Journal of Clinical Medical Research最新文献

{"title":"Application of HBOT with Minimally Invasive Guided Surgery to Heal chronic Brooker 4 Diabetic Ulcer","authors":"Gordon Slater","doi":"10.46889/jcmr.2024.5104","DOIUrl":"https://doi.org/10.46889/jcmr.2024.5104","url":null,"abstract":"Foot ulcers are a frequent precursor for a significant number of amputations in the diabetic population. This study presents a 71-year-old man with diabetes with a foot ulcer connected to a sinus fistula to a joint in his great toe. The patient was treated with a Minimally Invasive Image Guided (MIIGS) guided Interphalangeal Joint (IPJ) fusion with Hyperbaric Oxygen Therapy (HBOT) and injection of biologics with successful closure of the ulcer and resolution of surrounding cellulitis.\u0000\u0000Key points of study\u0000\u0000The patient had poorly controlled diabetes and severe foot ulcers, resulting in 2 amputated toes on the right foot\u0000Patient had 6 months of dressings and debridement’s and had been booked for amputation\u0000An IPJ fusion preceded and followed by HBOT sessions were successful in healing the ulcers and saving the remaining toe\u0000This approach shows promise as an alternative to amputation for diabetic foot ulcers, potentially reducing costs and improving patient outcomes\u0000This study suggests that a combination of MIIGS and HBOT can revolutionize treatment for diabetic foot ulcers. This approach offers a limb-saving alternative to amputation along with reducing the healthcare costs to the health industry and patients.","PeriodicalId":217402,"journal":{"name":"Journal of Clinical Medical Research","volume":"197 3-4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139847328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of HBOT with Minimally Invasive Guided Surgery to Heal chronic Brooker 4 Diabetic Ulcer","authors":"Gordon Slater","doi":"10.46889/jcmr.2024.5104","DOIUrl":"https://doi.org/10.46889/jcmr.2024.5104","url":null,"abstract":"Foot ulcers are a frequent precursor for a significant number of amputations in the diabetic population. This study presents a 71-year-old man with diabetes with a foot ulcer connected to a sinus fistula to a joint in his great toe. The patient was treated with a Minimally Invasive Image Guided (MIIGS) guided Interphalangeal Joint (IPJ) fusion with Hyperbaric Oxygen Therapy (HBOT) and injection of biologics with successful closure of the ulcer and resolution of surrounding cellulitis.\u0000\u0000Key points of study\u0000\u0000The patient had poorly controlled diabetes and severe foot ulcers, resulting in 2 amputated toes on the right foot\u0000Patient had 6 months of dressings and debridement’s and had been booked for amputation\u0000An IPJ fusion preceded and followed by HBOT sessions were successful in healing the ulcers and saving the remaining toe\u0000This approach shows promise as an alternative to amputation for diabetic foot ulcers, potentially reducing costs and improving patient outcomes\u0000This study suggests that a combination of MIIGS and HBOT can revolutionize treatment for diabetic foot ulcers. This approach offers a limb-saving alternative to amputation along with reducing the healthcare costs to the health industry and patients.","PeriodicalId":217402,"journal":{"name":"Journal of Clinical Medical Research","volume":" July","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139787510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotically Assisted Implantology - A Systematic Review from a Young Dental Professional’s Perspective: I Have No Fear, My Dental Robot Is Near!","authors":"Thomas G Wiedemann","doi":"10.46889/jcmr.2024.5103","DOIUrl":"https://doi.org/10.46889/jcmr.2024.5103","url":null,"abstract":"Objective: There are multiple opportunities to enhance the quality of dental care through robotics. Robotics-assisted dentistry continues to evolve from traditional navigational surgery to more complex systems that prove to be essential in implantology and the overall maintenance of oral health. The purpose of this study is to provide a brief literature review of robotics in dentistry and dental education, identify reasons for their limited penetration and highlight the enormous potential of robots to enhance the future of professionals, newly entering implantology.\u0000\u0000Methods: A systematic review of articles was performed, focusing on robotics in dentistry, a specificality in implantology within the last decade, limiting the search to English language publications. The search was conducted across two major electronic databases, PubMed and EMBASE and Google as a generic source of information. With articles up to July 2022. Employing a combination of relevant key terms and synonyms, including “robotics” Yomi”, “dental robots”, “robotic implantology” and aliases, over 31 articles were screened. In total, the systematic search identified 17 articles which were included in the review. The perspective of someone newly entering the profession was also included as an opinion.\u0000\u0000Results: The introduction of robotics in implantology dates back only a few years. The perception of robotics as cost-prohibitive or threatening to the dental profession are partly to blame. Among other reasons for the limited penetration are the lack of technology expertise and patient acceptance. Robotic implant systems have the potential to alter quality of care through improved and more precise treatment. Robotically guided implant placement allows for dynamic surgical tracking in real-time. It can be used to augment dental implant procedures for the placement of reliable, repeatable, dental implant outcomes. Dentists newly entering the profession can benefit from the accuracy, speed and agility of assistive robotics.\u0000\u0000Conclusion: Robotics in dentistry is delayed compared to medicine due to perception of cost, fear for displacement of the dental profession and limited technological readiness. New professionals entering the field of dentistry should not see robots displacing their role as dentists but rather enhancing it and transforming the holistic approach to dental care from planning to flawless execution. For new dentists, the foundational knowledge and compassionate ear will remain indispensable. I have no fear as I know my dental robot is near!","PeriodicalId":217402,"journal":{"name":"Journal of Clinical Medical Research","volume":"24 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139796905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Robotically Assisted Implantology - A Systematic Review from a Young Dental Professional’s Perspective: I Have No Fear, My Dental Robot Is Near!","authors":"Thomas G Wiedemann","doi":"10.46889/jcmr.2024.5103","DOIUrl":"https://doi.org/10.46889/jcmr.2024.5103","url":null,"abstract":"Objective: There are multiple opportunities to enhance the quality of dental care through robotics. Robotics-assisted dentistry continues to evolve from traditional navigational surgery to more complex systems that prove to be essential in implantology and the overall maintenance of oral health. The purpose of this study is to provide a brief literature review of robotics in dentistry and dental education, identify reasons for their limited penetration and highlight the enormous potential of robots to enhance the future of professionals, newly entering implantology.\u0000\u0000Methods: A systematic review of articles was performed, focusing on robotics in dentistry, a specificality in implantology within the last decade, limiting the search to English language publications. The search was conducted across two major electronic databases, PubMed and EMBASE and Google as a generic source of information. With articles up to July 2022. Employing a combination of relevant key terms and synonyms, including “robotics” Yomi”, “dental robots”, “robotic implantology” and aliases, over 31 articles were screened. In total, the systematic search identified 17 articles which were included in the review. The perspective of someone newly entering the profession was also included as an opinion.\u0000\u0000Results: The introduction of robotics in implantology dates back only a few years. The perception of robotics as cost-prohibitive or threatening to the dental profession are partly to blame. Among other reasons for the limited penetration are the lack of technology expertise and patient acceptance. Robotic implant systems have the potential to alter quality of care through improved and more precise treatment. Robotically guided implant placement allows for dynamic surgical tracking in real-time. It can be used to augment dental implant procedures for the placement of reliable, repeatable, dental implant outcomes. Dentists newly entering the profession can benefit from the accuracy, speed and agility of assistive robotics.\u0000\u0000Conclusion: Robotics in dentistry is delayed compared to medicine due to perception of cost, fear for displacement of the dental profession and limited technological readiness. New professionals entering the field of dentistry should not see robots displacing their role as dentists but rather enhancing it and transforming the holistic approach to dental care from planning to flawless execution. For new dentists, the foundational knowledge and compassionate ear will remain indispensable. I have no fear as I know my dental robot is near!","PeriodicalId":217402,"journal":{"name":"Journal of Clinical Medical Research","volume":"50 11-12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139856831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rare Case of Chronic Coxiella Endocarditis Without Fever or Classic Risk Factors","authors":"Steve J. Carlan","doi":"10.46889/jcmr.2024.5102","DOIUrl":"https://doi.org/10.46889/jcmr.2024.5102","url":null,"abstract":"Background: “Q-fever” is a zoonotic infectious disease caused by Coxiella burnetii which is most commonly transmitted globally through unpasteurized animal products or aerosolized fluid. This zoonosis is not thought to be common in developed countries due to modern utilization of pasteurization but risk for transmission remains high in those with extended contact with livestock and cattle. Acute Q-fever presents with an illness characterized by high fevers, myalgias, and segmental pneumonia, but rarely it may progress to chronic Q-fever. Chronic Q-fever most often presents with a culture-negative endocarditis with or without renal impairment and can be fatal if left untreated.\u0000\u0000Case Report: In this case report, we present a 72-year-old male with a 3-month history of body pain, cough, and weight loss who was eventually discovered to have an afebrile presentation of Coxiella endocarditis. This patient was found to have a mitral valve vegetation diagnosed through transesophageal echocardiography and had positive serology for chronic Q-fever. Surprisingly, this patient had no classical exposures, no history of valvular dysfunction or prosthesis, and no clinical signs suggesting endocarditis, making his case markedly atypical. He was placed on a 12 -18-month course of antibiotics and was monitored on an outpatient basis.\u0000\u0000Conclusion: Although chronic Q-fever is rare its variable presentation may cause diagnostic error if it is not kept on the differential. A transesophageal echocardiogram should be strongly preferred due to its superior visualization of heart valves. Serology remains the gold standard for diagnosis of Coxiella. When dealing with culture-negative endocarditis, clinicians should retain a high index of suspicion of Coxiella and obtain serologies for diagnosis","PeriodicalId":217402,"journal":{"name":"Journal of Clinical Medical Research","volume":"10 22","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139591868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Rare Case of Evans Syndrome Associated with Underlying Dermatomyositis Without Generalized Subcutaneous Edema: A Case Report","authors":"Steve J. Carlan","doi":"10.46889/jcmr.2023.4313","DOIUrl":"https://doi.org/10.46889/jcmr.2023.4313","url":null,"abstract":"Background: Primary Evans Syndrome is a typically idiopathic systemic illness associated with a number of autoimmune conditions and lymphomas and characterized by Coombs-positive warm-agglutinin Autoimmune Hemolytic Anemia (AIHA) and immune thrombocytopenia. The disease can be severe and prolonged with multiple recurring disease flares. Its association with dermatomyositis remains exceedingly rare and all reported cases have been accompanied by generalized subcutaneous edema. Case Report: We report a case of a 24-year-old male with a decade-long medical history of Evans Syndrome who presented to the emergency room with a one-week history of shortness of breath and fatigue. An extensive workup revealed severe anemia, thrombocytopenia and a left hemothorax. Active intervention included video-assisted thoracoscopy with decortication, blood products and autoimmune investigation. He was ultimately diagnosed with dermatomyositis after an electromyograph showed findings consistent with demyelinating peripheral polyneuropathy of motor nerves. Conclusion: Evans syndrome associated with dermatomyositis is extremely rare and this is to our knowledge the first reported case of Evans syndrome associated with dermatomyositis without generalized subcutaneous edema.","PeriodicalId":217402,"journal":{"name":"Journal of Clinical Medical Research","volume":"38 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139131414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Intricacies of Encephalitis in Mosquito-Borne Diseases through Vector-Host-Pathogen Interactions: A Critical Review","authors":"Mohammad Jamali","doi":"10.46889/jcmr.2023.4312","DOIUrl":"https://doi.org/10.46889/jcmr.2023.4312","url":null,"abstract":"Environmental changes, medication resistance and sociodemographic shifts have all contributed to a dramatic increase in vector-borne diseases in the last 40 years, impacting both people and domestic animals. Pandemics like the Dengue fever epidemic that hit Bangladesh in 2023 show how devastating these illnesses may be on a global scale. The authors of this work stress the significance of comprehending vector-host-pathogen pathways via their examination of arboviruses in Asia. The ecology and biology of Culex, Culiseta and Aedes species in connection to Dengue Virus, Japanese Encephalitis (JE), Eastern Equine Encephalitis (EEE) and Western Equine Encephalitis (WEE) are explored in a thorough literature review that utilizes MeSH terminology. Beginning with the Japanese Encephalitis Virus (JEV), this article examines the virus’s transmission from insects to vertebrates and, inadvertently, to humans as a disease. We then go on to dengue encephalitis, breaking its intricate pathophysiology into parts. This includes aspects like immune-mediated consequences, systemic problems and direct invasion. The Aedes mosquito is a key player in the human-mosquito-human cycle that transmits Dengue Virus (DENV) and the extrinsic incubation time impacts outbreaks. Continuing to focus on the neuroinvasive effects on horses and people, we have Eastern Equine Encephalopathy (EEE). The interaction between birds and Culiseta melanura mosquitoes highlights the transmission of the enzootic cycle. At last, we look at Western Equine Encephalitis (WEE), which WEEV causes and how it affects both horses and people. Importantly, Culex species, which include mosquitoes and birds, serve as vectors in the enzootic cycle. Factors including climate change and international travel are included in the study’s conclusion, which emphasizes the significance of continuing research to monitor and reduce the worldwide effect of these arboviruses.","PeriodicalId":217402,"journal":{"name":"Journal of Clinical Medical Research","volume":" 959","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139136391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary Cutaneous Cryptococcosis Caused by Cryptococcus neoformans in an Immunocompetent Patient","authors":"Melissa Orzechowski Xavier","doi":"10.46889/jcmr/2023.4217","DOIUrl":"https://doi.org/10.46889/jcmr/2023.4217","url":null,"abstract":"Background: Primary Cutaneous Cryptococcosis (PCC) is an uncommon disease restricted to cutaneous tissues caused by Cryptococcus spp. Case-report: We report a PCC case in a patient without any underlying disease. A 44-year-old man from Southern Brazil was referred to the hospital with 3-year recurrent skin lesions. A biopsy showed typical rounded and encapsulated blastoconidia typical of Cryptococcus and C. neoformans was identified in culture. Treatment with fluconazole (600 mg/day) was prescribed with improvement of the lesions. During the follow-up a self-reported interruption of treatment was detected and after 1 year of treatment, complete clinical cure was not yet achieved. Conclusion: This uncommon case reinforces the importance of mycologic examinations for correct diagnoses.","PeriodicalId":217402,"journal":{"name":"Journal of Clinical Medical Research","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125300862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Enigma Called Homeopathy","authors":"","doi":"10.46889/jcmr/2023.4216","DOIUrl":"https://doi.org/10.46889/jcmr/2023.4216","url":null,"abstract":"When I speak of an enigma, I adhere to its definition; the one given by the RAE (Royal Spanish Academy), which means: a statement whose meaning is artificially concealed to make it difficult to understand or interpret. Homeopathy (pathos=disease, homoios=similar); was created by the German Doctor Samuel Hahnemann in 1796. He was a man with a restless spirit and deeply dissatisfied with late 18th century medicine. After multiple verifications, Hahnemann creates the law that supports the homeopathic doctrine, the Law of Similars. It states that: ‘‘in order to cure a given illness, a remedy must be taken which, when administered to a healthy subject, will cause illnesses ‘and if it is capable of making one sick, it is also capable of curing. This principle of dilution accompanies the Law of Similars [1].","PeriodicalId":217402,"journal":{"name":"Journal of Clinical Medical Research","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115172910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Selecting the Safest Public Bathroom Stall in the Era of COVID-19","authors":"Thomas F. Heston","doi":"10.46889/jcmr/2023.4215","DOIUrl":"https://doi.org/10.46889/jcmr/2023.4215","url":null,"abstract":"COVID-19 and other respiratory diseases can be transmitted through contact with shared surfaces such as those found in public bathrooms. High-touch surfaces such as door handles, flush levers and toilet paper dispensers can potentially contribute to spreading disease-inducing viruses and bacteria. One strategy to mitigate this risk at an individual level is to use the least used bathroom stall, with less human traffic and potentially fewer pathogens. This study looked at occupancy rates of bathroom stalls in a public facility. Observation of stall occupancy was recorded at separate times. Only times when at least 1 stall was occupied were recorded. There were three stalls in a row. Stall 1 was located at one end, with one partition of this stall against a wall and the other partition was shared with the middle stall. Stall 2, the middle stall, shared a partition with Stall 1 and 3. Stall 3 shared a partition with Stall 2 and the other partition was adjacent to an open common area in the restroom. There was a total of 37 observations. Stall 1 was occupied 62% of the time, Stall 2 occupied 30% of the time and Stall 3 occupied 32% of the time. Stall 1, Stall 2 and Stall 3 accounted for 50%, 24% and 26% of overall occupancy. Stall 1 was significantly more likely to be occupied than Stall 2 or 3 (62% vs 30%, p = 0.0051 and 62% vs 32%, p = 0.0104). Stall 2 had the lowest occupancy, but statistically equally likely as Stall 3 to be occupied (30% vs 32%, p = 0.802). In conclusion, in a bank of 3 stalls, the least used one was the middle one and the most used was the end one with an adjoining wall.","PeriodicalId":217402,"journal":{"name":"Journal of Clinical Medical Research","volume":"56 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123923179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}