Brodersencowan6397
Melasma is a common skin condition that affects many patients with hyperpigmented patches on sun-exposed facial skin. It disproportionately affects people of Asian, African, and Hispanic descents. Unfortunately, there are not many lasting and effective treatment options available, which has led many practitioners and skincare companies to trial various topical ingredients. In the past several years, kojic acid has gained popularity as a skincare ingredient to treat hyperpigmentation and melasma. Kojic acid has more recently become popular in over-the-counter skincare products. We discuss the background of kojic acid, its suggested mechanism, and the available studies evaluating its utility in treating melasma.DiGeorge Syndrome is a group of diseases caused by a microdeletion, and some of its most frequent symptoms are those related with development and behavior. We present the case of a female patient with DiGeorge Syndrome and selective mutism since childhood, evaluated for the first time in a psychiatry consultation at the age of 18 for inaugural psychotic symptomatology. We describe the psychopathology, the diagnostic investigation, the treatment, and the clinical evolution. In the future, it will be important to better characterize patients with this syndrome who present psychiatric disease.
Technical skills training is fundamental for clinical practice although poorly emphasised in undergraduate medical curricula. In these circumstances, Peer Assisted Learning methodology has emerged as a valid alternative to overcome this insufficiency. Rutin The purpose of this study is to evaluate the impact on students of a Peer Assisted Learning program in basic surgical skills, regarding technical competences and knowledge improvement.
A total of 104 randomly selected third year medical students participated in a workshop delivered by fifth year students. From that total, 34 students were assessed before and after the workshop, using the Objective Structured Assessment of Technical Skills instrument, that consists of a global rating scale and a procedure-specific checklist. Sixth year students (control group) were also assessed in their performance without participating in the workshop. Before workshop versus after workshop Objective Structured Assessment of Technical Skills results were compared using Wilcoion to a much broader number of students.
This Peer Assisted Learning program revealed promising results concerning improvement of surgical skills in medical students, with little staff faculty contribution and extension to a much broader number of students.Migraine is highly prevalent and carries a significant personal, social and economic burden. It is the second cause of disability (years living with disability) worldwide and the first cause under 50 years of age. Chronic migraine (occurring for more than 15 days a month) and refractory migraine (treatment resistant), especially when there is also analgesic overuse, are the most disabling forms of migraine. These three disorders (chronic migraine, refractory migraine and medication overuse headache) are particularly difficult to treat. This article reviews their epidemiology, clinical presentation, diagnostic criteria, risk factors, comorbidities and social and personal impact. The therapeutic options available are discussed and focused on a multidisciplinary approach, non-pharmacological interventions treatment of comorbidities and avoiding analgesic overuse. Prophylactic treatments are mandatory and include the oral prophylactic treatments (topiramate), botulinum toxin type A and the novel monoclonal antibodies against calcitonin gene related peptide or its receptor, which are the first migraine preventive medicines developed specifically to target migraine pathogenesis. In refractory cases, multiple therapies are required including neurostimulation.
Portugal took early action to control the COVID-19 epidemic, initiating lockdown measures on March 16th when it recorded only 62 cases of COVID-19 per million inhabitants and reported no deaths. The Portuguese public complied quickly, reducing their overall mobility by 80%. The aim of this study was to estimate the initial impact of the lockdown in Portugal in terms of the reduction of the burden on the healthcare system.
We forecasted epidemic curves for Cases, hospital inpatients (overall and in intensive care), and deathswithout lockdown, assuming that the impact of containment measures would start 14 days after initial lockdown was implemented. We used exponential smoothing models for deaths, intensive care and hospitalizations and an ARIMA model for number of cases. Models were selected considering fitness to the observed data up to the 31st March 2020. We then compared observed (with intervention) and forecasted curves (without intervention).
Between April 1st and April 15th, there were 146 fewer vidual prevention efforts are necessary.
An early lockdown allowed time for the National Health Service to mobilize resources and acquire personal protective equipment, increase testing, contact tracing and hospital and intensive care capacity and to promote broad prevention and control measures. When lifting more stringent measures, strong surveillance and communication strategies that mobilize individual prevention efforts are necessary.
The Enhanced Recovery After Surgery® program comprises the implementation of various perioperative measures that reduce surgical stress and ultimately improve patient recovery and outcome. The purpose of this study is to evaluate the first-year compliance and clinical outcomes after implementation of the Enhanced Recovery After Surgery® program in elective colorectal surgery in our hospital.
An analysis was performed on the 210 patients who underwent elective colorectal surgery from May 2016 to December 2017. The group of patients that underwent surgery after the protocol implementation (Enhanced Recovery After Surgery® group) was compared to a conventional care control group (pre- Enhanced Recovery After Surgery® group). Differences between the two groups were adjusted using Propensity Score matching. The main outcomes were length of stay, return of bowel function, complications and mortality. The evolution of compliance with Enhanced Recovery After Surgery® principles was also analyzed.
After propensity score matching, 112 patients were included in the present study 56 patients formed the pre-Enhanced Recovery After Surgery® group and 56 the Enhanced Recovery After Surgery® group.
