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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
A Comparison of Immunohistochemical Expression of Epidermal Growth Factor Receptor and Human Epidermal Growth Factor Receptor 2 in Dental Follicles with Different Radiographic Sizes. 不同放射学大小的牙泡中表皮生长因子受体和人类表皮生长因子受体 2 的免疫组化表达比较。
IF 1.6 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-08-01 DOI: 10.30476/IJMS.2023.98602.3121
Shirin Saravani, Hamed Nemati Rezvani, Mehrdad Shahraki, Hamideh Kadeh

Background: Odontogenic cysts and tumors develop from the dental follicle of asymptomatic impacted teeth. Odontogenic tissues express the epidermal growth factor receptor family (EGFR), which mediates cell proliferation, survival, and neoplastic differentiation. The present study aimed to compare the immunohistochemical expression of EGFR and human epidermal growth factor receptor 2 (HER2) in the dental follicle of impacted wisdom teeth with normal and abnormal radiographic size.

Methods: In this analytical study, immunohistochemical staining of EGFR and HER2 was performed on 30 normal and 30 abnormal follicles of impacted third molars. Follicles with a width of <2.5 mm were considered normal, whereas those with a width of ≥2.5 mm were regarded as abnormal. The immunoreactive score (IRS) was used to report the expression levels of EGFR and HER2. The obtained data were analyzed using SPSS software. Age and sex were compared in normal and abnormal groups with independent t test and Chi square test, respectively. P<0.05 was considered statistically significant.

Results: The EGFR and HER2 overall expression was high in all normal and abnormal follicles. The comparison of the percentage of stained cells and intensity of EGFR and HER2 staining in normal and abnormal follicles were not significantly different (P=0.73, P=0.63, P=0.95, respectively).

Conclusion: Due to the high expression of EGFR and HER2 in normal and abnormal follicles, as well as the lack of significant differences in these two groups, the radiographic size of dental follicles might not indicate the potential capabilities of their cells, and more research in this field is recommended.

背景:牙源性囊肿和肿瘤是从无症状的阻生牙的牙泡中生长出来的。牙源性组织表达表皮生长因子受体家族(EGFR),该家族介导细胞增殖、存活和肿瘤分化。本研究旨在比较正常和影像学大小异常的阻生智齿牙槽窝中表皮生长因子受体(EGFR)和人表皮生长因子受体 2(HER2)的免疫组化表达情况:在这项分析研究中,对影响第三磨牙的 30 个正常和 30 个异常牙泡进行了表皮生长因子受体(EGFR)和人表皮生长因子受体 2(HER2)的免疫组化染色。卵泡宽度分别采用 t 检验和 Chi square 检验。结果:所有正常和异常卵泡的表皮生长因子受体(EGFR)和表皮生长因子受体(HER2)总体表达量都很高。正常卵泡和异常卵泡中染色细胞的百分比以及表皮生长因子受体和 HER2 染色强度的比较无显著差异(分别为 P=0.73、P=0.63、P=0.95):由于表皮生长因子受体(EGFR)和 HER2 在正常和异常毛囊中的高表达以及两组间无明显差异,牙科毛囊的影像学大小可能并不代表其细胞的潜在能力,建议在该领域开展更多研究。
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引用次数: 0
Alpha-Lipoic Acid Ameliorates Impaired Steroidogenesis in Human Granulosa Cells Induced by Advanced Glycation End-Products. α-硫辛酸可改善高级糖化终产物诱导的人类颗粒细胞中受损的类固醇生成。
IF 1.6 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-08-01 DOI: 10.30476/IJMS.2023.99512.3168
Zahra Derakhshan, Soghra Bahmanpour, Mohammad Hossein Nasr-Esfahani, Fatemeh Masjedi, Maryam Mirani, Mahintaj Dara, Seyed Mohammad Bagher Tabei

Background: Ovarian granulosa cells (GCs) are essential for follicular development. Ovarian advanced glycation end-products (AGEs) accumulation is related to GCs dysfunction. Alpha-lipoic acid (ALA) illustrates therapeutic capabilities for infertility-related disorders. Therefore, this study assessed the effects of ALA on AGEs-induced GCs hormonal dysfunction.

Methods: The study was conducted from October 2021 to September 2022 at the Department of Medical Genetics, Shiraz University of Medical Sciences. Isolated GCs (n=50) were divided into control, human glycated albumin (HGA), HGA+ALA, and ALA treatments. Steroidogenic enzymes and AGE receptor (RAGE) genes were assessed by qRT-PCR. Steroid hormones and RAGE protein were evaluated using ELISA and Western blotting. Data were analyzed using GraphPad Prism software (ver. 9), and P<0.05 was considered significant.

Results: Our findings showed that HGA treatment significantly (P=0.0001) increased RAGE (by 140.66%), STAR (by 117.65%), 3β-HSD (by 165.68%), and 17β-HSD (by 122.15%) expression, while it decreased CYP19A1 (by 68.37%) expression. RAGE protein level (by 267.10%) was also increased in HGA-treated GCs. A significant decrease in estradiol (by 59.66%) and a slight and sharp elevation in progesterone (by 30.40%) and total testosterone (by 158.24%) levels was also observed. ALA treatment ameliorated the HGA-induced changes in steroidogenic enzyme mRNA levels (P=0.001) and steroid hormone secretion (P=0.010).

Conclusion: This work shows that ALA therapy likely corrects hormonal dysfunctions caused by AGEs in luteinized GCs. This effect is probably achieved by decreased RAGE expression. Clinical research is needed to understand how AGEs and ALA interact in the ovary, which might lead to a more targeted ovarian dysfunction therapy.

背景:卵巢颗粒细胞(GCs)对卵泡发育至关重要。卵巢高级糖化终产物(AGEs)的积累与 GCs 功能障碍有关。α-硫辛酸(ALA)具有治疗不孕症相关疾病的能力。因此,本研究评估了 ALA 对 AGEs 诱导的 GCs 激素功能障碍的影响:研究于 2021 年 10 月至 2022 年 9 月在设拉子医科大学医学遗传学系进行。分离的 GCs(n=50)分为对照组、人糖化白蛋白(HGA)组、HGA+ALA 组和 ALA 组。通过 qRT-PCR 评估类固醇生成酶和 AGE 受体(RAGE)基因。类固醇激素和 RAGE 蛋白通过 ELISA 和 Western 印迹法进行评估。使用 GraphPad Prism 软件(第 9 版)和 PResults 分析数据:我们的研究结果表明,HGA 能显著(P=0.0001)增加 RAGE(140.66%)、STAR(117.65%)、3β-HSD(165.68%)和 17β-HSD (122.15%)的表达,而降低 CYP19A1 (68.37%)的表达。经 HGA 处理的 GC 中,RAGE 蛋白水平也有所升高(267.10%)。此外,还观察到雌二醇水平明显下降(59.66%),孕酮(30.40%)和总睾酮(158.24%)水平略有急剧上升。ALA 治疗可改善 HGA 诱导的类固醇生成酶 mRNA 水平变化(P=0.001)和类固醇激素分泌变化(P=0.010):这项研究表明,ALA疗法可纠正黄体化GC中AGEs导致的激素功能障碍。这种效果可能是通过减少 RAGE 的表达实现的。临床研究需要了解 AGEs 和 ALA 在卵巢中是如何相互作用的,这可能会导致更有针对性的卵巢功能障碍疗法。
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引用次数: 0
Clinical Characteristics and Prognosis of ICU-Admitted Patients with Guillain-Barre Syndrome: A Report from a Large Teaching Hospital in South Iran. 入住重症监护病房的格林-巴利综合征患者的临床特征和预后:来自伊朗南部一家大型教学医院的报告。
IF 1.6 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-08-01 DOI: 10.30476/ijms.2023.99401.3144
Vida Naderi-Boldaji, Farid Zand, Naeimehossadat Asmarian, Hoda Marbooti, Mansoor Masjedi, Seyedeh Maryam Tabibzadeh, Zahra Esmaeilinezhad, Masoume Nazeri

Background: Guillain-Barre Syndrome (GBS) is the most prevalent acute peripheral polyneuropathy disorder. The disparities between populations and variations in the major risk factors highlight the importance of country-specific studies. This study aimed to report clinical characteristics and outcomes of ICU-admitted patients with GBS in an academic medical center in Iran.

Methods: The data were collected retrospectively from all patients with GBS admitted to Namazi Hospital, affiliated with Shiraz University of Medical Sciences, (Shiraz, Iran), between March 2016 to March 2021. Specialized neurological information and the Acute Physiology and Chronic Health Evaluation (APACHE II) score were recorded. The SPSS software was used to analyze the data. The analyzed data were reported as numbers and percentages, or mean±SD, or median(Interquartile).

Results: The study included 132 GBS patients, with an average age of 47.87±15.4 years and a male-to-female ratio of 1.69:1. More than half of the patients (58.5%) were classified as having an axonal disease. In patients with axonal illness, 51.4% of patients had lower limb powers<3, while only 36% of those had the demyelinating disease. This group also required mechanical ventilation more frequently (54% vs. 46%) and for a longer duration (26 [9-37] vs. 10 [1-61]) days. Pneumonia and sepsis were each observed in 16% of patients, and 12% developed a urinary tract infection. The most common type of GBS was acute inflammatory demyelinating polyneuropathy (AIDP). Only 6 (3.8%) patients died.

Conclusion: The axonal type of GBS was more frequent, and these patients required mechanical ventilation more frequently and for a longer duration than those in other electrophysiological categories. A preprint version of the manuscript is available at DOI: https://doi.org/10.21203/rs.3.rs-2181605/v1.

背景:格林-巴利综合征(GBS)是最常见的急性周围多发性神经病。不同人群之间的差异和主要风险因素的不同凸显了国别研究的重要性。本研究旨在报告伊朗一家学术医疗中心收治的重症监护室 GBS 患者的临床特征和预后:方法:研究人员回顾性收集了2016年3月至2021年3月期间伊朗设拉子医科大学附属纳马济医院(伊朗设拉子)收治的所有GBS患者的数据。记录了专业神经信息和急性生理学和慢性健康评估(APACHE II)评分。数据采用 SPSS 软件进行分析。结果:研究共纳入 132 例 GBS 患者,平均年龄(47.87±15.4)岁,男女比例为 1.69:1。一半以上的患者(58.5%)被归类为轴索疾病。在轴索病患者中,51.4%的患者患有下肢瘫痪:结论:轴索型 GBS 的发病率更高,与其他电生理类型的患者相比,这些患者需要机械通气的频率更高、持续时间更长。该手稿的预印本可在以下网站获取:DOI: https://doi.org/10.21203/rs.3.rs-2181605/v1。
{"title":"Clinical Characteristics and Prognosis of ICU-Admitted Patients with Guillain-Barre Syndrome: A Report from a Large Teaching Hospital in South Iran.","authors":"Vida Naderi-Boldaji, Farid Zand, Naeimehossadat Asmarian, Hoda Marbooti, Mansoor Masjedi, Seyedeh Maryam Tabibzadeh, Zahra Esmaeilinezhad, Masoume Nazeri","doi":"10.30476/ijms.2023.99401.3144","DOIUrl":"10.30476/ijms.2023.99401.3144","url":null,"abstract":"<p><strong>Background: </strong>Guillain-Barre Syndrome (GBS) is the most prevalent acute peripheral polyneuropathy disorder. The disparities between populations and variations in the major risk factors highlight the importance of country-specific studies. This study aimed to report clinical characteristics and outcomes of ICU-admitted patients with GBS in an academic medical center in Iran.</p><p><strong>Methods: </strong>The data were collected retrospectively from all patients with GBS admitted to Namazi Hospital, affiliated with Shiraz University of Medical Sciences, (Shiraz, Iran), between March 2016 to March 2021. Specialized neurological information and the Acute Physiology and Chronic Health Evaluation (APACHE II) score were recorded. The SPSS software was used to analyze the data. The analyzed data were reported as numbers and percentages, or mean±SD, or median(Interquartile).</p><p><strong>Results: </strong>The study included 132 GBS patients, with an average age of 47.87±15.4 years and a male-to-female ratio of 1.69:1. More than half of the patients (58.5%) were classified as having an axonal disease. In patients with axonal illness, 51.4% of patients had lower limb powers<3, while only 36% of those had the demyelinating disease. This group also required mechanical ventilation more frequently (54% vs. 46%) and for a longer duration (26 [9-37] vs. 10 [1-61]) days. Pneumonia and sepsis were each observed in 16% of patients, and 12% developed a urinary tract infection. The most common type of GBS was acute inflammatory demyelinating polyneuropathy (AIDP). Only 6 (3.8%) patients died.</p><p><strong>Conclusion: </strong>The axonal type of GBS was more frequent, and these patients required mechanical ventilation more frequently and for a longer duration than those in other electrophysiological categories. A preprint version of the manuscript is available at DOI: https://doi.org/10.21203/rs.3.rs-2181605/v1.</p>","PeriodicalId":14510,"journal":{"name":"Iranian Journal of Medical Sciences","volume":"49 8","pages":"501-507"},"PeriodicalIF":1.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11347590/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142107515","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
A New Health Threat for Iran: Dengue Fever. 伊朗面临的新健康威胁:登革热
IF 1.6 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-08-01 DOI: 10.30476/ijms.2024.103325.3654
Mohammad Ali Davarpanah, Pariya Kouhi
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引用次数: 0
Investigation of Rate and Effective Factors on Discharge against Medical Advice in Psychiatric Patients Over a 10-Year Period. 调查 10 年间精神病患者违背医嘱出院的比率和有效因素。
IF 1.6 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-07-01 DOI: 10.30476/ijms.2024.99798.3193
Zahra Ebnehoseini, Hediye Khorasani, Zahra Koohjani, Mina Zibaei, Amir Deghatipour, Ali Saghebi, Ali Reza Ebrahimi, Masoumeh Boroujerdi, Mohammad Reza Mehri, Hamed Tabesh
{"title":"Investigation of Rate and Effective Factors on Discharge against Medical Advice in Psychiatric Patients Over a 10-Year Period.","authors":"Zahra Ebnehoseini, Hediye Khorasani, Zahra Koohjani, Mina Zibaei, Amir Deghatipour, Ali Saghebi, Ali Reza Ebrahimi, Masoumeh Boroujerdi, Mohammad Reza Mehri, Hamed Tabesh","doi":"10.30476/ijms.2024.99798.3193","DOIUrl":"10.30476/ijms.2024.99798.3193","url":null,"abstract":"","PeriodicalId":14510,"journal":{"name":"Iranian Journal of Medical Sciences","volume":"49 7","pages":"467-469"},"PeriodicalIF":1.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11300939/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141901758","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
Successful Management of Cervical and Tubal Stump Double Pregnancy after Assisted Reproductive Technologies Using Multiple High Doses of Methotrexate: A Case Report. 辅助生殖技术后使用多次大剂量甲氨蝶呤成功治疗宫颈和输卵管残端双妊娠:病例报告。
IF 1.6 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-07-01 DOI: 10.30476/IJMS.2024.102119.3487
Andrey Gaiday, Akylbek Tussupkaliyev, Abay Nurken, Assel Gaiday, Ainur Primbetova, Moldir Dossimbetova, Assemgul Yeszhanova, Bibigul Karimsakova, Nurgul Ablakimova

The incidence of ectopic pregnancy (EP) has increased in recent years, owing to causes such as pelvic inflammatory diseases and assisted reproductive technologies (ART). The present study reported a case of a 33-year-old nulliparous woman with a history of previous ectopic pregnancies, who underwent pelvic ultrasound in August 2022, which revealed a double EP including a cervical pregnancy and a tubal stump pregnancy. Despite known risk factors and elevated beta-human chorionic gonadotropin (β-hCG) levels, a conservative approach, utilizing multiple doses of systemic methotrexate (MTX) injections, was employed to preserve fertility at the Regional Perinatal Center in Aktobe, Kazakhstan. Treatment efficacy was monitored through β-hCG levels and ultrasound imaging, with successful resolution of both EPs and preservation of reproductive function. The present case highlighted the safety and efficacy of MTX therapy in managing complex EP presentations, emphasizing the necessity of individualized treatment approaches in reproductive medicine, particularly in terms of preserving fertility in patients undergoing ART. Multiple high doses of MTX injections were beneficial for pregnancy with two distinct regions, fetal cardiac activity, and elevated serum β-hCG level. Further research is required to explore optimal treatment strategies for EP, considering patient-specific factors and treatment goals.

近年来,由于盆腔炎和辅助生殖技术(ART)等原因,异位妊娠(EP)的发病率有所上升。本研究报告了一例曾有过宫外孕病史的 33 岁女患者,她于 2022 年 8 月接受了盆腔超声检查,结果显示她患有双宫外孕,包括宫颈妊娠和输卵管残端妊娠。尽管存在已知的风险因素和β-人绒毛膜促性腺激素(β-hCG)水平升高,但哈萨克斯坦阿克托别地区围产中心仍采用了保守治疗方法,即全身注射多个剂量的甲氨蝶呤(MTX),以保留生育能力。通过β-hCG水平和超声成像监测治疗效果,成功解决了两个EP,并保留了生殖功能。本病例凸显了MTX疗法在治疗复杂EP表现方面的安全性和有效性,强调了生殖医学中个体化治疗方法的必要性,尤其是在保留接受抗逆转录病毒疗法患者的生育能力方面。多次大剂量注射MTX有利于两个不同区域的妊娠、胎儿心脏活动和血清β-hCG水平升高。考虑到患者的具体因素和治疗目标,还需要进一步研究探索 EP 的最佳治疗策略。
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引用次数: 0
Incidence and Risk Factors of Surgical Site Infection in Abdominal Surgeries: A Scoping Review of Cohort and Case-Control Studies. 腹部手术中手术部位感染的发生率和风险因素:队列研究和病例对照研究的范围界定综述。
IF 1.6 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-07-01 DOI: 10.30476/ijms.2024.100819.3338
Fereidoun Jahangir, AliAkbar Haghdoost, Hossein Moameri, Maryam Okhovati

Background: Abdominal surgery is considered a high-risk procedure for the development of surgical site infection (SSI). Few studies have evaluated the relative importance of surgical site infection risk factors in terms of consistency in abdominal surgery. Therefore, this comprehensive review article mapped and summarized the evidence aimed to determine the relative importance of the risk factors and incidence of SSIs in abdominal surgery.

Methods: A literature review was conducted using electronic databases and search engines such as Scopus, PubMed, and Web of Science up to March 16, 2023. There was no language restriction for the papers to be included in the study. The relative consistency of the risk factors was measured and evaluated using the methodology of the Joanna Briggs Institute. Original peer-reviewed cohort and case-control studies were included if all types of SSIs were included. Meta-analysis was performed to determine the pooled estimates of SSI incidences.

Results: Of 14,237 identified records, 107 articles were included in the review. The pooled incidence of SSI was 10.6% (95% CI: 9.02-12.55%, χ2=12986.44, P<0.001). Operative time and higher wound class were both significant consistent risk factors for SSI incidence. Patients' educational status, malnutrition, functional status, and history of neurological/psychiatric disorders were all candidates for consistent risk factors, with insufficient evidence.

Conclusion: The findings of the present study indicated that SSI in abdominal surgery was a multifactorial phenomenon with a considerable risk and had different risk factors with various relative importance. Determining the relative importance of the risk factors for the prevention and control of SSI is strongly recommended.This manuscript has been released as a preprint at the research square: (https://doi.org/10.21203/rs.3.rs-3219597/v1).

背景:腹部手术被认为是发生手术部位感染(SSI)的高风险手术。很少有研究评估腹部手术中手术部位感染风险因素一致性的相对重要性。因此,这篇综合综述文章对证据进行了映射和总结,旨在确定腹部手术中 SSI 风险因素和发生率的相对重要性:使用 Scopus、PubMed 和 Web of Science 等电子数据库和搜索引擎对截至 2023 年 3 月 16 日的文献进行了综述。纳入研究的论文没有语言限制。采用乔安娜-布里格斯研究所(Joanna Briggs Institute)的方法对风险因素的相对一致性进行了测量和评估。如果包含所有类型的 SSI,则纳入同行评审的原始队列研究和病例对照研究。进行 Meta 分析以确定 SSI 发生率的汇总估计值:结果:在 14,237 份已确认的记录中,有 107 篇文章被纳入审查范围。SSI的汇总发生率为10.6%(95% CI:9.02-12.55%,χ2=12986.44,PC结论:本研究结果表明,腹部手术中的 SSI 是一种多因素现象,具有相当大的风险,而且不同的风险因素具有不同的相对重要性。强烈建议确定危险因素的相对重要性,以预防和控制 SSI。本稿件已作为预印本在研究广场发布:(https://doi.org/10.21203/rs.3.rs-3219597/v1)。
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引用次数: 0
Comparing the Sedative Effects of Intranasal Dexmedetomidine, Midazolam, and Ketamine in Outpatient Pediatric Surgeries: A Randomized Clinical Trial. 比较右美托咪定、咪达唑仑和氯胺酮在门诊儿科手术中的镇静效果:随机临床试验。
IF 1.6 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-07-01 DOI: 10.30476/ijms.2023.99122.3118
Simin Azemati, Maryam Keihani, Mohammad Ali Sahmeddini, Fatemeh Kanaani Nejad, Laleh Dehghanpisheh, Mohammad Bagher Khosravi, Naeimehossadat Asmarian

Background: The management of preoperative anxiety in pediatric patients, as well as its implications, has remained challenging for anesthesiologists. In this study, we compared the safety and efficacy of intranasal dexmedetomidine, midazolam, and ketamine as surgical premedication in children.

Methods: This double-blinded randomized clinical trial was conducted at two tertiary hospitals in January 2014, on 90 children aged between 2-7 years old. The participants' American Society of Anesthesiologists (ASA) physical status was I or II, and they were scheduled for elective unilateral inguinal herniorrhaphy. Using the block randomization method, the patients were randomly assigned to three groups, each receiving intranasal dexmedetomidine (2 µg/Kg), midazolam (0.2 mg/Kg), and ketamine (8 mg/Kg) 60 min before induction of anesthesia. Anxiety and sedation state were evaluated before drug administration, and then every 10 min for the next 50 min. Parental separation anxiety, mask acceptance, postoperative agitation, pain, nausea, and vomiting were also recorded and compared between these groups. All the statistical analyses were performed using SPSS software (version 21.0). P<0.05 was considered statistically significant.

Results: Ketamine indicated the strongest sedative effect 10, 20, and 30 min after administration of premedication (P<0.001, P=0.03, P=0.01, respectively). However, dexmedetomidine was more effective than other drugs after 40 and 50 min (P<0.001). Other variables indicated no statistically significant difference.

Conclusion: In case of emergencies, intranasal ketamine, with the shortest time of action, could be administered. Intranasal dexmedetomidine, which was revealed to be the most potent drug in this study, could be administrated 40-50 min before elective pediatric surgeries.Trial registration number: IRCT2013081614372N1.

背景:如何处理小儿患者的术前焦虑及其影响一直是麻醉医生面临的挑战。在这项研究中,我们比较了鼻内注射右美托咪定、咪达唑仑和氯胺酮作为儿童手术术前用药的安全性和有效性:这项双盲随机临床试验于 2014 年 1 月在两家三甲医院进行,共有 90 名 2-7 岁的儿童参加。参与者的美国麻醉医师协会(ASA)身体状况为I级或II级,计划进行择期单侧腹股沟疝成形术。采用区组随机法将患者随机分配到三组,每组在麻醉诱导前 60 分钟分别接受右美托咪定(2 µg/Kg)、咪达唑仑(0.2 mg/Kg)和氯胺酮(8 mg/Kg)的鼻内注射。在给药前评估焦虑和镇静状态,然后在接下来的 50 分钟内每隔 10 分钟评估一次。此外,还记录了父母的分离焦虑、面罩接受度、术后躁动、疼痛、恶心和呕吐情况,并在这些组别之间进行了比较。所有统计分析均使用 SPSS 软件(21.0 版)进行。结果氯胺酮在用药前 10 分钟、20 分钟和 30 分钟后的镇静效果最强(结论:氯胺酮在用药前 10 分钟、20 分钟和 30 分钟后的镇静效果最强:在紧急情况下,鼻内氯胺酮的作用时间最短。在本研究中,右美托咪定是药效最强的药物,可在儿科择期手术前 40-50 分钟使用。
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引用次数: 0
期刊
Iranian Journal of Medical Sciences
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