Examinando por Autor "Bruna-Mejias, Alejandro"
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Ítem Effectiveness of alpha-lipoic acid in patients with neuropathic pain associated with type i and type II diabetes mellitus: A systematic review and meta-Analysis(Lippincott Williams and Wilkins, 2023-11) Orellana-Donoso, Mathias; López-Chaparro, Michelle; Barahona-Vásquez, Marisol; Santana-Machuca, Andrés; Bruna-Mejias, Alejandro; Nova-Baeza, Pablo; Valenzuela-Fuenzalida, Juan JoséBackground: This systematic review explores the most current evidence regarding the mechanisms of neuropathic pain in patients with different types of diabetes and how this pain affects different functional and structural components of the neuroanatomical pain pathways. The review also seeks to provide guidelines for the best approach and treatment for patients experiencing this type of pain. The objective is to determine the effectiveness of alpha-lipoic acid (ALA) in improving functional and symptomatic outcomes in patients with diabetes mellitus type I and type II. Objective: To determine the effectiveness of alpha-lipoic acid (ALA) in improving functional and symptomatic outcomes in patients with diabetes mellitus type I and type II. Methods: We systematically search MEDLINE (via PubMed), EMBASE, SCOPUS, the Cochrane Central Register of Controlled Trials, the Cumulative Index to Nursing and Allied Health Literature, and Web of Science databases. Results: The findings of this review show that different forms of ALA do not present statistically significant changes for any of the scales included, including total symptom score (standardized mean difference [SMD] =-3.59, confidence interval [CI] =-4.16 to-3.02, and P <.00001), neuropathy impairment score (SMD =-1.42, CI =-3.68 to 0.84, and P =.22), and neuropathy symptom checklist (SMD =-0.09, CI =-0.15 to-0.02, and P =.01). Conclusion: In comparison to the use of a placebo, the findings suggest that ALA does not exhibit significant differences in terms of pain reduction and different functional scales. Moreover, no specific dosages are identified to support the use of ALA for the reduction of neuropathic pain. © 2023 Lippincott Williams and Wilkins. All rights reserved.Ítem Incidence and Clinical Implications of Anatomical Variations in the Pancreas and Its Ductal System: A Systematic Review and Meta-Analysis(Multidisciplinary Digital Publishing Institute (MDPI), 2023-08) Orellana-Donoso, Mathias; Milos-Brandenberg, Daniel; Benavente-Urtubia, Andoni; Guerra-Loyola, Javier; Bruna-Mejias, Alejandro; Nova-Baeza, Pablo; Becerra-Farfán, Álvaro; Sepulveda-Loyola, Walter; Luque-Bernal, Ricardo Miguel; Valenzuela-Fuenzalida, Juan JoséObjective: This systematic review analyzes the anatomical variants in the pancreas and its ductal system to report on their association with pancreatic pathologies. Methods: We conducted a search of the MEDLINE, Scopus, Web of Science, Google Scholar, CINAHL, and LILACS databases from their inception to July 2023. The methodological quality was assessed with the Anatomical Quality Assessment (AQUA) tool. Finally, the pooled prevalence was estimated using a random effects model. Results: 55 studies were found that met the eligibility criteria. The overall prevalence of pancreas divisum (PD) was 18% (95% CI = 15–21%). The prevalence of PD associated with pancreatitis was 30% (95% CI = 1–61%). Conclusions: An anatomical variant of the pancreas such as PD may be the cause of bile duct obstruction, resulting in various clinical complications, such as pancreatitis. Hence, knowing this variant is extremely important for surgeons, especially for those who treat the gastroduodenal region.