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Infiltration of micro-fragmented adipose tissue under local anesthesia for knee osteoarthritis treatment is a safe procedure: A case series 局部麻醉下微碎片脂肪组织浸润治疗膝骨关节炎是一种安全的方法:一个病例系列。
IF 2.2 4区 医学
Clinics Pub Date : 2025-01-01 DOI: 10.1016/j.clinsp.2024.100527
Bruno Butturi Varone, Daniel Peixoto Leal, Daniel Duarte Perini, Vitor Penteado Figueiredo Pagotto, Riccardo Gomes Gobbi, Marco Kawwamura Demange
{"title":"Infiltration of micro-fragmented adipose tissue under local anesthesia for knee osteoarthritis treatment is a safe procedure: A case series","authors":"Bruno Butturi Varone,&nbsp;Daniel Peixoto Leal,&nbsp;Daniel Duarte Perini,&nbsp;Vitor Penteado Figueiredo Pagotto,&nbsp;Riccardo Gomes Gobbi,&nbsp;Marco Kawwamura Demange","doi":"10.1016/j.clinsp.2024.100527","DOIUrl":"10.1016/j.clinsp.2024.100527","url":null,"abstract":"<div><h3>Introduction</h3><div>Knee osteoarthritis is a debilitating disease that has been increasing in prevalence, especially due to the aging population and rising incidence of obesity. Biological therapies (orthobiologics) have emerged, demonstrating efficacy in improving functional scores, including the injection of microfragmented Adipose Tissue (mFAT). The purpose of this study is to evaluate the safety of adipose tissue harvesting and mFAT injection under local anesthesia.</div></div><div><h3>Materials/methods</h3><div>A case series involving 34 patients who underwent adipose tissue collection from the abdomen under local anesthesia, without sedation, in a sterile environment, and who received the infiltration of microfragmented adipose tissue after single-time preparation, using a fat washing and microfragmentation kit.</div></div><div><h3>Results</h3><div>Evaluation was performed at the time of the procedure and after 7 days of follow-up. Only ecchymosis (76.5 %) and mild discomfort at the harvested site (70.6 %), as well as mild discomfort at the infiltrated knee (61.8 %), were identified. No major adverse events were identified.</div></div><div><h3>Conclusion</h3><div>The harvesting and injection of mFAT under local anesthesia is safe, with no major adverse events identified during this procedure.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"80 ","pages":"Article 100527"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11655688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142779538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Thrombin generation indices and Wells score predict pulmonary embolism in patients with acute exacerbation of chronic obstructive pulmonary disease
IF 2.2 4区 医学
Clinics Pub Date : 2025-01-01 DOI: 10.1016/j.clinsp.2025.100582
Linjie Luo , Dan Zheng , Li Da, Jian Cheng, Yirui Cao, Na Wang
{"title":"Thrombin generation indices and Wells score predict pulmonary embolism in patients with acute exacerbation of chronic obstructive pulmonary disease","authors":"Linjie Luo ,&nbsp;Dan Zheng ,&nbsp;Li Da,&nbsp;Jian Cheng,&nbsp;Yirui Cao,&nbsp;Na Wang","doi":"10.1016/j.clinsp.2025.100582","DOIUrl":"10.1016/j.clinsp.2025.100582","url":null,"abstract":"<div><h3>Objective</h3><div>This study investigated the predictive value of thrombin generation indices and Wells score in the development of Pulmonary Embolism (PE) in patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD).</div></div><div><h3>Methods</h3><div>160 patients who were admitted for AECOPD and underwent CT Pulmonary Arteriography (CTPA) were collected. Among them, a total of 62 cases were diagnosed with PE as the AECOPD with PE group, and the other 98 cases were not diagnosed with PE as the AECOPD group. The general data, past history and combined basic diseases, laboratory tests and other related clinical data of the two groups were compared, and the data collected were statistically analyzed to explore the diagnostic indexes that can predict PE in AECOPD.</div></div><div><h3>Results</h3><div>History of venous thromboembolism, <span>d</span>-Dimer as well as Endogenous Thrombin Potential (ETP), Activated Partial Thromboplastin Time (APTT) coagulation indices, and Wells score was significantly higher in the AECOPD with PE group than in the AECOPD group, and Time to Peak (ttpeak), Albumin (ALB) and total protein were lower than those in the AECOPD group. The Wells score had a positive correlation with ETP and APTT and a negative correlation with ttpeak, which were all independent risk factors for PE in AECOPD. The Wells score had the best efficacy in predicting the occurrence of PE in patients with AECOPD with a cutoff value of 4.62.</div></div><div><h3>Conclusion</h3><div>Significant correlations were found between the thrombin generation indices (ETP, APTT and ttpeak) and the Wells score, which can also be used for early diagnosis of PE in patients with AECOPD.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"80 ","pages":"Article 100582"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143511496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Corrigendum to “Exploration of the mechanism underlying the therapeutic effect of electroacupuncture at chengshan acupoint on post-hemorrhoidectomy anal pain: Insights from the mAChRs/IP3-Ca2+-CaM signaling pathway” [CLINSP 79 (2024) 10048] “电针成山穴治疗痔疮术后肛门疼痛的机制探讨:来自mAChRs/IP3-Ca2+-CaM信号通路的见解”[CLINSP 79(2024) 10048]。
IF 2.2 4区 医学
Clinics Pub Date : 2025-01-01 DOI: 10.1016/j.clinsp.2024.100568
Yang Song , Yang Wang , Ming Li , Yujuan Wang , Tianshu Xu
{"title":"Corrigendum to “Exploration of the mechanism underlying the therapeutic effect of electroacupuncture at chengshan acupoint on post-hemorrhoidectomy anal pain: Insights from the mAChRs/IP3-Ca2+-CaM signaling pathway” [CLINSP 79 (2024) 10048]","authors":"Yang Song ,&nbsp;Yang Wang ,&nbsp;Ming Li ,&nbsp;Yujuan Wang ,&nbsp;Tianshu Xu","doi":"10.1016/j.clinsp.2024.100568","DOIUrl":"10.1016/j.clinsp.2024.100568","url":null,"abstract":"","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"80 ","pages":"Article 100568"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11761927/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142945850","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Metabolomics in juvenile idiopathic arthritis: A distinct profile in patients under methotrexate
IF 2.2 4区 医学
Clinics Pub Date : 2025-01-01 DOI: 10.1016/j.clinsp.2024.100522
Renato B. Tomioka , Gabriela R.V. Ferreira , Nadia E. Aikawa , Gustavo A.R. Maciel , José M. Soares Junior , Edmund C. Baracat , Eloisa Bonfá , Ismael Dale Cotrim Guerreiro da Silva , Clovis Almeida da Silva
{"title":"Metabolomics in juvenile idiopathic arthritis: A distinct profile in patients under methotrexate","authors":"Renato B. Tomioka ,&nbsp;Gabriela R.V. Ferreira ,&nbsp;Nadia E. Aikawa ,&nbsp;Gustavo A.R. Maciel ,&nbsp;José M. Soares Junior ,&nbsp;Edmund C. Baracat ,&nbsp;Eloisa Bonfá ,&nbsp;Ismael Dale Cotrim Guerreiro da Silva ,&nbsp;Clovis Almeida da Silva","doi":"10.1016/j.clinsp.2024.100522","DOIUrl":"10.1016/j.clinsp.2024.100522","url":null,"abstract":"<div><div>The objective of the present study was to evaluate biochemical quantitative metabolites in peripheral blood serum samples of Juvenile Idiopathic Arthritis (JIA) patients and healthy controls. A cross-sectional study included 33 post-pubertal JIA (21 without and 12 with Methotrexate (MTX) women and 28 age-matched healthy controls. Metabolomic analyses based on targeted electrospray ionization tandem mass spectrometry were used to identify possible biochemical pathway modifications in serum from JIA patients. The mean current age (<em>p</em> = 0.065) was similar in JIA patients and healthy controls. Current MTX use in all subtypes of JIA patients was associated with an increase in concentrations of free carnitine [21.74 (12.7‒35.2) vs. 27.49 (14.5‒41.3) µM/L, <em>p</em> = 0.02], suggesting an enhanced mitochondrial metabolism and intestinal absorptive function. In contrast, a decreased mitochondrial metabolism was observed in polyarticular and systemic JIA subtypes, with a decrease of several acylcarnitines’ concentrations (<em>p</em> &lt; 0.05). In conclusion, the present study identified a distinctive pattern of serum metabolic signatures in JIA patients under MTX therapy. Our findings indicate that MTX use is associated with a more efficient mitochondrial function.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"80 ","pages":"Article 100522"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143063990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Incidence of mycobacteria in pulmonary granulomatous lesions 分枝杆菌在肺肉芽肿病变中的发病率。
IF 2.2 4区 医学
Clinics Pub Date : 2025-01-01 DOI: 10.1016/j.clinsp.2024.100564
Sibele Inácio Meireles, Mariana Vargas Cruz, Gustavo Palmer Irffi, Leonardo Abreu Testagrossa
{"title":"Incidence of mycobacteria in pulmonary granulomatous lesions","authors":"Sibele Inácio Meireles,&nbsp;Mariana Vargas Cruz,&nbsp;Gustavo Palmer Irffi,&nbsp;Leonardo Abreu Testagrossa","doi":"10.1016/j.clinsp.2024.100564","DOIUrl":"10.1016/j.clinsp.2024.100564","url":null,"abstract":"<div><div>Mycobacteria infections are caused by species of the <em>Mycobacterium tuberculosis</em> complex (MTB) and other species called Non-Tuberculosis Mycobacteria (NTM). Identification of mycobacteria species is very important to define treatment and it can be achieved by direct culture. However, the lack of clear protocols regarding the use of culture or molecular tests on specimens diagnosed with granulomatous lesions causes delays in the diagnosis of the etiological agents and, consequently, the definition of the right treatment. This work aimed to characterize the incidence of mycobacteria species in pulmonary granulomatous lesions and the contribution of Polymerase Chain Reaction (PCR) in Formalin-Fixed Paraffin-Embedded Tissue (FFPE), direct culture, and Ziehl-Neelsen histological stain to the diagnosis. The authors performed an observational, centralized, and retrospective study in a cohort of 336 cases with pulmonary granulomatous lesions. Mycobacteria were detected by ZNS in 54/323 (16.72 %) and by direct culture in 40/198 (20.20 %). MTB DNA was detected by PCR in 10/57 (17.54 %). Mycobacterial culture results revealed MTB in 26/40 (65.00 %), whereas NTM was detected in 13/40 (32.50 %). NTM was represented by <em>M. avium</em> (<em>n</em> = 4), <em>M. intracellulare</em> (<em>n</em> = 3), <em>M. kansasii</em> (<em>n</em> = 3), <em>M. colombiense</em> (<em>n</em> = 1), <em>M. paraffinicum</em> (<em>n</em> = 1), and <em>M. abscessus</em> subsp. <em>massiliense</em> (<em>n</em> = 1). In conclusion, this study demonstrated that mycobacteria are detected in 16.72 % to 20.20 % of pulmonary granulomatous lesions. Moreover, MTB and NTM were detected in these lesions. The use of different methods for mycobacteria detection, in addition to culture, is complementary and contributes to fastening and increasing the detection of mycobacteria in these lesions.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"80 ","pages":"Article 100564"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11743815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Efficacy and safety of a modified DVD regimen followed by lenalidomide for the treatment of Newly Diagnosed Multiple Myeloma
IF 2.2 4区 医学
Clinics Pub Date : 2025-01-01 DOI: 10.1016/j.clinsp.2025.100575
Zhichao Li , Wenhao Zhang , Fang Huang , Siguo Hao
{"title":"Efficacy and safety of a modified DVD regimen followed by lenalidomide for the treatment of Newly Diagnosed Multiple Myeloma","authors":"Zhichao Li ,&nbsp;Wenhao Zhang ,&nbsp;Fang Huang ,&nbsp;Siguo Hao","doi":"10.1016/j.clinsp.2025.100575","DOIUrl":"10.1016/j.clinsp.2025.100575","url":null,"abstract":"<div><h3>Background</h3><div>The common drugs used for the treatment of Newly Diagnosed Multiple Myeloma (NDMM) include bortezomib and lenalidomide, but the adverse effects of lenalidomide cannot be ignored, especially when it is used in the initial therapy.</div></div><div><h3>Methods</h3><div>This retrospective study evaluated the efficacy and safety of a modified DVD regimen (pegylated liposomal doxorubicin, bortezomib, and dexamethasone) followed by lenalidomide in the treatment of NDMM. A total of 40 NDMM patients were treated with a reduced dose of pegylated liposomal doxorubicin (20 mg/m<sup>2</sup>) on day 1, subcutaneous bortezomib (1.3 mg/m<sup>2</sup>) on days 1, 4, 8, and 11, and dexamethasone (20 mg) on days 1, 2, 3, 4, 8, 9, 11, and 12 (20 days for each course). When patients failed to achieve partial or better response after 2 courses of treatment, a regimen containing lenalidomide was administered. After the induction therapy, 15 eligible patients received Peripheral Blood Stem Cells (PBSC) mobilization and transplantation followed by maintenance therapy with lenalidomide.</div></div><div><h3>Results</h3><div>The response rate (≥ very good partial response) was 55% and 80% after 2 and 4 courses, respectively. The 18-month Progression Free Survival (PFS) and Overall Survival (OS) were 78.6% and 83.4%, respectively. Grade 3 or 4 hematologic toxicity occurred in less than 10% of patients. In addition, all 15 transplant-eligible patients successfully mobilized PBSC (median CD34<sup>+</sup>cells = 4.59 × 10<sup>6</sup>/kg) and underwent autologous PSBC transplantation.</div></div><div><h3>Conclusions</h3><div>This study suggests that the modified DVD regimen followed by lenalidomide is an effective and well-tolerated regimen, and has little influence on the PBSC collection and transplantation for patients with NDMM.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"80 ","pages":"Article 100575"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143051941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Association between serum C-reactive protein and low muscle mass among US adults: Results from NHANES 1999 to 2006
IF 2.2 4区 医学
Clinics Pub Date : 2025-01-01 DOI: 10.1016/j.clinsp.2025.100588
Ruzheng Lin , Ying Chen , Kai Liu
{"title":"Association between serum C-reactive protein and low muscle mass among US adults: Results from NHANES 1999 to 2006","authors":"Ruzheng Lin ,&nbsp;Ying Chen ,&nbsp;Kai Liu","doi":"10.1016/j.clinsp.2025.100588","DOIUrl":"10.1016/j.clinsp.2025.100588","url":null,"abstract":"<div><h3>Introduction</h3><div>Inflammation is hypothesized to be a pivotal factor influencing muscle function, with C-Reactive Protein (CRP) serving as a common biomarker of inflammation. However, the literature pertaining to the relationship between CRP and muscle mass remains scant, particularly among representative adult populations in the United States. The present study aimed to delve into the association between serum CRP levels and muscle mass among American adults, leveraging data from the National Health and Nutrition Examination Survey (NHANES) conducted from 1999 to 2006.</div></div><div><h3>Methods</h3><div>A cohort of 13,518 participants, representative of the US adult population, underwent dual-energy X-Ray Absorptiometry (DXA) to assess Appendicular Skeletal Muscle Mass (ASM) and had their CRP levels measured. Muscle mass was defined using ASM adjusted by Body Mass Index (ASM/BMI) criteria. Employing weighted logistic regression models, restricted cubic spline analysis, and subgroup analyses, the authors examined the association between serum CRP and low muscle mass.</div></div><div><h3>Results</h3><div>After meticulously adjusting for various covariates, the present findings revealed a positive association between serum CRP levels and the risk of low muscle mass in American adults (OR = 1.07, 95 % CI 1.01‒1.14, <em>p</em> = 0.016). Notably, an inverse J-shaped relationship was observed, with serum CRP inflection points of 0.273 mg/dL for the overall population, 0.172 mg/dL for males, and 0.296 mg/dL for females. Subgroup analysis further demonstrated that factors such as gender, race, educational level, smoking status, congestive heart failure, stroke, renal weakness/failure, coronary heart disease, diabetes, hypertension, vigorous physical activity, moderate physical activity, and muscle strengthening activities did not significantly impact this positive correlation (all p for interaction values &gt; 0.05).</div></div><div><h3>Conclusions</h3><div>This nationally representative cross-sectional study provides robust evidence of an inverse J-shaped association between serum CRP levels and the risk of low muscle mass in adults in the United States, with a critical inflection point of 0.273 mg/dL. These findings may inform future research and clinical strategies aimed at mitigating the negative effects of inflammation on muscle mass and function in the adult population.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"80 ","pages":"Article 100588"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143078788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Fatal long-term complications due to bendamustine for Waldenstrom's macroglobulinemia
IF 2.2 4区 医学
Clinics Pub Date : 2025-01-01 DOI: 10.1016/j.clinsp.2025.100591
Fulvio Alexandre Scorza , Carla Alexndra Scorza , Josef Finsterer
{"title":"Fatal long-term complications due to bendamustine for Waldenstrom's macroglobulinemia","authors":"Fulvio Alexandre Scorza ,&nbsp;Carla Alexndra Scorza ,&nbsp;Josef Finsterer","doi":"10.1016/j.clinsp.2025.100591","DOIUrl":"10.1016/j.clinsp.2025.100591","url":null,"abstract":"","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"80 ","pages":"Article 100591"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143203656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Anatomical variations of the marginal mandibular nerve 下颌边缘神经的解剖变异。
IF 2.2 4区 医学
Clinics Pub Date : 2025-01-01 DOI: 10.1016/j.clinsp.2024.100548
Arthur Paredes Gatti , Matheus Trovão Ribeiro , Flávio Hojaij
{"title":"Anatomical variations of the marginal mandibular nerve","authors":"Arthur Paredes Gatti ,&nbsp;Matheus Trovão Ribeiro ,&nbsp;Flávio Hojaij","doi":"10.1016/j.clinsp.2024.100548","DOIUrl":"10.1016/j.clinsp.2024.100548","url":null,"abstract":"<div><h3>Introduction</h3><div>The Marginal Mandibular Nerve (MMN), despite being didactically described as being a unique branch of the other branches of the Facial Nerve, has in practice an abundant anatomical variation. Both in relation to its ramifications and the positioning of these in relation to the lower edge of the mandible, as well as its anastomoses along its path, play a fundamental role in the surgical strategy during the approach of this cervicofacial site, and can generate, as underestimated its characteristics, inadvertent injuries and motor consequences to the patient.</div></div><div><h3>Objective</h3><div>To analyze the types of anatomical variations of the MMN in relation to its position, ramification, and distance from reference points, as well as its incidence that could imply technical difficulties in surgery.</div></div><div><h3>Methods</h3><div>A systematic review was conducted in the literature in search of anatomical studies, in vivo or in cadavers, between 1981 and 2024, which described the quantification of the MMN branches, their positioning and peculiarities in relation to anastomoses with other peripheral nerves.</div></div><div><h3>Results</h3><div>511 hemifaces were studied, with the identification of 290 cases of single nerve, 160 cases of double branch, 54 cases of triple branch, and 7 cases of quadruple branch. Of the 456 nerves that were possible to study, the average distance when superior to the lower limit of the mandible was 1.61 cm, while its lower analysis was 2.53 cm. The branches presented different proportions of presentation in relation to this reference point depending on how many branches it had, being more common to remain below it. Anastomoses were identified between the MMN and the buccal and cervical branch of the Facial Nerve, as well as with the Trigeminal Nerve.</div></div><div><h3>Conclusion</h3><div>The varied presentations of the MMN, both in its anatomical positioning and in the number of branches leads us to question whether the surgical thinking when performing an exploration in this site may not be the reason whythe authors verify several motor complaints superior to described injuries.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"80 ","pages":"Article 100548"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11664287/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142784317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Behavioral therapies for the treatment of autism spectrum disorder: A systematic review 行为疗法治疗自闭症谱系障碍:系统回顾。
IF 2.2 4区 医学
Clinics Pub Date : 2025-01-01 DOI: 10.1016/j.clinsp.2024.100566
Clara Lucato dos Santos , Indyanara Inacio Barreto , Ana Carolina Furian da Silva , Juliana Firmino Batista Soriano , Jeferson de Lima Silva Castro , Luca Schiliró Tristão , Wanderley Marques Bernardo
{"title":"Behavioral therapies for the treatment of autism spectrum disorder: A systematic review","authors":"Clara Lucato dos Santos ,&nbsp;Indyanara Inacio Barreto ,&nbsp;Ana Carolina Furian da Silva ,&nbsp;Juliana Firmino Batista Soriano ,&nbsp;Jeferson de Lima Silva Castro ,&nbsp;Luca Schiliró Tristão ,&nbsp;Wanderley Marques Bernardo","doi":"10.1016/j.clinsp.2024.100566","DOIUrl":"10.1016/j.clinsp.2024.100566","url":null,"abstract":"<div><h3>Introduction</h3><div>Autism Spectrum Disorder (ASD) is a neurodevelopment spectrum characterized by persistent deficits in social communication and interpersonal interaction, along with restricted and repetitive patterns of behavior, interest, or activities. The appropriate screening and diagnosis must be realized to improve the children's prognosis. Moreover, appropriate treatments are necessary to promote better social integration and development. In this scenario, this systematic review aims to evaluate the impacts of behavioral therapies applied in healthcare settings for patients with ASD.</div></div><div><h3>Methods</h3><div>This systematic review followed the PRISMA guidelines. The databases MEDLINE, Embase, CENTRAL (Cochrane), and Lilacs were accessed, and gray and manual searches were performed. The search strategy was created with terms referring to autism and behavioral therapy. The studies were assessed qualitatively.</div></div><div><h3>Results</h3><div>Randomized clinical trials and observational studies demonstrated improvements in cognitive and verbal components of patients who received behavioral therapies in therapeutic settings. These results indicate a positive impact of both cognitive-behavioral therapy and ESDM on the development of patients’ skills. Among the cognitive-behavioral therapies, the one based on the MASSI protocol did not impact the reduction of anxious symptoms. As for cognitive-behavioral therapy, one study demonstrated that the Behavioral Intervention for Anxiety in Children with Autism (BIACA), when compared to the Coping Cat protocol, improves cognition and reduces anxiety symptoms. Despite these results, further randomized clinical trials comparing behavioral therapies with one another are needed.</div></div><div><h3>Conclusion</h3><div>In the context of behavioral therapy within a healthcare setting, the Early Start Denver Model (ESDM) showed improvements in the cognitive, verbal, and social aspects of the evaluated patients. Improvement in scores sometimes is achieved independently of the group and related to the time of interventions.</div></div>","PeriodicalId":10472,"journal":{"name":"Clinics","volume":"80 ","pages":"Article 100566"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11732605/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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