JUNIOR MEDICAL RESEARCH最新文献

{"title":"Ultrasound guided intra-articular botulinum toxin injection for treatment of the osteoarthritic knee pain: expert opinion.","authors":"","doi":"10.32512/jmr.3.1.2020/25","DOIUrl":"https://doi.org/10.32512/jmr.3.1.2020/25","url":null,"abstract":"Osteoarthritis is the most common form of arthritis and cause of joint pain and disability [1]. The prevalence, burden and socioeconomic impact of osteoarthritis of the knee is considerable and growing [2]. Knee pain is the most cardinal symptom of the osteoarthritic knee and is associated with a high degree of impaired function and daily activities [3]. Intra-articular injection provides a safe and cost effective control of knee pain with improvement of function and activities of daily living [4]. Ultrasound guidance improves the accuracy of the intra-articular injection in knee joint and clinical outcomes and lowers health care costs [5]. Botulinum toxin targets many neuropeptides leading to reduction of pain, peripheral sensitization and in turn reduction of the central sensitization. Also, botulinum toxin plays an anti-inflammatory role by reduction of the neurogenic inflammation [6]. The following table summarizes how to use botulinum toxin in clinical practice according to authors experience. However, further large-scale multicenter randomized controlled trials are needed to confirm effectiveness and determine the exact position of this intervention in the therapeutic armamentarium for the osteoarthritic knee pain.","PeriodicalId":354267,"journal":{"name":"JUNIOR MEDICAL RESEARCH","volume":"41 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129478498","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 empty sella syndrome: Characteristics of the pituitary deficiency. A bicentric case series.","authors":"","doi":"10.32512/jmr.3.1.2020/3.7","DOIUrl":"https://doi.org/10.32512/jmr.3.1.2020/3.7","url":null,"abstract":"Background and aim Empty sella is the neuroradiological or pathological finding of an apparently empty sella turcica. The aim of the study was to analyze the clinical, hormonal and radiological characteristics of patients with empty sella and to compare anterior pituitary function in total versus partial primary empty sella. Methods The records of 36 patients with primary empty sella were retrospectively analyzed over a 24-years period. The patients were evaluated for pituitary function with basal hormone levels (FT4, TSH, IGF1, FSH, LH, cortisol, ACTH, prolactin) and dynamic testing when necessary. Results Our study included 26 women and 10 men with an average age of 47.64 ±15.47 years. Seventy-six per cent of women were multiparous. Fifteen patients were obese. The revealing symptoms were dominated by endocrine signs (52.7%). More than half of our patients complained of headache. Sixty-one of the patients had partial empty sella and the remaining 39% had total empty sella. Two or more pituitary hormone deficiency were found in 41% of cases. Secondary adrenal insufficiency was the most common pituitary hormone deficiency(41.7%).The percentage of hypopituitarism in complete primary empty sella was significantly higher than that in partial primary empty sella (P<0.05).The management was based on hormone replacement therapy in case of hypopituitarism and on analgesic therapy in case of headache. Conclusion The diagnosis of PES must be evoked in an obese, multiparous, hypertensive woman presenting with a symptomatology suggestive of a pituitary deficiency or chronic headache. The correlation between pituitary gland volume and the degree of hypopituitarism highlights the importance of the early diagnosis and hormones replacement.","PeriodicalId":354267,"journal":{"name":"JUNIOR MEDICAL RESEARCH","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122234524","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":"Surgical repair of perimembranous ventricular septal defect and aortic regurgitation in an adult patient with Laubry-Pezzi syndrome.","authors":"Riache Abir, Kebour Djamal, Sayah Toufik","doi":"10.32512/jmr.3.1.2020/15.17","DOIUrl":"https://doi.org/10.32512/jmr.3.1.2020/15.17","url":null,"abstract":"Laubry-Pezzi syndrome is a congenital heart disease that consist in a prolapse of aortic valve cusping into a subjacent ventricular septal defect due to Venturi effect. It results in progressive aortic valve insufficiency. The perimembranous type is the most common due to the proximity of the aortic annulus to such defects. The aim of this report is to highlight the specificity of the diagnosis and the surgical management of this syndrome in adult patients.","PeriodicalId":354267,"journal":{"name":"JUNIOR MEDICAL RESEARCH","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122639308","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":"Retrorenal Teratoma : A rare entity.","authors":"","doi":"10.32512/jmr.3.1.2020/21.22","DOIUrl":"https://doi.org/10.32512/jmr.3.1.2020/21.22","url":null,"abstract":"Les tératomes rétro péritonéaux constituent une entité rare. Ils représentent 3,5 à 5% de toutes les tumeurs germinales de l’enfant et 1 à 11% des tumeurs rétropéritonéales primitives [1,2,3]. Nous rapportons un cas de tératome mature rétro-rénal chez un nourrisson de 2 mois, sans antécédents pathologiques particuliers, qui a consulté pour une distension abdominale asymétrique notée par les parents dès la naissance. L’échographie abdominale, étant l'examen d'imagerie de première intention a mis en évidence une masse tissulaire rétropéritonéale hétérogène renfermant quelques calcifications. Cette masse refoulait le foie en haut et les intestins à gauche. Le scanner abdominal avec injection a montré une masse à triple composante kystique, graisseuse et osseuse, mesurant 103 mm sur 82 mm, sans envahissement des organes voisins. Pour le diagnostic précis de ces tumeurs l’angiographie, la vénocavographie inférieure, et la biopsie à l'aiguille peuvent être utilisés [4]. Le dosage de l’alpha- foetoprotéine (AFP) de notre patient était négatif. Il a bénéficié d’une exérèse complète de la masse par une laparotomie sus-ombilicale transverse. L’exploration per-opératoire a retrouvé un contact intime de la masse avec le rein et le pédicule rénale droite Enfin, nous avons procédé à une fixation bipolaire du rein droit dans sa loge. Le contrôle vasculaire initial a permis une résection tumorale totale et fermée. \u0000Les tératomes rétropéritonéaux extirpables sont souvent de nature bénigne et l’exérèse doit être tentée quelle que soit la taille de la tumeur [5]. Les suites opératoires immédiates étaient simples. Une échographie rénale avec doppler couleur à 1 mois a montré un rein droit bien différencié avec un pédicule rénal droit normal au doppler.","PeriodicalId":354267,"journal":{"name":"JUNIOR MEDICAL RESEARCH","volume":"73 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117144135","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":"VIT D : The black knight","authors":"","doi":"10.32512/jmr/2.2.2019/16.19","DOIUrl":"https://doi.org/10.32512/jmr/2.2.2019/16.19","url":null,"abstract":"","PeriodicalId":354267,"journal":{"name":"JUNIOR MEDICAL RESEARCH","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130872263","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":"One more anatomic variant of the celiac trunk(in French)","authors":"","doi":"10.32512/jmr/2.2.2019/","DOIUrl":"https://doi.org/10.32512/jmr/2.2.2019/","url":null,"abstract":"Anatomical variations of the celiac trunk are numerous. Variants of the hepatic artery\u0000are important to consider especially in the bilio-pancreatic procedures. Unusual\u0000arterial anatomy increases the risk of postoperative specific complications. We report\u0000a case of a rare anatomic variant of the celiac trunk that gives rise to a left and right\u0000hepatic artery separately. It is an exceptional variant found in a patient with a\u0000pancreatic head tumor and candidate for duodenopancreatectomy.\u0000Key words: celiac trunk, right hepatic artery, anatomic variant.","PeriodicalId":354267,"journal":{"name":"JUNIOR MEDICAL RESEARCH","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115495474","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-emergency applications","authors":"","doi":"10.32512/jmr/2.2.2019/2.3","DOIUrl":"https://doi.org/10.32512/jmr/2.2.2019/2.3","url":null,"abstract":"Overcrowding in emergency departments (ED) could\u0000delay and alter the quality of critical services provided.\u0000Despite the generalization of developed triage system,\u0000the rate of nonurgent applicants is still considerable\u0000worldwide. This usually leads to long waiting patients\u0000lists, healthcare practitioners over stress, and patients\u0000unsastisfaction. A recent literature review reported that\u0000between 4.8% to 90% of ED patients were potentially\u0000nonurgent cases and the sudden death cases reported\u0000in ED should be simply urgent; long waiting unmanaged\u0000cases [1]. Among the leading reasons for unsuitable use\u0000of ED for “nonurgent complaints.”; patients related\u0000factors are most frequent. Elderly patients with heavy\u0000chronic conditions and lack of familial support are\u0000frequent ED users. Some patients prefer the ED due to\u0000the easy access and availability of all investigation tools.\u0000Ed is always convenient providing nonstop care by\u0000trained specialized team. According to some studies; it\u0000has been proved that a higher rate of nonemergency\u0000application is noticed in case of unavailability of primary\u0000health care centers access and during off-clinic hours\u0000[2]. The delayed appointments, and the lack of access\u0000to outpatient clinics on evenings and weekends is\u0000usually influencing the patient’s attitude. Interestingly,\u0000some other reports showed that most of the patients\u0000admitted to the ED with mild and simple complaints are\u0000well educated, have good social status and do not have\u0000chronic diseases [3]. For these cases, wrong perception\u0000could be bilateral. The patient is always considering his\u0000personal case as extremely urgent; and the health\u0000practitioner could not infirm the emergency before the\u0000investigations. This risk-averse patient risk-averse doctor\u0000relationship could explain the major part of non-emergency\u0000applications [4]. With these overwhelmed available\u0000resources, the increase of nonurgent visits results in risks for\u0000patient safety. This problematic has been recognized long\u0000time ago. Since early 90s many triage systems were\u0000implemented. However only five level triage instruments are\u0000significantly correlated with resource utilization, rate of\u0000admission for inpatient treatment, duration of emergency\u0000management, and frequency of transfer to intensive care or\u0000mortality. Unfortunately, these instruments could not be\u0000generalized to all ED [5]. Several other solutions have been\u0000proposed. Gatekeeping; redirecting patient systems, or\u0000health services cost sharing were not enough and difficult to\u0000implement. The benefit a financial penalty for patients\u0000categorized as nonurgent after the consultation or targeting\u0000frequent users by case management approach is still unclear\u0000[6]. In our point of view; the solution to decrease the rate of\u0000nonurgent visits is outside of emergency room and not\u0000inside. The only valuable option is to provide an alternative\u0000to ED by improving the outpatient departments and primary\u0000healthcare centers services quality. With patient large\u0000sensibilization, the ","PeriodicalId":354267,"journal":{"name":"JUNIOR MEDICAL RESEARCH","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124065895","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":"Isolated right adrenal metastasis from an invasive ductal breast carcinoma.","authors":"Taha M. M. Hassan, Al Emadi Mohammed Abdullah, Lotfy Mohammed, Mustafa Mohamed, Naser, Omar Amany Mohammed Rabie, Elahe Saleh","doi":"10.32512/jmr/2.2.2019/10.13","DOIUrl":"https://doi.org/10.32512/jmr/2.2.2019/10.13","url":null,"abstract":"Invasive ductal carcinoma (IDC) is the most common histopathological type of breast cancer, accounting for up to 85% of all invasive breast carcinomas [1]. It spreads usually to the bone first. Solitary metastasis is commonly located in the lung, liver or brain [2]. Adrenal glands locations are extremely rare [3]. We report a case of isolated metachronous right adrenal metastasis, diagnosed four years after breast IDC management. The aim is to highlight clinical, diagnostic and therapeutic characteristics of this entity.","PeriodicalId":354267,"journal":{"name":"JUNIOR MEDICAL RESEARCH","volume":"6 6","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132365611","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":"Bilateral posterior fracture-dislocation of the shoulder after epileptic seizures: A case report","authors":"","doi":"10.32512/jmr.2.1.2019/13.17","DOIUrl":"https://doi.org/10.32512/jmr.2.1.2019/13.17","url":null,"abstract":"Bilateral shoulder dislocation is a rare entity usually caused by sports injuries, electrical shock, or electroconvulsive therapy. Epileptic seizures account in less than 2% of cases . Almost always posterior, bilateral shoulder dislocation is usually due to unbalanced tonic muscles contraction and may be associated with fracture of the upper end of the humerus . The diagnosis is made by pertinent clinical examination and appropriate standard X ray requests and may easily be missed. Delayed management may lead to irreversible sequelae. We report a case of 46- year-old male who sustained bilateral posterior shoulder fracture- dislocation following epileptic seizures. The aim is to highlight diagnosis circumstances and the results of the management.","PeriodicalId":354267,"journal":{"name":"JUNIOR MEDICAL RESEARCH","volume":"45 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124007531","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":"Spinal Osteoid Osteoma and scoliosis: who is the painful?","authors":"J. Zied, Kaffel Dhia","doi":"10.32512/jmr.2.1.2019/18.19","DOIUrl":"https://doi.org/10.32512/jmr.2.1.2019/18.19","url":null,"abstract":"Ten-year-old girl was referred to our clinic for back pain and stiffness of the spine. X-ray of the spine showed a dorsal scoliosis with no other abnormality (figure 1a). Computed Tomography (CT) showed the nidus in right pedicle of the 3rd lumbar vertebra (figure 1b). The diagnosis of Osteoid osteoma was retained and confirmed after surgical resection and pathological examination. Osteoid osteoma (O.O) accounts for 10 % to 20 % of benign bone tumors [1]. Up to 25% of all O.O are found in the spine. Two thirds of spinal O.O manifest as painful scoliosis [2]. The diagnosis of the tumor is usually delayed because easily missed on standard X-ray investigation. Systematic CT or MRI with dynamic contrast would be recommended for young patients presenting with painful scoliosis [3].","PeriodicalId":354267,"journal":{"name":"JUNIOR MEDICAL RESEARCH","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115774110","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}