Articles: treatment.
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Pol. Arch. Med. Wewn. · Feb 2024
ReviewObesity, cardiovascular and cerebrovascular disease: the role of GLP-1 receptor agonists.
Worldwide prevalence of obesity is increasing dramatically, imposing a significant economic burden on our society. Treatment of obesity is challenging, potentially due to different disease phenotypes. Taking into consideration "obesities" rather than "obesity," and thus aiming to understand different pathophysiologic mechanisms of individual phenotypes, might help identify more tailored treatment strategies. ⋯ In the heart, GLP‑1RAs ameliorate cardiomyocyte survival and myocardial contractility, reduce cardiac hypertrophy, and are one of few drugs that can reduce epicardial fat thickness. In this review, we summarize recent evidence concerning the effects of GLP‑1RAs on obesity / dysmetabolism and on cardio- / cerebrovascular health. We further highlight the possible role of GLP‑1RAs in the treatment of obesity‑related CV diseases by describing the principal molecular mechanisms reported in the current literature.
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Dental caries are a limiting factor in maintaining dental and medical readiness in the military. Untreated dental caries can lead to dire health consequences. Consistent and comprehensive access to dental care is often limited due to the intensive operational demands on our nation's warfighters. The standard of care for dental caries is a surgical model where diseased tooth tissue is surgically removed and restored with appropriate restorative materials. While effective, it is not practical in the military operational environment, especially under time constraints. Dental restoratives offer military personnel a simple and preventive treatment of dental caries and are suitable as self-applied first aids. The purpose of this study was to measure the shear bond strengths of two dental restorative materials to human teeth paired with two different fluoride treatments and the hardness and biofilm formation on teeth after applying the fluoride varnishes. ⋯ Mechanical and antimicrobial testing indicated Riva Star, compared favorably with and in some cases, performed better in the laboratory than a Mark3 NaF varnish. Hardness measurements indicated Riva Star is more effective in dentin tubule occlusion compared to NaF varnish. Our findings help provide practical suggestions to dental treatment, particularly to the unique dental environments seen in the military. Riva Star may be used as an adjunctive treatment prior to placing a final restoration. This study supports the use of Riva Star in conjunction with GC Fuji II LC or Filtek Z250 restorative materials, making it a promising treatment in military dental applications.
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The treatment of peripheral nerve injuries has seen tremendous innovations over the past century. Dr Gotthelf Carl Huber, an American immigrant and early experimental pioneer in the field of peripheral nerve injury, created a foundation of scientific knowledge for these advancements. ⋯ Because of the external forces of the First World War, Dr Huber's focus returned to translational projects concentrated on the treatment of neuromas and war time peripheral nerve injuries. Huber's scientific impact in the field of peripheral nerve injury and repair came as a result of his incredible work ethic, mentorship, and tremendous leadership qualities; through this, his work still influences clinical practice today, a century later.
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Enterobius vermicularis is the most common helminthic infection in the United States, infecting an estimated 40 million persons. A rare complication of E. vermicularis infestation is appendicitis. The diagnosis must be considered during pathologic examination to ensure appropriate treatment with anti-helminthic therapy.
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Case Reports
Landmine Injury Resulting in Comminuted Lumbar Facet Fracture as a Cause of Lumbar Stenosis and Spondylolisthesis.
Lumbar facet fractures are rarely reported and have been linked to sports and spine surgery. We describe the case of a 77-year-old patient who sustained an injury from multiple landmine blasts during the Vietnam War. He had low back pain since that time, which was initially managed conservatively. ⋯ We performed an L5/6 decompressive laminectomy, with removal of these fragments, and posterior instrumented fusion, with substantial improvement in symptoms. This case illustrates a unique mechanism of lumbar facet fracture and the biomechanic origination, natural history, and optimal treatment of this entity. We expand on the spectrum of lumbosacral injuries associated with the combat blast injury that have only increased in prevalence in recent conflicts.