Estudo das diferentes formas de tratamento para disfunções temporomandibulares / Study of different treatment modalities for Temporomandibular Disorders / Estudio de diferentes formas de tratamiento para Trastornos Temporomandibulares

Introdução:Disfunções temporomandibularessão um termo coletivopara uma série de sinais e sintomas clínicos que envolvem os músculos mastigatórios, a articulação temporomandibular e estruturas associadas. O tratamento de pacientes deverá envolver uma equipe multidisciplinareparaquehajauma intervenção eficaz notratamento da disfunção é necessário que os profissionais envolvidos atuem emconjuntoetenhamplenoconhecimento das funções estomatognáticas.Objetivo:revisar aliteratura sobreas formas terapêuticas das disfunções temporomandibulares e sua eficácia.Metodologia:Trata-se de um estudosobre o panorama atual das terapêuticas utilizadas para o tratamento de disfunções temporomandibulares.Para compor o presente trabalho foi consultado o banco de dados da PubMed utilizando as palavras-chave "temporomandibular disorder" e "therapy" associados ao operador booleano AND. Os critérios de inclusão foram os artigos publicados, limitando-se ao período de 2020 a 2024 no idioma inglês. A busca computou um total de 545 artigos, dos quais foram excluídos os artigos que desviavam do tema proposto, artigos que abordavam técnicas com pouco embasamento científico e os artigos que não estavam disponíveis por completo.Resultados:os achados na literatura corroboram com a escolhaem primeiro plano de um tratamentoconservador, reversível e não invasivo. Dentre as opções destacam-se orientações de autocuidado, confecção de placa oclusal, terapias manuais, exercícios musculares, biofeedback e manejo farmacológico em casos de sintomas somáticos. A toxina botulínica tem sido sugerida para tratamento em casos de disfunções temporomandibularesmusculares, no entanto, com baixa evidência científicaquanto aos efeitos adversos. Técnicas cirúrgicas são indicadas em casos de não resolução com terapias conservadoras.Conclusões:Apesar dagrande diversidade nos protocolos,o tratamento conservador demonstra resolução do problema na maioria dos casos de disfunções temporomandibularese aquelestratamentos que combinam várias técnicasevidenciam melhores resultados do que tratamentos isolados (AU).

Introduction: Temporomandibular disorders are a collectiveterm for a range of clinical signs and symptoms involving the masticatory muscles, the temporomandibular joint, and associated structures. Treating patients with disorder temporomandibularshould involve a multidisciplinary team, and for effective intervention in dysfunction treatment, it is necessary for the involved professionals to work together and have a comprehensive understanding of stomatognathic functions. Objective: review the literature on therapeutic modalities for temporomandibular disorders and their effectiveness. Methodology:This is a study on the current landscape of therapies used for the treatment of temporomandibular disorders. To compose this work, the PubMed database was consulted using the keywords "temporomandibular disorder" and "therapy" associated with the boolean operator AND. Inclusion criteria were articles published in English from 2020 to 2024. The search yielded a total of 545 articles, from which articles deviating from the proposed theme, articles discussing techniques with little scientific basis, and articles not fully available were excluded. Results:Literature findings support the prioritization of conservative, reversible, and non-invasive treatment. Among the options, self-care guidance, occlusal splint fabrication, manual therapies, muscle exercises, biofeedback, and pharmacological management for somatic symptoms stand out. Botulinum toxin has been suggested for treatment in cases of muscular disordertemporomandibular, however, with low scientific evidence regarding adverse effects. Surgical techniques are indicated in cases where conservative therapies fail to resolve the issue. Conclusions:Despite the diversity in protocols, conservative treatment demonstrates resolution of the problem in most cases of disorder temporomandibular,and treatments combining multiple techniques show better results than isolated treatments (AU).

Introducción:Las disfunciones temporomandibulares son un término colectivopara una serie de signos y síntomas clínicos que afectan a los músculos masticatorios, la articulación temporomandibular y estructuras asociadas. El tratamiento de pacientes con disfunciones temporomandibularesdebe involucrar a un equipo multidisciplinario para una intervención efectiva, requiriendo que los profesionales actúen conjuntamente y conozcan bien las funciones estomatognáticas. Objetivo:revisar la literatura sobre las terapias paradisfunciones temporomandibularesy su eficacia. Metodología:Estudio comparativo de las terapias actuales para disfunciones temporomandibulares, utilizando la base de datos PubMed con las palabrasclaves "temporomandibular disorder" y "therapy" y el operador booleano AND, limitado a 2020-2024 en inglés. La búsqueda obtuvo un total de 545 artículos de los cuales fueron excluidos los que no abordaban el tema propuesto. Resultados:Los hallazgos respaldan un tratamiento conservador, reversible y no invasivo, destacando el autocuidado, placas oclusales, terapias manuales, ejercicios, biofeedback y manejo farmacológico. La toxina botulínica se sugiere para disfunciones temporomandibulares musculares, pero con poca evidencia científica de sus efectos adversos. Las técnicas quirúrgicas se reservan para casos sin resolución.Conclusiones: A pesar de la diversidad de protocolos, el tratamiento conservador resolveula mayoría de los casos de disfunciones temporomandibulares, y los tratamientos combinados muestran mejores resultados que los aislados (AU).

Decompression Associated with Irrigation with Elixir Sanativo® Before Enucleation of Odontogenic Keratocysts: report of Two Cases / Descompresión Asociada a Irrigación con Elixir Sanativo® antes de la Enucleación de Queratoquistes Odontogénicos: reporte de Dos Casos

Odontogenic Keratocyst (OKC) is an aggressive cystic lesion of the jaws and one of the most common odontogenic cysts, usually affecting the posterior region of the mandible. Recurrences are frequently recorded and may be directly related to the treatment modality adopted. Two patients presenting OKC were treated by combining decompression and intralesional irrigation with the drug Elixir Sanativo® for 8 months before enucleation surgery. In both patients, the association between decompression and irrigation with Elixir Sanativo® represented a safe and effective method to reduce the preoperative lesion dimensions.

El queratoquiste odontogénico (QO) es una lesión quística agresiva de la mandíbula y es uno de los quistes odontogénicos más frecuentes, que suele afectar a la región posterior de la mandíbula. Las recidivas se registran con frecuencia y pueden estar directamente relacionadas con la modalidad de tratamiento adoptada. Presentación del caso: Dos pacientes que presentaban OKC fueron tratados combinando descompresión e irrigación intralesional con el fármaco Elixir Sanativo® durante 8 meses antes de la cirugía de enucleación. En ambos pacientes, la asociación entre descompresión e irrigación con Elixir Sanativo® representó un método seguro y eficaz para reducir las dimensiones de la lesión preoperatoria.

Infiltração resinosa em lesões brancas cariosas e não cariosas: relato de casos / Infiltración resinosa em lesiones blancas cariosas y no cariosas: Reporte de Casos / Resinous infiltration in carious and non-carious white lesions: Case Reports

Introdução: O processo de desmineralização proveniente da cárie leva à formação de manchas brancas que são a primeira manifestação visível da doença. Os infiltrantes resinosos surgem como uma alternativa para o tratamento dessas lesões não cavitadas, pois sãoresinas de baixa viscosidade e faz parte dos procedimentos que visam uma odontologia menos invasiva. Objetivo: Este estudo objetiva relatar a experiência clínica no uso de infiltrante resinoso, Icon, em lesões de mancha branca de etiologias cariosa e não cariosa em dois pacientes distintos, insatisfeitos com a estética do seu sorriso. Descrição do caso: Ao exame clínico foi observado nos pacientes com lesões brancas. No primeiro paciente, de 14 anos, verificou-se a presença da atividade de cárie e micro cavitações. Dessa forma, o plano de tratamento perpassou orientação de higiene oral supervisionada, aplicação de verniz fluoretado, Enamelast, semanal, adequação do meio com restaurações em resina, e só então o uso do infiltrante. A segunda paciente, de 11 anos, já possuía saúde bucal adequada e tinha queixa estética devido à lesão branca não cariosa, hipoplasia, cujo plano de tratamento foi à utilização do Icon apenas. Conclusões: Nos dois casos obteve-se melhoria estética considerável com este procedimento microinvasivo. Melhoria na saúde bucal, aliado à devolução da estética, pode ser observada com o uso de infiltrantes resinosos (AU).

Introduction: The process of demineralization resulting from caries leads to the formation of white spots that are the first visible manifestation of the disease. Resin infiltrants appear as an alternative for the treatment of these non-cavitated lesions, since they are low viscosity resins and are part of the procedures that aim at a less invasive dentistry.Objective:This study aims to report the clinical experience in the use of a resin infiltrant, Icon,in white spot lesions of carious and non-carious etiologies in two different patients who were dissatisfied with the esthetics of their smiles.Methodology: On clinical examination, white lesions were observed in both patients. In the first patient,14 years old,the presence of caries activity and micro cavitations was verified. Thus, the treatment plan included supervised oral hygiene guidance, weekly application of fluoride varnish,Enamelast, adaptation of the environment with resin restorations, and, onlythen, the use of the infiltrant, Icon. The second patient, 11 years old,already had adequate oral health and had an esthetic complaint due to a non-carious white lesion, hypoplasia, whose treatment plan consisted of the use of Icon only.Conclusions:In both cases considerable esthetic improvement was obtained with this microinvasive procedure. Improvement in oral health, combined with the return of esthetics, can be observed with the use of resin infiltrants (AU).

Introducción: El proceso de desmineralización resultante de la caries conduce a la formación de manchas blancas, que son la primera manifestación visible de la enfermedad. Losinfiltrantes de resina aparecen como una alternativa para el tratamiento de estas lesiones no cavitadas, pues se tratan de resinas de baja viscosidad y forman parte de los procedimientos que buscan una odontología menos invasiva. Objetivo:Este estudio tiene como objetivo relatar la experiencia clínica en el uso del infiltrante de resina,Iconen lesiones de mancha blanca de etiologías cariosas y no cariosas en dos pacientes diferentes, insatisfechos con la estética de sus sonrisas.Metodología: En el examen clínico se observaron lesiones blancas en ambos pacientes. En el primer paciente, 14 añosse verificó la presencia de actividad de caries y micro cavitaciones. De ese modo, el plan de tratamiento incluyó la orientación supervisada de la higiene bucal,la aplicación semanal de barniz de flúor (Enamelast), la adaptación del entorno con restauraciones de resina y, sólo después, el uso del infiltrante,Icon. La segunda paciente, 11 años,ya tenía una salud bucal adecuada y presentaba una queja estética debido a una lesión blanca no cariosa, hipoplasia, cuyo plan de tratamiento fue el uso exclusivo de Icon. Conclusiones: En ambos casos, se consiguió una mejora estética considerable con este procedimiento microinvasivo. La mejora de la salud bucal, unida a la recuperación de la estética, puede observarse con el uso de infiltrantes de resina (AU).

Evaluation of Various Therapeutic Approaches in Treating Medication-related Osteonecrosis of the Jaw: A Systematic Review

Background and Aims: Medication-related osteonecrosis of the jaws (MRONJ) is a significant and potentially debilitating side effect caused by antiresorptive and antiangiogenic drugs, which can lead to bone exposure in the oral cavity. However, the management of this condition remains controversial, with adjuvant therapies being employed despite limited scientific evidence. This systematic review aimed to identify effective therapeutic procedures for treating MRONJ. Methodology: A literature search was conducted without any temporal limitations. The PRISMA protocol was followed. To identify relevant studies, we developed electronic search strategies for various bibliographic databases, as Cochrane, Embase, PubMed, Scopus, and Web of Science. It was conducted a comprehensive analysis of 30 studies involving 2,079 patients from 35 countries to evaluate the effectiveness of various treatment approaches for MRONJ. Results: The systematic review revealed that long-term use of Zoledronic acid for approximately 452.04 months (±27.41; 12-102) exposed many patients (n=772) to the risk of MRONJ. Similarly, Alendronate use for approximately 104.4 months (±60.16; 6-180) also posed a risk, affecting 650 patients, while Pamidronate use for about 20.74 months (±4.94; 6-96) was associated with MRONJ risk in 121 patients. Among the treatment approaches, conservative surgical management was the most frequently employed (27.92%), followed by local debridement (13.57%) and conservative treatment (11.21%). Treatment complications were observed in 13.03% of cases, with the most frequent complications being resistant or worsening clinical stage of osteonecrosis, followed by incomplete mucosal healing or dehiscence and mental nerve injury. Conclusion: While conservative surgical management, local debridement, and conservative treatment are commonly utilized approaches, the treatment of MRONJ lacks a standardized consensus due to the scarcity of scientific evidence. Further research and comprehensive studies are imperative to establish effective therapeutic strategies for managing this condition.

Tratamiento conservador no invasivo del traumatismo esplénico / Non-invasive conservative treatment of splenic trauma

RESUMEN Antecedentes: el tratamiento conservador no invasivo del traumatismo esplénico disminuye intervenciones quirúrgicas innecesarias y depende centro asistencial donde es aplicado. Objetivo: describir los resultados del tratamiento conservador no invasivo de pacientes con traumatismo abdominal cerrado con lesión esplénica y correlacionarlos con variables preoperatorias. Material y métodos: trabajo observacional descriptivo de pacientes con traumatismo abdominal cerrado con lesión esplénica ingresados entre 2012-2022. Se analizaron cinemática del traumatismo, lesiones asociadas, grado de lesión tomográfica y de hemoperitoneo, lugar de internación y resultado del tratamiento conservador no invasivo. Resultados: en 102 pacientes la cinemática del traumatismo de mayor frecuencia fue moto/auto (47,1%); el porcentaje de éxito del tratamiento conservador no invasivo fue 66,6%, y se relacionó con el grado de lesión tomográfica (p <0,001), grado de hemoperitoneo (p <0,001), presencia de otras lesiones (p <0,001), traumatismo encéfalo craneano grave (p <0,009), y lugar de internación (p <0,002). Conclusión: a pesar de no contar con todos los recursos humanos y tecnológicos recomendados, el tratamiento conservador no invasivo en esta serie tuvo resultados comparables con centros de mayor complejidad.

ABSTRACT Background: Non-invasive conservative treatment of splenic trauma reduces the rate of unnecessary surgical interventions and depends on the type of healthcare center involved. Objective: The aim of this study is to describe the outcomes of non-invasive conservative treatment in patients with blunt abdominal trauma and splenic injury and their correlation with the preoperative variables. Material and methods: We conducted a retrospective and observational study of patients admitted with blunt abdominal trauma and splenic injury between 2012 and 2022. The variables analyzed were kinematics of trauma, lesion severity on computed tomography images, amount of hemoperitoneum, type of unit of hospitalization and results of non-invasive conservative treatment. Results: Among 102 patients, the most common kinematics of trauma was motorcycle-to-car collisions (47.1%); the success rate of non-invasive conservative treatment was 66.6%, and was associated with lesion severity on computed tomography images (p < 0.001), amount of hemoperitoneum (p < 0.001), presence of other injuries (p < 0.001), severe trauma brain injury (p < 0.009), and type of unit of hospitalization (p < 0.002). Conclusion: Despite the absence of recommended human and technological resources, the results of non-invasive conservative treatment in this series were comparable to those obtained in high complexity centers.

Dying with end stage kidney disease: factors associated with place of death on a palliative care program / Fim de vida na doença renal terminal: fatores associados ao local de óbito num programa de cuidados paliativos

Abstract Introduction: End of life care of patients with end-stage kidney disease (ESKD) may be particularly challenging and requires the intervention of a specialized palliative care team (PCT). Objective: To characterize the population of ESKD patients referred to a PCT and evaluate the determinants of planned dying at home. Methods: We performed a retrospective observational cohort study of all patients with ESKD referred to our PCT between January 2014 and December 2021 (n = 60) and further characterized those with previously known ESKD regarding place of death (n = 53). Results: The majority of the patients were female and the median age was 84 years. Half of the patients were on conservative treatment, 43% were on chronic hemodialysis, and the remainder underwent hemodialysis on a trial basis and were subsequently suspended. Of those with previously known ESKD, 18% died at home and neither gender, age, cognition, performance status, comorbidities, CKD etiology, or treatment modality were associated with place of death. Anuria was significantly associated with dying at the hospital as was shorter time from dialysis suspension and death. Although not reaching statistical significance, we found a tendency towards a longer duration of palliative care follow-up in those dying at home. Conclusion: Dying at home is possible in a palliative domiciliary program regardless of age, gender, etiology of CKD, major comorbidities, and treatment modality. Anuria and shorter survival from RRT withdrawal may be limiting factors for planned dying at home. A longer follow-up by palliative care may favor dying at home.

Resumo Introdução: Os cuidados de fim de vida em doentescom doença renal terminal (DRT) podem ser desafiantes e necessitar do apoio de uma equipa especializada em cuidados paliativos (ECP). Objetivo: Caracterizar a população de doentes com DRT encaminhada à ECP e avaliar os determinantes para um fim de vida planeado no domicílio. Métodos: Realizámos um estudo de coorte observacional retrospectivo dos doentes com DRT encaminhados à ECP entre janeiro/2014 e dezembro/2021 (n = 60) e caracterizámos aqueles com DRT previamente conhecida relativamente ao local de fim de vida (n = 53). Resultados: A maioria dos pacientes eram mulheres comidade mediana de 84 anos. Metade dos doentes encontrava-se em tratamento conservador, 43% em hemodiálise crónica e os restantes suspenderam diálise iniciada agudamente. Daqueles com DRT previamente conhecida, 18% morreram em casa. Não foi objetivada associação entre género, idade, cognição, status funcional, comorbilidades, etiologia da DRC ou modalidade de tratamento da DRT e o local de óbito. A anúria e a menor sobrevida após suspensão de diálise associaram-se a um fim de vida no hospital e verificámos uma tendência para o fim de vida em casa nos doentes com mais tempo de acompanhamento pela ECP. Conclusão: O fim de vida no domicílio é possível num programa domiciliário de cuidados paliativos, independentemente de idade, sexo, etiologia da DRC, principais comorbilidades e modalidade de tratamento. A anúria e o menor tempo de sobrevida após suspensão da TRS podem ser fatores limitantes. Um acompanhamento mais longo em cuidados paliativos pode favorecer o fim de vida no domicílio.

Management Of Lumbosacral Pain With Radiculopathy By Epidural Steroid Injection In Tertiary Care Hospital In Dar Es Salaam, Tanzania

Introduction:- The aim of this retrospective observational study was to compare the potential efcacy of epidural steroid injection along with other conservative measures for relieving pain and improving function in patients with lumbosacral pain with radiculopathy caused by lumbar disc herniation. The route of administration (transforaminal, caudal or translaminar) were chosen on basis of pattern of radiculopathy and mri ndings of disc herniation. Methods:- This study included 131 patients who presented with low back pain and radiculopathy due to lumbar disc herniation(at levels of L4–L5 or L5–S1) diagnosed clinically and conrmed by means of MRI. 4 patients were lost to follow up remainig 127 patients at nal follow up.(127 patients)All patients were given fair trial of conservative treatment with drugs and physiotherapy. All patients were assessed at presentation and after starting the treatment at the second week and then third and sixth month using the visual analogue scale (VAS) for pain and the Oswestry Disability Index (ODI) for function status. Results:- In the transforaminal group (45 patients), there was a statistically signicant improvement in the ODI scores from before the injection (ODI mean 62.4) to 2 weeks after the injection (ODI mean 24.4, P < 0.01), and upon follow-up at 3 months. (ODI mean 20.8, P < 0.01). 21 patients (16.5%) required 1 or 2 repeated injections, 4 (3.1%) patients underwent surgery. In the interlaminar group (19 patients), there was a statistically signicant improvement in the ODI scores from before the injection (ODI mean 60.7) to 2 weeks after the injection (ODI mean 30.1, P < 0.01), but not upon follow-up (ODI mean 43.2, P = 0.09).5 (26.3%) patients required 1 or 2 repeated injection, 2 (10.5%) patients underwent surgery and 4(21%) patients developed transient paraparesis.In caudal group(63 patients) there was statistically signicant improvement in ODI SCROES from before the injection (ODI mean 39.6) to 2 weeks after the injection (ODI mean 29.6) which deteriorate at 3 months( ODI mean 31.8).There was an insignicant difference (P > 0.05) between the transformainal and caudal groups in the VAS, except at the third month (P < 0.05). Epidural steroid injection could be a preferable choice in chronic lowback and radicular Conclusion:- pain due to LDH. It has shown good short term outcomes and can be safe, cost effective and minimally invasive treatment and alternative to surgery.

Manejo y resultados de pacientes con diverticulitis aguda: experiencia de cinco años en el Hospital San Vicente Fundación / Management and results of patients with acute diverticulitis. Five year-experience at the San Vicente Fundación Hospital

Introducción. Los datos epidemiológicos de la diverticulitis en Colombia son limitados. El objetivo de este artículo fue caracterizar una población que ingresó con diverticulitis aguda al Hospital Universitario San Vicente Fundación, un centro de referencia de la ciudad de Medellín, Colombia, para analizar la presentación y comportamiento de la enfermedad en la población local, con estadísticas propias y desenlaces de la enfermedad en los últimos años. Métodos. Estudio observacional retrospectivo, descriptivo, entre enero de 2015 y diciembre de 2019. Se hizo un estudio exploratorio uni-, bi- y multivariado de factores de riesgo para fallo en el tratamiento y la mortalidad. Resultados. Se incluyeron 103 pacientes. Se presentó principalmente en mujeres y la edad promedio fue de 65 años. La diverticulitis Hinchey Ia fue la más frecuente (41,7 %) y el manejo médico fue exitoso en todos los casos, mientras que en las tipo III y IV, todos se manejaron de forma quirúrgica, con tasas de éxito entre el 50 y el 64 %. La presencia de signos de irritación peritoneal al examen físico, el recuento de leucocitos y la PCR, el ingreso a la Unidad de Cuidados Intensivos y la mortalidad aumentaron de forma directamente proporcional con el estadio de Hinchey. Conclusiones. Existe una relación directamente proporcional entre la clasificación de Hinchey y los signos de respuesta inflamatoria clínicos y paraclínicos, la necesidad de manejo quirúrgico, la estancia en la Unidad de Cuidados Intensivos y la mortalidad.

Introduction. Epidemiological data on diverticulitis in Colombia are limited. The objective of this article was to characterize a population that was admitted with acute diverticulitis to the San Vicente Fundación University Hospital, a reference center in the city of Medellín, Colombia, to analyze the presentation and behavior of the disease in the local population, with its own statistics, and outcomes of the disease in recent years. Methods. Retrospective descriptive observational study between January 2015 and December 2019. An exploratory uni-, bi- and multivariate study of risk factors for treatment failure and mortality was performed. Results. A total of 103 patients were included. The most frequent Hinchey classification was Ia (41.7%). It occurs mainly in women, mean age 65 years. Hinchey Ia diverticulitis is the most frequent and medical management is successful in 100% of cases; while in III and IV, 100% were managed surgically with success rates between 50 and 64%. The presence of peritoneal signs on physical examination, leukocyte count and CRP, ICU admission and mortality increased directly proportional with Hinchey stage. Conclusions. There is a directly proportional relationship between Hinchey staging with clinical and paraclinical signs of inflammatory response, need for surgical management, ICU stay and mortality.

Plant-based diets and their effects on the metabolism and survival of chronic renal patients undergoing conservative treatment

Diet therapy in conservative treatment of chronic kidney disease involves protein restriction, but there is not enough evidence to recommend a particular type of protein, whether animal or plant based. However, studies suggest that plant-based diets help reduce the consumption of total and animal protein, reduce the need for nephroprotective drugs, improve complications and bring advantages in terms of disease progression and patient survival. The article considers up-to-date data on the effects of this diet and observed that when low in protein, primarily vegetable and in some cases supplemented with ketoanalogues, it can result in positive clinical outcomes, such as: delay in the decrease in the glomerular filtration rate, lower concentrations of urea, reduction of serum creatinine and phosphorus concentrations, lower metabolic acidosis, higher insulin sensitivity and lower systemic inflammation. As a whole, this dietary pattern may be able to postpone the start of dialysis with less progression of renal insufficiency. Additional research is needed to better characterize this dietary pattern.

La dietoterapia en el tratamiento conservador de la enfermedad renal crónica implica la restricción de proteínas, pero aún no hay pruebas suficientes para recomendar un tipo concreto de proteínas, ya sean animales o vegetales. Sin embargo, los estudios sugieren que las dietas basadas en plantas ayudan a reducir la ingesta de proteínas totales y animales, disminuyen la necesidad de fármacos nefroprotectores, mejoran las complicaciones y presentan ventajas con respecto a la progresión de la enfermedad y la supervivencia de los pacientes. En este artículo se consideran datos actualizados sobre los efectos de esta dieta y se observa que, cuando es hipoproteica, principalmente vegetal y en algunos casos se complementa con cetoanálogos, puede dar lugar a resultados clínicos positivos, como una disminución retardada de la tasa de filtración glomerular, concentraciones más bajas de urea, concentraciones reducidas de creatinina y fósforo séricos, menor acidosis metabólica, mayor sensibilidad a la insulina y menor inflamación sistémica. En conjunto, este patrón dietético tiene el potencial de retrasar el inicio de la diálisis con una menor progresión de la insuficiencia renal. Es necesario seguir investigando para caracterizar mejor este patrón dietético.

Evolución clínica en pacientes con síndrome del túnel carpiano tratados con ultrasonido o infiltración con corticoesteroides / Clinical Evolution in Patients with Carpal Tunnel Syndrome Treated with Ultrasound or Corticosteroid Infiltration

Introducción. El Síndrome del túnel carpiano es la neuropatía periférica compresiva más común de la extremidad superior, que se produce por la compresión del nervio mediano. Los casos leves y moderados pueden tratarse con métodos conservadores como ultrasonido terapéutico o infiltración con corticoesteroides. Objetivo. Describir la evolución clínica de pacientes con síndrome de túnel carpiano tratados con terapia por ultrasonido e infiltración de corticoesteroides. Metodología. Ensayo clínico abierto, en pacientes con síndrome del túnel carpiano leve y moderado, que consultaron del 1 de octubre 2021 al 30 de mayo 2022. Se formaron dos grupos; el que recibió tratamiento con ultrasonido con 12 casos y el grupo tratado con infiltración con corticoesteroides con seis casos. Ambos grupos fueron intervenidos en la consulta inicial, y luego, en las cuatro y ocho semanas posteriores al inicio del tratamiento. Resultados. Se muestran los resultados descriptivos relacionados con la intensidad de dolor, valorada con la Escala Visual Numérica, la infiltración obtuvo dos casos sin dolor y cuatro con dolor moderado, contrario a ultrasonido que se mantuvo con cuatro casos leves, tres moderados y cinco intensos. En los síntomas, la infiltración redujo el número de casos en cuatro de los síntomas estudiados, en cambio el ultrasonido únicamente en dos. En severidad, valorada con el cuestionario de Boston para túnel carpal, con infiltración se obtuvieron dos casos asintomáticos y ninguno con ultrasonido. Respecto a los signos clínicos, el signo de Tinel desapareció en cuatro casos en ambos grupos, mientras que signo de Phalen desapareció en cuatro casos en ultrasonido y dos en infiltración. Conclusión. En intensidad de dolor y grado de severidad, la infiltración generó casos asintomáticos y redujo mayor cantidad de síntomas que el ultrasonido. Ambos tratamientos disminuyeron la presencia de signos clínicos

Introduction. Carpal tunnel syndrome is the most common compressive peripheral neuropathy of the upper extremity, which is caused by compression of the median nerve. Mild and moderate cases can be treated with conservative methods such as therapeutic ultrasound or corticosteroid infiltration. Objective. To describe the clinical evolution of patients with carpal tunnel syndrome treated with ultrasound therapy and corticosteroid infiltration. Methodology. A prospective open clinical trial was conducted in patients with mild and moderate carpal tunnel syndrome who consulted from October 1, 2021 to May 30, 2022. Two groups were formed: the group that received ultrasound treatment with 12 cases and the group treated with corticosteroid infiltration with six cases. Both groups were treated at the initial consultation and then at four and eight weeks after the start of treatment. Results. The descriptive results related to the intensity of pain, evaluated with the Visual Numeric Scale, are shown. Infiltration obtained two cases without pain and four with moderate pain, contrary to ultrasound which was maintained with four mild, three moderate and five intense cases. In symptoms, infiltration reduced the number of cases in four of the symptoms studied, while ultrasound reduced the number of cases in only two. In severity, assessed with the Boston carpal tunnel questionnaire, with infiltration, there were two asymptomatic cases and none with ultrasound. Regarding clinical signs, Tinel's sign disappeared in four cases in both groups, while Phalen's sign disappeared in four cases in ultrasound and two in infiltration. Conclusion. Infiltration produced asymptomatic patients and reduced more symptoms than ultrasonography in terms of pain intensity and severity. Clinical symptoms were less common with both treatments.

Manejo conservador en hemorragia puerperal por placenta acreta / Conservative management in puerperal hemorrhage due to placenta accreta

RESUMEN El espectro placenta acreta se encuentra en incremento debido a múltiples causas, especialmente por el aumento de las cesáreas. El diagnóstico supone un reto, pues la mayoría de casos se asocia a hemorragia tras el alumbramiento. La ecografía morfológica prenatal debe valorar signos que hagan sospechar acretismo placentario. Se presenta el caso de una paciente diagnosticada de placenta acreta luego de abundante hemorragia puerperal 48 horas después del alumbramiento que requirió dos legrados uterinos y la administración de metotrexato intramuscular. En cuanto al tratamiento, aunque anteriormente se optaba por el manejo radical, la tendencia actual es un manejo conservador con el fin de preservar la fertilidad de la paciente.

ABSTRACT The placenta accreta spectrum is on the rise due to multiple causes, especially the increase in cesarean sections. Diagnosis is challenging, as most are associated with hemorrhage after delivery. Prenatal morphologic ultrasonography should evaluate for signs of suspected placental accreta. We present the case of a patient diagnosed with placenta accreta after abundant puerperal hemorrhage 48 hours after delivery, which required two uterine curettages and the administration of intramuscular methotrexate. As for treatment, although previously radical management was chosen, the current trend is conservative management in order to preserve the patient's fertility.

Controversies in the diagnosis and treatment of acute lateral ankle sprains / 国际外科学杂志

Acute lateral ankle sprains are the most common musculoskeletal injury of the lower limbs. Without timely intervention, the condition may progress to chronic ankle instability, leading to a series of adverse consequences. Therefore, accurate diagnosis, classification, and active intervention are essential. Currently, there are numerous diagnostic methods, classification criteria, and treatment methods for acute lateral ankle sprains in clinical practice, with some aspects still subject to debate. This article will provide an overview of the progress and controversial issue in diagnosis, classification, and treatment methods for acute lateral ankle sprains.

Diagnosis and treatment of 11 cases of liver injury due to percutaneous nephrolithotripsy / 现代泌尿外科杂志

【Objective】 To explore the diagnosis and management of liver injury caused by percutaneous nephrolithotripsy (PCNL), so as to provide reference for the diagnoise and treatment of similar patients. 【Methods】 The clinical data of 926 patients who underwent PCNL during Oct.2017 and Oct.2022 were searched, and the data of those complicated with liver injury were analyzed. 【Results】 A total of 11 cases were collected, including 6 males and 5 females, average age (55.00±13.25)years.All injuries were confirmed with CT.The average decrease of hemoglobin after operation was (14.00±11.97)g/L.One patient needed blood transfusion due to pyonephrosis and multiple operations, and all patients were cured and discharged after delaying the removal of nephrostomy tube [an average of (6.73±1.27)days] . 【Conclusion】 In the absence of obvious signs of peritonitis and hemodynamic stability, conservative treatment of liver injury caused by PCNL is safe and effective.

Comparison of efficacy and safety between arthroscopic anterior glenohumeral joint release and conservative treatment for frozen shoulder / 中国内镜杂志

Objective To explore the difference of efficacy and safety between arthroscopic anterior glenohumeral joint release and conservative treatment for frozen shoulder.Methods 98 patients with frozen shoulder from October 2021 to October 2022 were prospectively selected as the study subjects.They were randomly divided into group A and group B.48 patients in group A were treated with anterior glenohumeral joint release under shoulder arthroscopy,and 50 patients in group B were treated conservatively.The clinical effects of the two groups were compared.The Constant-Murley shoulder function score,shoulder range of motion,visual analogue scale(VAS),active range of motion(AROM)score and Pittsburgh sleep quality index(PSQI)were compared before and after treatment in the two groups,and the complications of the two groups were observed.Result The total effective rate of clinical treatment in group A was 93.75%(45/48),which was significantly higher than that in group B 76.00%(38/50);After 3 months of treatment,the shoulder joint function score of group A was higher than that of group B,the activity indexes of flexion,internal rotation,abduction and external rotation in two groups were increased after treatment,and group A was higher than group B,VAS and PSQI scores were lower and AROM scores was higher in group A than in group B,the differences were statistically significant(P<0.05).Conclusion The anterior glenohumeral joint release under arthroscopy has a better therapeutic effect on patients with frozen shoulder than conservative treatment.It can significantly improve the function and activity of the shoulder joint,reduce joint pain,improve sleep quality,and has no significant complications.It is worthy of clinical reference.

Epidemiological profile of patients undergoing non-operative management of solid organ injury and associated factors with mortality / Perfil epidemiológico dos pacientes submetidos a tratamento não operatório de lesão de órgãos sólidos e os fatores associados a óbito

ABSTRACT Introduction: Trauma primarily affects the economically active population, causing social and economic impact. The non-operative management of solid organ injuries aims to preserve organ function, reducing the morbidity and mortality associated with surgical interventions. The aim of study was to demonstrate the epidemiological profile of patients undergoing non-operative management in a trauma hospital and to evaluate factors associated with mortality in these patients. Methods: This is a historical cohort of patients undergoing non-operative management for solid organ injuries at a Brazilian trauma reference hospital between 2018 and 2022. Included were patients with blunt and penetrating trauma, analyzing epidemiological characteristics, blood transfusion, and association with the need for surgical intervention. Results: A total of 365 patients were included in the study. Three hundred and forty-three patients were discharged (93.97%), and the success rate of non-operative treatment was 84.6%. There was an association between mortality and the following associated injuries: hemothorax, sternal fracture, aortic dissection, and traumatic brain injury. There was an association between the need for transfusion and surgical intervention. Thirty-eight patients required some form of surgical intervention. Conclusion: The profile of patients undergoing non-operative treatment consists of young men who are victims of blunt trauma. Non-operative treatment is safe and has a high success rate.

RESUMO Introdução: O trauma atinge principalmente a população economicamente ativa, causando impacto social e econômico. O tratamento não operatório das lesões de órgãos sólidos tem como objetivo preservar a função do órgão, diminuindo a morbimortalidade envolvida nos tratamentos cirúrgicos. O objetivo do estudo foi demonstrar o perfil epidemiológico dos pacientes submetidos ao tratamento não operatório em um hospital de trauma, bem como avaliar o fatores associados ao óbito nesses pacientes. Métodos: Trata-se de uma coorte histórica de pacientes submetidos à tratamento não operatório de lesão de órgãos sólidos, em um hospital referência de trauma brasileiro, entre 2018 e 2022. Foram incluídos pacientes vítimas de trauma contuso e penetrante, analisando as características epidemiológicas, hemotransfusão e associação ou não com necessidade de abordagem cirúrgica. Resultados: Foram incluídos 365 pacientes no estudo. Trezentos e quarenta e três pacientes receberam alta (93,97%) e a taxa de sucesso no tratamento não operatório foi de de 84,6%. Houve associação entre o desfecho óbito e as seguintes lesões associadas: hemopneumotorax, fratura de esterno, dissecção de aorta e traumatismo crânio encefálico. Houve associação entre necessidade de transfusão e abordagem cirúrgica. Trinta e oito pacientes necessitaram de alguma abordagem cirúrgica. Conclusão: O perfil dos pacientes submetidos a TNO são homens jovens, vítimas de trauma contuso. O tratamento não operatório é seguro e apresenta alta taxa de sucesso.

Radiographic evaluation of conservative treatment of distal radius fractures / Avaliação radiográfica do tratamento conservador em fraturas distais do rádio

ABSTRACT Objective: This article aims to evaluate the evolution of radio-graphic parameters (radial tilt, volar tilt, and radial height) of distal radius fractures in patients indicated for conservative treatment at three different times: date of diagnosis, first outpatient visit within 2 weeks after closed reduction, and last outpatient visit. Methods: We included 84 patients seen at the emergency department of Hospital Municipal Odilon Behrens, with a diagnosis of distal radius fracture and an indication for conservative treatment. We considered only those patients who had serial radiographs taken at least three different times (n=69) in this analysis. Results: There was an improvement in radiographic parameters of volar tilt after closed reduction and immobilization, which was maintained until the last outpatient visit. Radial inclination and radial height showed increased values from the first to the second radiographic evaluation and both values had regression when comparing the second to the third (last) evaluation. Conclusion: Universal classification stable fractures tend to evolve well with conservative therapy. Level of Evidence II; Development of Diagnostic Criteria in Consecutive Patients (with Gold Standard of Reference Applied).

RESUMO Objetivo: O objetivo deste artigo foi avaliar a evolução dos parâmetros radiográficos (inclinação radial, inclinação volar e altura radial) das fraturas da extremidade distal do rádio em pacientes com indicação de tratamento conservador em três momentos diferentes: data do diagnóstico, primeira consulta ambulatorial dentro de. semanas após a redução fechada e última consulta ambulatorial. Métodos: Incluímos 84 pacientes atendidos no departamento de emergência do Hospital Municipal Odilon Behrens, com diagnóstico de fratura distal do rádio e indicação de. conservador. Consideramos nesta análise apenas os pacientes que tiveram radiografias seriadas realizadas pelo menos três vezes diferentes (n=69). Resultados: Houve uma melhora nos parâmetros radiográficos da inclinação volar após a redução fechada e a imobilização, que foi mantida até a última consulta ambulatorial. A inclinação radial e a altura radial apresentaram valores aumentados da primeira para a segunda avaliação radiográfica e ambos os valores tiveram regressão quando comparados da segunda para a terceira (última) avaliação. Conclusão: As fraturas estáveis de classificação universal tendem a evoluir bem com a terapia conservadora. Nível de Evidência II; Desenvolvimento de critérios diagnósticos em pacientes consecutivos (com aplicação de referência padrão ouro).

Treatment Options for Intracranial Epidural Hematoma - An Integrative Review of the Past Three Decades / Opções de tratamento para hematoma epidural intracraniano - Uma revisão integrativa das últimas três décadas

Introduction Acute epidural intracranial hematoma (IEH) has been considered one of the most relevant neurosurgical emergencies in recent decades due to its high potential for morbidity and mortality. Early diagnosis followed by appropriate treatment results in a more favorable prognosis considering its rapid progression. Objective To describe the various treatment modalities for IEH in the last three decades and their updates. Methods Integrative literature review on therapeutic options in IEH treatment. The terms "Epidural hematoma," "Traumatic brain injury," and "treatment" were used in the Medline/PubMed, Google Scholar, and SciELO platforms, resulting in 90 articles. Results Appropriate treatment for IEH depends directly on the Glasgow Coma Scale score obtained during admission, bleeding location, lesion size, presence of associated intracranial injuries, and the neurosurgeon's experience. Conclusion Initial treatment for IEH is predominantly surgical, with conservative treatment indicated in selected cases. Both neurosurgeons and clinicians must identify characteristic signs and symptoms promptly to avoid treatment delay. Moreover, minimally invasive approaches have gained prominence in recent decades, associated with image-guided procedures, and when well-indicated, result in rapid recovery and lower morbidity.

Introdução O hematoma epidural intracraniano agudo (HEIA) tem sido considerado uma das emergências neurocirúrgicas de maior relevância das últimas décadas devido ao seu alto potencial de morbimortalidade. O diagnóstico precoce seguido de tratamento adequado resulta em prognóstico mais favorável, tendo em vista sua progressão galopante. Objetivo Descrever as diversas modalidades de tratamento do HEIA nas últimas três décadas e suas atualizações. Métodos Revisão integrativa de literatura sobre as opções terapêuticas no tratamento do HEIA. Foram utilizados os termos: "Hematoma epidural", "Traumatismo cranioencefálico" e "tratamento" nas plataformas Medline/PubMed, Google Scholar e SciELO, resultando em 90 artigos. Resultados O tratamento adequado para o HEIA, depende diretamente do escore na escala de coma de Glasgow obtido durante a admissão, localização do sangramento, tamanho da lesão, presença de lesões intracranianas associadas e da experiência do neurocirurgião. Conclusão O tratamento inicial para o HEIA é eminentemente cirúrgico. Sendo o tratamento conservador indicado em casos selecionados. É de suma importância que tanto neurocirurgiões quanto clínicos devam saber identificar os sinais e sintomas característicos para não retardar o tratamento. Além disso, a abordagem minimamente invasiva vem ganhando notoriedade nas últimas décadas, associada aos procedimentos guiados por imagem, e, quando bem indicadas, resultam numa rápida recuperação e menor morbidade.

Pelvic floor muscle training in men with post-prostatectomy urinary incontinence: a scoping review / Entrenamiento de los músculos del piso pélvico en hombres con incontinencia urinaria post prostatectomía: revisión de alcance / Treinamento dos músculos do assoalho pélvico em homens com incontinência urinária pós-prostatectomia: revisão do escopo

Objective: to map pelvic floor muscle training protocols available in the literature for the management of post-prostatectomy urinary incontinence. Method: this is a scoping review conducted in six databases. Information retrieval was performed using a specific instrument, including: title, authorship, year of publication, journal, objective, study design and description of the protocols' content. Results: a total of 24 studies were included, which resulted in different protocols. The most frequent recommendations were the following: three sessions per day; with a frequency of six to 15 contractions per session; performing the exercises in the lying, sitting, and standing positions. The most cited guidelines in the protocols were anal sphincter and bulbocavernosus muscle contractions. All protocols followed the principle of regular pelvic floor muscle contraction, but there was no consensus regarding the start of the protocol, treatment duration, contraction/relaxation time, and intensity of the contraction force. Conclusion: different orientations were found in the pelvic floor muscle training protocols post-prostatectomy urinary incontinence, with emphasis on contraction time, relaxation time, number of contractions per session, training position, and protocol duration time. Different concepts were adopted to define urinary continence in the protocols. It is necessary to develop consensus guidelines that clearly define the parameters of training protocols.

Objetivo: mapear los protocolos de ejercicios para los músculos pélvicos disponibles en la literatura para el tratamiento de la incontinencia urinaria post prostatectomía. Método: esta es una revisión de alcance realizada en seis bases de datos. La recuperación de información se realizó mediante un instrumento específico, que incluye: título, autoría, año de publicación, revista, objetivo, diseño del estudio y descripción del contenido de los protocolos. Resultados: se incluyeron 24 estudios en total, de los cuales se obtuvieron diferentes protocolos. Las recomendaciones más frecuentes fueron: tres sesiones por día, con una frecuencia de seis a 15 contracciones por sesión; realizar los ejercicios en posición acostada, sentada y de pie. Las orientaciones más citadas en los protocolos fueron las contracciones del esfínter anal y del músculo bulbocavernoso. Todos los protocolos siguieron el principio de contracción regular de los músculos del piso pélvico, pero no hubo consenso sobre el inicio del protocolo, la duración del tratamiento, el tiempo de contracción/relajación y la intensidad de la fuerza de contracción. Conclusión: se encontraron diferentes orientaciones en los protocolos de entrenamiento de los músculos del piso pélvico para la incontinencia urinaria post prostatectomía, fundamentalmente sobre el tiempo de contracción, tiempo de relajación, número de contracciones por sesión, posición de entrenamiento y tiempo de duración del protocolo. Se adoptaron diferentes conceptos para definir la continencia urinaria en los protocolos. Es necesario desarrollar guías consensuadas que definan claramente los parámetros de los protocolos de entrenamiento.

Objetivo: mapear os protocolos de treinamento dos músculos do assoalho pélvico disponíveis na literatura para o tratamento da incontinência urinária pós-prostatectomia. Método: trata-se de uma revisão de escopo realizada em seis bases de dados. A recuperação de informações foi realizada por meio de um instrumento específico, incluindo: título, autoria, ano de publicação, periódico, objetivo, desenho do estudo e descrição do conteúdo dos protocolos. Resultados: um total de 24 estudos foram incluídos, o que resultou em diferentes protocolos. As recomendações mais frequentes foram as seguintes: três sessões por dia; com frequência de seis a 15 contrações por sessão; realização dos exercícios nas posições deitada, sentada e em pé. As diretrizes mais citadas nos protocolos foram as contrações do esfíncter anal e do músculo bulbocavernoso. Todos os protocolos seguiram o princípio da contração regular dos músculos do assoalho pélvico, mas não houve consenso quanto ao início do protocolo, duração do tratamento, tempo de contração/relaxamento e intensidade da força de contração. Conclusão: foram encontradas diferentes orientações nos protocolos de treinamento dos músculos do assoalho pélvico para incontinência urinária pós-prostatectomia, com ênfase no tempo de contração, tempo de relaxamento, número de contrações por sessão, posição de treinamento e tempo de duração do protocolo. Diferentes conceitos foram adotados para definir a continência urinária nos protocolos. É necessário desenvolver diretrizes de consenso que definam claramente os parâmetros dos protocolos de treinamento.

Use of Telenursing in the conservative treatment of patients with chronic renal insufficiency: scoping review / Uso de la Teleenfermería en el tratamiento conservador de pacientes con insuficiencia renal crónica: revisión de alcance / Uso da Telenfermagem no tratamento conservador de pacientes com insuficiência renal crônica: revisão de escopo

Objective: to map the evidence of the use of telenursing in adherence to treatment and promotion of self-care in patients with chronic renal insufficiency undergoing conservative treatment. Method: scoping review study, with selection of documents indexed in eight databases and two catalogs of theses and dissertations. Additionally, the reference lists of selected studies were consulted. Selection and analysis of studies were carried out using Rayyan software through double, independent and blind investigation. Results: 56 eligible publications were found and ten were selected to compose the study. The following stand out among telenursing interventions: cell phone applications, websites, digital platform, telephone support and teleconferencing. Conclusion: it was evident that the use of Telehealth by Nursing is relevant to the health sector, but still little explored in national and international literature, representing a gap in knowledge to be filled in future research. Studies have shown that its implementation helps and supports healthcare professionals, providing inferences and guidance for quick, safe and effective assistance, even remotely. Telenursing presents itself as a strategy capable of promoting adherence to treatment and self-care in patients with chronic renal insufficiency undergoing conservative treatment.

Objetivo: mapear la evidencia del uso de la teleenfermería en la adherencia al tratamiento y promoción del autocuidado en pacientes con insuficiencia renal crónica en tratamiento conservador. Método: estudio de revisión de alcance, con selección de documentos indexados en ocho bases de datos y dos catálogos de tesis y disertaciones. Además, se consultaron las listas de referencias de los estudios seleccionados. La selección y análisis de los estudios se realizó mediante el software Rayyan por medio investigación doble, independiente y ciega. Resultados: se encontraron 56 publicaciones elegibles y se seleccionaron diez para componer el estudio. Entre las intervenciones de teleenfermería se destacaron: aplicaciones para celulares, sitios web , plataforma digital, atención telefónica y teleconferencias. Conclusión: se evidenció que el uso de la Telesalud por parte de Enfermería es relevante para el sector de la salud, pero aún poco explorado en la literatura nacional e internacional, representando un vacío de conocimiento a ser llenado en futuras investigaciones. Estudios han demostrado que su implementación ayuda y apoya a los profesionales de la salud, brindando inferencias y orientaciones para una asistencia rápida, segura y eficaz, incluso a distancia. La teleenfermería se presenta como una estrategia capaz de promover la adherencia al tratamiento y al autocuidado en pacientes con insuficiencia renal crónica en tratamiento conservador.

Objetivo: mapear as evidências do uso da telenfermagem na adesão ao tratamento e promoção do autocuidado em pacientes com insuficiência renal crônica em tratamento conservador. Método: estudo de revisão de escopo, com seleção de documentos indexados em oito bases de dados e dois catálogos de teses e dissertações. Adicionalmente, foram consultadas as listas de referências dos estudos selecionados. A seleção e a análise dos estudos foram realizadas no software Rayyan por meio de dupla investigação, independente e cega. Resultados: foram encontradas 56 publicações elegíveis e foram selecionadas dez para compor o estudo. Destacaram-se entre as intervenções de telenfermagem: aplicativos para celular, websites, plataforma digital, suporte telefônico e teleconferência. Conclusão: evidenciou-se que o uso da Telessaúde pela Enfermagem é relevante para o âmbito da saúde, porém ainda pouco explorado pela literatura nacional e internacional, representando uma lacuna no conhecimento a ser preenchida em futuras pesquisas. Os estudos demonstraram que sua implementação auxilia e dá suporte aos profissionais da saúde, proporcionando inferências e orientações para uma assistência rápida, segura e efetiva, mesmo que à distância. A telenfermagem se apresenta como estratégia capaz de promover a adesão ao tratamento e ao autocuidado em pacientes com insuficiência renal crônica em tratamento conservador.

Trans-nasal sphenopalatine ganglion block for post-dural puncture headache management: a meta-analysis of randomized trials

Abstract Objective: To evaluate the efficacy and safety of trans-nasal Sphenopalatine Ganglion (SPG) block over other treatments for Post-Dural Puncture Headache (PDPH) management. Methods: A systematic literature search was conducted on databases for Randomized Controlled Trials (RCTs) comparing trans-nasal SPG blockade for the management of PDPH over other treatment modalities. All outcomes were pooled using the Mantel-Haenszel method and random effect model. Analyses of all outcomes were performed as a subgroup based on the type of control interventions (conservative, intranasal lignocaine puffs, sham, and Greater Occipital Nerve [GON] block). The quality of evidence was assessed using the GRADE approach. Results: After screening 1748 relevant articles, 9 RCTs comparing SPG block with other interventions (6 conservative treatments, 1 sham, 1 GON and 1 intranasal lidocaine puff) were included in this meta-analysis. SPG block demonstrated superiority over conservative treatment in pain reduction at 30 min, 1 h, 2 h, 4 h after interventions and treatment failures with "very low" to "moderate" quality of evidence. The SPG block failed to demonstrate superiority over conservative treatment in pain reduction beyond 6 h, need for rescue treatment, and adverse events. SPG block demonstrated superiority over intranasal lignocaine puff in pain reduction at 30 min, 1 h, 6 h, and 24 h after interventions. SPG block did not show superiority or equivalence in all efficacy and safety outcomes as compared to sham and GON block. Conclusion: Very Low to moderate quality evidence suggests the superiority of SPG block over conservative treatment and lignocaine puff for short-term pain relief from PDPH. PROSPERO Registration: CRD42021291707.