
MedNEXT Journal of Medical and Health Sciences pp 20-25; doi:10.34256/mdnt2134
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.
MedNEXT Journal of Medical and Health Sciences pp 32-41; doi:10.34256/mdnt2136
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.
MedNEXT Journal of Medical and Health Sciences pp 6-12; doi:10.34256/mdnt2132
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.