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2.
Adv Physiol Educ ; 48(2): 205-210, 2024 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-38205516

RESUMO

Medical education continually adapts to the needs of future health care professionals, with student motivation in research being a pivotal aspect. This study at Alfaisal University aimed to explore the motivations, benefits, and challenges faced by medical students in extracurricular research activities. Using a mixed-method approach, we combined quantitative surveys with qualitative group interviews. Findings revealed that both extrinsic (e.g., enhancing postgraduate training prospects) and intrinsic (e.g., personal interest and skill refinement) factors significantly motivate students to be involved in research activities. Participants unanimously acknowledged skill enhancement, particularly in literature comprehension, creative ideation, and networking. However, challenges such as conflicts with course scheduling, lack of hands-on experiences, and mentorship issues were identified as potential barriers to research participation. Addressing these barriers and understanding motivations can inform the design of research programs, enhancing the overall student research experience. This study underscores the importance of research in medical education, emphasizing the need for institutions to prioritize addressing challenges and leveraging benefits to prepare medical students for a research-integrated clinical future.NEW & NOTEWORTHY This article examines the motivating factors and obstacles of extracurricular research in Alfaisal University, Saudi Arabia. The study utilizes a mixed methodology of online surveys and in-person group interviews to gain insights from the medical students of the university. We revealed several extrinsic and intrinsic motivators that drove the students; however, there remain several challenges to students during their research journey. Addressing these challenges will help the students obtain a more fruitful, educational research experience.


Assuntos
Educação Médica , Estudantes de Medicina , Humanos , Universidades , Motivação , Currículo
3.
J Clin Med ; 13(2)2024 Jan 17.
Artigo em Inglês | MEDLINE | ID: mdl-38256646

RESUMO

Neutrophil extracellular traps (NETs) play an essential role in antimicrobial defense. However, NETs have also been shown to promote and mediate a wide spectrum of diseases, including cancer, diabetes mellitus, cardiovascular diseases, and ocular diseases. Data regarding NETs in ocular diseases remain limited. In physiological conditions, NETs protect the eye from debris and cleave proinflammatory cytokines, including several interleukins. On the other hand, NETs play a role in corneal diseases, such as dry eye disease and ocular graft-versus-host disease, where they promote acinar atrophy and delayed wound healing. Additionally, NET levels positively correlate with increased severity of uveitis. NETs have also been described in the context of diabetic retinopathy. Although increased NET biomarkers are associated with an increased risk of the disease, NETs also assist in the elimination of pathological blood vessels and the regeneration of normal vessels. Targeting NET pathways for the treatment of ocular diseases has shown promising outcomes; however, more studies are still needed in this regard. In this article, we summarize the literature on the protective roles of NETs in the eye. Then, we describe their pathogenetic effects in ocular diseases, including those of the cornea, uvea, and retinal blood vessels. Finally, we describe the therapeutic implications of targeting NETs in such conditions.

4.
Parasite Immunol ; 46(1): e13015, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37846743

RESUMO

Soil-transmitted helminths (STHs) parasitic infection is known as one of the most common infections around the world affecting more than a quarter of the world's population. The relationship between STH infections and micronutrient deficiencies are closely related and often coexist among the affected population. The study, therefore, aimed to summarise the available literature focusing on the effect of zinc status/deficiency or supplementation on STH infection or reinfection in children. For this purpose, we adopted a systematic approach and searched the existing literature on PubMed, Scopus, and Cochrane Library databases. A search term was entered to retrieve the available data. A total of 12 articles were included in this review after applying the inclusion/exclusion criteria. Most of the included studies reported a lower zinc status in children affected with any parasitic infection. Regarding the effect of zinc status and supplementation on parasitic infection in children, we found only a few studies (n = 4) with inconsistent result findings. This review reported that children infected with STH have lower zinc levels; however, a limited number of studies showed the effect of zinc supplements on the risk of STH warrants the need for further studies in this regard.


Assuntos
Helmintíase , Helmintos , Criança , Animais , Humanos , Zinco , Solo/parasitologia , Helmintíase/complicações , Helmintíase/epidemiologia , Suplementos Nutricionais , Prevalência
5.
Artigo em Inglês | MEDLINE | ID: mdl-38015258

RESUMO

Cytarabine, an antimetabolite antineoplastic agent, has been utilized to treat various cancers. However, because of its short half-life, low stability, and limited bioavailability, achieving an optimal plasma concentration requires continuous intravenous administration, which can lead to toxicity in normal cells and tissues. Addressing these limitations is crucial to optimize the therapeutic efficacy of cytarabine while minimizing its adverse effects. The use of novel drug delivery systems, such as polymer-based nanocarriers have emerged as promising vehicles for targeted drug delivery due to their unique properties, including high stability, biocompatibility, and tunable release kinetics. In this review, we examine the application of various polymer-based nanocarriers, including polymeric nanoparticles, polymeric micelles, dendrimers, polymer-drug conjugates, and nano-hydrogels, for the delivery of cytarabine. The article highlights the limitations of conventional cytarabine administration which often lead to suboptimal therapeutic outcomes and systemic toxicity. The rationale for using polymer-based nanocarriers is discussed, highlighting their ability to overcome challenges by providing controlled drug release, improved stability, and enhanced targeting capabilities. In summary, this review offers a valuable resource for drug delivery scientists by providing insights into the design principles, formulation strategies, and potential applications of polymer-based nanocarriers that can enhance the therapeutic efficacy of cytarabine.

6.
PeerJ ; 11: e16059, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37719115

RESUMO

Background: Physical activity can improve health-related quality of life (HRQoL) in adults. However, the effect of physical activity on quality of life is unclear among the Saudi adult population. The study aimed to determine the association between physical activity and HRQoL in apparently healthy adults in Jeddah, Saudi Arabia. Methods: This cross-sectional study was conducted among visitors of shopping malls, walking tracks/fitness centres/gyms and governmental hospitals in Jeddah from March to September 2022. Physical activity was measured with the electronic template of the general practice physical activity questionnaire (GPPAQ), while the HRQoL was measured using the 36-Item Short Form Survey (SF-36) questionnaire. A multiple linear regression model investigated the relationship between physical activity and HRQoL. Results: A total of 693 individuals participated in this study, with a mean age of 36 (±11). Individuals who fall in the active category of the physical activity level were mostly younger men (37% vs 21%), were non-smokers (30% vs 10%) and had no comorbid condition (29% vs 15%). After adjusting for covariates, men (adjusted ß 4.43, 95% CI [1.44-7.41]) with higher physical activity levels (active-adjusted ß 10.11, 95% CI [5.44-14.77]) had better scores on the physical component summary (PCS). Similarly, mental component summary (MCS) scores for men (adjusted ß 6.51, 95% CI [3.40-9.63]) and physical activity levels (active-adjusted ß 9.77, 95% CI [4.90-14.64]) were high. Conclusion: The article reinforces how physical activity contributes towards each dimension of HRQoL. Physical inactivity is a growing public health challenge in Saudi Arabia, affecting all age groups. Investing in innovative strategies and establishing targeted health education programs for academic institutions and communities are required to enhance healthy habits. Additionally, constructing more local sports facilities and concession packages, especially for the females at the gyms, can motivate individuals and promote physical activity.


Assuntos
Exercício Físico , Qualidade de Vida , Feminino , Masculino , Humanos , Adulto , Estudos Transversais , Arábia Saudita , Caminhada
7.
Cancers (Basel) ; 15(8)2023 Apr 08.
Artigo em Inglês | MEDLINE | ID: mdl-37190133

RESUMO

Breast cancer is a heterogeneous disease with different molecular subtypes. Breast cancer is the second leading cause of mortality in woman due to rapid metastasis and disease recurrence. Precision medicine remains an essential source to lower the off-target toxicities of chemotherapeutic agents and maximize the patient benefits. This is a crucial approach for a more effective treatment and prevention of disease. Precision-medicine methods are based on the selection of suitable biomarkers to envision the effectiveness of targeted therapy in a specific group of patients. Several druggable mutations have been identified in breast cancer patients. Current improvements in omics technologies have focused on more precise strategies for precision therapy. The development of next-generation sequencing technologies has raised hopes for precision-medicine treatment strategies in breast cancer (BC) and triple-negative breast cancer (TNBC). Targeted therapies utilizing immune checkpoint inhibitors (ICIs), epidermal growth factor receptor inhibitor (EGFRi), poly(ADP-ribose) polymerase inhibitor (PARPi), antibody-drug conjugates (ADCs), oncolytic viruses (OVs), glucose transporter-1 inhibitor (GLUT1i), and targeting signaling pathways are potential treatment approaches for BC and TNBC. This review emphasizes the recent progress made with the precision-medicine therapy of metastatic breast cancer and TNBC.

8.
Cell Mol Biol (Noisy-le-grand) ; 69(1): 137-144, 2023 Jan 31.
Artigo em Inglês | MEDLINE | ID: mdl-37213142

RESUMO

Spirulina, a blue-green microalga is an eminent functional food due to its unique nutritional and disease-mitigating properties. The main objective of this article is to present an overview of the nutritional composition of Spirulina. Along with its therapeutic potential and applications in the food industry. Studies included in this review have suggested spirulina to be a rich source of complete proteins, essential fatty acids (EFAs), vitamins, minerals and various bioactive compounds like carotenoids, chlorophyll, and xanthophylls. This makes Spirulina a promising functional food for the treatment of ailments like diabetes, cancer, cardiovascular disorders (CVDs), COVID-19, neuroinflammatory conditions and gut dysbiosis. Additionally, data from numerous studies suggest its use in food formulations, primarily in sports supplements, bakery products, beverages, dairy products, snack sources and confectionaries. It has also been used by the National Aeronautics and Space Association (NASA) for astronauts on space missions to the Moon and Mars. Furthermore, spirulina's use as a natural food additive possesses enormous potential for further research. Owing to its high nutritional profile and disease-fighting potential, it lends itself to numerous food formulations. Therefore, based on the findings of previous studies, further progress can be made considering spirulina's application in the food additive industry.


Assuntos
COVID-19 , Spirulina , Humanos , Alimento Funcional , Spirulina/metabolismo , Suplementos Nutricionais , Aditivos Alimentares/metabolismo
9.
Bioeng Transl Med ; 8(2): e10441, 2023 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-36925703

RESUMO

Poly(lactic-co-glycolic acid) (PLGA) nanoparticles (NPs) are commonly used for drug delivery because of their favored biocompatibility and suitability for sustained and controlled drug release. To prolong NP circulation time, enable target-specific drug delivery and overcome physiological barriers, NPs camouflaged in cell membranes have been developed and evaluated to improve drug delivery. Here, we discuss recent advances in cell membrane-coated PLGA NPs, their preparation methods, and their application to cancer therapy, management of inflammation, treatment of cardiovascular disease and control of infection. We address the current challenges and highlight future research directions needed for effective use of cell membrane-camouflaged NPs.

10.
PLoS One ; 18(2): e0281004, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36854019

RESUMO

The present study aimed to prepare solid lipid-based nanoparticles (SLNs) using Precirol® ATO 5 as solid lipid and Poloxamer 188 and Tween 80 as surfactant and co-surfactant respectively, and SLNs-derived gel for sustained delivery, enhanced in-vitro cytotoxicity, enhanced cellular uptake of 5-FU and enhanced permeation of 5-FU across the skin. The 5-FU-loaded SLNs were prepared by the hot melt encapsulation method and converted into SLN-derived gel using a gelling agent (Carbopol 940). The 5-FU-loaded SLNs had a particle size in the range of 76.82±1.48 to 327±4.46 nm, zeta potential between -11.3±2.11 and -28.4±2.40 mV, and entrapment efficiency (%) in range of 63.46±1.13 and 76.08±2.42. The FTIR analysis depicted that there was no chemical interaction between 5-FU and formulation components. Differential scanning calorimetric analysis showed thermal stability of 5-FU in the nanoparticles and powdered X-ray diffraction analysis revealed successful incorporation of 5-FU in nanoparticles. The in-vitro release study of 5-FU-loaded SLNs showed biphasic release behavior with initial burst release followed by sustained release over 48 hr. The 5-FU-loaded SLNs showed a greater cytotoxic effect on skin melanoma (B16F10 cells) and squamous cell carcinoma (A-431 cells) as compared to free 5-FU drug solution after 48 hr. Flow cytometry and fluorescence microscopy displayed enhanced quantitative and qualitative cellular uptake of SLNs. The SLNs formulation showed acceptable safety and biocompatible profile after an acute toxicity study in Wistar rats. Moreover, ex-vivo permeation studies depicted 2.13±0.076 folds enhanced flux of 5-FU-loaded SLN derived gel compared to 5-FU plain gel, and skin retention studies revealed target efficiency (%) 2.54±0.03 of 5-FU-loaded SLN derived gel compared to 5-FU plain gel.


Assuntos
Antineoplásicos , Carcinoma de Células Escamosas , Melanoma , Ratos , Animais , Ratos Wistar , Fluoruracila/farmacologia , Preparações de Ação Retardada , Melanoma/tratamento farmacológico , Tensoativos , Lipídeos , Melanoma Maligno Cutâneo
11.
Eye (Lond) ; 37(6): 1249-1253, 2023 04.
Artigo em Inglês | MEDLINE | ID: mdl-35606549

RESUMO

BACKGROUND/OBJECTIVES: Our goal was to compare the characteristics and surgical outcomes of patients who underwent primary eye removal surgery after open globe injury with those who underwent secondary eye removal surgery after open globe repair. SUBJECTS/METHODS: This was a retrospective review of subjects who underwent evisceration or enucleation within 3 months of an open globe injury, at three Level I trauma centres in three U.S. cities between July 2014 and July 2020. RESULTS: 19 patients underwent primary eye removal and 20 underwent secondary eye removal. The most common mechanism of trauma in patients who underwent primary eye removal was gunshot. Compared to the secondary eye removal group, patients who underwent primary eye removal were significantly more likely to be male; have longer hospital stays; be discharged to another care facility rather than home; have facial fractures; suffer intracranial injury; and be unable to consent themselves for surgery. Both groups had a low surgical complication rate with one case of socket contracture in each group. CONCLUSIONS: The standard of care for an open globe injury is prompt repair, but there are occasions when the globe is so damaged that it is deemed unrepairable. We found that globes that required primary eye removal were more often due to gunshot wounds, and that there was greater morbidity associated with these injuries. The authors' preferred surgical approach was evisceration with placement of a silicone sphere; patient outcomes demonstrate that this method was found to be safe, with a low complication and infection rate.


Assuntos
Ferimentos Oculares Penetrantes , Traumatismos Oculares , Ferimentos por Arma de Fogo , Humanos , Masculino , Feminino , Ferimentos por Arma de Fogo/complicações , Ferimentos por Arma de Fogo/cirurgia , Enucleação Ocular , Traumatismos Oculares/etiologia , Procedimentos Cirúrgicos Oftalmológicos/efeitos adversos , Olho , Estudos Retrospectivos , Ferimentos Oculares Penetrantes/etiologia
12.
Artigo em Inglês | WPRIM (Pacífico Ocidental) | ID: wpr-1000710

RESUMO

Nosocomial infections, commonly referred to as healthcare-associated infections, are illnesses that patients get while hospitalized and are typically either not yet manifest or may develop. One of the most prevalent nosocomial diseases in hospitalized patients is pneumonia, among the leading causes of mortality and morbidity. Viral, bacterial, and fungal pathogens cause pneumonia. More severe introductions commonly included Staphylococcus aureus, which is at the top of bacterial infections, per World Health Organization reports. The staphylococci, S. aureus, strain RMI-014804, mesophile, on-sporulating, and non-motile bacterium, was isolated from the sputum of a pulmonary patient in Pakistan. Many characteristics of S. aureus strain RMI-014804 have been revealed in this paper, with complete genome sequence and annotation. Our findings indicate that the genome is a single circular 2.82 Mbp long genome with 1,962 protein-coding genes, 15 rRNA, 49 tRNA, 62 pseudogenes, and a GC content of 28.76%. As a result of this genome sequencing analysis, researchers will fully understand the genetic and molecular basis of the virulence of the S. aureus bacteria, which could help prevent the spread of nosocomial infections like pneumonia. Genome analysis of this strain was necessary to identify the specific genes and molecular mechanisms that contribute to its pathogenicity, antibiotic resistance, and genetic diversity, allowing for a more in-depth investigation of its pathogenesis to develop new treatments and preventive measures against infections caused by this bacterium.

13.
Front Nutr ; 9: 1028956, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36451738

RESUMO

Iron supplementation and fortification are the well-known approaches to treat iron deficiency anemia (IDA) in women of reproductive age. The objective of the current randomized controlled trial (RCT) was to evaluate the cumulative effects of prebiotics and iron fortification among women of reproductive age. For this purpose, a total of 75 iron deficient women of childbearing age were recruited and randomly divided into 5 groups (4 treatment groups and 1 control group). Four different types of fortified wheat flour were prepared using two iron fortificants (NaFeEDTA and FeSO4) and two prebiotics [inulin and galacto oligosaccharides (GOS)], while control group was treated with iron fortified flour without any prebiotics. Blood samples were collected from overnight fasted women on monthly basis up to 90 days. Hematological indices such as Hemoglobin (Hb), Hematocrit, Red Blood Cell (RBC) Count and Mean Corpuscular Volume (MCV), as well as iron biomarkers including serum iron, ferritin, transferrin, and Total Iron Binding Capacity (TIBC) were evaluated for analyses. The results showed a considerable positive improvement in all iron biomarkers as well as hematological indices among the treatment groups (P-value < 0.05), as compared to the control group. A maximum Hb (11.86 ± 0.24 mg/dL) and hematocrit value (35.06 ± 1.32%), was reported in group G3 which was treated with fortified wheat flour at a dose of 963 mg/kg GOS + 15 ppm FeSO4. On the other hand, highest mean values for RBC Count (4.73 ± 0.41 mil/mm3), MCV (81.41 ± 3.21 fL), serum iron (75.62 ± 2.79 µg/dL), serum transferrin (16.82 ± 0.30 mg/dL), and TIBC (403.68 ± 7.27 µg/dL) were observed in G4 group receiving the fortified wheat flour at a dose of 963 mg/kg GOS + 30 ppm FeSO4 level. The study concluded that prebiotic fortification along with iron salts helps to enhance iron absorption among iron deficiency anemic women of reproductive age.

14.
Int J Biol Macromol ; 222(Pt A): 497-508, 2022 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-36174854

RESUMO

The study aimed to develop folate decorated lipid chitosan hybrid nanoparticles for targeted delivery of 5-fluorouracil in colon cancer by utilizing the overexpressed folate receptors on the surface of HT-29 and HCT 116 cancer cell lines. The developed formulations were prepared by the ionic gelation method with slight modifications. The developed formulations exhibited spherical morphology, smaller particle size (158 to 225 nm), zeta potential (32.24 to 35.95 mV), PDI (0.19 to 0.35), and high encapsulation efficiency (85.3 % to 94.2 %) with optimal physicochemical characteristics. The in vitro release showed a biphasic release pattern with an initial burst release followed by a sustained release for 48 h. Moreover, the in vitro cell line study revealed that FA-CLPN-2 exhibited an enhanced cellular uptake and greater cytotoxic effect in HT-29 and HCT 116 cell lines compared to non-targeted CLPN-2 and free drug solution due to the folate receptor facilitated endocytosis process. The in vivo toxicity study revealed the safety and biocompatibility of the developed formulations in biological systems. The stability study demonstrates the stability of the developed formulations. Overall, these results suggest that the folate decorated lipid chitosan hybrid nanoparticles could be used as a potential delivery system for tumor-targeted therapy with reduced side effects.


Assuntos
Quitosana , Neoplasias do Colo , Nanopartículas , Humanos , Ácido Fólico , Fluoruracila/farmacologia , Tamanho da Partícula , Neoplasias do Colo/tratamento farmacológico , Lipídeos , Sistemas de Liberação de Medicamentos/métodos , Portadores de Fármacos , Linhagem Celular Tumoral
15.
Front Psychol ; 13: 946362, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35967710

RESUMO

Consumer well-being is a micromarketing concept that emphasizes on contributions of marketing activities in social welfare. The major objective of the current study is to analyze the impact of self-incongruence on brand dissatisfaction, brand hate, and consumer well-being. This study has utilized the Self-incongruity Theory and the Stimulus-Organism-Response model to test the impact of self-incongruity on anti-consumption and consumer voice behaviors, and subsequent effects on consumer well-being. Data were collected from young consumers of technology products from major cities of Pakistan. A total of 592 consumers answered a paper-and-pencil questionnaire using purposive sampling technique. The data were analyzed by partial least square structural equation modeling. The findings of this study reveal that functional and symbolic incongruity predict brand hate and dissatisfaction, which is positively related with brand retaliation. Brand retaliation is negatively related with consumer well-being. This study offers implications for product designers, marketers, advertisers and other stakeholders to improve congruence between what young consumers of technology products expect and what brands are offering to mitigate negative attitudes and behaviors and increase consumer well-being.

16.
Front Psychol ; 13: 923870, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35837645

RESUMO

In this era of razor-edge competition, marketers strive to outperform their rivals by improving their brands. Increasing brand coolness may be the best way to do it. This study used a stimulus organism response (SOR) model by integration with brand attribution theory to conduct a cross sectional study using purposive sampling technique and surveying young consumers of smart gadgets in Pakistan. A total of 1,178 responses were received and analyzed by structural equation modeling. The results found a positive impact of brand coolness (stimulus) on brand love and brand engagement (both modeled as organism). Brand experience moderated these links. Brand love and brand engagement also mediated the relationship between brand coolness and consumer well-being and delight (both modeled as response). The findings suggest a very important contribution to theory and practice by testing unexploited outcomes of brand coolness. Especially, this study contributes to the consumer well-being literature, again an unexploited aspect of marketing literature. Despite the uniqueness of the findings, the cross sectional design of this study remains a major limitation. Future research may supplement the findings with the help of longitudinal studies. Marketers and practitioners may benefit from this study by improving the coolness of their brands so they may not only increase consumer engagement with the brand but they will also make consumers happy with their brands.

17.
Int J Biol Macromol ; 213: 465-477, 2022 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-35661673

RESUMO

This study was designed to improve oral bioavailability of the methotrexate (MTX) by sustaining its release profile and integration into core-shell polymeric nanoparticles. The self-micellization and ionotropic gelation technique was employed which resulted into spherical shaped nanoparticles (181-417 nm) with encapsulation efficiency of 80.14% to 85.54%. Furthermore, Fourier Transform Infrared Spectroscopy and Differential Scanning Calorimetry analyses were carried out to investigate physicochemical and thermal stability of the produced engineered core shell nanoparticles of the methotrexate. . Entrapment of drug in polymeric core was confirmed by X-ray diffraction analysis. In-vitro sustained release behavior of nanoparticles was observed at pH 6.8 for 48 h while low drug release was observed at pH 1.2 due to pH-responsive nature of Pluronic F127. Acute toxicity study confirmed safety and biocompatible profile of nanoparticles. MTX loaded polymeric nanoparticles ameliorated the pharmacokinetic profile (8 folds greater half-life, 6.26 folds higher AUC0-t and 3.48 folds higher mean residence time). In vivo study conducted in rat model depicted the improved therapeutic efficacy and healing of arthritis through MTX loaded polymeric nanoparticles, preferentially attributable to high accretion of MTX in the inflamed site. In conclusion, MTX loaded polymeric nanoparticles is an attractive drug delivery strategy for an effective management and treatment of rheumatoid arthritis.


Assuntos
Artrite Reumatoide , Quitosana , Nanopartículas , Animais , Artrite Reumatoide/tratamento farmacológico , Quitosana/química , Portadores de Fármacos/química , Metotrexato/farmacologia , Metotrexato/uso terapêutico , Nanopartículas/química , Tamanho da Partícula , Poloxâmero/química , Polímeros/química , Ratos
18.
Int J Surg Case Rep ; 96: 107272, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35704986

RESUMO

INTRODUCTION AND IMPORTANCE: The rare presentation of duodenal injuries has led to a lack of guidelines for managing and diagnosing such cases. In most duodenal injuries, intramural hematoma and perforation are seen; however, complete resection of the duodenum is rare, which is seen in our case. CASE PRESENTATION: We report a rare case of a 6-year-old boy who suffered from a complete isolated duodenal transection at the pylorus and a 90% transection at D3 and D4 following a seat-belt injury. The surgeon performed a primary anastomosis for the first part of the duodenum with pyloric exclusion. Then, primary repair with controlled fistula for the second transection at D3 and D4 and a gastrojejunostomy were performed. After further management, the patient was discharged with no further complaints. CLINICAL DISCUSSION: Due to the retroperitoneal location of the duodenum, it is challenging to diagnose a duodenal injury. CT scan with contrast is considered the best diagnostic tool in the case of a duodenal injury. Treatment of duodenal injuries depends on the type of injury and the present level of damage. It is imperative to differentiate between a duodenal hematoma, a duodenal perforation, or a duodenal transection as the management for each complication differs. CONCLUSION: No official guidelines have been set in the case of management or diagnosis of duodenal transection. Based on our experience with this patient and similar literature, guidelines for managing and diagnosing duodenal transection should be set, and further studies on the matter are warranted.

19.
Int J Surg Case Rep ; 96: 107280, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35751964

RESUMO

INTRODUCTION AND IMPORTANCE: Foreign bodies in paranasal sinuses are rarely encountered and most commonly present in the maxillary sinus. Guidelines for managing paranasal sinus object removal are limited due to its rarity. However, there are three major management options: open surgery, endoscopic sinus surgery, and observation. CASE PRESENTATION: We report a rare case of an 18-year-old boy who underwent extended frontal sinus surgery to retrieve a retained air gun pellet in the right frontal sinus and repair the skull base defect resulting from the air gun pellet. CLINICAL DISCUSSION: Physicians commonly use endoscopic sinus surgery (ESS) for improving sinus drainage in recurrent chronic and acute infective sinusitis. Extended sinus surgery aims to maximize the communication between the paranasal sinuses and the nasal cavity. This extended communication helps improve access to the sinus, enhance drainage, and improve the delivery of topical medications. In addition, the use of ESS with the modified Lothrop procedure allows for better exposure of the skull base, which can help with the repair of a CSF leak. CONCLUSION: Based on our experience with this patient and similar literature, ESS should be considered a treatment option for patients with retained foreign objects in the frontal sinus.

20.
Am J Ophthalmol ; 242: 139-143, 2022 10.
Artigo em Inglês | MEDLINE | ID: mdl-35594916

RESUMO

PURPOSE: To characterize ocular injuries from drive-by paintball shootings with a focus on the severity of injuries sustained, clinical management, and visual outcomes. DESIGN: Retrospective, interventional case series. METHODS: Setting: University practice and emergency department. PATIENT POPULATION: Patients evaluated by the ophthalmology service for paintball injuries. OBSERVATION PROCEDURE: Age, sex, eye laterality, mechanism of injury, initial best-corrected visual acuity (BCVA), and initial diagnosis. MAIN OUTCOME MEASURES: Clinical intervention(s), BCVA at last follow-up visit, and severity of injuries with a focus on ruptured globes. RESULTS: Twenty patients suffered unilateral ocular injuries from drive-by paintball shootings between January 2020 and December 2021. The median follow-up interval was 7.1 weeks (range: 3 days to 11.4 months). The average patient age at presentation was 36.6 years (range: 13-64 years). Fourteen patients (70%) had an initial BCVA of counting fingers or worse. Six patients (30%) suffered a ruptured globe injury requiring surgical repair, of whom 3 (15%) underwent subsequent evisceration. Twelve patients (60%) suffered ocular injuries requiring surgical intervention. Fifteen ocular surgeries were performed on 9 patients (45%) at our institution with 3 patients referred to outside providers for definitive surgical management due to insurance. BCVA at last follow-up visit was no light perception in 5 patients. CONCLUSIONS: The severity of injury after paintball-induced ocular trauma is higher in this case series than what has previously been reported in the literature. Paintball guns can cause devastating ocular injury when used as an assault weapon, and their use in unregulated settings bears further scrutiny.


Assuntos
Traumatismos Oculares , Jogos e Brinquedos , Traumatismos Oculares/diagnóstico , Traumatismos Oculares/etiologia , Traumatismos Oculares/cirurgia , Humanos , Procedimentos Cirúrgicos Oftalmológicos/efeitos adversos , Estudos Retrospectivos , Acuidade Visual
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