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  • 1
    In: EPRA International Journal of Multidisciplinary Research (IJMR), EPRA JOURNALS
    Abstract: Introduction: Hiatal hernia (HH) occurs frequently in the population, characterized by various non-specific symptoms, however most of these symptoms are found to be related to gastroesophageal reflux disease. A hiatal hernia is said to be a medical condition in which the upper portion of the stomach or other internal organ protrudes through an opening in the diaphragm. Objective: to detail current information related to hiatal hernia, description, etiology, classification, diagnosis, differential, prognosis, management and complications. Methodology: a total of 38 articles were analyzed in this review, including review and original articles, as well as clinical cases, of which 27 bibliographies were used because the other articles were not relevant for this study. The sources of information were PubMed, Google Scholar and Cochrane; the terms used to search for information in Spanish, Portuguese and English were: hiatal hernia, hiatal repair, diagnosis, management. Results: The incidence of symptomatic cases of hiatal hernia is related to the diagnosis of gastroesophageal reflux disease (GERD). The incidence of hiatal hernias increases with age. About 55%-60% of individuals over 50 years of age have a hiatal hernia. However, approximately 9% have symptoms and it depends on the type and competence of the lower esophageal sphincter (LES). The largest percentage of these hernias are type I sliding hiatal hernias. Type II, paraesophageal hernias, represent approximately 5% of hiatal hernias in which the LES remains stationary, with the stomach protruding superiorly to the diaphragm. There is also a high prevalence in women, attributable to increased intra-abdominal pressure during pregnancy. The estimated overall 30-day mortality rate in relation to antireflux surgery is approximately 0.19%. Conclusions: Hiatal hernia (HH) is relatively common in the general population. It is caused by increased intra-abdominal pressure, leading to protrusion of the stomach and other abdominal viscera into the mediastinum. Hiatal hernias can be congenital or acquired. The current anatomical classification of hiatal hernias consists of four types or categories, each with its different characteristics. Diagnosis of hiatal hernia can be challenging because of the change in the anatomy of the esophagogastric junction on swallowing, breathing and movement. The pre-surgical study of the individual supports the diagnosis and the exclusion of other pathologic entities to properly direct the surgical intervention. The success of hiatal hernia surgery can be measured by the improvement of symptoms, such as esophageal acid exposure, complications and the requirement for reoperation. Complications of surgery are usually mild and are not directly linked to the surgery itself. KEY WORDS: surgery, hernia, hiatus, diagnosis, management.
    Type of Medium: Online Resource
    ISSN: 2455-3662
    Language: Unknown
    Publisher: EPRA JOURNALS
    Publication Date: 2023
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  • 2
    In: EPRA International Journal of Multidisciplinary Research (IJMR), EPRA JOURNALS
    Abstract: Acne is the most traumatic and globally annoying chronic inflammatory skin disease. Its prevalence is highest among patients aged 12-24 years, at a frequency of 85%, although it can persist into adulthood, despite treatment. Its effect involves emotional and physical aspects (presence of marks), in addition to its effect on quality of life. Its clinical presentation ranges from the presence of comedones to mixed comedogenic acne with inflammation (1)(2). The face is the most affected area in most cases, and the trunk is affected in 61% of patients. The lesions caused by this can range from scarring to the presence of post-inflammatory hyperpigmentation. Stimulation of the immune system by hypercolonisation of Propionibacterium acnes is thought to be the possible cause (3). The aim of this literature review is to communicate to the scientific community the different measures and treatments for this disease, which, as will be analysed, has not only personal impacts, but also psychological and social implications. In fact, this work is based on a dissemination of studies and reviews from 5 years ago, which means that we have all the most up-to-date information possible on this subject. KEYWORDS: Acne, scars, benzoyl peroxide, comedones, sebaceous glands.
    Type of Medium: Online Resource
    ISSN: 2455-3662
    Language: Unknown
    Publisher: EPRA JOURNALS
    Publication Date: 2022
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  • 3
    In: EPRA International Journal of Multidisciplinary Research (IJMR), EPRA JOURNALS
    Abstract: Introduction: A cerebrovascular event is a pathology that affects brain tissue by an interruption of blood flow, which may result in irreversible injury. If there is spontaneous recovery of symptoms and no brain damage, it is called a transient ischaemic attack. Early diagnosis and treatment can reduce the likelihood of sequelae in stroke patients (1). Aim: The aim is to mention therapeutic novelties, both pharmacological and non-pharmacological, about stroke management, based on review articles and original articles from 2017 to the present. Methodology: This review was conducted by searching for information in Cochrane Library, Google Scholar, Science Direct and PubMed. The documents found were in Spanish and English. Some articles were excluded due to lack of relevance and not corresponding to the time needed. Results: For the initial approach to stroke, we have: acetylsalicylic acid, clopidogrel, statins and initiate thrombolysis or thrombectomy as soon as possible. Therapies such as carotid endarterectomy are vital to avoid recurrences. For the rehabilitation of patients with sequelae we have: speech and language therapy, mental practice, electromechanical trainings, mirror therapies, and above all the improvement of health services. Conclusions: Strokes need to be diagnosed early. Computed tomography or magnetic resonance imaging can help in diagnosis. There are pharmacological and non-pharmacological therapeutic alternatives. Pharmacological therapies are used in acute phases of stroke, while non-pharmacological therapies are more directed towards rehabilitation therapies. KEYWORDS: Stroke, Thrombolytic Therapy, Endarterectomy, Stroke Rehabilitation, Transient Ischaemic Attack.
    Type of Medium: Online Resource
    ISSN: 2455-3662
    Language: Unknown
    Publisher: EPRA JOURNALS
    Publication Date: 2022
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  • 4
    In: EPRA International Journal of Multidisciplinary Research (IJMR), EPRA JOURNALS
    Abstract: Introduction: Traumatic hip dislocation is an uncommon injury, approximately making up 2 to 5% of all dislocations generated by high-energy trauma. This type of dislocation can be pure or related to other injuries or alterations such as fracture of the femoral head, femoral neck or acetabulum. Objective: to detail the current information related to hip dislocation, anatomical description, epidemiology, mechanisms of action, classification, clinical presentation, imaging presentation, treatment, complications and dislocation after total hip replacement. Methodology: a total of 30 articles were analyzed in this review, including review and original articles, as well as clinical cases, of which 21 bibliographies were used because the other articles were not relevant to this study. The sources of information were PubMed, SciELO, Google Scholar and Cochrane; the terms used to search for information in Spanish, Portuguese and English were: hip dislocation, proximal femur, femoroacetabular dislocation, prosthetic dislocation. Results: Anterior dislocations account for 10% to 15% of traumatic hip dislocations, with the remainder being assigned to posterior dislocations. The incidence of osteonecrosis of the femoral head is between 2% to 17% of individuals, while 16% form post-traumatic osteoarthritis. The sciatic nerve is affected in about 10% to 20% of posterior dislocations. There is no correlation between early weight bearing and osteonecrosis. Dislocation of the total hip endoprosthesis is observed in about 2% of individuals within one year after surgery. There are dislocation rates of up to 28% following revision and implant exchange surgeries. Conclusions: The capsular ligaments of the hip joint (iliofemoral, ischiofemoral, and pubofemoral) act very importantly in the functional mobility and stability of the joint. Hip dislocations are caused by high-energy trauma, such as traffic accidents, which are becoming more common due to the increase of these. Posterior dislocations are more common compared to anterior hip dislocations. A complete and thorough trauma evaluation is important in the clinical assessment. Those with a posterior dislocation of the hip show marked pain and the hip in flexion, internal rotation and adduction. Those with an anterior dislocation remain with the hip in marked external rotation, slight flexion and abduction. The importance of an anteroposterior projection of the pelvis and a cross lateral projection of the injured hip is emphasized. Treatment may be closed or open reduction depending on the circumstances, clinical situation and associated injuries. Complications such as osteonecrosis may be associated with the time of evolution. The treatment of instability following total hip replacement should follow a standardized algorithm. KEY WORDS: dislocation, hip, femur, acetabulum, prosthesis.
    Type of Medium: Online Resource
    ISSN: 2455-3662
    Language: Unknown
    Publisher: EPRA JOURNALS
    Publication Date: 2023
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  • 5
    In: EPRA International Journal of Multidisciplinary Research (IJMR), EPRA JOURNALS
    Abstract: Introduction: Monkeypox or "Monkeypox" is a species of poxvirus, which possesses double-stranded DNA. This species has the potential to be used as bioterrorism; and currently has re-emerged in non-endemic countries. Objective: To detail the current information related to monkeypox and its epidemiological repercussions; in addition, to analyze the management and prevention of the contagion of this disease. Methodology: a search was carried out in PubMed, Elsevier and Google Scholar, with the terms Monkeypox, Ape Pox and Monkeypox. Some articles were rejected due to lack of relevance. Results: Monkeypox is transmitted by nasopharyngeal, oropharyngeal or intradermal routes; it has an incubation period of 5 to 21 days. Its diagnosis is made by laboratory tests such as PCR-RT and biopsy of skin lesions. Prevention is carried out with vaccines (especially the Ankara vaccine), which is 85% effective. Other drugs can be used in case of infection by this virus; however, their efficacy has not been determined so far. Currently, third generation vaccines are being developed. Conclusions: Monkeypox had its outbreak in the 1970s and re-emerged in 1990. In 2020, 5257 suspected patients were found. It has now been discovered in the United Kingdom, Israel, United States, Singapore, among others. Current management is symptomatic and prevention with vaccines. The administration of Tecovirimat and Brincidofovir have controversial efficacy. Vaccines have shown greater effectiveness. KEY WORDS: Monkeypox, orthopoxvirus, smallpox, Polymerase Chain Reaction, Poxviridae infections.
    Type of Medium: Online Resource
    ISSN: 2455-3662
    Language: Unknown
    Publisher: EPRA JOURNALS
    Publication Date: 2022
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  • 6
    In: EPRA International Journal of Multidisciplinary Research (IJMR), EPRA JOURNALS
    Abstract: INTRODUCTION: Quervains tenosynovitis is a condition involving tendon entrapment affecting the first dorsal compartment of the wrist, causing pain that increases with thumb movement and radial and ulnar deviation of the wrist. OBJECTIVE: To detail the current information related to Quervains tenosynovitis and its management, as well as to analyze the conservative and surgical treatment of this disease. METHODOLOGY: A total of 28 articles were analyzed in this review, including review and original articles, as well as clinical cases, of which 18 bibliographies were used because the other 10 articles were not relevant for this study. The sources of information were PubMed, Google Scholar and Elsevier; the terms used to search for information in Spanish and English were: Quervains Tenosynovitis, surgical quervains tenosynovitis. corticosteroids and quervain, non-surgical treatment tenosynovitis. RESULTS: The choice of preferred treatment is subject to the severity of the condition. Oral non-steroidal anti-inflammatory drugs accompanied by immobilization are a good option. Corticosteroid injections are effective for this tenosynovitis, leading to success 73.4% of the time with 2 injections. The use of ultrasound can improve the accuracy of the injections. Surgery is essential in cases that recur and are not relieved by conservative therapies over the course of 3 to 6 months. CONCLUSIONS: De Quervains tenosynovitis is a pathology based on inflammation of the tendon sheath of the abductor pollicis longus and extensor pollicis brevis in the first extensor compartment of the wrist. Its diagnosis is clinical with a positive Finkelsteins test. Non-surgical measures are preferred for its treatment. The use of splints and corticosteroid injections together provides more benefit than when used individually. And finally surgical treatment is effective and safe but is not without complications. KEY WORDS: Tenosynovitis, Quervains, inflammation
    Type of Medium: Online Resource
    ISSN: 2455-3662
    Language: Unknown
    Publisher: EPRA JOURNALS
    Publication Date: 2022
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  • 7
    In: EPRA International Journal of Multidisciplinary Research (IJMR), EPRA JOURNALS
    Abstract: Introduction: Guillain-Barre syndrome is an uncommon, yet potentially fatal, immune-mediated disease affecting peripheral nerves and nerve roots that is commonly generated by infections. Recent studies have shown a strong relationship between Guillain-Barre syndrome and SARS-CoV-2, making SARS-CoV-2 a potential trigger for GBS. Objective: to detail the current information related to Guillain-Barre syndrome, causes, epidemiology, immunopathogenic mechanisms, diagnosis, evaluation, differential and treatment. Methodology: a total of 42 articles were analyzed in this review, including review and original articles, as well as clinical cases, of which 33 bibliographies were used because the other articles were not relevant for this study. The sources of information were PubMed, Google Scholar and Cochrane; the terms used to search for information in Spanish, Portuguese and English were: Guillain-Barre, peripheral nerves, SARS-CoV-2, nerve roots, epidemics, inflammatory disease of the peripheral nervous system. Results: Approximately 70% of affected individuals show signs of previous illness 1 to 6 weeks before the debut of Guillain-Barre syndrome. GBS post influenza infection is up to 7 times more likely than post-vaccine GBS. The studies reviewed indicate a strong relationship between Guillain-Barre syndrome and SARS-CoV-2, the latter being a potential trigger for GBS. Cerebrospinal fluid (CSF) shows a classic pattern of albuminocytologic dissociation. Generally, most individuals affected with GBS present good prognosis, and about 85 % of those present independent ambulation with recovery; however, significant morbidity is present. Conclusions: Guillain-Barre syndrome can become difficult to diagnose and treat, as its clinical manifestations are heterogeneous. Treatment of GBS can be challenging during periods of infectious outbreaks, as seen in the Zika virus and SARS-CoV-2 epidemics. Since not all individuals affected by this syndrome are labeled as positive for antiganglioside antibodies, more quality research is needed to clarify the role of antiganglioside antibodies in Guillain-Barre syndrome as a secondary origin or phenomenon. In proportion to the evolution of scientific information and knowledge of Guillain-Barre syndrome, the diagnosis, management and prognosis are improving all the time. KEYWORDS: guillain-barre, GBS, neuropathy, immune-mediated, postinfectious.
    Type of Medium: Online Resource
    ISSN: 2455-3662
    Language: Unknown
    Publisher: EPRA JOURNALS
    Publication Date: 2023
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  • 8
    In: EPRA International Journal of Multidisciplinary Research (IJMR), EPRA JOURNALS
    Abstract: INTRODUCTION: IgG subclass deficiency was described by William Terry in a patient with recurrent infections. Selective IgG subclass is defined as a significant decrease in serum concentration of 1 or more IgG subclasses with normal total IgG, IgA and IgM levels. Persistent low serum levels of one or more immunoglobulin G (IgG) subclasses may be found in a high proportion of adult patients with increased susceptibility to infections (17). This deficiency has been described in association with other primary immunodeficiencies, including: selective IgA deficiency, selective IgM deficiency and Ataxia-Telangiectasia, growth hormone deficiency, Down syndrome, cystic fibrosis, among others (1). CLINICAL CASE:We present the clinical case of a 28-year-old female patient with a history of selective immunodeficiency to IgG immunoglobulin, repeated urinary tract infections, repeated vaginal infections and herpes simplex II infection, all of which have been treated, She went to a hospital in Morona Santiago three days ago for presenting, as the apparent cause, administration of immunoglobulin for a basic illness, a mild holocranial headache that evolved into a severe headache, accompanied by nausea that led to vomiting on one occasion, for which she was admitted to the hospital for pain management. Complementary examinations showed that there was no metabolic alteration or neurological deterioration, which is why she was classified as an adverse effect of the administration of immunoglobulin 3 days earlier. EVOLUTION:The patient was admitted for pain management due to severe headaches, multiple analgesics were administered without adequate response, so it was decided to start a tramadol infusion pump. During the following hours of hospitalization she remained with a feeling of nausea and weakness, however, the headache gradually subsided and it was decided to discontinue analgesic medication to assess the response of the clinical picture, and she was discharged 24 hours after admission with a favorable evolution. CONCLUSIONS: IgG subclass deficiency is a pathology characterized by the fact that it occurs in women over 16 years of age, with a very low prevalence; the presence of respiratory pathologies gives rise to the suspicion of this disease. The treatment of this pathology is based solely on the intravenous or subcutaneous administration of Immunoglobulin G, together with the concomitant treatment of the infections that the patient presents. Adverse effects should always be taken into account, as they are temporary, but quite disabling. KEYWORDS: Headache, Immunoglobulin G, Urinary Tract Infections, Herpes Simplex
    Type of Medium: Online Resource
    ISSN: 2455-3662
    Language: Unknown
    Publisher: EPRA JOURNALS
    Publication Date: 2022
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  • 9
    In: EPRA International Journal of Multidisciplinary Research (IJMR), EPRA JOURNALS
    Abstract: Introduction: Osteoarthrosis (OA), degenerative articular cartilage disease is a chronic inflammatory arthropathy involving joint elements (subchondral bone, synovial membrane, hyaline cartilage and others). It is due to a disorder in the regulation between degradation and synthesis of the extracellular matrix of cartilage, involving bone and synovial membrane in a biochemical process mediated by growth factors and cytokines which, in turn, intervene in the course of bone remodeling and joint destruction. Objective: to detail the current information related to osteoarthrosis, description, etiology, classification, imaging classification, management and current treatments. Methodology: a total of 52 articles were analyzed in this review, including review and original articles, as well as clinical cases, of which 38 bibliographies were used because the other articles were not relevant for this study. The sources of information were PubMed, Google Scholar and Cochrane; the terms used to search for information in Spanish, Portuguese and English were: arthrosis, osteoartrose, bones, osteoartrosis, articular cartilage. Results: The prevalence of osteoarthrosis increases directly with age 25-35 years 0.1 % 35-65 years 30 % and over 80 years 80-100 %. An improvement of pain and sensitivity is observed with local treatment with capsaicin. Paracetamol can be considered as the basic analgesic in the treatment of most chronic osteoarticular pain in doses of 1 gram four times/day. Opioids have an analgesic effect that almost completely eliminates all kinds of pain regardless of its intensity or site of affection. Short-term and long-term parenteral corticosteroid use is effective in controlling pain and stiffness. Systemic use of corticosteroids in OA is not warranted and only intra-articular injections are advised. Diacerein decreases IL 1Beta production in cartilage as well as nitric oxide levels by antagonizing the catabolic process and stimulates the anabolic process of cartilage. Chondroitin sulfate does not present a clinically relevant effect on joint pain or joint space reduction. Conclusions: osteoarthritis should be considered as a chronic, irreversible and progressive lesion. There are factors that aggravate its prognosis. Many measures are recommended to the patient and his family, especially if it is an elderly patient, in order to avoid the progression of joint damage. Surgical treatment is reserved for patients with severe pain or marked deformity, which occurs in advanced OA. Among the most frequently used procedures are: valgus osteotomy of the proximal tibia, arthroplasty, arthrodesis and amniotic membrane implantation. Bone tissue regenerative currents using tetracyclines that prevent the activation of metalloproteases, autologous chondrocyte implants, hypoxia inducible factor (HIF-1/2a), parathyroid hormone that stimulates chondrocyte multiplication and the use of in situ stem cells, cartilage regeneration and a better understanding of the developmental protein ancestor of osteogenesis, will be part of the medical management protocol, being a promising therapy for future therapy. KEY WORDS: Osteoarthrosis, osteoartrose, bones, osteoartrosis, articular cartilage.
    Type of Medium: Online Resource
    ISSN: 2455-3662
    Language: Unknown
    Publisher: EPRA JOURNALS
    Publication Date: 2023
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  • 10
    In: EPRA International Journal of Multidisciplinary Research (IJMR), EPRA JOURNALS
    Abstract: Introduction: Carpal tunnel syndrome (CTS), also called median wrist mononeuropathy, is the most frequent nerve compression syndrome reaching up to 90%. Objective: To detail the current information related to carpal tunnel syndrome and its management, as well as to analyze the conservative and surgical treatment of this disease. Methodology: A total of 27 articles were analyzed in this review, including review and original articles, as well as clinical cases, of which 18 bibliographies were used because the other 9 articles were not relevant to this study. The sources of information were PubMed, Google Scholar and Cochrane; the terms used to search for information in Spanish, Portuguese and English were: túnel carpiano, síndrome do túnel do carpo e AINEs, carpal tunnel syndrome, treatment in patients with carpal tunnel syndrome and corticoids in carpal tunnel. Results: Wrist flexion and extension increase pressure in the carpal canal, leading to the following symptoms: pain, numbness and paresthesia. Corticosteroid injections are recommended in mild to moderate carpal tunnel syndrome. Endoscopic carpal tunnel release has less postoperative pain, earlier recovery in grip and pinch strength, compared to open release. Postoperative complications are infrequent and most are minimal and transient. Conclusions: Carpal tunnel syndrome is the oppression of the median nerve at the level of the wrist joint, which may be accompanied with limitation in epineural and axoplasmic blood flow, leading to nerve dysfunction, edema, and scarring. The diagnosis of carpal tunnel syndrome has been made through a mixture of clinical history and physical examination maneuvers, however, the use of ultrasound and electrodiagnostic tests is now being supported. There are conservative and surgical treatments, among which evidence shows that steroid injection and carpal tunnel release are effective and present good treatment results. KEY WORDS: Syndrome, tunnel, carpal, mononeuropathy
    Type of Medium: Online Resource
    ISSN: 2455-3662
    Language: Unknown
    Publisher: EPRA JOURNALS
    Publication Date: 2022
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