Scielo RSS <![CDATA[Iberoamerican Journal of Medicine]]> http://scielo.isciii.es/rss.php?pid=2695-507520210001&lang=pt vol. 3 num. 1 lang. pt <![CDATA[SciELO Logo]]> http://scielo.isciii.es/img/en/fbpelogp.gif http://scielo.isciii.es <![CDATA[COVID-19 pandemic and medical resident education]]> http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S2695-50752021000100001&lng=pt&nrm=iso&tlng=pt <![CDATA[Incidence of bacterial skin infections in Libya: a retrospective population-based study]]> http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S2695-50752021000100002&lng=pt&nrm=iso&tlng=pt Abstract Introduction: The global burden of bacterial skin infection is substantial. We aimed to determine the common pathogens causes skin infections and their antimicrobial resistance pattern. Methods: A retrospective record review of data claimed from the microbiology department at Ber-Ustta Milad skin hospital between Jan 2009 to December 2018 was conducted. The consequence of interest was the antimicrobial sensitivity of bacterial isolates. Chi square was used for statistical analysis. Results: Out of 1,141 collected samples, a total of 455 isolates of different medically-significant bacteria were analyzed. The most common pathogen was S. aureus (97.14%), followed by E. coli (93.71%), and the least common was Shigella (0.57%). From the various inoculated samples, S. aureus and Proteus were highly resistant to penicillin (34.3%, 75% respectively) and ampicillin (28.6%, 62.5% respectively). E. coli was highly resistant to ampicillin (45.12%) and penicillin (35.96%), whereas the lowest resistant was against imipenem (3.05%). While, Pseudomonas was highly resistant to ampicillin and augmentin (62.5%), whereas the lowest resistance rate was marked to erythromycin, sulfamethoxazole and imipenem (25%). Ciprofloxacin, gentamicin and nalidixic acid were the only sensitive agents. Conclusions: There is a high burden of bacterial resistance to common antibiotics in our population samples. Recognition of the potential resistant strains of pathogen causing skin infection can help in guiding proper choice of antibiotic therapy. <![CDATA[Efficacy of casein phosphopeptide varnish reducing dental hypersensitivity: a randomized clinical trial]]> http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S2695-50752021000100003&lng=pt&nrm=iso&tlng=pt Abstract Introduction: Dentin hypersensitivity (DH) is the most common concern faced by most dentists in their day-to-day clinical practice. It is characterized by short-term, acute pain of variable intensity, which occurs in response to thermal, tactile, osmotic or chemical stimuli that cannot be attributed to any other type of defect or dental decay. Casein phosphopeptide varnish is a newer material used to treat dentinal hypersensitivity as it reduces demineralization and promotes remineralization. The aim of this study is to evaluate the efficacy of casein phosphopeptide based varnish (MI Varnish®) vs sodium fluoride-based varnish (Fluoritop SR® varnish) in treating dentinal hypersensitivity. Materials and methods: 40 subjects with a chief complaint of DH were divided into two equal groups, Group A (MI varnish®) and Group B (Fluoritop SR® varnish). Scaling and root planing was done and sensitivity was assessed using Visual analog scale (VAS) at baseline. On the 14th day, sensitivity was reassessed using VAS. The data obtained were subjected to statistical analysis using students‘t’ test. Results: On intragroup comparison, VAS scale showed a statistically significant difference for both the groups. On intergroup comparison, no statistical difference was found between both groups (p = 0.139). Conclusions: From the above results, it can be concluded that MI varnish® and Fluoritop SR® varnish are equally efficacious in reducing dentinal hypersensitivity. <![CDATA[Triggering cultured human osteoblast-like cells' maturation by an extremely low magnitude alternating electromagnetic field]]> http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S2695-50752021000100004&lng=pt&nrm=iso&tlng=pt Abstract Introduction: Alternating and pulsed electromagnetic magnetic fields (AEMF and PEMF) of different amplitudes and frequencies can induce metabolic and proliferative effects in osteoblasts, but there is no clearly directed tendency of these effects. I hypothesize that there are extremely low triggering parameters of alternating electromagnetic field (EMF) intensity, i.e., above the background magnetic field on earth but below the lowest AEMF and PEMF that have been investigated to date (above 0.07 mT and below 0.4 mT) that induce cellular response. Methods: Accordingly, human monolayer explant culture replica were exposed four times in 24-hour intervals to two minutes of 10 kHz AEMF or PEMF (10 Hz pulses at a basic 5 kHz frequency) with a maximal EMF intensity of 0.2 mT for both. Cell proliferation was estimated from microscopic cell counting and cell death by lactate dehydrogenase (LDH) specific activity in culture media (measured using a colorimetric method). The early marker of osteoblast maturation, cellular alkaline phosphatase (AP) specific activity, was measured using a colorimetric method (n=6 for all experiment conditions). Results: No difference was found in cell numbers in the culture samples exposed either to AEMF or PEMF and in the LDH's specific activity in culture media in comparison to the unexposed controls (p&gt;0.05, for both). The cellular AP's specific activity increased significantly only in cell cultures exposed to the 10 kHz AEMF (p=0.011). Conclusions: The triggering for human osteoblast activation for maturation by an extremely low AEMF (10 kHz) is at least 0.2 mT, which is distinct and below the previously found triggering range of a PEMF for proliferation induction. Therefore, application of these EMF parameters in a clinical setup by a separate finetuning of osteoblast proliferation and maturation might have a therapeutic value in enhancing damaged bone regeneration. <![CDATA[Prevalence and determinants of diabetic peripheral neuropathy/foot ayndrome in the rural population of North India]]> http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S2695-50752021000100005&lng=pt&nrm=iso&tlng=pt Abstract Introduction: Diabetic peripheral neuropathy (DPN), a common and troublesome complication of diabetes mellitus (DM), leads to a higher risk of diabetic foot ulcers and lower limb amputation. This study aimed to assess the prevalence of DPN among patients of type 2 DM from rural North India and associated risk factors for the condition. Materials and Methods: A facility-based cross-sectional study was carried out among type 2 diabetic patients attending the Non-Communicable Diseases (NCD) clinic of a secondary care hospital in rural North India. A questionnaire that included sociodemographic details, clinical and laboratory parameters, and the Michigan Neuropathy Screening Instrument (MNSI) for detecting peripheral neuropathy was administered to 100 consecutive eligible patients. Statistical Package for Social Sciences (SPSS) version 25.0 was used for entering and analyzing data. Bivariate analysis was performed to determine the factors significantly associated with the presence of DPN. Results: The prevalence of DPN was found to be 42.0%. Male gender, advancing age (≥60 years), longer duration of diabetes (&gt;10 years), smoking, physical inactivity, obesity, uncontrolled blood pressure, poor glycemic control and altered lipid profile were found to be significantly associated with the presence of DPN. Conclusions: The prevalence of DPN among type 2 diabetes patients from rural northern India is alarmingly high. There is a need for essential screening of all diabetic patients by their primary care provider for early detection of DPN, particularly in rural India. <![CDATA[The possible role of PtdIns(4,5)P2 and PtdIns(3,4,5)P3 at the leading and trailing edges of the breast cancer cell line]]> http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S2695-50752021000100006&lng=pt&nrm=iso&tlng=pt Abstract Introduction: Phosphoinositides play a key role in the regulation of focal adhesions (FAs) turnover during cell adhesion and migration. However, their potential role in FA turnover at leading and trailing edge of cell are not yet fully understood. In this study, we investigate their spatial co-localisation with paxillin directly at leading and trailing edge of MDA-MB-231 breast cancer cell line. Materials and methods: Cell lines and cell culture experiments were done using MDA-MB-231human adenocarcinoma cells. Co-trnasfection and confocal microscopy were performed to visualise phosphoinositides and FAs by using GFP-C1-PLCdelta-PH/Btk-PH-GFP and 3 µɡ paxillin-RFP as biosensors. Then, ImageJ was used to measure co-localisation point between Phosphatidylinositol 4,5-trisphosphate (PtdIns(4,5)P2) or Phosphatidylinositol 3,4,5-trisphosphate (PtdIns(3,4,5)P3) and paxillin Spearman's rank correlation value was taken between PtdIns(4,5)P2/PtdIns(3,4,5)P3. Results: Our results demonstrate that the spatial co-localistion of PtdIns(4,5)P2 and PtdIns(3,4,5)P3 with FA at leading and trailing age of cell were slightly changed. Conclusions: This suggests that PtdIns(4,5)P2 and PtdIns(3,4,5)P3 play an equal role at the leading and trailing edges of the cancer metastasis through interaction with FA proteins. <![CDATA[Quantitative immunohistochemical expression of GP88 in invasive ductal carcinoma (IDC) of human breast cancer]]> http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S2695-50752021000100007&lng=pt&nrm=iso&tlng=pt Abstract Introduction: Progranulin or acrogranin is an 88-kDa glycoprotein identified by a biological screen for protein targets associated with high tumorigenicity. This work was aimed to investigate the digital expression of GP88, and HER2/neu as a predictive biomarker in human invasive ductal carcinoma (IDC) versus benign tumors and normal breast tissues, as well as its correlation with different pathological parameters. Methods: The immunohistochemical avidin-biotin complex protocol of the paraffin section was used to detect the expression of GP88 and HER2/neu in IDC of 60 patients, 30 benign, and ten normal breast tissues. Results: The study showed a high expression of GP88 in IDC comparing to normal and benign breast tissues. A higher significant statistical correlation between the expression of GP88 and large tumor size, tumor grade, and lymph node metastasis (LNM). While a negative statistical correlation was noticed between the expression of GP88 and ER, PR, and HER2/neu status. Discussion: The results of the quantitative immunostaining density of GP88 glycoprotein antibody revealed it to be a valuable predictive and therapeutic marker of GP88 in human IDC patients. <![CDATA[Application of diphenydramine ointment to the eyelids for allergic conjunctivitis]]> http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S2695-50752021000100008&lng=pt&nrm=iso&tlng=pt Abstract Introduction: Allergic conjunctivitis is treated with oral anti-allergy agents or topical eye drops, but the response is often incomplete, and symptoms persist. We considered that topical treatment with an antihistamine ointment (diphenhydramine-Restamin Cream®) on the eyelids could be effective as supplemental therapy. This study investigates the efficacy and safety of Restamin Cream® for allergic conjunctivitis. Methods: In patients with allergic conjunctivitis, Restamin Cream® was applied to both eyelids twice a day for 2 weeks. There was a 2-week observation period before treatment and a 2-week washout period after treatment. Patients recorded symptoms (eye itching and watering) on a visual analogue scale for the entire 6-week period. Assessment of quality of life, evaluation of conjunctivitis, and measurement of visual acuity and intraocular pressure were conducted at the start of observation, at initiation of treatment, at completion of treatment, and at the end of washout. Results: 7 patients were enrolled; 5 completed the study and 2 discontinued due to adverse reactions. The quality of life score and objective ocular findings improved in all 5 patients. Visual analogue scale scores for itching and watering also improved significantly in 3 and 2 patients, respectively. Adverse reactions included local skin irritation in 3/7 patients, and transient blurred vision and eye pain in 1 patient each. There were no changes of visual acuity or intraocular pressure. Conclusions: Application of diphenhydramine ointment to the eyelids was effective for allergic conjunctivitis. <![CDATA[How to design and apply an Objective Structured Clinical Examination (OSCE) in medical education?]]> http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S2695-50752021000100009&lng=pt&nrm=iso&tlng=pt Abstract The Objective Structured Clinical Examination (OSCE) is considered a gold standard summative and formative assessment method wherein it is a comprehensive and standardized tool assessing the clinical competencies including psychomotor domain, attitudes, and behaviors that will be manifested in the real work of the medical graduates. Therefore, the implementation of OSCE depends on the design of a blueprint that consists of two axes; the first axis is the tested competencies according to the learning objectives while the second axis represents a system or problem that is related to these competencies. Thus, the blueprint of OSCE is a translation for the learning objectives into clinical competences such as history taking, physical examination, radiographic and laboratory data interpretation, technical skills, attitudinal behaviors, and counseling skills. In addition, the utility index proved that OSCE has a good balance for acceptability, reliability, validity, credibility, feasibility, cost, and educational impact. However, the use of OSCE for the students' assessment is considered expensive and exhausted because it requires many facilities, a great deal of the personnel besides the needed consuming time for its application. <![CDATA[An overview of the physiological and pathological role of mast cells in the central nervous system]]> http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S2695-50752021000100010&lng=pt&nrm=iso&tlng=pt Abstract Neurological disorders present a major group of diseases with the global prevalence of 6.3%. They are responsible for 12% global mortality. Mast cells are one of the most abundantly present cell of the immune system in the connective tissue and the central nervous system is not an exception. In this article is presented a review of studies on mast cells regarding their physiological role in cental nervous system. We also disscuss their role in several conditions like: multiple sclerosis, amyotrophic lateral sclerosis, Alzheimer's disease, neuropsychiatric disorders, cerebrovascular disorders and central nervous system trauma, epilepsy, seizures and tumors. Finally, we evaluate whether they can be used as a targed for pharmaceutical treatment. <![CDATA[Coexistence of central precocious puberty and intraventricular arachnoid cyst: a brief literature update]]> http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S2695-50752021000100011&lng=pt&nrm=iso&tlng=pt Abstract Central precocious puberty (CPP) is a rare disease. The mean annual incidence in girls is 0.8-1.1/100,000 and in boys 0-0.1/100,000. Intracranial arachnoid cysts (ICACs) are usually congenital and represent 1% of intracranial masses in newborns. Intraventricular location is rare. The objective of this work is to carry out a literature updated review of the coexistence of CPP and intraventricular arachnoid cyst (IVAC). ICACs are usually asymptomatic but can present with CPP in 10-40% of patients. IVACs represents only 0.3-1.4% of ICACs, and most seemed originate from the velum interpositum cistern. CPP in girls is usually idiopathic, while in 30-70% of boys are due to an intracranial lesion. Therefore, the coexistence of PPC and IVAC is very rare in boys and exceptional in girls. The exact mechanism of a cyst´s influence on the hypothalamic-pituitary axis is not completely understood. Theories include increased ventricular volume, associated mass effect on the hypothalamus, and direct compression of portions of the hypothalamic-pituitary axis. Analysis of LH peaks after GnRH testing is the gold standard for the diagnosis of CPP. Brain MRI should be part of the assessment in boys and also in girls since clinical features, including age and sex, are not helpful in predicting those with underlying brain pathology. In cases of CPP with IVAC, surgery does not have any effect on the course of pubertal development. The indication for surgery is the onset of neurological symptoms. The medical treatment selected, safe and effective, is GnRH analog depot preparations. In conclusion, there seems to be a consensus for the diagnosis and management of the coexistence of CPP and IVAC, but the etiopathogenesis is not yet well recognized. <![CDATA[ABO blood group is associated with COVID-19 susceptibility: a systematic review and meta-analysis]]> http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S2695-50752021000100012&lng=pt&nrm=iso&tlng=pt Abstract Introduction: Conflicting evidences exist that ABO blood groups correlate with the susceptibility to COVID-19 and its clinical outcomes. This study aimed to pool available articles that assessed a possible relationship between COVID-19 and ABO blood groups. Materials and methods: A search was conducted in four databases comprising Pubmed/Medline, Google scholar, Journal storage (JSTOR) and African Journals Online (AJOL) for relevant studies available before 25th August 2020 and contained extractable data on ABO blood type distribution and COVID-19 disease. Search terms included a combination of “ABO blood group, and COVID-19, coronavirus, and SARS-COV-2”. Results: Fourteen articles that met study inclusion criteria were selected from a total of five hundred and eighty-five articles identified through database search. The fourteen articles reviewed comprised of a total of 73934 subjects (13189 SARS-COV-2 positive cases and 60745 controls). Overall, the risk of SARS-COV-2 infection was found to be significantly increased in patients with blood group A with ORs: 1.24 (95%Cl: 1.09-1.41, P = 0.001). Additionally, blood group O subjects were seen to have decreased odds of contracting COVID-19 infection (OR: 0.78, 95%Cl: 0.68 – 0.89, P=0.0003). No significant association was found between ABO blood groups and COVID -19 severity and mortality. Conclusions: Blood group A was associated with a higher risk of SARS-COV-2 infection whereas risk of infection was lower in blood group O subjects. No statistical significant association was found between ABO blood groups and COVID-19 severity and mortality. The precise role of ABO blood group in COVID-19 susceptibility, severity and mortality requires further research for clarification. <![CDATA[A Systematic review of the calcium content of the normal human prostate gland]]> http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S2695-50752021000100013&lng=pt&nrm=iso&tlng=pt Abstract Introduction: There is much lack of knowledge concerning most prostatic malfunction, especially the reasons and detailed nature of its pathologies. In spite of advances in medical science, the differential diagnosis of prostatic pathologies has steadily increased in complexity and controversy. A proposal has been made that prostatic calcium (Ca) content determinations may aid in resolving these issues for prostate disorders and especially as an indicator of its carcinoma risk. As a result many measurements of normal prostatic Ca have been made. Materials and methods: Here we analyze data published concerning Ca prostatic levels in healthy subjects. In all 1911 items in the literature of the years dating back to 1921 were identified in the following databases: PubMed, the Cochrane Library, Scopus, Web of Science and ELSEVIER-EMBASE. This data was subject to an analysis employing both the “range” and “median” of means. In this way the disparate nature of published Ca content of normal prostates was evaluated. From the papers examined, 36 were selected for the objective analysis of data from their 1357 healthy patients. Results: On a wet mass basis prostatic Ca levels spanned the interval from 73 mg/kg to 1280 mg/kg with 360 mg/kg as the median of their means. It is accepted that the prostatic Ca content is contingent on a wide variety of aspects of the host's milieu, including androgen levels, zone of human prostate sampled, relative amounts of different types of prostatic tissue studied, Ca content of food and drink, Ca supplement intake, age, and the method of analysis. Conclusions: The data encompassed a wide range of values and the sample was small, hence it is advisable that further studies be performed. <![CDATA[Case Report: When Shingles Disrupts Bladder Function]]> http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S2695-50752021000100014&lng=pt&nrm=iso&tlng=pt Abstract Varicella Zoster (shingles) virus is a double stranded DNA in the Herpesviridae family that can present as both chicken pox and as shingles. The virus enters through the respiratory system, replicating in the nasopharynx, and causes a viremia upon primary infection. Varicella Zoster spreads to other organs and often lies dormant in the dorsal root ganglion. Reactivation of the virus is more common in older or immunocompromised patients and often presents as a painful vesicular rash in a unilateral dermatomal distribution with possible concurrent radiculopathy. A rare complication of herpes zoster is urinary dysfunction. We report a case of a 42-year-old patient diagnosed with herpes zoster whose primary complaint was left buttock pain and a maculovesicular rash in the S2-S4 dermatomal distribution. She was prescribed Valacyclovir and began to experience urinary retention two days after starting the medication. <![CDATA[Pseudo prune belly syndrome: a female case report]]> http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S2695-50752021000100015&lng=pt&nrm=iso&tlng=pt Abstract Varicella Zoster (shingles) virus is a double stranded DNA in the Herpesviridae family that can present as both chicken pox and as shingles. The virus enters through the respiratory system, replicating in the nasopharynx, and causes a viremia upon primary infection. Varicella Zoster spreads to other organs and often lies dormant in the dorsal root ganglion. Reactivation of the virus is more common in older or immunocompromised patients and often presents as a painful vesicular rash in a unilateral dermatomal distribution with possible concurrent radiculopathy. A rare complication of herpes zoster is urinary dysfunction. We report a case of a 42-year-old patient diagnosed with herpes zoster whose primary complaint was left buttock pain and a maculovesicular rash in the S2-S4 dermatomal distribution. She was prescribed Valacyclovir and began to experience urinary retention two days after starting the medication.