JOURNAL OF SURGICAL AND CLINICAL RESEARCH

Leveraging Artificial Intelligence to enhance the Quality of Life for patients with Autism Spectrum Disorder: A Comprehensive Review.

Irami Araujo-Filho, Prof. Dr. — Fri, 27 Dec 2024 00:00:00 -0300

Integrating Artificial Intelligence (AI) into healthcare, specifically for managing Autism Spectrum Disorder (ASD), offers transformative potential to enhance diagnostic accuracy, personalize treatment, and improve patient outcomes. This review explores the application of various AI programs in ASD management, discussing their functionalities, ethical considerations, implementation challenges, and the need for comprehensive regulatory frameworks. Critical AI applications such as AI-driven diagnostic imaging, predictive analytics, assisted therapy robots, remote monitoring, treatment personalization, decision support systems, and therapeutic chatbots are examined. Each technology is analyzed for its ability to improve the quality of life for individuals with ASD by offering more personalized, efficient, and effective care and support. Ethical issues, particularly concerning data bias and privacy, are highlighted as significant challenges that need addressing to maximize AI's benefits while minimizing risks. Practical hurdles like integration with existing healthcare systems, the need for scalable solutions across diverse geographic and socio-economic contexts, and the high costs associated with AI development are also discussed. Furthermore, the review underscores the necessity for robust regulatory policies that ensure patient safety, protect data privacy, and maintain high ethical standards in AI deployment. The paper concludes that while AI presents substantial opportunities for advancing ASD management, achieving these benefits requires a concerted effort from technologists, clinicians, ethicists, and policymakers to develop AI tools that are not only innovative but also ethical, equitable, and universally beneficial.

Decision-Making in Severe Acute Pancreatitis: The role of Artificial Intelligence and Severity Scales

Irami Araujo-Filho, Prof. Dr. — Fri, 27 Dec 2024 00:00:00 -0300

Severe acute pancreatitis (SAP) presents a complex clinical scenario that demands prompt and accurate decision-making regarding the appropriate course of treatment. The management of SAP involves a delicate balance between surgical intervention and conservative therapy, aiming to optimize patient outcomes while minimizing morbidity and mortality. Traditional methods of assessing disease severity, such as the Balthazar scale, Ranson criteria, Glasgow-Imrie score, and APACHE II score, provide valuable clinical insight but may lack the precision necessary for individualized patient care. In recent years, integrating artificial intelligence (AI) technologies into healthcare has shown promise in augmenting clinical decision-making processes. By leveraging machine learning algorithms and predictive analytics, AI has the potential to enhance the accuracy and efficiency of severity assessment in SAP. This article explores the role of AI in conjunction with existing severity scales in aiding surgeons' decision-making regarding the timing and modality of intervention in patients with SAP. Through a comprehensive review of current literature and case studies, we will examine the advantages and limitations of AI-based approaches and propose strategies for integrating these technologies into clinical practice. By harnessing the power of AI, surgeons can potentially optimize patient outcomes, improve resource utilization, and reduce the burden of SAP on healthcare systems worldwide.

Neoadjuvant Immunotherapy as a risk factor for Hashimoto's Disease

Irami Araujo-Filho, Prof. Dr. — Fri, 27 Dec 2024 00:00:00 -0300

This review investigates the association between neoadjuvant immunotherapy and the onset of Hashimoto's disease in patients with neoplastic conditions. With the increasing use of immunotherapy in oncology, understanding potential immune-related adverse events, particularly autoimmune thyroiditis, is crucial for optimizing patient outcomes and managing therapy-related risks. Our findings suggest a notable incidence of Hashimoto's disease among cancer patients receiving neoadjuvant immunotherapy. The underlying mechanisms may involve immune checkpoint inhibitors disrupting immune tolerance, leading to autoimmune thyroiditis. This review highlights the need for vigilant monitoring of thyroid function in patients undergoing immunotherapy and suggests potential strategies for early detection and management of Hashimoto's disease in this population. Further research is required to elucidate the precise mechanisms and risk factors involved, which could inform clinical guidelines and improve patient care.

Long COVID and lung thromboembolism in young adults

Irami Araujo-Filho, Prof. Dr. — Fri, 27 Dec 2024 00:00:00 -0300

Long-term COVID-19 (Long COVID) and pulmonary thromboembolism (PTE) significantly challenge healthcare, especially in young adults who are typically at lower risk for such severe outcomes. This review explores the complex relationship between long-term COVID and PTE, focusing on the pathophysiological mechanisms, diagnostic challenges, and therapeutic approaches. Persistent inflammation and immune dysregulation associated with long-term COVID-19 contribute to this demographic's increased thrombotic risk. The symptom overlaps between long-term COVID and PTE complicate the accuracy and timeliness of diagnoses, highlighting the necessity for improved diagnostic strategies. Findings emphasize the need for anticoagulation protocols tailored to the specific clinical presentations of Long COVID patients and suggest that extended treatment durations may be beneficial. The potential of genetic and biomarker research to identify individuals at heightened risk of thrombotic complications is discussed. The review calls for a multidisciplinary approach that integrates medical and psychosocial interventions to manage the long-term effects of COVID-19 effectively. As the pandemic evolves, advancing our understanding and adapting healthcare strategies to these insights are crucial for developing effective clinical practices. This is essential for addressing the immediate health impacts and reducing the broader socioeconomic burdens associated with long-term COVID and PTE in young adults.

Instrumentação e montagem da mesa cirúrgica para sinusectomia via endoscópica

Fri, 27 Dec 2024 00:00:00 -0300

Introduction: The objective of endoscopic sinus surgery is to return adequate functionality of the paranasal sinuses, with recovery and restoration of the sinus mucosa, in which the use of the endoscope makes the surgery less invasive and more effective. Objectives: This review article proposes to list the surgical instruments used in endoscopic sinus surgery, as well as how the surgical table is prepared. Methods: Didactically, real images of surgical instruments and the surgical table intended for instrumentation. Conclusion: The use of surgical instruments correctly allows the surgical procedure to be more effective and achieve its objective.

Adenocarcinoma of small bowel: why is it so rare

Aldo C Medeiros, Albert Dikson de Lima Filho — Fri, 27 Dec 2024 00:00:00 -0300

Small bowel adenocarcinoma (SBA) is a rare gastrointestinal neoplasm and despite the small intestine's significant surface area, SBA accounts for less than 3% of such tumors. Early detection is challenging and the reason arises from its asymptomatic nature, often leading to late-stage discovery and poor prognosis. Treatment involves chemotherapy with a 5-fluorouracil combination, but the lack of effective chemotherapy contributes to a generally poor prognosis. SBAs are linked to genetic disorders and risk factors, including chronic inflammatory conditions. The unique characteristics of the small bowel, such as rapid cell renewal and an active immune system, contributes to the rarity of these tumors as well as the high intratumoral infiltration of immune cells is associated with a favorable prognosis. Microsatellite instability in SBA is associated with a high tumor mutational burden, affecting the prognosis and response to immunotherapy. The presence of PD-L1 and programmed cell death, along with tumor-infiltrating lymphocytes, plays a crucial role in the complex microenvironment of SBA and contributes to a more favorable prognosis, especially in the context of high MSI tumors. Stromal tumor infiltratinglymphocytes are identified as independent prognostic indicators andthe association between MSI status and a favorable prognosis, emphasizes theimportance of evaluating the immune status of tumors for treatment decisions.

In conclusion, small bowel adenocacinoma is a rare disease, the organ has some caracteristics that contributes to the small incidence of SBA. Finally, the diagnosis, treatmentand survival are challenging.

Presença de anormalidades anatômicas na eminência arqueada do osso temporal: um estudo em cadáveres

Kelvin Moura — Fri, 27 Dec 2024 00:00:00 -0300

ABSTRACT

Introduction: the arcuate eminence (AS) is an important anatomical repair to demarcate the location of the superior semicircular canal (SSC) during surgeries with access through the middle cranial fossa. However, its use has been questioned in the literature due to its varied presentation and questionable relationship with CSS. Objective: to elucidate the topography of the arcuate eminence and observe the presence of anatomical changes and/or variations in this structure. Methodology: this is a cross-sectional study developed from the open dissection of adult cadaver heads. All anatomical measurements were performed with the aid of a digital carbon fiber caliper with an accuracy of 0.1 mm. Results: the study consisted of the analysis of 40 antimeres from 20 specimens. It was possible to identify EA in 92.5% of these pieces and no CSS dehiscence was observed in any of the pieces studied. The distance from EA to cranial vault was on average 25.66mm with a standard deviation of ± 4.6; from the EA to the internal carotid arteries was 47.12mm with a standard deviation of ± 4.2 and from the EA to the internal auditory canal the distance was 18.23mm, with a standard deviation of ± 2.6. Conclusion: EA is a structure with varied presentation, such that an individualized and detailed preoperative study is necessary for a correct and safe surgical technique. CSS dehiscence is a rare variation that requires local studies on its prevalence.