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Does the incidence of infectious endocarditis show seasonal patterns? - a single center retrospective study. 感染性心内膜炎的发病率是否有季节性?-单中心回顾性研究。
Q3 Medicine Pub Date : 2023-04-30 DOI: 10.24425/fmc.2023.145428
Anna Tofilska, Katarzyna Zięba, Andrzej Surdacki, Marek Rajzer, Agnieszka Olszanecka

I n t r o d u c t i o n: Seasonal variation has been observed for bacterial and viral infections (e.g., COVID-19 [1]), but also for numerous cardiac problems. However, little information is available on the seasonality of infectious endocarditis (IE), a rare disease that is usually linked to a bacterial origin. Data from the Polish population are lacking. Materials and M e t h o d s: Our retrospective study focused on the identification of patients with IE, who were hospitalized at the University Hospital in Krakow between 2005-2022. For this purpose, we searched the medical records system using the ICD-10 code. We decided to divide our patients into four groups (winter, spring, summer, autumn), based on the date of admission to the hospital. Comparison of the distribution of IE incidents by season was performed with the ch2 test. R e s u l t s: One hundred and ten patients were included in the study (median age 62.5 years (range 20-94), 72 men (65.45%)). The left native valve IE was diagnosed in 49% of the patients, the prosthetic valve IE in 16%, the right valve IE in 27% and the implantable cardiac electronic devices IE in 12% of the subjects. The outcomes comprised of cardiac surgery (n = 53), embolism (n = 16), death (n = 15) and metastatic infections (n = 5). No differences in the incidence of IE by season were observed. C o n c l u s i o n s: In the preliminary observation of IE cases of patients admitted to the University Hospital in Krakow, Poland no seasonal pattern of IE was detected. Therefore, IE should be taken into account in the differential diagnosis at any time of the year.

在细菌和病毒感染(例如COVID-19[1])中观察到季节性变化,但在许多心脏问题中也存在季节性变化。然而,关于感染性心内膜炎(IE)的季节性信息很少,这是一种罕见的疾病,通常与细菌起源有关。缺乏波兰人口的数据。我们的回顾性研究重点是识别2005-2022年在克拉科夫大学医院住院的IE患者。为此,我们使用ICD-10代码检索病历系统。我们决定将患者根据入院日期分为冬、春、夏、秋四组。采用ch2检验比较不同季节IE事件的分布。研究共纳入110例患者(中位年龄62.5岁(范围20-94),男性72例(65.45%))。49%的患者被诊断为左瓣膜IE, 16%的患者被诊断为人工瓣膜IE, 27%的患者被诊断为右瓣膜IE, 12%的患者被诊断为植入式心脏电子设备IE。结果包括心脏手术(n = 53)、栓塞(n = 16)、死亡(n = 15)和转移性感染(n = 5)。不同季节IE的发生率无差异。在对波兰克拉科夫大学医院住院的IE病例的初步观察中,未发现IE的季节性特征。因此,在一年中的任何时候,鉴别诊断都应考虑IE。
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引用次数: 0
Clinical aspects of the treatment of atopic dermatitis with topical glucocorticoids and calcineurin inhibitors - a pilot questionnaire study. 局部糖皮质激素和钙调磷酸酶抑制剂治疗特应性皮炎的临床方面-一项试点问卷研究。
Q3 Medicine Pub Date : 2023-04-30 DOI: 10.24425/fmc.2023.145433
Przemysław Hałubiec, Andrzej Kazimierz Jaworek, Anna Wojas-Pelc

Atopic dermatitis (AD) is the most common inflammatory skin disease. However, recent reports concerning the simple clinical aspects of treatment with topical glucocorticosteroids (TCS) and calcineurin inhibitors (TCI) are lacking. The objective of this study is providing an update on these characteristics of AD management. A group of 150 adults suffering from AD treated with TCS during last year was asked to fill an anonymous questionnaire. The course of topical treatment was analyzed in the context of the severity of symptoms and the knowledge of the patients about therapy. During the last year, the majority of patients (66%) were treated with class IV TCS; however, in the last two weeks, class I TCS was used the most frequently (35%). Only 11% were familiar with the concept of intermittent therapy and 4% used the fingertip unit (FTU). In total, 77% of them used TCI. Most of the patients used the same class of TCS permanently. Unfortunately, patients are unaware of simple approaches (like intermittent therapy or FTU) that increase both the effectiveness and safety of the treatment. Practicians should be aware of these problems to identify and eliminate them, primarily through the education of patients.

特应性皮炎(AD)是最常见的炎症性皮肤病。然而,最近关于局部糖皮质激素(TCS)和钙调磷酸酶抑制剂(TCI)治疗的简单临床方面的报道缺乏。本研究的目的是提供有关AD管理的这些特征的最新信息。一组150名在去年接受TCS治疗的AD患者被要求填写一份匿名问卷。根据症状的严重程度和患者对治疗的了解情况,分析局部治疗的过程。在过去一年中,大多数患者(66%)接受IV类TCS治疗;然而,在最后两周,I类TCS使用频率最高(35%)。只有11%的人熟悉间歇治疗的概念,4%的人使用指尖单元(FTU)。总共有77%的人使用了TCI。大多数患者长期使用同一类型的TCS。不幸的是,患者并不知道一些简单的方法(如间歇治疗或FTU)可以提高治疗的有效性和安全性。医生应该意识到这些问题,主要是通过对患者的教育来识别和消除这些问题。
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引用次数: 0
Detecting undetectable - epidemiology, etiology, and diagnosis of carcinoma of unknown primary - systematic review. 发现无法检测的-原发不明的癌症的流行病学、病因学和诊断-系统回顾。
Q3 Medicine Pub Date : 2023-04-30 DOI: 10.24425/fmc.2023.145427
Justyna Ostojewska, Iga Wieczorek, Olaf Pachciński, Wojciech Zdziennicki, Franciszek Burdan

Carcinoma of unknown primary (CUP) is a heterogeneous group of oncological diseases in which it is impossible to determine the primary tumor. The incidence is 3-5% of oncologic patients, but the survival time varies from 6 weeks to 5 months. The diagnostics should begin with a clinical evaluation and basic laboratory tests. For CUP placed in head and neck the positron emission tomography - computed tomography is recommended; pancreatic or lung neoplasms are diagnosed with the computed tomography as well. Recently, the magnetic resonance, especially whole-body diffusion-weighted imaging has been introduced to the imaging panel. The lesion obtained during surgically removed metastases or biopsy material should be histopathological and molecularly examined to define the type of tumor. The basic immunoexpression panel should include cytokeratin-5/6, -7 and -20, EMA, synaptophysin, chromogranin, vimentin and GATA3 and molecular expression of ERBB2, PIK3CA, NF1, NF2, BRAF, IDH1, PTEN, FGFR2, EGFR, MET and CDK6. During the accurate diagnostics enable to classify malignancy of undefined primary origin as provisional CUP or finally confirmed CUP in which the primary place of tumor remains undetectable. The detailed diagnostics should be performed in highly specified centers to establish an accurate diagnosis and to initiate personalized treatment. Majority of patients are diagnosed with adenocarcinoma (70%), undifferentiated carcinoma (20%), squamous cell or transitional cell/uroepithelial carcinoma (5-10%), neuroendocrine tumor (5%) and with minor incidence other histological types, including melanoma.

原发性未知癌(CUP)是一种异质性的肿瘤疾病,无法确定其原发肿瘤。发病率为肿瘤患者的3-5%,但生存时间从6周到5个月不等。诊断应从临床评估和基本实验室检查开始。对于头部和颈部的CUP,建议采用正电子发射断层扫描-计算机断层扫描;胰腺或肺部肿瘤也可用计算机断层扫描诊断。近年来,磁共振尤其是全身弥散加权成像被引入到成像面板中。在手术切除转移瘤或活检材料中获得的病变应进行组织病理学和分子检查以确定肿瘤的类型。基本免疫表达面板应包括细胞角蛋白5/6、-7和-20、EMA、synaptophysin、chromogranin、vimentin和GATA3以及ERBB2、PIK3CA、NF1、NF2、BRAF、IDH1、PTEN、FGFR2、EGFR、MET和CDK6的分子表达。在准确的诊断过程中,可以将原发来源不明确的恶性肿瘤分类为临时CUP或最终确诊的CUP,其中原发肿瘤仍无法检测到。详细的诊断应在高度指定的中心进行,以建立准确的诊断并开始个性化的治疗。大多数患者被诊断为腺癌(70%)、未分化癌(20%)、鳞状细胞癌或移行细胞/尿上皮癌(5-10%)、神经内分泌肿瘤(5%),其他组织学类型(包括黑色素瘤)的发病率较低。
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引用次数: 0
Squamous Cell Carcinoma of perineal area developed from the Buschke-Löwenstein tumor. 会阴区鳞状细胞癌起源于Buschke-Löwenstein肿瘤。
Q3 Medicine Pub Date : 2023-04-30 DOI: 10.24425/fmc.2023.145432
Grzegorz J Stępień, Jakub Włodarczyk, Marcin Włodarczyk, Łukasz Dziki

The Buschke-Löwenstein tumor is a rare disease associated with human papillomavirus infection. The condition manifests with an ulcerative, exophytic tumor localized in the perineal area. Generally considered as non-cancerous, the growth may develop malignant transformation. Our manuscript highlights the importance of early diagnosis with histopathological analysis.

Buschke-Löwenstein肿瘤是一种罕见的与人乳头瘤病毒感染相关的疾病。此病表现为会阴区溃疡性外生性肿瘤。一般认为是非癌性的,但生长可能发展为恶性转化。我们的手稿强调早期诊断与组织病理学分析的重要性。
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引用次数: 0
Analysis of the epidemic situation of the COVID-19 coronavirus infection in Ukraine. 乌克兰新型冠状病毒感染疫情分析
Q3 Medicine Pub Date : 2023-04-30 DOI: 10.24425/fmc.2023.145434
Alla Podavalenko, Nina Malysh, Viktoriya Zadorozhna, Kateryna Zhuk, Galina Zaitseva, Inna Chorna

The epidemic process of COVID-19 in the world developed rapidly. The situation with morbidity, despite the establishment of quarantine, the introduction of restrictive anti-epidemic measures, and vaccination, remains difficult. The results of research on the influence of meteorological factors on the dynamics of the incidence of COVID-19, hospitalization, and mortality are ambiguous and contradictory. The purpose of this study is to analyze the indicators of morbidity, hospitalization, and mortality from COVID-19 in Ukraine, and to establish the level of influence of meteorological factors on them. A high variation in morbidity, hospitalization, and mortality rates was observed in Ukraine, in 2020-2021. A total of 3 waves of disease growth were established. The curve of hospitalization indicators of patients with COVID-19 had a correlation dependence on the incidence curve r = 0.766 (р <0.05), the maximum rates of hospitalization and mortality were registered in September-December 2021. A direct strong correlation was established between the frequency of registration of cases of COVID-19 and mortality - r = 0.899 (р <0.05). Most cases of COVID-19 were registered in the cold season, the least in June-August. Inverse correlations of moderate strength were established between the indicators of morbidity, hospitalization, and mortality and air temperature levels (-0.370< r <-0.461). Direct correlations of average strength (0.538< r <0.632) were established with the levels of relative air humidity.

新冠肺炎疫情在世界范围内迅速发展。尽管建立了隔离,采取了限制性防疫措施,并进行了疫苗接种,但发病率的情况仍然很困难。气象因素对新冠肺炎发病率、住院率和死亡率动态影响的研究结果是模糊和矛盾的。本研究的目的是分析乌克兰新冠肺炎的发病率、住院率和死亡率指标,并建立气象因素对其影响程度。2020-2021年,乌克兰的发病率、住院率和死亡率变化很大。共建立了3波疾病生长。新冠肺炎患者住院指标曲线与发病率曲线呈相关依赖关系,r = 0.766 (p < 0.05)
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引用次数: 1
Retrospective analysis of a case report of a left ovarian ectopic pregnancy after the former tubal 前输卵管后左卵巢异位妊娠1例回顾性分析
Q3 Medicine Pub Date : 2023-03-09 DOI: 10.24425/fmc.2022.142372
Anna Wrona, Veronika Aleksandrovych, Anna Gil, Magdalena Kurnik-Łucka, Jerzy A Walocha, Krzysztof Gil
Up to 2% of pregnancies may be extrauterine. Despite reproductive problems, they might increase the risk of serious complications. We present a case report of a 31-year-old woman with two extrauterine pregnancies - tubal and ovarian, which occurred at the same side with little time difference. In addition, we aimed to examine possible reasons underlying this rare pathology. Thus, surgically removed tissue specimens were morphologically assessed and further compared with specimens from healthy control patients. Telocytes were analysed in detail due to their pivotal role in the female reproductive system. Our study had observational character and obvious limitations typical for a clinical case. Yet, such a clinical case of two ectopic pregnancies has not been previously reported in the literature.
高达2%的妊娠可能是宫外妊娠。尽管存在生殖问题,但它们可能会增加严重并发症的风险。我们报告了一例31岁的女性有两个子宫外妊娠-输卵管和卵巢,发生在同一侧,几乎没有时间差异。此外,我们的目的是研究这种罕见病理的可能原因。因此,对手术切除的组织标本进行形态学评估,并进一步与健康对照患者的标本进行比较。由于远端细胞在女性生殖系统中的关键作用,我们对它们进行了详细的分析。本研究具有临床病例典型的观察性特征和明显的局限性。然而,这种两次异位妊娠的临床病例在以前的文献中尚未报道。
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引用次数: 0
Higher milk consumption is not associated with fracture risk reduction: systematic review and meta-analysis 高牛奶消费量与骨折风险降低无关:系统回顾和荟萃分析
Q3 Medicine Pub Date : 2023-03-09 DOI: 10.24425/fmc.2022.144088
Grzegorz Goncerz, Patrycja Kojm, Sylwia Skocelas, Krzysztof Więckowski, Tomasz Gallina, Paulina Pietrzyk, Sebastian Goncerz
Osteoporosis affects over 200 million people worldwide causing nearly 9 million fractures annually, with more than half in America and Europe.This meta-analysis was conducted to investigate whether low milk intake is associated with an increased risk of fractures by summarizing all the available evidence.Relevant studies were identified by searching the PubMed and EMBASE databases up to June 2020. The pooled relative risks with 95% confidence intervals were calculated.In a meta-regression analysis of 20 included studies (11 cohort and 9 case-control studies), a higher milk intake was not associated with a reduction in the total fracture risk in both sexes (OR 0.95, 95% CI: 0.84- 1.08), either in cohort (OR 0.91; 95% CI: 0.79-1.05) or case-control studies (OR 1.09; 95% CI: 0.82-1.44), as well as separately in men (OR 0.87; 95% CI: 0.71-1.07) and women (OR 0.95; 95% CI: 0.80-1.13).Higher milk consumption is not associated with fracture risk reduction and should not be recommended for fracture prevention.
骨质疏松症影响全球超过2亿人,每年造成近900万例骨折,其中一半以上发生在美国和欧洲。这项荟萃分析是通过总结所有现有证据来调查低牛奶摄入量是否与骨折风险增加有关。通过检索截至2020年6月的PubMed和EMBASE数据库确定相关研究。以95%置信区间计算合并相对危险度。在20项纳入研究(11项队列研究和9项病例对照研究)的荟萃回归分析中,高牛奶摄入量与两性总骨折风险降低无关(OR 0.95, 95% CI: 0.84- 1.08),无论是队列研究(OR 0.91;95% CI: 0.79-1.05)或病例对照研究(or 1.09;95% CI: 0.82-1.44),以及单独在男性中(OR 0.87;95% CI: 0.71-1.07)和女性(OR 0.95;95% ci: 0.80-1.13)。高牛奶摄入量与骨折风险降低无关,不应被推荐用于预防骨折。
{"title":"Higher milk consumption is not associated with fracture risk reduction: systematic review and meta-analysis","authors":"Grzegorz Goncerz, Patrycja Kojm, Sylwia Skocelas, Krzysztof Więckowski, Tomasz Gallina, Paulina Pietrzyk, Sebastian Goncerz","doi":"10.24425/fmc.2022.144088","DOIUrl":"https://doi.org/10.24425/fmc.2022.144088","url":null,"abstract":"Osteoporosis affects over 200 million people worldwide causing nearly 9 million fractures annually, with more than half in America and Europe.This meta-analysis was conducted to investigate whether low milk intake is associated with an increased risk of fractures by summarizing all the available evidence.Relevant studies were identified by searching the PubMed and EMBASE databases up to June 2020. The pooled relative risks with 95% confidence intervals were calculated.In a meta-regression analysis of 20 included studies (11 cohort and 9 case-control studies), a higher milk intake was not associated with a reduction in the total fracture risk in both sexes (OR 0.95, 95% CI: 0.84- 1.08), either in cohort (OR 0.91; 95% CI: 0.79-1.05) or case-control studies (OR 1.09; 95% CI: 0.82-1.44), as well as separately in men (OR 0.87; 95% CI: 0.71-1.07) and women (OR 0.95; 95% CI: 0.80-1.13).Higher milk consumption is not associated with fracture risk reduction and should not be recommended for fracture prevention.","PeriodicalId":12106,"journal":{"name":"Folia medica Cracoviensia","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136170579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Habits related to the use of insulin infusion set in patients with type 1 diabetes on pump therapy — the effect of the educational intervention 1型糖尿病患者胰岛素输液器使用习惯对泵治疗的影响——教育干预的效果
Q3 Medicine Pub Date : 2023-03-09 DOI: 10.24425/fmc.2022.144079
Damian Ucieklak, Sandra Mrozińska, Aleksandra Wojnarska, Maciej T Małecki, Tomasz Klupa, Bartłomiej Matejko
Proper use of insulin infusion sets (IIS) plays an important role in pump therapy of patients with type 1 diabetes mellitus (T1DM). We assessed the habits associated with the use of IIS in patients with T1DM treated with insulin pump.This study included 79 T1DM patients who were examined for the presence of lipohypertrophy (LH) and retrained for proper IIS use. They completed a standard questionnaire regarding IIS at the time of study entry and at the follow-up. R e s u l t s: At baseline, most of the patients declared to have been using a plastic cannula (n = 68; 86.1%), changing the infusion set regularly (n = 65; 82.3%), and placing the infusion sets on the abdomen wall (n = 68; 86.1%). The most common rotation habit was the "curve pattern" on both sides of the umbilicus (n = 16; 20.3%). After a median of 23 weeks (IQR 20-34), 58 patients were available for the follow-up. A rise in the proportion of patients who declared to change IIS regularly (n = 48; 82.8% vs. n = 57; 98.3%, p = 0.016), change IIS every 2 to 3 days (n = 27; 46.6% vs. n = 35; 60.3%, p = 0.043), use "crisscross" rotation (n = 5; 8.8% vs. n = 12; 21.4%, p = 0.027) was observed. There were less patients reporting not having repeatable rotation manner (n = 15; 26.3% vs. n = 2; 5.4%, p = 0.009). C o n c l u s i o n s: A substantial proportion of T1DM patients on pump therapy declare that they do not follow the recommended principles of IIS use. The intervention consisting of LH assessment and retrain- ing of proper use of IIS might be effective in improving patient compliance.
正确使用胰岛素输液器(IIS)在1型糖尿病(T1DM)患者的泵治疗中起着重要作用。我们评估了接受胰岛素泵治疗的T1DM患者使用IIS的相关习惯。本研究纳入了79名T1DM患者,检查了是否存在脂肪肥大(LH),并对其进行了再培训,以便正确使用IIS。他们在研究开始时和随访时完成了一份关于IIS的标准问卷。在基线时,大多数患者宣称使用塑料套管(n = 68;86.1%),定期更换输液器(n = 65;82.3%),将输液器放置于腹壁(n = 68;86.1%)。最常见的旋转习惯是脐两侧的“曲线模式”(n = 16;20.3%)。中位数为23周(IQR 20-34)后,58例患者可进行随访。声称定期更换IIS的患者比例上升(n = 48;82.8%对n = 57;98.3%, p = 0.016),每2 ~ 3天更换一次IIS (n = 27;46.6% vs. n = 35;60.3%, p = 0.043),使用“交叉”旋转(n = 5;8.8%对n = 12;21.4%, p = 0.027)。报告没有重复旋转方式的患者较少(n = 15;26.3%对n = 2;5.4%, p = 0.009)。在接受泵治疗的T1DM患者中,有相当大比例的患者声称他们没有遵循推荐的IIS使用原则。干预包括LH评估和再培训正确使用IIS可能有效地提高患者的依从性。
{"title":"Habits related to the use of insulin infusion set in patients with type 1 diabetes on pump therapy — the effect of the educational intervention","authors":"Damian Ucieklak, Sandra Mrozińska, Aleksandra Wojnarska, Maciej T Małecki, Tomasz Klupa, Bartłomiej Matejko","doi":"10.24425/fmc.2022.144079","DOIUrl":"https://doi.org/10.24425/fmc.2022.144079","url":null,"abstract":"Proper use of insulin infusion sets (IIS) plays an important role in pump therapy of patients with type 1 diabetes mellitus (T1DM). We assessed the habits associated with the use of IIS in patients with T1DM treated with insulin pump.This study included 79 T1DM patients who were examined for the presence of lipohypertrophy (LH) and retrained for proper IIS use. They completed a standard questionnaire regarding IIS at the time of study entry and at the follow-up. R e s u l t s: At baseline, most of the patients declared to have been using a plastic cannula (n = 68; 86.1%), changing the infusion set regularly (n = 65; 82.3%), and placing the infusion sets on the abdomen wall (n = 68; 86.1%). The most common rotation habit was the \"curve pattern\" on both sides of the umbilicus (n = 16; 20.3%). After a median of 23 weeks (IQR 20-34), 58 patients were available for the follow-up. A rise in the proportion of patients who declared to change IIS regularly (n = 48; 82.8% vs. n = 57; 98.3%, p = 0.016), change IIS every 2 to 3 days (n = 27; 46.6% vs. n = 35; 60.3%, p = 0.043), use \"crisscross\" rotation (n = 5; 8.8% vs. n = 12; 21.4%, p = 0.027) was observed. There were less patients reporting not having repeatable rotation manner (n = 15; 26.3% vs. n = 2; 5.4%, p = 0.009). C o n c l u s i o n s: A substantial proportion of T1DM patients on pump therapy declare that they do not follow the recommended principles of IIS use. The intervention consisting of LH assessment and retrain- ing of proper use of IIS might be effective in improving patient compliance.","PeriodicalId":12106,"journal":{"name":"Folia medica Cracoviensia","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136170577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Inguinal hernia management in preterm infants: addressing current issues of interest. 腹股沟疝管理的早产儿:解决当前的问题感兴趣。
Q3 Medicine Pub Date : 2023-03-09 DOI: 10.24425/fmc.2020.136203
I. Patoulias, I. Gkalonaki, D. Patoulias
: We define as preterm any newborn born before 37 weeks of gestation. The incidence of inguinal hernia is 1–4.4% among full term neonates and older children. In preterm newborns it is significantly more often, with an incidence that raises up to 30%. In this comprehensive review of the literature we provide evidence-based answers in various questions concerning the optimal treatment of inguinal hernias in preterm neonates. Such questions include the proper time of intervention, the choice of optimal anesthesia, the necessity for contralateral investigation in case of an ipsilateral hernia, the prevention of post-operative apnea and the choice between classic and laparoscopic surgical techniques.
我们将妊娠37周前出生的新生儿定义为早产。足月新生儿和大龄儿童腹股沟疝的发生率为1-4.4%。在早产新生儿中更为常见,发病率高达30%。在这篇全面的文献综述中,我们提供了关于早产儿腹股沟疝最佳治疗的各种问题的循证答案。这些问题包括适当的干预时间、最佳麻醉的选择、同侧疝时对侧检查的必要性、术后呼吸暂停的预防以及经典手术技术和腹腔镜手术技术的选择。
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引用次数: 1
Past strong experiences determine acute cardiovascular autonomic responses to acoustic stress. 过去的强烈经历决定了对声学应激的急性心血管自主反应。
Q3 Medicine Pub Date : 2023-02-21 DOI: 10.24425/fmc.2020.136206
Michał Jurczyk, Andrzej Boryczko, A. Furgała, Adrian Poniatowski, A. Surdacki, K. Gil
BACKGROUNDStress is a major risk factor for cardiovascular (CV) disease. We hypothesized that past strong experiences might modulate acute CV autonomic responses to an unexpected acoustic stimulus. A i m: The study's aim was to compare acute CV autonomic responses to acoustic stress between students with and without a past strong experience associated with the acoustic stimulus.MATERIALS AND METHODSTwenty five healthy young volunteers - medical and non-medical students - were included in the study. CV hemodynamic parameters, heart rate (HR), and blood pressure (BP) variability were assessed for 10 min at rest and for 10 min after two different acoustic stimuli: a standard sound signal and a specific sound signal used during a practical anatomy exam (so-called "pins").RESULTSBoth sounds stimulated the autonomic nervous system. The "pins" signal caused a stronger increase in HR in medical students (69 ± 10 vs. 73 ± 13 bpm, p = 0.004) when compared to non-medical students (69 ± 6 vs. 70 ± 10, p = 0.695). Rises in diastolic BP, observed 15 seconds after sound stressors, were more pronounced after the "pins" sound than after the standard sound signal only in medical students (3.1% and 1.4% vs. 3% and 4.4%), which was also reflected by low-frequency diastolic BP variability (medical students: 6.2 ± 1.6 vs. 4.1 ± 0.8 ms2, p = 0.04; non-medical students: 6.0 ± 4.3 vs. 4.1 ± 2.6 ms2, p = 0.06).CONCLUSIONSThe "pins" sound, which medical students remembered from their anatomy practical exam, provoked greater sympathetic activity in the medical student group than in their non-medical peers. Thus, past strong experiences modulate CV autonomic responses to acute acoustic stress.
背景:应激是心血管疾病的主要危险因素。我们假设过去强烈的经历可能会调节急性CV自主神经对意外声刺激的反应。A:这项研究的目的是比较有和没有与声刺激相关的强烈经验的学生对声应激的急性CV自主反应。材料和方法25名健康的年轻志愿者——医学院和非医学院的学生——被纳入研究。静息10分钟和两种不同声刺激后10分钟评估CV血流动力学参数、心率(HR)和血压(BP)变异性:标准声信号和实际解剖检查中使用的特定声信号(所谓的“针”)。结果两种声音均刺激自主神经系统。“针”信号导致医学生心率(69±10比73±13 bpm, p = 0.004)高于非医学生(69±6比70±10,p = 0.695)。在声音刺激后15秒,医学生的舒张压升高比标准声音信号后更明显(3.1%和1.4% vs. 3%和4.4%),这也反映在低频舒张压变异性上(医学生:6.2±1.6 vs. 4.1±0.8 ms2, p = 0.04;非医学生:6.0±4.3比4.1±2.6,p = 0.06)。结论医学生在解剖学实践考试中记住的“针”声,在医学生组中引起的交感神经活动大于非医学生组。因此,过去强烈的经验调节CV对急性声应激的自主反应。
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引用次数: 0
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Folia medica Cracoviensia
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