Journal of Advances in Medicine and Medical Research

The Management of Urological Emergencies During Pregnancy

2025-03-27T12:34:47+00:00

Urological emergencies during pregnancy, though rare, can pose significant risks to both maternal and fetal health. Because of changes in the body during pregnancy, conditions like urinary tract infections (UTIs), pyelonephritis, nephrolithiasis, hydronephrosis, and obstructive uropathy need to be carefully managed. This systematic review aims to evaluate the management strategies, diagnostic challenges, and clinical outcomes associated with urological emergencies in pregnant women. We analyze various diagnostic techniques, including ultrasound and MRI, as well as treatment options, with a focus on ensuring maternal and fetal safety. Our findings highlight the importance of a multidisciplinary approach and suggest recommendations for improving clinical practices in managing these emergencies. The review concludes with a call for standardized guidelines and further research into the long-term outcomes for both mother and fetus. In addition to the early intervention especially fetal minor invasive procedures would enhance its clinical relevance and impact.

Histological Response and Bone Neoformation of Bioceramic Cements in Rat Calvaria

2025-03-12T11:40:23+00:00

Aims: This study evaluated the level of inflammatory infiltrate, vasodilation, granulation tissue, and bone regeneration of two repair materials: White MTA (Angelus, Londrina, Brazil) and Bio-C Repair (Angelus, Londrina, Brazil) in rat calvaria.

Study Design: This is an in vivo study with a sample of adult Wistar rats, approximately three months old and weighing between 250 and 300 grams.

Place and Duration of Study: The selected analysis periods were 7, 30, and 60 days, corresponding to the following divisions: Group 1 (7 days): 5 rats; Group 2 (30 days): 5 rats; Group 3 (60 days): 5 rats.

Methodology: A total of 15 Wistar rats were divided into three groups (n=5) based on the euthanasia period (G7, G30, and G60 days). After sedation, two bone defects, approximately 1.5 mm in depth and 5 mm in diameter, were created in the calvaria of each animal. After euthanasia, the calvaria were removed, histologically prepared in 6 µm sections, and stained with hematoxylin-eosin (H/E). The material was quantitatively analyzed using the Statistical Package for the Social Sciences (SPSS), adopting a significance level of 5% (p < 0.05).

Results: At 7 days, both materials showed an acute inflammatory response. After 30 days, there was a reduction in the inflammatory process in both bioceramics cements. At 60 days, both White MTA and Bio C Repair did not induce severe inflammation. During this period, Bio C Repair showed greater bone tissue formation, with inflammatory infiltrate levels at 60 days being equivalent between the two materials.

Conclusion: Both bioceramics cements preserved the integrity of the bone tissue and stimulated bone neoformation.

High-speed Compressed Air Filtration Device: An Effective Alternative to Decrease Cross-contamination in Dental Care

2025-03-17T11:07:53+00:00

Aims: To develop and evaluate the effectiveness of a filtration device designed to decrease the microbial load in the air system of the dental chair.

Methodology: This experimental, laboratory-based, quantitative study involved the construction of a filtration device using modified high-speed handpieces, rubber gaskets, N95 mask filters, and welding. Sample collection was organized into four groups: Group A - Sterilized distilled water; Group B - High-speed handpiece with a closed water system and the filtration device; Group C - High-speed handpiece with a closed water system without the filtration device; and Group D – The filter from the filtration device after use. Samples were incubated at 37°C for 48 hours, quantified for microbial growth, Gram-stained, and analyzed microscopically. Data were analyzed using SPSS Statistics 25®, with nonparametric tests applied (Kruskal-Wallis and Dunn’s post hoc test) due to the non-normal data distribution (Shapiro-Wilk test, P < 0.05).

Results: No microbial growth was observed in Group A, confirming the sterility of the water. Group B, exhibited an average of 3.33±3.50 colony-forming units (CFU), representing a significant reduction (p<0.05) compared to Group C, which showed substantially higher contamination (32.11±188.36 CFU). The filter in Group D retained microorganisms, with an average growth of 3.00±6.00 CFU, confirming its role in microbial filtration.

Conclusion: The filtration device effectively reduced the microbial load in the dental chair's air system, demonstrating its effectiveness as a biosafety measure to minimize cross-contamination in dental environments. Its implementation can contribute to improving infection control, enhancing safety for both professionals and patients.

The Impact of Children's Oral Health on Families: The Role of Pain, Anxiety, and Socioeconomic Factors

2025-03-19T12:27:59+00:00

Aims: This study aimed to evaluate children's oral health-related quality of life (OHRQoL) and its impact on family life, considering factors such as anxiety, fear, stress, and dental caries.

Study Design: Cross-sectional study.

Place and Duration of Study: The study was carried out with children aged between 6 and 12 who came to the Pediatric Dentistry Clinic at the Federal University of Alfenas (UNIFAL-MG) between March and June 2024.

Methodology: To measure these variables, the Parent/Caregiver Perceptions Questionnaire (P-CPQ), the Family Impact Scale (FIS), the Jarman Socioeconomic Conditions Assessment Questionnaire, the Visual Analog Scale (VAS), and the deft/DMFT indices were used. Data were collected and tabulated in Excel and subsequently analyzed using JAMOVI software, version 2.3.

Results: When comparing the FIS scale with parental age (P=.04) and the occurrence of toothache in children (P=.03), a statistically significant association was found. However, when comparing the P-CPQ scale with variables such as age (P=.51) and toothache (P=.21), no association was observed. Analyzing family income (P=.69; P=.50), fear (P=.31; P=.11), anxiety (P=.57; P=.62), stress (P=.57; P=.66), caries severity (P=.33; P=.81), and child’s age (P=.82; P=.08), no significant association was found with either scale, P-CPQ and FIS, respectively.

Conclusion: When assessing OHRQoL, it was observed that there was a greater family impact when children experienced toothache and in families where parents were over 30 years old.

Perception of Doctors in Surgical Specialties about Fasting Guidelines for Day Case Surgeries in a Tertiary Hospital in South-South, Nigeria

2025-03-21T08:33:00+00:00

Background: Preoperative fasting is a prescribed period before a procedure, when patients are not allowed oral liquids and solids. It is an essential aspect of anaesthesia, as lack of practice is detrimental to the patient. This study was carried out to assess the perception of doctors in surgical specialties about fasting guidelines for day case surgeries.

Methods: Measurements were done using an electronic, self-administered questionnaire divided into three main sections; Demography (age, sex, gender, marital status); knowledge; and practice. Data was entered into SPSS 27 and analysed.

Results: The response rate to this study was 73%. Up to 90% were aware of the ASA published practice guidelines for preoperative fasting in healthy patients undergoing elective procedures, 50% described the correct practice guideline for adults and 60% for paediatric cases, but only 40% follow the guidelines for adults and 51% for paediatrics. The absence of standard hospital protocol and differing fasting instructions by surgical specialty residents and anaesthesia residents were the most common barriers for not complying with the guidelines.

Conclusion: Majority of the respondents were aware of the ASA fasting guidelines and up to half could describe it correctly, but the implementation and actual practice of these guidelines was poor among respondents.

Influence of Dentoalveolar Trauma and Orthodontic Forces on Dentin Pulp Complex: A Experimental Study in Rats

2025-03-21T10:58:07+00:00

Aims: The present study aims to analyze the amount of tooth movement and pulp conditions in teeth with dentoalveolar trauma history (extrusive luxation), when three types of orthodontic forces are applied.

Study Design: Experimental research.

Methodology: Wistar rats (n = 48) were divided into 8 groups (n = 6), having as variables the three different types of orthodontic forces: continuous (CF), interrupted continuous (ICF) and intermittent (IF), the presence or absence of trauma (PT or AT) and the presence or not orthodontic movement (WM or WOM). The groups were arranged as follows: ATCF, ATICF, ATIF, PTCF, PTICF, PTIF, PTWM and ATWOM (control group). Extrusive dislocation (ED) of the healthy upper right first molar was performed and after 15 days for periodontal reestablishment, the orthodontic springs were installed as devices to promote induced tooth movement and on the 14^th day after the first activation, the amount of tooth movement was measured, and euthanasia of the animals was performed for mounting the histological slides and histomorphometric evaluation. The variables were performed using the parametric analysis of variance (ANOVA) with Tukey’s post-test and Kruskal-Wallis test with Dunn’s post-test, depending on the characteristic of each variable. Differences were considered statistically significant at the 5% level (p<0.05). The variables analyzed were divided into 4 major groups: cellularity pattern, dystrophic alterations, hemodynamic alterations and dentin alterations. The data obtained were statistically examined by an appropriate test according to the characteristics of each variable.

Results: The results showed that there was a statistically significant difference in tooth movement for CF and ICF forces compared with IF (p <0.05). There was a lower amount of inflammatory infiltrate in the control group compared with others. The CF showed a higher resorption area.

Conclusion: Pulpal changes are more frequent in relation to hemodynamic alterations, followed by dentin alterations, cellularity alterations, and lastly, dystrophic alterations, but without difference among the groups.

A Community-Based Survey on Diabetes Mellitus at Mile One Market, Port Harcourt, Nigeria

2025-03-21T12:40:46+00:00

Background: Diabetes mellitus remains a major public health concern, with multiple demographic, blood glucose, and lifestyle factors contributing to its risk. The associations between diabetes risk and various parameters, including age, sex, occupation, residence, alcohol consumption, and body mass index (BMI) were examined, while assessing correlations between blood glucose and cardiovascular markers.

Methods: A cross-sectional survey was conducted among consenting adult Nigerians, with fasting blood glucose (FBG), random blood glucose (RBG), systolic blood pressure (SBP), diastolic blood pressure (DBP), BMI, and waist-to-hip ratio measured. Statistical analyses included correlation tests, regression modelling, and significance testing to evaluate associations between diabetes risk and predictor variables.

Results: The total number of participants was 95. Age was significantly associated with diabetes risk (p = 0.007), with individuals aged 41–60 years and >60 years more frequently classified as pre-diabetic or diabetic. However, sex, occupation, residence, alcohol consumption, and BMI were not significantly associated with diabetes risk (p > 0.05). Most participants in all glucose categories were traders (90.5%), suggesting limited occupational variability because of the study site. There were no significant differences in FBG (p = 0.51), RBG (p = 0.45), SBP (p = 0.42), DBP (p = 0.26), or BMI (p = 0.18). However, waist-to-hip ratio differed significantly between sexes (p = 0.04), with males exhibiting higher values (1.02 ± 0.005) than females (1.00 ± 0.005). Age was positively correlated with FBG (r = 0.27, p < 0.05), SBP (r = 0.40, p < 0.01), DBP (r = 0.45, p < 0.01), and BMI (r = 0.23, p < 0.05). Regression analysis showed no significant predictors of FBG, though SBP and DBP exhibited the strongest, albeit non-significant, associations.

Conclusion: Age emerged as a key factor in diabetes risk, while other demographic and blood glucose variables showed weaker associations. Future research should explore additional covariates and diverse populations to enhance understanding of blood glucose health determinants.

Assessment of Four Different Methods of Measuring Biparietal Diameter through Comparative Analysis: A Prospective Study

2025-03-26T11:17:51+00:00

The study evaluates the accuracy of the different methods of measuring biparietal diameter (BPD) as an index of estimating gestational age (GA). This study was a prospective comparative analysis with 107 pregnant patient’s participants. They were examined abdominally in university of Calabar teaching hospital, cross River, Nigeria. The paired t-test was employed to compare the different methods of biparietal diameter to assess their accuracy. The results showed that there was no significant difference (P˂0.05) in the methods of estimating gestational age using biparietal method except for outer to inner and table and table method which was 0.0719. When the paired t-test sample was used to compare the different methods with the last menstrual period (LMP) and gestational age, there was no significant difference in all the four different methods. However, the outer to inner and table to table method appears to be more significant indicating its suitability as a method of obtaining gestational age using biparietal diameter.

Effect of Orthodontic Forces on the Periodontium of Tooth with Extrusive Luxation

2025-03-26T12:28:33+00:00

Aims: This study assessed the effect of different types of orthodontic forces (continuous (C), continuous interrupted (Ci) and intermittent (I)) on the amount of tooth movement (TM) and root resorption (RR) mesio-vestibular and intermediate (RRmv, RRi, respectively) of teeth submitted (L) or not (nL) to extrusive luxation (EL). Data on hyaline areas were also assessed.

Study Design: Experimental research.

Methodology: Forty-eight Wistar rats were randomly divided into 8 groups (n=6) according to the combination of independent variables (the type of force and luxation): the moved [nL-C, nL-Ci, nL-I, L-C, L-Ci, L-I] and the non-moving [L-nM and nL-nM (control)]. The EL of the first right upper molar was performed under a force of 1500 cN for 10 seconds. After 15 days, TM was initiated with a force of 50 cN, with the three types of force (C, Ci, I). On the 14th day, the amount of TM was measured, and the animals were euthanized, the parts processed, included, cut at the cervical level of the molars, and submitted to staining with hematoxylin and eosin (HE).

Results: The results showed more significant movement for the C and Ci forces when compared to I in the groups submitted to luxation (p<0.05). The luxation factor did not influence tooth movement, except for the Ci force (nL-Ci =0.25 x L-Ci=0.44) (p<0.05).

Conclusion: The amount of RR was not influenced by the type of force nor by the EL. Regarding the number of hyaline areas, it was not possible to visualize differences between the groups, under the conditions of this study.

Hospitalizations Due to Covid-19 in a Public Hospital of Sistema Único de Saúde (SUS), Brazil

2025-03-27T09:21:18+00:00

Background: Covid-19 began in Wuhan, China, at the end of 2019 and was declared a pandemic on March 11, 2020. The risk groups related to a serious outcome are: age >75 years, men, severe obesity, hypertension, diabetes and cardiovascular and respiratory diseases.

Objective: This study aims to identify the profile of patients with Covid-19 and their clinical outcome in a hospital of the Unified Health System, in the first two years of the pandemic.

Methods: This is a retrospective, descriptive study with a quantitative approach. The sample consisted of 285 medical records.

Results: There was a predominance of white males with primary and secondary education. Comorbidities increased in the second year, with hypertension and type II diabetes mellitus standing out. The nurse's station was predominant in year 1 and the intensive care unit in year 2. The spectacle-type nasal cannula was widely used in both years, while orotracheal intubation prevailed in the second year. As for the outcome, discharge or death, there were variations in terms of age, place and time of hospitalization, method of ventilatory support and pulmonary impairment between the two groups.

Conclusions: The study contributes to a better understanding of the factors involved and the outcomes of Covid-19 hospitalizations and shows the epidemiological- demographic parameters and clinical parameters of the patient in this locality.

Epidemiological Profile of Leprosy in the State of Pará between the Years 2019 and 2023

2025-03-27T09:32:35+00:00

Objective: This study aims to analyze the epidemiological profile of reported leprosy cases in the state of Pará between the years 2019 and 2023.

Methods: Regarding methodological aspects, this is an epidemiological, retrospective, quantitative, cross-sectional, observational, and descriptive study. Data were collected from the Notifiable Diseases Information System of the Department of Health Information (SINAN/DATASUS). The following variables were obtained: age group, sex, education level, self-declared race/color, reported clinical form, reported disability assessment, diagnosed operational classification, and municipality of notification.

Results: The results showed that, during the analyzed period, there was a predominance of leprosy cases in patients of mixed race, accounting for 73.4% of the total cases, and in males, with 65% of cases. The dimorphic clinical form was the most common (55.3%), and most patients were diagnosed in the multibacillary phase (82.8%), with a physical disability grade of 0 (53.4%). In terms of sociodemographic distribution, the municipality of Marituba had the highest number of reported cases, representing 13.4% of the total.

Conclusion: The analysis indicated a relationship between socioeconomic factors, low education levels, and the prevalence of leprosy, especially among men. The COVID-19 pandemic possibly affected case reporting between 2020 and 2021, leading to potential underreporting. The predominance of the multibacillary form and the high percentage of cases in men may suggest limitations in early diagnosis and health policies aimed at controlling leprosy in the state.

Photobiomodulation Therapy Reduces Inflammation and Improves Skin Flap Survival in Animal Model

2025-03-28T09:19:48+00:00

Photobiomodulation, a noninvasive and efficient technique, has the potential to improve microcirculation and promote neovascularization. Therefore, photobiomodulation has emerged as a promising method for reducing the risk of skin flap necrosis. This study aimed to evaluate the effect of photobiomodulation on inflammatory cells and cytokine levels in skin flaps in a murine model. Forty-eight adult male mice (Balb/C, 20-25g) were divided into control (n=24) and experiment (n=24) groups. Skin flap was raised on the dorsum of each animal, with the experiment group receiving irradiation. Photobiomodulation treatment had a wavelength of 660 nm, radiant exposure of 2 J/cm²for 20 s in the internal vascular pedicle of the flap. Animals were euthanized on the 4th, 7th, and 10th postoperative day. A skin sample was collected for histological assessment, and a blood sample was immediately taken to determine interleukin levels. Results showed that PBM treatment significantly decreased flap necrosis at all evaluation times, accompanied by a significantly reduced pro-inflammatory interleukin (IL) IL-1\(\beta\), IL-6 and tumor necrosis factor-alpha (TNF-α) while increasing the levels of the anti-inflammatory IL-10. In addition, photobiomodulation treatment led to a significant reduction in inflammatory cells in the skin flaps. These findings demonstrate that photobiomodulation enhances the healing process and promotes tissue reconstruction in skin flaps by modulating inflammatory mediators.

Assessing the Impact of Pre-Third-Party Logistics (PRE-3PLS) and 3PLS on Viral Load Sample Turn-around Time in the Management of HIV/AIDS Patients in Ekiti State, Nigeria: A Retrospective Cross-Sectional Study

2025-03-28T10:08:56+00:00

Background: In 2014, The Joint United Nations Program on HIV/AIDS and its partners launched the 90–90–90 treatment targets, which aimed to diagnose 90% of all people living with Human Immunodeficiency Virus (PLHIV), 90% of PLHIV should be on antiretroviral therapy (ART) and 90% of those on ART should achieve viral suppression by 2020. Prompt HIV viral load testing and reporting is crucial to achieving the third 90% component of the target. This study aims to assess impact of Pre-Third-Party Logistics (Pre-3PLs) and Third-Party Logistics (3PLs) on viral load sample Turn-around Time (TAT) in the management of HIV/AIDS patients in Ekiti State, Nigeria

Methods: A cross-sectional study was carried out in ten health facilities. Quantitative and qualitative data were collected and analyzed using the R statistical software.

Results: High load facilities had a mean TAT of 83.68 and 30.76 days for pre-3PLs and 3PLs respectively with a mean difference of 52.92 days (95% CI:18.86-86.97, p<0.05). Low load facilities had a mean TAT of 104.4 and 26.9 days for pre-3PLs and 3PLs respectively with a mean difference of 77.38 days (95% CI: 64.50-90.26, p<0.05). Other than transportation, manpower, sample quality/integrity, reagent stockout and machine downtime, proximity, and human factors were also identified as factors associated with TAT.

Conclusion: The TAT reduced significantly from pre 3PLs to the present era of 3PLs. The continuous use of 3PLs should be encouraged as this could further ensure that more PLHIV will have their viral load tested with their results received on time.

Digital Health Augmented Orthopedic Recovery in Worker’s Compensation Patients Demonstrates Good Engagement

2025-03-28T10:18:41+00:00

Research on orthopedic recovery for injured workers covered by the United States Worker’s Compensation System is limited, revealing challenges with poorer outcomes and low engagement. Current literature shows non-compliance to home exercise plans as high as 70%. One possible solution to address these challenges is through digital health solutions. For example, Recupe from Plethy uses a mobile app paired with a sensor and a designed, live coach to enhance engagement and has been shown to improve home exercise adherence and outcomes in Group Health.

This study followed 1018 injured workers over two years who used Recupe in conjunction with medical and physical therapy or occupational therapy care for their work injury recovery. Analysis shows that 72% of injured workers engaged in the Recupe app at least 3 times per week, with 52 percent engaging over 75 percent of days. Additionally, average pain scores improved 3.9 points out of 10.

Digital health appears to improve an injured worker’s engagement and adherence to their home exercise plans. Moreover, the observed pain improvement suggests progress in recovery. Though injured workers were onboarded a day after referral, this averaged to be 44 days after the date of injury. Such a delay likely slows recovery. Despite this, digital health shows good promise and warrants further study in the Worker’s Compensation space.

To summarize, digital health, tested with the Recupe solution, greatly improved engagement compared to previous research. Thus, injured workers are more likely to follow a home exercise plan that healthcare practitioner have prescribed for their recovery.

Detection of KPC-producing Enterobacteria and Antimicrobial Resistance in Brazilian Sewage Treatment Plants

2025-04-01T12:40:34+00:00

Background and Aims: Pathogenic microorganisms can be found in sewage and may cause several infections and deleterious health effects. In this scenario, Enterobacterales can trigger several diseases in humans and animals, since antimicrobial resistance bacteria, as well as antimicrobial resistance genes, are considered a global public health problem that tends to increase. Therefore, this study aims to identify Enterobacterales resistant to third- and fourth-generation cephalosporins and carbapenems isolated from Sewage Treatment Plants (STP) in Brazil.

Methodology: Four sampling campaigns were performed weekly from the affluent and effluent of two STPs at the Oswaldo Cruz Foundation. In each campaign, four samples were collected in different points in the affluent at the entrance to the STP and the effluent at the exit. A chromogenic medium infused with third-generation cephalosporin was employed, which Gram-negative and oxidase-negative bacteria underwent conventional screening and biochemical tests. Identification was performed with an automated method in VITEK 2^® (BioMérieux). The antimicrobial susceptibility tests (AST) and phenotypic assays for carbapenemase detection were evaluated using the agar diffusion methodology in Müeller-Hinton agar, and antibiotic disks suitable for Enterobacterales. The profile of enterobacteria was categorized as Sensitive (S), Intermediate (I), and Resistant (R). The identification of genes related to bacterial resistance were based on PCR reactions, where DNA was extracted using the heat shock method.

Results: Eight species were identified in the 19 Enterobacterales isolates. Of these, 26% were Klebsiella pneumoniae, 16% Escherichia coli, 16% Citrobacter freundii, 16% Kluyvera cryocrescens, 11% Kluyvera intermedia, 5% Enterobacter asburiae, 5% Citrobacter farmeri and 5% Citrobacter amalonaticus. K. pneumoniae was isolated in all samples of raw sewage from STP B, which was already expected since STP B receives hospital waste. However, it was not found in STP A or any sample of treated sewage from either STP. Among these isolates, 75% were non-sensitive to ciprofloxacin, 71% to ceftriaxone, 57% to ceftazidime, 46% to cefoxitin, 36% to cefepime, 28% to piperacillin + tazobactam, and 11% to gentamicin, respectively. Phenotypic tests effectively screened carbapenem resistance mechanisms, displaying high concordance with molecular tests. These findings indicate the presence of the blaKPC gene, reflecting the predominance of this enterobacteria in Brazil.

Conclusion: A high profile of non-sensitivity to most antimicrobials tested, especially third-generation cephalosporins, quinolones, and carbapenems were reported. These results emphasize the dissemination of potentially pathogenic and antimicrobial-resistant microorganisms in the environment from STP’s final effluents, regardless of the type of system adopted. Therefore, the concern related to environmental contamination and the spread of bacterial resistance to antimicrobials in aquatic reservoirs must be addressed.

Antimicrobial Properties of Graphene Applied in Endodontic Agents and Materials: A Scoping Review

2025-03-13T12:57:42+00:00

Background: Graphene, with multifunctional potential in dentistry, is being explored in a variety of fields, including endodontics, due to its antibacterial properties. However, it is not yet a widely accepted reality in endodontics. As a result, a scoping review was undertaken to throw light on studies in the literature that combine graphene and its antimicrobial impact in various ways in endodontic therapy, with the goal of identifying the major developments and uses of graphene, as well as its potential applications in endodontics.

Methods: A scoping review was done to identify graphene's primary achievements and usage, as well as potential endodontic applications. Our protocol was created using the Preferred Reporting Items for Systematic Reviews and Meta-analysis Extension for Scoping Reviews (PRISMA-ScR), and the following bibliographic databases were searched without regard to publication year or language: PubMed, Scopus, Embase, and Web of Science. As inclusion requirements, the study must use a qualitative or quantitative antimicrobial test model to evaluate the substance, and at least one group must be tested with an endodontic agent or material for clinical use.

Results: The evaluation comprised nine research that used graphene oxide, reduced graphene oxide, and nano-graphene oxide in in vitro and ex vivo experiments. Graphene has been employed in biofilm investigations as an irrigant, filler, intracanal medicament, and photosensitizer.

Conclusion: Although studies show positive results with graphene, standardization of research, manner of usage, and concentration is required for direct comparison of studies and a prospective meta-analysis.

The Role of Comorbidities in Opioid Overdose Risk: A Systematic Review

2025-03-18T13:27:17+00:00

The opioid overdose crisis has escalated into an international public health emergency, with mortality rates continuing to rise, a trend that was further intensified during the COVID-19 pandemic. Individuals with mental health conditions such as anxiety, depression, and thought disorders are at a heightened risk of opioid overdose, yet the relationship between mental health diagnoses and opioid overdose remains poorly understood. This systematic review aims to assess existing studies that explore the link between opioid overdose risk and diagnosed mental health disorders in developed countries, including North America, Western Europe, and Australia. Following PRISMA guidelines, the review examines 28 studies investigating the prevalence of both fatal and non-fatal opioid overdoses among individuals with mental health disorders. The findings consistently reveal a positive association between mood disorders, particularly depression and anxiety, and an increased risk of opioid overdose. The bidirectional relationship between mental health issues and opioid misuse highlights the critical need for integrated treatment approaches that address both psychiatric and substance use disorders. Future research should focus on longitudinal studies and the development of dual interventions targeting mental health and opioid use disorder (OUD) prevention for at-risk populations. To effectively combat the ongoing opioid overdose crisis, comprehensive harm reduction strategies and mental health programs must be implemented in a unified manner.

Atraumatic Extraction of an Anterior Tooth with Immediate Implant Placement and Provisional Restoration: A Case Report

2025-03-18T13:28:05+00:00

Introduction: Implant dentistry focuses on restoring lost teeth by achieving both function and aesthetics through fixed prostheses. Rehabilitating the anterior maxilla presents a significant challenge due to high aesthetic demands. Advancements in techniques have demonstrated greater success when atraumatic extraction, immediate implant placement, bone grafting, and provisional restoration are performed simultaneously.

Objective: To present a clinical case involving the atraumatic extraction of tooth 21, immediate implant placement, xenografting, and a screw-retained provisional restoration.

Case Report: Atraumatic extraction was performed while preserving the alveolar framework. The implant was placed in the palatal bone remnant with minimal primary stability, enabling the fabrication of a screw-retained provisional restoration. The alveolar gap was filled with bovine xenograft. The provisional restoration remained in infraocclusion for six months, during which follow-up imaging confirmed successful vertical and horizontal bone preservation. Additionally, the gingival framework was maintained, achieving an optimal emergence profile.

Conclusion: This case adhered to contemporary best practices, allowing for alveolar framework preservation and a satisfactory outcome without the need for connective tissue grafting.

Inadvertent Knot Formation on a Lumbar Epidural Catheter: A Rare Complication

2025-03-27T09:43:18+00:00

The knotting of an epidural catheter is an unusual complication that can result in disfunction of the catheter, difficult removal and may require surgical management.We report a case of knot formation on a lumbar epidural catheter, introduced at the L2-L3 level, which presented difficulty during withdrawal. Lumbar CT images were taken to evaluate the knot position and discuss posible solutions. The catheter was successfully removed without breakage, showing a simple knot 7 mm from its end. No neurological complications were observed. This case report demonstrates that knot formation in a lumbar epidural catheter is possible. Anesthesiology professionals should consider this complication when experiencing resistance during catheter withdrawal or injection.

Anti-arthritic Potential of Alocasia macrorrhizos Aqueous Extract in an Adjuvant Induced Arthritis Model

2025-03-28T06:51:13+00:00

Rheumatoid arthritis is a chronic, inflammatory and autoimmune disease characterized by joint inflammation and systemic manifestations. This study aimed to evaluate the therapeutic potential of Alocasia macrorrhizos (EAAm) aqueous extract in an Adjuvant-Induced Arthritis (AIA) model. Holtzman strain rats were used and AIA was performed by intradermal injection of 100 µL of Freund's Complete Adjuvant (FCA) at the base of the tail, followed by injection into the left knee joint. Induced animals were treated with Phosphate-buffered saline or EAAm (100 mg/kg) during nine days. Arthritic animals of both sexes showed intense inflammatory reactions and systemic manifestations. Treatment with EAAm reduced the knee edema, tissue inflammatory infiltrate, as well as the cytokines expression (IFN-y, IL-6 and IL-12p70), in serum and regional lymph nodes of the animals. These findings suggest that Alocasia macrorrhizos exhibits anti-arthritic effects, supporting its potential as a natural therapeutic alternative for inflammatory diseases.