JUNIOR MEDICAL RESEARCH最新文献

{"title":"Effectiveness of augmented reality telesurgery: Lessons learned from Covid-19 pandemic","authors":"","doi":"10.32512/jmr.3.3.2020/28","DOIUrl":"https://doi.org/10.32512/jmr.3.3.2020/28","url":null,"abstract":"Virtual reality (VR) is an artificially simulated environment that permits multiple\u0000interactions. Augmented reality (AR) is an interactive experience of a real-world\u0000environment where the objects are enhanced by computer-generated perceptual\u0000information [1,2].\u0000Enhanced versions of these concepts were being used in several clinical practices.\u0000Virtual Interactive Presence (VIP) is a technology by which surgeons located\u0000remotely can simultaneously view each other's visual field, allowing them to telecollaborate long distance surgeries [3]. Virtual interactive presence and augmented\u0000reality (VIPAR) platform allows a surgeon from a remote location to deliver realtime assistance to a local surgeon using a standard internet connection.\u0000Pandemic typically led to a surge in demand for healthcare services overwhelming\u0000usually local capabilities. The SARS-Cov-2 outbreak was a big challenge for both\u0000patients and health practitioners. Surgical procedures were reserved only to most\u0000critical cases. Long lockdown limited patients’ access to different health facilities.\u0000Most of the savant societies recommended implementing telemedicine and\u0000incorporating telemedicine as part of COVID-19 outbreak response systems [4].\u0000Telemedicine involves not only consultation, radiodiagnosis and clinical follow up\u0000but also surgical procedures and surgeon’s assisting guidance.\u0000Telemedicine is no longer a futuristic tool. It becomes a need in the present\u0000situation where human interaction has been made difficult by the pandemic. The\u0000touch sense haptic technology and teledactyl were predicted since 1878. Nowadays\u0000it may provide a more realistic and “physical” doctor- patient interaction remotely.\u0000Since the first successful tele-laparoscopic cholecystectomy in 2001, telesurgery\u0000allowed collaboration between different surgeons located distantly across world.\u0000This Tele-collaboration contributed to complex wound repairs in war zones. The\u0000same concept was useful in the management of some high-risk procedures such\u0000as emergency surgeries in COVID-19 positive patients [5,6].\u0000Telesurgery could revolutionize training concept as well. Real-time access to three‐\u0000dimensional reconstructions in patient imaging and remote interaction with\u0000colleagues may provide comprehensive high-quality skills transfer [7].\u0000Before 2020, telesurgery was always an exciting technology but with unclear\u0000endpoints. The limited access to tele-guided procedures was mostly explained by\u0000the lack of patient’s trust and the high cost. The pandemic outbreak taught us a\u0000lot about its safety and effectiveness. Nowadays, health care delivery is feasible\u0000anytime in all restricted areas.","PeriodicalId":354267,"journal":{"name":"JUNIOR MEDICAL RESEARCH","volume":"45 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124920368","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":"Inverted flap in the management of idiopathic large macular holes: A comparative study of different techniques","authors":"Zgolli Hsouna, Mabrouk Sonya, Maslah Tarek, Fekih Olfa, Malek Ines, Nacef Leila","doi":"10.32512/jmr.3.3.2020/3.8","DOIUrl":"https://doi.org/10.32512/jmr.3.3.2020/3.8","url":null,"abstract":"Background\u0000Macular holes are vitreoretinal interface disorders due to anatomical defects in the\u0000fovea causing poor central vision. The aim of this study was to compare the results of\u0000four different variants of inverted flap (IF) technique, for the closure of macular holes\u0000larger than 400µm.\u0000Methods\u0000This is a prospective comparative case series. Thirty-six eyes with large macular hole\u0000were enrolled: group 1: inserted internal limiting membrane (ILM); group 2: classic IF\u0000ILM; group 3: IF without manipulation (Free Flap technique), group 4: temporal IF\u0000technique. Best-corrected visual acuity (BCVA), anatomical closure rate, and ellipsoid\u0000zone (EZ) and external limiting membrane (ELM) defects were evaluated\u0000preoperatively, at 1 month and 3 months after surgery. Odds ratio (OR) and its 95%\u0000confidence interval (CI) were used to compare the anatomical and functional results\u0000of classic inverted flap ILM peeling (group 2) and modified inverted flap ILM peeling\u0000(Group 1,3 and 4).\u0000Results\u0000Mean BCVA improved in all four groups 3 months after surgery. The improvement\u0000was significant in group 2,3, and 4 (P=0.001). The rate of successful hole closure\u0000ranged from 87.5% to 100% in different groups (P=0.661). The integrity of EZ was\u0000achieved in 65.6% and the restoration of the inner layers of the retina in 71.5%.\u0000Conclusion\u0000Inverted flap ILM technique is efficient for the treatment of large full thickness\u0000macular hole (FTMH). Different modified inverted flap techniques have been\u0000described on the last decade. Through our study, we demonstrated that the inserted\u0000flap, may alter outer retinal layer and compromise final functional results despite final\u0000closure of the macular hole. The classic IF technique, the temporal and the free flap\u0000techniques have finally comparable good functional and anatomical results.\u0000Key words\u0000inverted flap technique, macular hole, surgery, outcomes","PeriodicalId":354267,"journal":{"name":"JUNIOR MEDICAL RESEARCH","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122176294","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":"Clinical criteria for Peutz-Jeghers syndrome diagnosis: Look for what is missing","authors":"","doi":"10.32512/jmr.3.3.2020/22.23","DOIUrl":"https://doi.org/10.32512/jmr.3.3.2020/22.23","url":null,"abstract":"The Peutz-Jeghers syndrome (PJS) is an autosomal dominant disorder characterized by\u0000hamartomatous gastrointestinal polyposis and mucocutaneous melanin pigmentation. In\u0000this report we discuss diagnostic circumstances of new PJS family.\u0000Keywords:\u0000Intestinal obstruction; intussusception; Peutz-Jeghers syndrome; polyps; surgery.","PeriodicalId":354267,"journal":{"name":"JUNIOR MEDICAL RESEARCH","volume":"92 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124623845","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":"Vaccine-induced tuberculous osteomyelitis","authors":"","doi":"10.32512/jmr.3.3.2020/20.21","DOIUrl":"https://doi.org/10.32512/jmr.3.3.2020/20.21","url":null,"abstract":"Tuberculosis (TB) has an endemic evolution in Tunisia. Bacille Calmette-Guerin\u0000(BCG) vaccination is systematically provided to all children. The vaccination is\u0000exceptionally complicated by a dissemination beyond the injection site (0.018 case\u0000per 100000 vaccination). We report a case of induced osteomyelitis in one-year old\u0000child following BCG vaccination.\u0000Keywords:\u0000Tuberculosis; BCG vaccine; Osteomyelitis; Management.","PeriodicalId":354267,"journal":{"name":"JUNIOR MEDICAL RESEARCH","volume":"161 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121308770","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":"Resistance to anti-EGFR targeted therapy mediated by oncogenetic\u0000mutations in colorectal cancer: Revision of the dogma?","authors":"Dr. Kan Chi","doi":"10.32512/jmr.3.3.2020/2","DOIUrl":"https://doi.org/10.32512/jmr.3.3.2020/2","url":null,"abstract":"Traditionally, systemic treatment for high stage colorectal carcinoma (CRC) is mainly fluorouracil-based\u0000chemotherapy [1]. The anti-epidermal growth factor receptor (EGFR) monoclonal antibodies, by acting on\u0000specific molecular pathways in tumor growth or modulating immune response towards tumor cells, provide\u0000a more targeted response, a better side effect profile and greater impact on patient survival compared with\u0000conventional molecules. This monoclonal antibody that binds the extracellular domain of epidermal growth\u0000factor receptor, is known to be effective only in a subset of KRAS wild-type colorectal cancers.\u0000Patients with mutations in either KRAS or NRAS gene are not eligible for anti-EGFR monoclonal antibody\u0000therapy [3]. This is due to downstream activation of the Ras/Raf/MAPK pathway by mutated RAS protein,\u0000leading to cell proliferation which cannot be sufficiently inhibited by anti-EGFR receptor monoclonal\u0000antibodies [4]. With the increasing choices of targeted agents, more and more biomarkers are tested.\u0000Currently, the standard recommended biomarker panel for colorectal carcinoma would include KRAS, NRAS,\u0000BRAF gene hotspot mutation detection and microsatellite instability test [5].\u0000With the advances in genomic profiling and sequencing and the understanding of the resistance\u0000mechanisms, the contraindication of anti-EGFR therapy in mutant KRAS patients may be revised.\u0000Based on the fact that the KRAS mutation in CRC suppresses the phosphorylation of the AMP-activated\u0000protein kinase (AMPK) known to be toxic for the tumor cells, Hua et al obtained a satisfactory response to\u0000for the anti-EGFR antibodies in mutant KRAS CRC xenograft models after reactivation of the AMPK [6].\u0000Knickelbein et al demonstrated that the anti-EGFR antibodies induce the death of CRC cells via a p73-\u0000dependent transcriptional activation of the pro-apoptotic Bcl-2 family protein (PUMA). This action is\u0000abolished in case of KRAS mutation. These authors admitted that the restoration of this pathway by\u0000inhibiting aurora kinases preferentially kills mutant KRAS CRC cells and overcomes KRAS-mediated\u0000resistance to anti-EGFR antibodies [7]. In fifty-one CRC patient-derived xenografts study, Lee et al showed\u0000that KRAS mutants expressed remarkably elevated autocrine levels of high-affinity EGFR ligands compared\u0000with wild-type KRAS. The use of an anti-EGFR IgG1 antibody that displays potent inhibitory effects on highaffinity EGFR ligand enhanced CRC KRAS mutant cells cytotoxicity [8].\u0000Dealing with the resistance to targeted therapies in CRC patient looks feasible. It could allow to broaden\u0000the indications of anti-EGFR therapy and provide a better survival for a larger group of CRC patients. In this\u0000era of precision and personalized medicine, a complete case specific tumor profiling and the comprehensive\u0000study of the tumorogenesis mechanisms should allow to overcome the intrinsic and acquired resistance to\u0000these targeted high effective therapies.","PeriodicalId":354267,"journal":{"name":"JUNIOR MEDICAL RESEARCH","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122921320","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":"Lyme Disease: A rare cause of complete atrioventricular block.","authors":"","doi":"10.32512/jmr.3.3.2020/27","DOIUrl":"https://doi.org/10.32512/jmr.3.3.2020/27","url":null,"abstract":"","PeriodicalId":354267,"journal":{"name":"JUNIOR MEDICAL RESEARCH","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122968800","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":"Non-thrombotic vertebrobasilar stroke in Crohn’s disease patient","authors":"","doi":"10.32512/jmr.3.3.2020/13.14","DOIUrl":"https://doi.org/10.32512/jmr.3.3.2020/13.14","url":null,"abstract":"Crohn’s disease is a chronic inflammatory bowel disease (IBD) that could affect any part of\u0000the gastrointestinal tract. The association between posterior circulation stroke and Crohn’s\u0000disease is rarely reported and was controversial for long time. We report herein a case of a\u0000stroke in the right posterior inferior cerebellar artery (PICA) territory in a male patient with\u0000no cardiovascular risk factors who was monitored for ileocolic active Crohn’s Disease.\u0000The aim is to assess the pathophysiological correlation between this inflammatory condition\u0000and the predominance of vertebrobasilar strokes and to highlight appropriate management\u0000characteristics.","PeriodicalId":354267,"journal":{"name":"JUNIOR MEDICAL RESEARCH","volume":"66 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117344869","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":"Sclerosing stromal ovarian tumor","authors":"Kouas Sofiane, Zoukar Olfa, Issa Rahma, Ikridih Khouloud, Mahdhi Sameh, Haddad Anis","doi":"10.32512/jmr.3.3.2020/24.25","DOIUrl":"https://doi.org/10.32512/jmr.3.3.2020/24.25","url":null,"abstract":"","PeriodicalId":354267,"journal":{"name":"JUNIOR MEDICAL RESEARCH","volume":"78 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132848333","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":"Choroidal neovascular membrane: Report of pediatric idiopathic case","authors":"","doi":"10.32512/jmr.3.3.2020/15.19","DOIUrl":"https://doi.org/10.32512/jmr.3.3.2020/15.19","url":null,"abstract":"The choroid neovascular membrane is a rare cause of central vision loss among\u0000children. Its etiopathogenesis is still unclear and the management is not\u0000standardized. The neovascularization may be due to inflammatory, post-traumatic,\u0000or dystrophic causes. We described herein a case of choroidal neovascular\u0000membrane in a 14-year-old boy with no evident origin after investigations.\u0000Keywords:\u0000choroidal neovascular membrane, idiopathic, child.","PeriodicalId":354267,"journal":{"name":"JUNIOR MEDICAL RESEARCH","volume":"48 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124262167","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":"Effectiveness of augmented reality telesurgery: Lessons learned from\u0000Covid-19 pandemic.","authors":"","doi":"10.32512//jmr.3.3.2020/28","DOIUrl":"https://doi.org/10.32512//jmr.3.3.2020/28","url":null,"abstract":"v1, *.\u0000Virtual reality (VR) is an artificially simulated environment that permits multiple\u0000interactions. Augmented reality (AR) is an interactive experience of a real-world\u0000environment where the objects are enhanced by computer-generated perceptual\u0000information [1,2].\u0000Enhanced versions of these concepts were being used in several clinical practices.\u0000Virtual Interactive Presence (VIP) is a technology by which surgeons located\u0000remotely can simultaneously view each other's visual field, allowing them to telecollaborate long distance surgeries [3]. Virtual interactive presence and augmented\u0000reality (VIPAR) platform allows a surgeon from a remote location to deliver realtime assistance to a local surgeon using a standard internet connection.\u0000Pandemic typically led to a surge in demand for healthcare services overwhelming\u0000usually local capabilities. The SARS-Cov-2 outbreak was a big challenge for both\u0000patients and health practitioners. Surgical procedures were reserved only to most\u0000critical cases. Long lockdown limited patients’ access to different health facilities.\u0000Most of the savant societies recommended implementing telemedicine and\u0000incorporating telemedicine as part of COVID-19 outbreak response systems [4].\u0000Telemedicine involves not only consultation, radiodiagnosis and clinical follow up\u0000but also surgical procedures and surgeon’s assisting guidance.\u0000Telemedicine is no longer a futuristic tool. It becomes a need in the present\u0000situation where human interaction has been made difficult by the pandemic. The\u0000touch sense haptic technology and teledactyl were predicted since 1878. Nowadays\u0000it may provide a more realistic and “physical” doctor- patient interaction remotely.\u0000Since the first successful tele-laparoscopic cholecystectomy in 2001, telesurgery\u0000allowed collaboration between different surgeons located distantly across world.\u0000This Tele-collaboration contributed to complex wound repairs in war zones. The\u0000same concept was useful in the management of some high-risk procedures such\u0000as emergency surgeries in COVID-19 positive patients [5,6].\u0000Telesurgery could revolutionize training concept as well. Real-time access to three‐\u0000dimensional reconstructions in patient imaging and remote interaction with\u0000colleagues may provide comprehensive high-quality skills transfer [7].\u0000Before 2020, telesurgery was always an exciting technology but with unclear\u0000endpoints. The limited access to tele-guided procedures was mostly explained by\u0000the lack of patient’s trust and the high cost. The pandemic outbreak taught us a\u0000lot about its safety and effectiveness. Nowadays, health care delivery is feasible\u0000anytime in all restricted areas.","PeriodicalId":354267,"journal":{"name":"JUNIOR MEDICAL RESEARCH","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129120674","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}