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Ankylosis Due Sequel Of Fracture Of The Mandibular Condyle: Case Report

The Ankylosis of the Temporomandibular joint (TMJ) is a disorder of craniofacial complex that results in the merger between the condyle and the mandibular fossa, causing partial or complete immobilization of the mandible. The etiological factors are local and systemic inflammation, infection in the area of TMJ, rheumatic diseases and neoplasms, having the trauma as the main etiologic factor. The traumas are responsible for 31% to 98% of cases of ankylosis. The diagnosis is made from the anamnesis and imaging scans (computed tomography) pointing to the union of joint components. The treatment of ankylosis is a big challenge due the high rate of recurrence that can be affected by factors such as type of ankylosis, surgical technique, age of the patient, post-operative physiotherapy and systematic follow-up of the patient. The various forms of treatment require careful analysis of type of ankylosis if it is intra or extra-articular, unilateral or bilateral and if it is bony or fibrous, There is no consensus in current literature regarding the best treatment. The aim of this work is to present through the report of a clinical case, a surgical treatment of Unilateral Temporomandibular joint Ankylosis, due to sequel of condylar fracture with re-establishment of the stomatognathic functions in postoperative follow-up.

from International Archives of Medicine
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Endometrial osseous metaplasia: Presentation of two rare cases related with infertility, and their hysteroscopic approaching

Objective: To present two cases of patients diagnosed of endometrial osseous metaplasia related with infertility and their hysteroscopic approaching.

Design: Case report.

Setting: Two clinical cases diagnosed and treated at Institutional University Hospital. Patients: Two premenopasual women diagnosed and treated in our Center.

Interventions: Transvaginal ultrasound scan, diagnostic hysteroscopy and hysteroscopic removal of bone fragments. Main Outcome Measures: Ultrasound scan during further clinical follow up.

Results: Both patients underwent a diagnostic hysteroscopy, and removal of all the bone fragments with total resolution of their pathology.

Conclusions: Endometrial osseous metaplasia is a rare pathology that should be suspected in patients with a history of secondary infertility, several miscarriages and curettages, that present with an ultrasound image compatible with an intrauterine device. Hysteroscopic approach is the best diagnostic and therapeutic option.

 

Key words: Endometrial osseous metaplasia, bony intrauterine tissue, miscarriage, infertility, hysteroscopy, unadverted intrauterine device.

from International Archives of Medicine
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Use Of Mandibular Advancement Devices For Obstructive Sleep Apnoea Treatment In Adults

ABSTRACT

Introduction: This article is based on Clinical Guidelines for obstructive sleep apnoea (OSA) established by a taskforce coordinated by the Brazilian Sleep Association.

Objective: The aim of this article is to evaluate the available scientific evidence regarding the efficacy, adherence and safety of using mandibular advancement devices (MAD) as a therapeutic course for treating obstructive sleep apnoea in adult patients.

Method: Active searches were performed in the PubMed/MEDLINE, EMBASE, Scielo/LILACS and Cochrane Library databases.  Methodological aspects were used to rank the levels of evidence according to the criteria of the Centre for Evidence-Based Medicine at Oxford.

Results: Mandibular advancement devices offer the best results for patients with primary snoring, upper airway resistance syndrome and mild or moderate OSA (Levels of Evidence I and II).  Patients seem to exhibit greater adherence to oral appliances (MAD) than to continuous positive airway pressure (CPAP) devices, although the latter are more effective in controlling OSA (Level of Evidence I).  The long-term side effects most observed after the use of MADs are related to changes in the mandibular and dental positions (Levels of Evidence I and II).

 

Conclusion: MAD constitute a therapeutic alternative for OSA and promote favourable results with good efficacy and adherence to treatment.  Side effects can arise in the short, medium or long term.  Patients must be informed about the possible occurrence of these adverse effects, and the orthodontist must be able to manage any side effects that occur due to the use of these devices.

from International Archives of Medicine
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Adrenal Myelolipoma Diagnosed in a 72-Year-Old Patient with Abdominal Pain

BACKGROUND: Adrenal myelolipoma is a rare benign tumor formed by hematopoietic tissue and mature adipose tissue. Usually is insidious and found occasionally on image exams, therefore is also called incidentaloma. Image studies and anatomopathological exam are important to define the diagnosis of adrenal myelolipoma. This study’s objective was to report the case of this rare adrenal tumor and its main diagnostic means.

CASE: It was report case about a 72-year-old patient, whose initial symptom was diffuse abdominal pain, nausea and vomiting, diagnosed with adrenal myelolipoma after image studies even in the absence of laboratory abnormalities, and submitted at a private hospital at Belém-PA.

CONCLUSIONS: The adrenal myelolipoma, due its usual asymptomatic characteristics or its no-specifics symptoms, requires a meticulous analysis concerning both diagnosis and treatment. Thus, our case report corroborates the importance of the image studies in front of an obscure and difficult diagnosis, especially the computed tomography, and anatomopathological evaluation, since they are essential to the best decision making and consequently a better prognosis of the patient.

 

from International Archives of Medicine
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Quality Of Life Of Patients With Breast And Gynecological Cancer Faced With Anticancer Chemotherapy

Quality of life of patients with breast and gynecological cancer faced with anticancer chemotherapy

 Backgroud: the evaluation of quality of life in cancer patients is of interest to researchers due to its impact on health policies. The aim of this study was to assess the quality of life of patients with breast and gynecological cancer, undergoing chemotherapy.

 Methods and Findings: this was a quantitative, descriptive and longitudinal study, conducted in the Clinical Hospital of the Triangulo Mineiro Federal University. To assess the quality of life, the Portuguese brief version of the World Health Organization Quality of Life (WHOQOL-BREF) instrument was applied. The paired Student’s t-test was used for the analysis of the means of/ the scores of the domains. The study included 14 women. The lowest means were observed in the physical domain, 51.78±15.89 and 50.25±15.37, respectively before and after treatment. There was also a compromise of the psychological and environment domains, however, the data analyzed did not show statistical significance. The main limitation of this study is the sample size.

 Conclusion: quality of life presents itself as an important factor for the measurement of results in clinical studies.

Keywords: Quality of Life; Breast Neoplasms; Genital Neoplasms, Females; Chemotherapy.

from International Archives of Medicine
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Similarity Analysis About The Training Of Family Health Strategy Professionals For The Psychosocial Care Of The Elderly

Background: Elderly mental health is an important topic of discussion to Brazilian public health because it involves factors related to the training of health professionals focused on these demands in the Family Health Strategy.

Objectives: To make a similarity analysis about the training of the Family Health Strategy professionals for psychosocial care for the elderly.

Methodology: Qualitative research carried out with 31 professionals from the Family Health Strategy in the city of Picos, Piauí, Brazil. Data were collected through a semi-structured interview script. The interviews were performed in a reserved room and recorded with the aid of an MP4 player. The data were processed by the IRAMUTEQ software and analyzed through similarity analysis that is based on graph theory.

Results: The study participants were 13 doctors and 18 nurses, 27 (87.09%) were female. The training time of these professionals was comprised between 2 to 32 years of training and the duration of the Health Strategy from 1 year to 16 years. According to the co-occurrence tree, the data indicate that: the word “elderly” is at the heart of the ramifications and expresses how family and professionals can contribute to treatment; another demonstrated representation is that it is difficult for professionals to carry out their activities with the elderly due to lack of training in the specific area of ​​mental health.

Conclusion: the family plays a fundamental role in the elderly care with psychosocial needs and the professionals of the Family Health Strategy present difficulties to carry out comprehensive care due to deficiencies in their training.

Keywords: Mental health. Family Health. Elderly.

from International Archives of Medicine
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Complete Blood Count Interpretation: A Survey Of Health Professional In Brazil

Background: Complete blood count is one of the most ordered tests in clinical and surgical practice. However, it is important to know how to properly interpret it. The aim of this study was to measure the level of knowledge that health professionals have concerning the proper interpretation of the CBC test.

Methods and Findings: The article reports and analyzes the responses of questionnaires on the interpretation of CBC results applied in a sample of one hundred health professionals. A semi-structured tool was developed and composed of topics regarding sociodemographic data, a specific knowledge test on CBC, and a self-evaluation on the interpretation and the importance of the test. All participants scored less than 90% on the questionnaire, a result that was established as unsatisfactory regarding CBC interpretation. Only physicians and biomedical scientists showed suitable knowledge on the interpretation of hematological terms.

Conclusion: Despite the fact CBC is one of the main tests in clinical routine, our results showed deficits in knowledge on the theme by health professionals. Perhaps these results may help to reinforce the importance of multidisciplinarity and also highlight the deficiencies of training in the different professions studied.

from International Archives of Medicine
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Evaluation Of The Overload Of Care In Families Of Psychiatric Patients In Psychosocial Care Center

Introduction: The burden of care in family refers to the weight caused by the primary caregiver role to psychiatric patients and the difficulties encountered in performing this function in daily life.

Objectives: Assessing the objective and subjective overload of family members who live with the reality of psychiatric disorder in a child day-care psychosocial care center. Methods: Cross-sectional study, descriptive-exploratory, of quantitative approach, with non-probabilistic samples of accidental type with 80 families of psychiatric patients held in a Psychosocial Care Center. For overload evaluation, the subscales “B” and “D” of the Family Overload Rating Scale (FBIS-BR) were used.

Results: The study was conducted with 80 families of psychiatric patients. The average age of female caregivers was 39,6 years old, and 40,7 years old for male caregivers, with female predominance (87,5%) compared to men (12,5%), with low education for both genres. Family caregivers presented high objective burden due to excessive demand attention (p<0,001), heteroaggressiveness (p<0,001) and perplexing behavior of psychiatric patients regarding the supervision of problematic behaviors (p<0,001). The items on the impact on the family’s daily routine have not helped to generate objective overload for the family members. On subjective overload, it was clear to observe familiar members with high degree of disturbance in all the dimensions assessed (p < 0,001).

Conclusion: The high degree of care overload observed in family members indicates the need to develop contacts with the family of the psychiatric patient to answer questions, offer support and assistance to the family caregiver.

Keywords: Caregivers. Patients. Mental Health Services.

from International Archives of Medicine
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Leprosy: The Present Of A Disease From The Past

Introduction: Leprosy is one of the oldest and most stigmatizing diseases to affect mankind and is still considered a public health problem in many developing countries. 

Objective: To analyze how the social representations of leprosy patients are structured. 

Method: The purpose of this study was to analyze how the social consequences of leprosy affect people carrying the disease. A multi-method approach was used, based on the Theory of Social Representations. A total of 100 subjects participated in this study (50 males and 50 females). Data were analyzed using the following software: SPSS (to assess social, economic, and clinical aspects, EVOC, SIMI, and AVRIL (to integrate the structure of social consequences). 

Results: The central core for women was “family”. In the similitude test, this word was associated with “exclusion”. For men, the central core was composed of “family”, “work”, and “treatment”. 

Conclusions: The healthcare model must strive to take into account the day-to-day concerns of leprosy patients, with a view towards greater consideration of gender differences and the development of a more humanized care system based on full assistance in order to control this disease.

from International Archives of Medicine
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Nursing Practices In Intravenous Therapy In Newborns: An Integrative Review

Objective: to identify the evidence on nursing practices in intravenous therapy in newborns.

Method: integrative review in the PubMed, Scopus and SciELO databases. A total of 150 articles were selected, and after thorough reading, eight studies remained.

Results: Most of the studies were descriptive and cross-sectional (50%), using peripheral venous catheter (62.5%). The years varied between 2006 and 2014. Brazilian studies corresponded to 37.5%.

Conclusion: The main nursing practices were: use of saline solution for catheter clearing; use of larger caliber catheters; use of splints to support the limbs; adequate positioning of the upper limb during radiography for correct confirmation of the positioning of the tip of the peripherally inserted central catheter; management of pain with pharmacological and non-pharmacological actions. Descriptors: Nursing care; Newborn; Peripheral catheterization; Vascular access devices; Evidence-Based Clinical Practice.

from International Archives of Medicine
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