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Infancy Urogenital Myiasis: A Case Report. 婴幼儿尿道肌炎:病例报告。
IF 1.6 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-09-01 DOI: 10.30476/ijms.2024.102202.3497
Ehsan Mohammadi, Mohammad Abtahi, Parham Manouchehri, Tahereh Saberi, Sedigheh Saberi

Myiasis is a parasitic infestation of fly larvae caused by dipterous larvae that live in the host's dead or living tissues. This study reported the first case of urogenital myiasis in infants from Iran caused by Lucilia sericata. The 10-month-old boy was taken to the hospital by his mother due to restlessness and abdominal pain. During the examination, motile and live larvae were observed in the penis area. The patient had no history of infectious disease or immune system deficiency, and his blood tests were normal. The entomological analysis found that the source of this myiasis was Lucilia sericata fly larvae. The report of such cases highlighted the importance of physical examination and the awareness of physicians in dealing with myiasis, as well as the necessity of educating mothers on the hygiene of the living environment and child care in rural areas.

蝇蛆病是由寄生在宿主死亡或存活组织中的双翅目幼虫引起的蝇蛆寄生虫病。本研究报告了伊朗首例由绢毛蝇蛆(Lucilia sericata)引起的婴儿泌尿生殖器蠅蛆病病例。这名 10 个月大的男孩因烦躁不安和腹痛被母亲送往医院。在检查过程中,在阴茎部位发现了活动的活幼虫。患者没有传染病史或免疫系统缺陷,血液化验也正常。昆虫学分析发现,这种肌炎的病源是绢毛蝇蛆幼虫。此类病例的报告强调了体格检查的重要性和医生在处理蠅蛆病时的意识,以及在农村地区对母亲进行生活环境卫生和儿童护理教育的必要性。
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引用次数: 0
Occupational Therapy Assessment Tools for Children and Adolescents in Iran: A Scoping Review. 伊朗儿童和青少年的作业疗法评估工具:范围审查。
IF 1.6 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-09-01 DOI: 10.30476/ijms.2024.100756.3325
Ehsan Jamshidian, Aynaz Jabbari, Fatemeh Dehghan, Elahe Fathi Azar, Hooshang Mirzaie

Background: Assessment tools are essential in occupational therapy for providing client-centered care, clinical decision-making, evidence-based documentation, and defining expected outcomes. This study investigated available occupational therapy assessment tools for children and adolescents in Iran.

Methods: A comprehensive search was conducted in MEDLINE, PubMed Central, Web of Science, Embase, Scopus, SID, Magiran, and Google Scholar from their inception until May 24, 2022. Two reviewers screened records and applied inclusion criteria focused on peer-reviewed articles in English or Persian, covering children and adolescents aged 0-18 years old in Iran. The methodological quality of each study and the evidence quality of each measurement tool was assessed using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) Risk of Bias Checklist, and the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach.

Results: A review of 66 articles published between 2010 and 2021, identified 51 assessment tools. The majority of tools (70.7%) targeted typically developing children and those with cerebral palsy, with limited options for adolescents (n=5) and infants (n=1). These tools primarily focused on assessing body functions (47.06%), particularly sensory-motor functions. While numerous tools demonstrated good reliability (66.67%) and significant content validity (31.37%), there was a paucity of high-quality evidence supporting other psychometric properties.

Conclusion: This study identified 51 occupational therapy assessment tools for Iranian children and adolescents. However, the present research identified some concerning trends, such as lack of tools available for specific populations, an overreliance on translated tools, and a predominant focus on body functions. Moreover, there were concerns about the methodological quality of studies using these tools.

背景:在职业治疗中,评估工具对于提供以客户为中心的护理、临床决策、循证记录和确定预期结果至关重要。本研究调查了伊朗现有的儿童和青少年职业疗法评估工具:从 MEDLINE、PubMed Central、Web of Science、Embase、Scopus、SID、Magiran 和 Google Scholar 开始到 2022 年 5 月 24 日进行了全面搜索。两名审稿人对记录进行了筛选,并采用了纳入标准,重点关注同行评议的英语或波斯语文章,涉及伊朗 0-18 岁的儿童和青少年。采用基于共识的健康测量工具选择标准(COSMIN)偏倚风险检查表和建议、评估、发展和评价分级(GRADE)方法对每项研究的方法学质量和每种测量工具的证据质量进行了评估:对 2010 年至 2021 年间发表的 66 篇文章进行了审查,确定了 51 种评估工具。大多数工具(70.7%)针对发育正常的儿童和脑瘫患者,青少年(5 个)和婴儿(1 个)的选择有限。这些工具主要侧重于评估身体功能(47.06%),尤其是感觉运动功能。虽然许多工具显示出良好的可靠性(66.67%)和显著的内容效度(31.37%),但支持其他心理测量特性的高质量证据却很少:本研究为伊朗儿童和青少年确定了 51 种职业治疗评估工具。然而,本研究发现了一些令人担忧的趋势,如缺乏针对特定人群的工具、过度依赖翻译工具以及主要侧重于身体功能。此外,使用这些工具进行研究的方法质量也令人担忧。
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引用次数: 0
Association of Weight-indexed Conventional Ultrafiltration Volume with Post-operative Lactate in Patients Undergoing Cardiopulmonary Bypass. 接受心肺搭桥术的患者按体重指数计算的常规超滤量与术后乳酸的关系
IF 1.6 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-09-01 DOI: 10.30476/ijms.2023.99730.3186
Hamid Gerami, Javad Sajedianfard, Bahram Ghasemzadeh, Maryam AnsariLari

Background: Conventional ultrafiltration (CUF) during cardiopulmonary bypass (CPB) is utilized to minimize hemodilution. However, removing high volumes leads to tissue hypoperfusion by activating the anaerobic glycolysis pathways. This study aimed to determine the association between weight-indexed CUF volumes and lactate in patients who underwent coronary artery bypass grafting (CABG).

Methods: In this single-center retrospective study, 641 CABG patients, who were referred to Al-Zahra Hospital (Shiraz, Iran) and underwent CPB, during 2019-2021, were recruited. Peri-operative parameters were extracted from the patient's records. The patients with non-elective status, pre-existing liver and renal diseases, ejection fraction<35%, and repeated sternotomy were excluded from the study. An increase in post-operative lactate level≥4 mmol/L after 6 hours was defined as hyperlactatemia (HL). To predict HL, univariable and multiple logistic regression modeling, while controlling confounding factors, were employed.

Results: The patients' mean age was 58.8±11.1 years, and 39.2% were women. The incidence of HL was 14.5% (93 patients). There was a significant association between weight-indexed CUF volume and HL. The volume removed in the HL patients was almost doubled (43.37±11.32 vs. 21.41±8.15 mL/Kg, P<0.001), and the higher the weight-indexed CUF volume, the more likely to develop an HL at a rate of 1.38 (Odds ratio=1.38 [1.27-1.49], 95% CI, P<0.001). Furthermore, the multiple logistic regression model showed that HL was associated with the lowest mean arterial pressure (MAP) during CPB.

Conclusion: A higher volume of ultrafiltration was associated with increased post-operative serum lactate levels.

背景:心肺旁路术(CPB)期间的常规超滤(CUF)可最大限度地减少血液稀释。然而,大量抽吸会激活无氧糖酵解途径,导致组织灌注不足。本研究旨在确定接受冠状动脉旁路移植术(CABG)患者的体重指数 CUF 容量与乳酸之间的关系:在这项单中心回顾性研究中,共招募了641名2019-2021年间转诊至Al-Zahra医院(伊朗设拉子)并接受CPB的CABG患者。围手术期参数从患者病历中提取。结果显示,患者的平均年龄为 58.5 岁,平均射血分数为 0.5:患者的平均年龄为(58.8±11.1)岁,39.2%为女性。HL的发病率为14.5%(93名患者)。体重指数 CUF 容量与 HL 之间存在明显关联。HL患者的超滤量几乎增加了一倍(43.37±11.32 vs. 21.41±8.15 mL/Kg,PC结论:超滤量越大,术后血清乳酸水平越高。
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引用次数: 0
The Adrenal Pheochromocytoma Cell Line PC12 Efficiently Promotes the Regeneration Capability of Adipose Tissue-Derived Mesenchymal Stem Cells in Myogenesis: A Particular Approach to Improving Skeletal Muscle Cell Regeneration. 肾上腺嗜铬细胞瘤细胞系 PC12 有效促进脂肪组织间充质干细胞在肌肉生成中的再生能力:改善骨骼肌细胞再生的特殊方法。
IF 1.6 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-09-01 DOI: 10.30476/ijms.2023.99642.3175
Zeinab Shafiei Seifabadi, Dian Dayer, Seyyed Saeed Azandeh, Mohammad Rashno, Vahid Bayati

Background: Researchers are looking for a way to improve the myogenic differentiation of stem cells. Adipose-derived stem cells (ADSCs), known for their multipotency and regenerative capabilities, have been extensively studied for their therapeutic potential. Meanwhile, PC12 cells, derived from rat pheochromocytoma, have been found pivotal in neuroscience research, particularly as a neuronal model system. The current study investigated the effect of the PC12 adrenal pheochromocytoma cell line on the myogenic differentiation of ADSCs.

Methods: This experimental study was conducted during 2019-2022 (Ahvaz, Iran). Differentiation of ADSCs was induced by using 3 μg/mL 5-azacytidine for 24 hours. Then, the culture media was changed with Dulbecco's Modified Eagle-High Glucose (DMEM-HG) containing 5% horse serum (HS) and kept for 7 days. Different percentages of differentiated ADSCs and PC12 (100:0, 70:30, 50:50, 30:70) were cocultured for 7 days in DMEM-HG containing 5% HS. PC12 was labeled with cell tracker C7000. The real-time polymerase chain reaction and Western blotting techniques were utilized to assess gene and protein expression. All experiments were repeated three times. Data were analyzed using GraphPad Prism 8.0.2 software with a one-way analysis of variance. P<0.05 was considered statistically significant.

Results: PC12 visualization confirmed the accuracy of the co-culture process. The differentiated cells showed an aligned, multinucleated shape. The differentiated ADSCs revealed significantly elevated levels of Myh1, Myh2, and Chrn-α1 gene expression compared with undifferentiated ADSCs (P<0.0001). The ADSCs cocultured with PC12 cells showed significantly higher Myh1, Myh2, and Chrn-α1 gene expression than differentiated ADSCs (P<0.001). ADSCs cocultured with 50% PC12 revealed significantly higher MYH and nAchR protein expression than the differentiated group (P<0.01 and P<0.001).

Conclusion: Coculturing PC12 cells and ADSCs improves the efficiency of myogenic differentiation. However, the effectiveness of myogenic differentiation depends on the proportions of administered PC12 cells.

背景:研究人员正在寻找改善干细胞成肌分化的方法。脂肪源性干细胞(ADSCs)以其多潜能性和再生能力而闻名,其治疗潜力已被广泛研究。与此同时,从大鼠嗜铬细胞瘤中提取的 PC12 细胞在神经科学研究中,特别是作为神经元模型系统中,也具有举足轻重的作用。本研究探讨了PC12肾上腺嗜铬细胞瘤细胞系对ADSCs成肌分化的影响:本实验研究于 2019-2022 年期间进行(伊朗阿瓦士)。使用 3 μg/mL 5-azacytidine 诱导 ADSCs 分化 24 小时。然后,用含 5%马血清(HS)的 Dulbecco's Modified Eagle-High Glucose(DMEM-HG)更换培养基并保存 7 天。不同比例的分化 ADSCs 和 PC12(100:0、70:30、50:50、30:70)在含 5% HS 的 DMEM-HG 中共培养 7 天。PC12 用细胞追踪器 C7000 标记。利用实时聚合酶链反应和 Western 印迹技术评估基因和蛋白质的表达。所有实验重复三次。使用 GraphPad Prism 8.0.2 软件对数据进行单因素方差分析。结果PC12 的可视化证实了共培养过程的准确性。分化的细胞呈现出排列整齐的多核形状。与未分化 ADSCs 相比,分化 ADSCs 的 Myh1、Myh2 和 Chrn-α1 基因表达水平明显升高(PMyh1、Myh2 和 Chrn-α1 基因表达水平高于分化 ADSCs):PC12细胞与ADSCs共培养可提高成肌分化的效率。然而,成肌分化的效果取决于所加入的 PC12 细胞的比例。
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引用次数: 0
Suggestions for Solving the Suicide Mystery among Iranian Medical Residents. 解决伊朗医学住院医生自杀之谜的建议。
IF 1.6 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-09-01 DOI: 10.30476/ijms.2024.102570.3562
Ali Hosseinzadeh Oskouei, Mohammad Sadegh Zamani Zarchi, Mandana Piryaei, Hamid Yaghubi, Jamal Shams, Amir Sam Kianimoghadam
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引用次数: 0
Study of Patients' Privacy during the COVID-19 Pandemic in Iranian Health Care Settings. 研究伊朗医疗机构在 COVID-19 大流行期间病人的隐私。
IF 1.6 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-09-01 DOI: 10.30476/ijms.2023.97795.3070
Mina Mobasher, Hamidreza Samzadeh Kermani, Mahin Eslami Shahrbabaki, Afshin Sarafinejad

Background: Patient's privacy protection is a challenging ethical issue. The complex situation of the COVID-19 pandemic was a probable predictor of breaching confidentiality. This study aimed to assess the viewpoints of COVID-19-confirmed patients, who were hospitalized, and their healthcare providers about the compliance of different aspects of patient's privacy.

Methods: This cross-sectional study included 3433 COVID-19-confirmed patients who were hospitalized in Kerman, between 2020 and 2021, and about 1228 related physicians, nurses, and paraclinical staff. Two separate validated researcher-made questionnaires were developed, each including subscales for physical, informational, and spatial privacy, as well as a satisfaction rate of privacy protection. The data were analyzed using SPSS software version 26, with independent samples t test, Mann-Whitney-U, Kruskal Wallis, and Multiple Linear Regression tests at a 95% confidence interval.

Results: The mean percentages of the patients' privacy scores in physical, spatial, and informational areas were significantly lower (P<0.001) than the average of the medical staff's scores in all three areas (Difference: 10.27%, 14.83%, and 4.91%, respectively). Physical and spatial privacy scores could be predicted based on the participants' classification, patients or medical staff, and sex. The mean patients' satisfaction score was 9.25% lower than the medical staff's (P<0.001). Moreover, only academic hospitals showed a statistically significant difference between the patient's satisfaction with privacy protection and medical staff's viewpoints (P<0.001).

Conclusion: Although this study indicated the benefits of protecting patients' privacy in the healthcare setting, patients' privacy scores and satisfaction were lower than their healthcare providers. The pandemic conditions might have been an obstacle to preserving patients' rights. These findings demonstrated the importance of sensitizing healthcare providers to manage these ethical challenges in a complicated critical state such as the COVID-19 pandemic.

背景:保护病人隐私是一个具有挑战性的伦理问题。COVID-19 大流行的复杂情况很可能导致违反保密规定。本研究旨在评估确诊为 COVID-19 的住院患者及其医疗服务提供者对遵守患者隐私不同方面规定的看法:这项横断面研究包括 2020 年至 2021 年期间在克尔曼住院的 3433 名 COVID-19 确诊患者,以及约 1228 名相关医生、护士和医务辅助人员。研究人员分别制作了两份经过验证的调查问卷,每份问卷都包括物理隐私、信息隐私和空间隐私的子量表,以及隐私保护的满意度。数据使用 SPSS 软件 26 版进行分析,采用独立样本 t 检验、Mann-Whitney-U、Kruskal Wallis 和多元线性回归检验,置信区间为 95%:结果:患者在物理、空间和信息方面的隐私评分的平均百分比明显较低(PC结论:尽管本研究表明保护隐私对患者有好处,但患者在物理、空间和信息方面的隐私评分的平均百分比明显较低:尽管这项研究表明了在医疗环境中保护患者隐私的益处,但患者的隐私得分和满意度均低于医疗服务提供者。大流行病的条件可能是维护患者权利的一个障碍。这些研究结果表明,在 COVID-19 大流行这种复杂的危急情况下,提高医疗服务提供者对处理这些伦理挑战的敏感性非常重要。
{"title":"Study of Patients' Privacy during the COVID-19 Pandemic in Iranian Health Care Settings.","authors":"Mina Mobasher, Hamidreza Samzadeh Kermani, Mahin Eslami Shahrbabaki, Afshin Sarafinejad","doi":"10.30476/ijms.2023.97795.3070","DOIUrl":"10.30476/ijms.2023.97795.3070","url":null,"abstract":"<p><strong>Background: </strong>Patient's privacy protection is a challenging ethical issue. The complex situation of the COVID-19 pandemic was a probable predictor of breaching confidentiality. This study aimed to assess the viewpoints of COVID-19-confirmed patients, who were hospitalized, and their healthcare providers about the compliance of different aspects of patient's privacy.</p><p><strong>Methods: </strong>This cross-sectional study included 3433 COVID-19-confirmed patients who were hospitalized in Kerman, between 2020 and 2021, and about 1228 related physicians, nurses, and paraclinical staff. Two separate validated researcher-made questionnaires were developed, each including subscales for physical, informational, and spatial privacy, as well as a satisfaction rate of privacy protection. The data were analyzed using SPSS software version 26, with independent samples <i>t</i> test, Mann-Whitney-U, Kruskal Wallis, and Multiple Linear Regression tests at a 95% confidence interval.</p><p><strong>Results: </strong>The mean percentages of the patients' privacy scores in physical, spatial, and informational areas were significantly lower (P<0.001) than the average of the medical staff's scores in all three areas (Difference: 10.27%, 14.83%, and 4.91%, respectively). Physical and spatial privacy scores could be predicted based on the participants' classification, patients or medical staff, and sex. The mean patients' satisfaction score was 9.25% lower than the medical staff's (P<0.001). Moreover, only academic hospitals showed a statistically significant difference between the patient's satisfaction with privacy protection and medical staff's viewpoints (P<0.001).</p><p><strong>Conclusion: </strong>Although this study indicated the benefits of protecting patients' privacy in the healthcare setting, patients' privacy scores and satisfaction were lower than their healthcare providers. The pandemic conditions might have been an obstacle to preserving patients' rights. These findings demonstrated the importance of sensitizing healthcare providers to manage these ethical challenges in a complicated critical state such as the COVID-19 pandemic.</p>","PeriodicalId":14510,"journal":{"name":"Iranian Journal of Medical Sciences","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11452588/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Use of Platelet Count and Indices as Prognostic Factors for Mortality in Children with Sepsis. 将血小板计数和指标作为败血症患儿死亡率的预后因素。
IF 1.6 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-08-01 DOI: 10.30476/IJMS.2023.99084.3113
Meliani Meliani, Jelita Siregar, Inke Nadia Diniyanti Lubis

Background: Sepsis is still one of the leading causes of mortality and morbidity in children worldwide. Consumptive coagulopathy and suppression of thrombopoiesis in the bone marrow resulting from immune dysregulation are pathological mechanisms that cause thrombocytopenia in sepsis. Platelet count (PLT) and indices, such as mean platelet volume (MPV), platelet distribution width (PDW), and plateletcrit (PCT) are markers of platelet activation and are strongly influenced by platelet morphology and proliferation kinetics. We aimed to study the use of platelet count and indices as predictors of mortality in children with sepsis.

Methods: This is a cross-sectional study of 45 children diagnosed with sepsis on admission at Haji Adam Malik Hospital, Medan, North Sumatra, Indonesia, between October and November 2022. Blood samples were drawn upon admission, and platelet count and indices were then determined for all children. Subjects were followed up till discharge from hospital or death. Receiver Operating Characteristic (ROC) curve analysis of platelet parameters was done to determine the area under the curve (AUC), optimal cut-off value, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) in predicting mortality in children with sepsis. Using the cut-off values from ROC curve analysis, the odds ratio with 95% confidence interval was calculated using multiple logistic regression analyses. A P value less than 0.05 was considered statistically significant.

Results: MPV, PDW, and PDW/PLT were significantly higher in non-survivors than survivors (P=0.04, P=0.02, and P=0.04, respectively). ROC curve analysis showed that PDW had the largest AUC (0.708 [95% CI=0.549-0.866]) with a cut-off value of 14.1%, sensitivity of 63.6%, and specificity of 82.6%. PDW was also the only parameter that significantly affected the outcome of children with sepsis. PDW≥14.1% at admission increases the risk of mortality by 5.7 times.

Conclusion: Admission PDW is a fast and specific tool to predict the outcome of children with sepsis.

背景:败血症仍然是全球儿童死亡和发病的主要原因之一。免疫调节失调导致的消耗性凝血病和骨髓血栓生成抑制是败血症导致血小板减少的病理机制。血小板计数(PLT)和指数,如平均血小板体积(MPV)、血小板分布宽度(PDW)和血小板屈光度(PCT)是血小板活化的标志,受血小板形态和增殖动力学的影响很大。我们的目的是研究如何利用血小板计数和指数来预测脓毒症患儿的死亡率:这是一项横断面研究,研究对象是2022年10月至11月期间在印度尼西亚北苏门答腊棉兰市哈吉-亚当-马利克医院(Haji Adam Malik Hospital)入院时被诊断为败血症的45名儿童。所有儿童在入院时抽取血液样本,然后测定血小板计数和指数。对受试者进行随访,直至出院或死亡。对血小板参数进行受试者操作特征曲线(ROC)分析,以确定预测败血症患儿死亡率的曲线下面积(AUC)、最佳临界值、灵敏度、特异性、阳性预测值(PPV)和阴性预测值(NPV)。利用 ROC 曲线分析得出的临界值,通过多重逻辑回归分析计算出了带有 95% 置信区间的几率比。P值小于0.05为具有统计学意义:非幸存者的 MPV、PDW 和 PDW/PLT 显著高于幸存者(分别为 P=0.04、P=0.02 和 P=0.04)。ROC 曲线分析显示,PDW 的 AUC 最大(0.708 [95% CI=0.549-0.866]),临界值为 14.1%,灵敏度为 63.6%,特异性为 82.6%。PDW也是唯一对败血症患儿预后有显著影响的参数。入院时PDW≥14.1%会使死亡风险增加5.7倍:入院时的PDW是预测脓毒症患儿预后的快速而特异的工具。
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引用次数: 0
Key Focus Areas in Pouchitis Therapeutic Status: A Narrative Review. 小袋炎治疗现状的重点领域:叙述性综述。
IF 1.6 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-08-01 DOI: 10.30476/ijms.2024.100782.3326
Seyed Mohammad Kazem Hosseini-Asl, Golnoush Mehrabani, Seyed Jalil Masoumi

Pouchitis, as the most common complication after ileal pouch-anal anastomosis (IPAA), has an incidence from 7% to 46%. Pouchitis treatment still represents one of the biggest gaps of knowledge in the treatment of diseases. This review has focused on achievements and challenges in the treatment of pouchitis. A combined assessment of symptoms, endoscopic findings, histologic results, quick biomarkers, and fecal calprotectin test were determined to be valuable diagnostic criteria. Conventional therapy was described as a modification of bacterial flora, mainly with antibiotics and more recently with probiotics such as bifidobacteria, lactobacilli, and streptococci. Other therapeutic approaches such as anti-tumor necrosis factor, infliximab, adalimumab, vedolizumab, ustekinumab, tacrolimus, tofacitinib, thiopurines, corticosteroids, prolyl hydroxylase-containing enzymes, povidone-iodine, dextrose spray, fecal microbiota transplantation, herbal medicines, and leukocyte apheresis have been discussed. Changes in dietary components, and administration of complementary and alternative medicine, probiotics, and fecal transplantation in addition to conventional therapies were also shown to affect the outcome of disease. Due to the potential significant impairment in quality of life caused by pouchitis, it is essential to address the gaps in knowledge for both patients and physicians in its treatment. Therefore, well-designed and adequately powered studies should assess the optimal treatment for pouchitis.

肠袋炎是回肠肠袋-肛门吻合术(IPAA)后最常见的并发症,发病率为 7% 至 46%。肠袋炎的治疗仍然是疾病治疗领域最大的知识空白之一。本综述重点介绍了治疗肛门袋炎的成就和挑战。综合评估症状、内窥镜检查结果、组织学结果、快速生物标记物和粪便钙蛋白检测结果被认为是有价值的诊断标准。传统疗法被描述为改变细菌菌群,主要是使用抗生素,最近则使用益生菌,如双歧杆菌、乳酸杆菌和链球菌。还讨论了其他治疗方法,如抗肿瘤坏死因子、英夫利昔单抗、阿达木单抗、维妥珠单抗、乌斯特库单抗、他克莫司、托法替尼、硫嘌呤类药物、皮质类固醇、含脯氨酰羟化酶的酶、聚维酮碘、葡萄糖喷雾剂、粪便微生物群移植、草药和白细胞分离术。除常规疗法外,饮食成分的改变以及补充和替代药物、益生菌和粪便移植的使用也会影响疾病的治疗效果。由于肠袋炎可能会严重影响患者的生活质量,因此必须填补患者和医生在治疗方面的知识空白。因此,应开展设计合理、充分有效的研究,评估治疗胃袋炎的最佳方法。
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引用次数: 0
The Complex Role of Autophagy in Cirrhosis Progression; A Call for Comprehensive Research: Letter to the Editor. 自噬在肝硬化进展中的复杂作用;呼吁全面研究:致编辑的信
IF 1.6 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-08-01 DOI: 10.30476/ijms.2024.102332.3516
Foolad Eghbali, Ali Jaliliyan
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引用次数: 0
Clinical Analysis of Sinistral Portal Hypertension. 窦状门静脉高压症的临床分析
IF 1.6 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-08-01 DOI: 10.30476/ijms.2023.99570.3164
Jie Zheng, Gang Luo, Ming Ming Deng

Background: Sinistral portal hypertension (SPH) is the only type of portal hypertension that is entirely curable. However, it can easily cause varicose veins in the esophagus and/or stomach, as well as upper gastrointestinal hemorrhage. This study aimed to investigate the clinical characteristics and treatments of sinistral portal hypertension.

Methods: All patients with pancreatic disease were included in this retrospective cohort study at the Affiliated Hospital of Southwest Medical University (Luzhou, China) from September 2019 to September 2021. The required information including the patient's demographics, serum laboratory indicators, imaging and endoscopy examinations, and clinical features were gathered and evaluated. The results were expressed as numbers and percentages.

Results: Out of the 830 patients with pancreatic diseases, 61 (7.3%) developed SPH. The most common cause of SPH was acute pancreatitis (80.3%), followed by chronic pancreatitis (11.5%). The splenic vein was the most frequently affected vein in patients (45/61, 73.8%). The findings of the contrast-enhanced computed tomography (CECT) indicated that 51 cases (83.6%) had gastric fundal-body varices, and three cases had combined gastric and esophageal varices. In the perigastric collateral channel formation, gastroepiploic varices (43/61, 70.5%) most frequently occurred in patients with SPH. Splenomegaly was a prevalent manifestation in SPH patients (45.9%). Five cases had gastrointestinal variceal hemorrhage.

Conclusion: SPH was associated with the patency of the splenic vein and the formation of distinctive perigastric collateral veins. Surgery and/or endoscopic treatment were recommended, particularly for patients who have experienced a significant amount of gastrointestinal bleeding and have failed conservative treatment.

背景:窦状门静脉高压症(SPH)是唯一一种完全可以治愈的门静脉高压症。然而,它很容易引起食管和/或胃的静脉曲张以及上消化道出血。本研究旨在探讨窦状门静脉高压症的临床特点和治疗方法:2019年9月至2021年9月期间,西南医科大学附属医院(中国泸州)对所有胰腺疾病患者进行了回顾性队列研究。研究收集并评估了所需信息,包括患者的人口统计学特征、血清实验室指标、影像学和内镜检查以及临床特征。结果以数字和百分比表示:在 830 名胰腺疾病患者中,61 人(7.3%)患上了 SPH。导致 SPH 的最常见原因是急性胰腺炎(80.3%),其次是慢性胰腺炎(11.5%)。脾静脉是最常受影响的静脉(45/61,73.8%)。造影剂增强计算机断层扫描(CECT)结果显示,51 例(83.6%)患者为胃底-胃体静脉曲张,3 例合并胃和食管静脉曲张。在胃周围侧支通道形成中,胃底静脉曲张(43/61,70.5%)最常见于 SPH 患者。脾肿大是 SPH 患者的常见表现(45.9%)。5例患者出现消化道静脉曲张出血:结论:SPH与脾静脉的通畅和独特的胃周侧静脉的形成有关。建议进行手术和/或内窥镜治疗,特别是对于出现大量消化道出血且保守治疗无效的患者。
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引用次数: 0
期刊
Iranian Journal of Medical Sciences
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