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The Use of Hydroxyapatite Polymer with Curdlan in the Treatment of Bone Defects Associated with Ectopic Tooth Extraction in Dogs—A Case Series 使用羟基磷灰石聚合物和 Curdlan 治疗狗异位拔牙引起的骨缺损--病例系列
Pub Date : 2024-07-15 DOI: 10.3390/life14070879
Anna Misztal-Kunecka, P. Prządka, Stanisław Dzimira
Ectopic teeth are an eruption disorder in which teeth are located in anatomical structures where, physiologically, they should not occur. An ectopic tooth is a very rare phenomenon, affecting approximately 0.5% of the canine population, and few descriptions of the treatment of such teeth in dogs can be found in the available literature. This article describes the diagnostic and therapeutic handling of cavities following extraction of ectopic teeth in nine dogs. The cases are subdivided into uncomplicated (when the ectopic tooth was encapsulated in the surrounding connective tissue, without lysis of the bone around the tooth) and complicated (in which, in addition to the presence of the ectopic tooth, a dentigerous cyst had formed). Four cases of complicated ectopic teeth are described in more detail. In this study, special attention was paid not only to the technique of tooth extraction itself but also to the method of securing and healing large bone defects after the extraction using hydroxyapatite curdlan polymer. Owing to the plastic properties of the bone substitute preparation, it was possible to implant the material without enlarging the bone defect created during the tooth extraction. Control radiographs showed features of bone regeneration, and clinical examination at both the early and late stages revealed no postoperative complications.
异位牙是一种萌出障碍,牙齿位于解剖结构中生理学上不应该出现的位置。异位牙是一种非常罕见的现象,约占犬类总数的 0.5%,现有文献中很少有关于治疗犬类异位牙的描述。本文介绍了九只犬异位牙拔除后龋齿的诊断和治疗处理方法。这些病例又分为非复杂性(异位牙被周围的结缔组织包裹,牙齿周围的骨头没有溶解)和复杂性(除了异位牙的存在,还形成了齿状囊肿)。本文对四例复杂性异位牙进行了详细描述。这项研究不仅特别关注拔牙技术本身,还特别关注使用羟基磷灰石凝胶聚合物固定和愈合拔牙后大面积骨缺损的方法。由于骨替代制剂具有可塑性,因此可以在不扩大拔牙时造成的骨缺损的情况下植入这种材料。对照X光片显示出骨再生的特征,早期和晚期的临床检查均未发现术后并发症。
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引用次数: 0
Selected Lark Mitochondrial Genomes Provide Insights into the Evolution of Second Control Region with Tandem Repeats in Alaudidae (Aves, Passeriformes) 选定的云雀线粒体基因组为了解云雀科(鸟类,雀形目)带有串联重复的第二控制区的进化提供了启示
Pub Date : 2024-07-15 DOI: 10.3390/life14070881
Chuan Jiang, Hui Kang, Yang Zhou, Wenwen Zhu, Xilong Zhao, Nassoro Mohamed, Bo Li
The control region (CR) regulates the replication and transcription of the mitochondrial genome (mitogenome). Some avian mitogenomes possess two CRs, and the second control region (CR2) may enhance replication and transcription; however, the CR2 in lark mitogenome appears to be undergoing loss and is accompanied by tandem repeats. Here, we characterized six lark mitogenomes from Alaudala cheleensis, Eremophila alpestris, Alauda razae, and Calandrella cinerea and reconstructed the phylogeny of Passerida. Through further comparative analysis among larks, we traced the evolutionary process of CR2. The mitochondrial gene orders were conserved in all published lark mitogenomes, with Cytb-trnT-CR1-trnP-ND6-trnE-remnant CR2 with tandem repeat-trnF-rrnS. Phylogenetic analysis revealed Alaudidae and Panuridae are sister groups at the base of Sylvioidea, and sporadic losses of CR2 may occur in their common ancestor. CR sequence and phylogeny analysis indicated CR2 tandem repeats were generated within CR2, originating in the ancestor of all larks, rather than inherited from CR1. The secondary structure comparison of tandem repeat units within and between species suggested slipped-strand mispairing and DNA turnover as suitable models for explaining the origin and evolution of these repeats. This study reveals the evolutionary process of the CR2 containing tandem repeat in Alaudidae, providing reference for understanding the evolutionary characteristics and dynamics of tandem repeats.
控制区(CR)调节线粒体基因组(有丝分裂基因组)的复制和转录。一些鸟类的有丝分裂基因组具有两个CR,第二个控制区(CR2)可能会增强复制和转录;然而,云雀有丝分裂基因组中的CR2似乎正在消失,并伴有串联重复。在这里,我们对来自Alaudala cheleensis、Eremophila alpestris、Alauda razae和Calandrella cinerea的六个云雀有丝分裂基因组进行了鉴定,并重建了百灵鸟的系统发育。通过云雀之间的进一步比较分析,我们追溯了CR2的进化过程。在所有已发表的云雀有丝分裂基因组中,线粒体基因顺序是一致的,即Cytb-trnT-CR1-trnP-ND6-trnE-remnant CR2与串联重复-trnF-rrnS。系统发生学分析表明,秃尾蝶科(Alaaudidae)和蝶形花蝶科(Panuridae)是蝶形花蝶科(Sylvioidea)基部的姊妹群,它们的共同祖先中可能存在零星的 CR2 缺失。CR序列和系统进化分析表明,CR2串联重复序列产生于CR2内部,起源于所有云雀的祖先,而不是从CR1继承而来。物种内和物种间串联重复单元的二级结构比较表明,滑链错配和DNA周转是解释这些重复序列起源和进化的合适模型。本研究揭示了杓鹬科含有CR2的串联重复的进化过程,为了解串联重复的进化特征和动态提供了参考。
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引用次数: 0
Clinical Trends and Novel Research Insights into Testicular and Penile Disorders and Infertility 睾丸和阴茎疾病以及不育症的临床趋势和新研究见解
Pub Date : 2024-07-15 DOI: 10.3390/life14070878
U. Bumbaširević
Due to their great heterogeneity with regard to etiopathogenesis, the clinical presentations, diagnostics, treatment approaches, and potential complications of testicular and penile disorders, despite posing a significant public health burden, constitute an immensely complex, highly fascinating, and continually evolving topic in urology [...]
睾丸和阴茎疾病的临床表现、诊断、治疗方法和潜在并发症尽管给公共卫生带来了巨大负担,但由于其发病机制的巨大异质性,它们构成了泌尿外科一个极其复杂、极具吸引力且不断发展的课题 [...] 。
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引用次数: 0
A New Methodology for the Accurate Measurement of Tibiofemoral Kinematics in Human Cadaveric Knees: An Evaluation of the Anterior–Posterior Laxity Pre- and Post-Cruciate Ligament Resection 精确测量人体尸体膝关节胫股关节运动学的新方法:评估韧带切除前后的前后松弛度
Pub Date : 2024-07-14 DOI: 10.3390/life14070877
Saskia A. Brendle, S. Krueger, Joachim Grifka, Peter E. Müller, T. Grupp
Anterior–posterior (AP) stability is an important measure of knee performance after total knee arthroplasty (TKA). To improve the stabilizing effect of implants designed to compensate for the loss of the cruciate ligaments, it is important to understand the tibiofemoral contact situation within the native ligamentous situation of the knee and how it changes after cruciate ligament resection. This in vitro study introduces a new approach to accurately measure the tibiofemoral kinematics in a six-degrees-of-freedom joint motion simulator by tracking landmark-based coordinate systems and their corresponding bone geometries. The tibiofemoral contact situation was investigated by projecting the medial and lateral flexion facet centers onto the tibial plateau under AP shear forces across various flexion angles in thirteen knees. Tests were conducted pre- and post-cruciate ligament resection. Post-cruciate ligament resection, the femoral condyles shifted closer to or even exceeded the posterior border of the tibial plateau, but only slightly closer to the anterior border. This study presents a new methodology for measuring the tibiofemoral kinematics that can be applied to multiple loading profiles. It provides a basis for further investigations, including passive or active muscle forces, to enhance the design of total knee protheses and improve surgical outcomes.
前后(AP)稳定性是衡量全膝关节置换术(TKA)后膝关节性能的重要指标。为了提高为补偿十字韧带缺失而设计的假体的稳定效果,了解膝关节原生韧带情况下的胫骨-股骨接触情况及其在十字韧带切除后的变化情况非常重要。这项体外研究引入了一种新方法,通过跟踪基于地标的坐标系及其相应的骨骼几何形状,在六自由度关节运动模拟器中精确测量胫骨和股骨的运动学特性。在不同屈曲角度的 AP 剪切力作用下,将 13 个膝关节的内侧和外侧屈曲面中心投影到胫骨平台上,从而研究胫骨与股骨的接触情况。测试在韧带切除前后进行。韧带切除后,股骨髁移近甚至超过了胫骨平台的后缘,但仅稍微移近前缘。本研究提出了一种测量胫骨-股骨运动学的新方法,该方法可应用于多种负荷情况。它为进一步的研究提供了基础,包括被动或主动肌肉力量,以加强全膝关节假体的设计并改善手术效果。
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引用次数: 0
Haemolytic Anaemia-Related Pulmonary Hypertension 溶血性贫血相关性肺动脉高压
Pub Date : 2024-07-14 DOI: 10.3390/life14070876
P. Karyofyllis, E. Demerouti, Eleftheria-Garyfallia Tsetika, Styliani Apostolopoulou, Panagiotis Tsiapras, Ioannis Iakovou, Dimitrios Tsiapras
Haemolytic anaemia represents a risk factor for the development of pulmonary hypertension (PH), currently classified as World Health Organization group 5 PH, and data regarding appropriate therapeutic strategy are limited. A total of 28 patients, 85.7% with thalassaemia and 14.3% with sickle cell disease, with a diagnosis of PH confirmed by right heart catheterization were included in the study. The patients were divided into three groups according to the PH haemodynamic definition and overall diagnostic approach: 42.9% had precapillary PH (pulmonary arterial hypertension—PAH group), 25% had post-capillary PH, and 32.1% had chronic thromboembolic PH (CTEPH) (29% of b-thalassemia and 50% of SCD patients). The therapeutic approach in each group and its impact on the outcome and haemodynamics were recorded. PAH-specific drug therapy received 82.1% of patients, and balloon pulmonary angioplasty (BPA) was performed in six patients with CTEPH. There were statistically significant differences in baseline mPAP and PVR values between the CTEPH-haemolytic anaemia group and other groups. PAH-specific drug therapy resulted in haemodynamic improvement for the PAH group. Patients who underwent BPA had improved pulmonary haemodynamics. The median survival time was 162 months, and the survival rate was 1 year—100%; 2, 3, 4, 5, and 6 years—96%; 9 years—90%; and 13 years—78%. In patients with haemolytic anaemia, the wide spectrum of induced PH highlighted the importance of a correct predominant diagnosis. BPA in CTEPH patients and specific-PAH drug therapy for PAH patients represent potential therapeutic strategies; however, the management should be offered in expert PH centres under individualized approaches for patients.
溶血性贫血是肺动脉高压(PH)的危险因素之一,目前被世界卫生组织列为第 5 类肺动脉高压,但有关适当治疗策略的数据却很有限。研究共纳入了 28 名经右心导管检查确诊为 PH 的患者,其中 85.7% 患有地中海贫血症,14.3% 患有镰状细胞病。根据 PH 血流动力学定义和整体诊断方法,患者被分为三组:42.9%的患者患有毛细血管前 PH(肺动脉高压-PAH 组),25%的患者患有毛细血管后 PH,32.1%的患者患有慢性血栓栓塞性 PH(CTEPH)(29%的地中海贫血患者和 50%的 SCD 患者)。记录了各组的治疗方法及其对预后和血液动力学的影响。82.1%的患者接受了针对 PAH 的药物治疗,6 名 CTEPH 患者接受了球囊肺血管成形术(BPA)。溶血性贫血 CTEPH 组与其他组的 mPAP 和 PVR 基线值在统计学上存在显著差异。PAH 特异性药物治疗使 PAH 组的血流动力学得到改善。接受BPA治疗的患者肺血流动力学得到改善。中位生存时间为 162 个月,生存率为 1 年-100%;2、3、4、5 和 6 年-96%;9 年-90%;13 年-78%。在溶血性贫血患者中,诱发 PH 的范围很广,这凸显了正确诊断的重要性。CTEPH患者的BPA和PAH患者的特异性PAH药物治疗是潜在的治疗策略;但是,应在PH专家中心根据患者的个体化情况进行治疗。
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引用次数: 0
Northern Pulmonary Hypertension: A Forgotten Kind of Pulmonary Circulation Pathology 北部肺动脉高压:一种被遗忘的肺循环病理学
Pub Date : 2024-07-13 DOI: 10.3390/life14070875
D. Kosanovic, S. N. Avdeev, Andrey P. Milovanov, A. L. Chernyaev
Northern pulmonary hypertension (NPH) is a medical condition that is still enigmatic in non-Russian-speaking countries. The extant previous literature is mostly available in the Russian language and, therefore, not accessible to the rest of the world. The recent increased interest in climate changes and environmental effects on pulmonary circulation prompted us to summarize the knowledge from the past about the effects of cold on pulmonary vasculature. In this review, we, for the first time, describe, in detail, the pathological attributes of human NPH, a medical disorder that occurs in people living in extremely cold regions, in the English language. Briefly, NPH is characterized by the hyper-muscularization of the pulmonary arteries and de novo muscularization of the arterioles with the ultimate development of right ventricular hypertrophy. However, the profound molecular mechanisms of the NPH pathology are to be revealed in future comprehensive studies.
北肺动脉高压(NPH)是一种在非俄语国家仍很神秘的疾病。现存的文献大多是俄语版本,因此世界其他地区无法查阅。最近,人们越来越关注气候变化和环境对肺循环的影响,这促使我们总结过去有关寒冷对肺血管影响的知识。在这篇综述中,我们首次用英语详细描述了人类 NPH 的病理特征,这是一种发生在极寒地区人群中的医学疾病。简而言之,NPH 的特点是肺动脉肌肉化和动脉血管新生肌肉化,最终发展为右心室肥大。然而,NPH 病理的深层分子机制有待今后的全面研究来揭示。
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引用次数: 0
Mental Manifestations and Biomarkers of Alcohol Consumption 饮酒的精神表现和生物标志物
Pub Date : 2024-07-12 DOI: 10.3390/life14070873
Ana-Maria Sarpe (Paduraru), Cristina Dodul, Emil-Andrei Vlase, Cristian Onisor, E. Niculeț, O. Ciobotaru, Eduard Polea Drima
The purpose of this study is to examine healthcare usage, morbidities, and alcohol consumption monitoring in patients before a diagnosis of mental manifestations to assist in the early identification of individuals at risk. Biological markers of alcoholism are separated into two groups: those biological variables that highlight with great confidence and validate the presence of a predisposition to alcoholism, also called trait markers, or those that highlight alcohol consumption, called markers of alcoholism (“status markers”). Biomarkers are the true “gold standard” for the diagnosis of alcoholism. They are valuable for tracking evolution and progress during biological and psychological therapy and for highlighting relapse. This review compiles the existing data from research on healthcare utilization, comorbidities, and alcohol consumption monitoring in patients before a diagnosis of mental manifestations to aid in the early identification of individuals at risk. This documentary study took place over three to four months by searching for terms on the Science Direct platform, PubMed, Web of Science, and Google Scholar such as alcoholism, alcohol use disorders, alcohol abuse, and biomarkers. Studies reporting on the development, characteristics, and utilization of blood biomarkers for alcohol consumption were included in the search. The initial search included a number of 11.019 articles that contained the keywords biomarkers and alcohol. Finally, a total of 50 research articles were considered. I am involved in clinical studies, meta-analyses, reviews, and case studies regarding alcohol consumption detection, as well as potential alcohol markers.
本研究的目的是在诊断出精神症状之前,对患者的医疗保健使用情况、发病率和饮酒量进行监测,以帮助及早识别高危人群。酗酒的生物标志物分为两类:一类是非常有把握地强调和验证存在酗酒倾向的生物变量,也称为特质标志物;另一类是强调酒精消耗的生物变量,称为酗酒标志物("状态标志物")。生物标志物是诊断酗酒的真正 "金标准"。它们对于跟踪生物和心理治疗过程中的演变和进展,以及突出复发情况都很有价值。本综述汇编了现有的研究数据,这些数据涉及患者在被诊断出精神症状之前的医疗保健利用率、合并症和酒精消耗量监测,以帮助早期识别高危人群。这项文献研究历时三至四个月,通过在 Science Direct 平台、PubMed、Web of Science 和 Google Scholar 上搜索酗酒、酒精使用障碍、酒精滥用和生物标志物等术语来完成。报告酒精消费血液生物标志物的开发、特点和使用情况的研究也在搜索之列。初步搜索包括了 11.019 篇包含生物标志物和酒精关键词的文章。最后,共考虑了 50 篇研究文章。我参与了有关酒精消耗检测以及潜在酒精标志物的临床研究、荟萃分析、综述和案例研究。
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引用次数: 0
The Combination of Laparoscopic and Robotic Surgery: First Experience with the Dexter Robotic System™ in Visceral Surgery 腹腔镜手术与机器人手术的结合:Dexter Robotic System™ 在内脏手术中的首次使用体验
Pub Date : 2024-07-12 DOI: 10.3390/life14070874
Pernilla Virginia Conrad, A. Mehdorn, I. Alkatout, T. Becker, J. H. Beckmann, J. Pochhammer
Introduction: For over two decades, abdominal surgical procedures have been safely performed robotically. After the first patent expiration, alternative robotic systems entered the market. The Dexter Robotic System™ is a small-format, modular, and robotic platform consisting of a surgeon’s console, two patient carts with instrument arms, and one endoscope arm. We report our initial experiences with Dexter since its installation at our visceral surgery department. Methods: The system and surgical setup are described. Demographic and perioperative data of all operated patients as well as the system docking times were analyzed. Results: From 56 procedures performed with Dexter, the most common ones included cholecystectomy (n = 15), inguinal hernia repair (TAPP; unilateral n = 15; bilateral n = 3), and right oncologic hemicolectomy (n = 15). The median docking time was 6 min (2–16 min) and was reduced to 4 min in the last tertile of procedures performed. Conclusions: In our experience, Dexter can be implemented without any major challenges, and visceral surgical procedures of simple to medium complexity can be performed safely. The simplicity and accessibility of the system along with the ease of switching between robotics and laparoscopy could be particularly suitable for beginners in robotic surgery
简介二十多年来,腹部外科手术一直采用机器人安全进行。首个专利到期后,替代机器人系统进入市场。Dexter Robotic System™ 是一种小型、模块化的机器人平台,由一个外科医生控制台、两个带器械臂的病人推车和一个内窥镜臂组成。我们报告了内脏外科安装 Dexter 后的初步使用经验。方法:介绍系统和手术设置。对所有手术患者的人口统计学和围手术期数据以及系统对接时间进行了分析。结果:在使用 Dexter 进行的 56 例手术中,最常见的手术包括胆囊切除术(15 例)、腹股沟疝修补术(TAPP;单侧 15 例;双侧 3 例)和右侧肿瘤性半结肠切除术(15 例)。对接时间的中位数为 6 分钟(2-16 分钟),在最后一组手术中缩短至 4 分钟。结论:根据我们的经验,实施 Dexter 不会遇到任何重大挑战,简单到中等复杂程度的内脏外科手术都能安全进行。该系统简单易用,机器人与腹腔镜之间切换方便,特别适合机器人手术初学者使用。
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引用次数: 0
Genome-Wide Identification, Evolution, and Female-Biased Expression Analysis of Odorant Receptors in Tuta absoluta (Lepidoptera: Gelechiidae) Tuta absoluta(鳞翅目:Gelechiidae)气味受体的全基因组鉴定、进化和雌性表达分析
Pub Date : 2024-07-12 DOI: 10.3390/life14070872
Cong Huang, Xiaolan Ou, Yusheng Wang, Yanan Zhou, Guifen Zhang, Wanxue Liu, Fanghao Wan, Hongbo Jiang, Yibo Zhang
The tomato leafminer, Tuta absoluta (Lepidoptera: Gelechiidae), is a highly destructive invasive pest targeting Solanaceae crops. Its olfactory system plays a crucial role in host location, mate finding, and other behavioral activities. However, there is a notable gap in the literature regarding the characterization of its chemosensory genes. In this study, we conducted a genome-wide identification of 58 odorant receptors (ORs) of T. absoluta. The identified ORs exhibit coding sequence (CDS) lengths ranging from 1062 bp to 1419 bp, encoding proteins of 354 to 473 amino acids. Gene structure analysis showed that the majority of these ORs consist of five, seven, eight, or nine exons, collectively representing 67% of the total ORs identified. Through chromosomal mapping, we identified several tandemly duplicate genes, including TabsOR12a, TabsOR12b, TabsOR12c, TabsOR21a, TabsOR21b, TabsOR34a, TabsOR34b, TabsOR34c, TabsOR62a, and TabsOR62b. The phylogenetic analysis indicated that six TabsORs were clustered within the lepidopteran sex pheromone receptor clade, while an expansion clade containing ten TabsORs resulted from tandem duplication events. Additionally, five TabsORs were classified into a specific OR clade in T. absoluta. Furthermore, through RNA-Seq and RT-qPCR analyses, we identified five TabsORs (TabsOR21a, TabsOR26a, TabsOR34a, TabsOR34c, and TabsOR36) exhibiting female-antennae-biased expression. Our study provides a valuable foundation to further investigations into the molecular and ecological functions of TabsORs, particularly in relation to oviposition behavior. These findings provide foundational data for the future exploration of the functions of female-biased expression OR genes in T. absoluta, thereby facilitating the further development of eco-friendly attract-and-kill techniques for the prevention and control of T. absoluta.
番茄潜叶蝇 Tuta absoluta(鳞翅目:Gelechiidae)是一种针对茄科作物的高破坏性入侵害虫。它的嗅觉系统在寄主定位、寻找配偶和其他行为活动中起着至关重要的作用。然而,有关其化感基因特征的文献却明显不足。在这项研究中,我们对 T. absoluta 的 58 个气味受体(ORs)进行了全基因组鉴定。鉴定出的 ORs 的编码序列(CDS)长度从 1062 bp 到 1419 bp 不等,编码 354 到 473 个氨基酸的蛋白质。基因结构分析表明,这些ORs大多由5、7、8或9个外显子组成,共占已鉴定ORs总数的67%。通过染色体图谱,我们发现了几个串联重复的基因,包括 TabsOR12a、TabsOR12b、TabsOR12c、TabsOR21a、TabsOR21b、TabsOR34a、TabsOR34b、TabsOR34c、TabsOR62a 和 TabsOR62b。系统进化分析表明,6 个 TabsORs 聚类在鳞翅目性信息素受体支系中,而一个包含 10 个 TabsORs 的扩展支系是由串联重复事件产生的。此外,在 T. absoluta 中,有五个 TabsORs 被归入一个特定的 OR 支系。此外,通过 RNA-Seq 和 RT-qPCR 分析,我们确定了五个 TabsORs(TabsOR21a、TabsOR26a、TabsOR34a、TabsOR34c 和 TabsOR36)表现出雌性天线偏向表达。我们的研究为进一步研究 TabsORs 的分子和生态功能,尤其是与产卵行为相关的功能奠定了宝贵的基础。这些发现为今后探索雌性偏向表达的 OR 基因在 T. absoluta 中的功能提供了基础数据,从而有助于进一步开发生态友好型引诱-杀灭技术,防控 T. absoluta。
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引用次数: 0
A More Targeted and Selective Use of Implantable Loop Recorders Improves the Effectiveness of Syncope Units: A Single-Center Experience 更有针对性和选择性地使用植入式环路记录器可提高晕厥单元的疗效:单中心经验
Pub Date : 2024-07-12 DOI: 10.3390/life14070871
S. Archontakis, E. Oikonomou, Konstantinos Sideris, Panagiotis Dourvas, Nikias Milaras, Panagiotis Kostakis, Tzonatan Klogkeri, Epameinondas Triantafyllou, P. Theofilis, Ioannis Ntalakouras, P. Arsenos, Athanasia Gkika, K. Gatzoulis, S. Sideris, Dimitris Tousoulis
Purpose: Syncope remains a common medical problem. Recently, the role of dedicated syncope units and implantable loop recorders has emerged in the investigation of unexplained syncope. This study aims to investigate the possibilities for a more rational and targeted use of various diagnostic tools. Methods: In this retrospective single-center study, 196 patients with unexplained syncope were included between March 2019 and February 2023. Various diagnostic tools were utilized during the investigation, according to clinical judgement. Patients were retrospectively allocated into Group A (including those who, among other tests, underwent loop recorder insertion) and Group B (including patients investigated without loop recorder implantation). Data were compared with Group C, including patients assessed prior to syncope unit establishment. Results: There was no difference between Group A (n = 133) and Group B (n = 63) in the diagnostic yield (74% vs. 76%, p = 0.22). There were significant differences between Groups A and B regarding age (67.3 ± 16.9 years vs. 48.3 ± 19.1 years, p < 0.001) and cause of syncope (cardiogenic in 69% of Group A, reflex syncope in 77% of Group B, p < 0.001). Electrocardiography-based diagnosis occurred in 55% and 19% of Groups A and B, respectively (p < 0.001). The time to diagnosis was 4.2 ± 2.7 months in Group A and 7.5 ± 5.6 months in Group B (p < 0.001). In Group C, the diagnostic yield was 57.9% and the electrocardiography-based diagnostic yield was 18.3%. Conclusions: A selective use of loop recorders according to clinical and electrocardiographic characteristics increases the effectiveness of the structured syncope unit approach and further preserves financial resources.
目的:晕厥仍然是一个常见的医学问题。最近,专门的晕厥室和植入式回路记录器在不明原因晕厥的调查中发挥了作用。本研究旨在探讨更合理、更有针对性地使用各种诊断工具的可能性。方法:在这项回顾性单中心研究中,纳入了 2019 年 3 月至 2023 年 2 月期间的 196 名不明原因晕厥患者。调查期间,根据临床判断使用了各种诊断工具。回顾性地将患者分为 A 组(包括接受了循环记录器植入等检查的患者)和 B 组(包括未接受循环记录器植入检查的患者)。数据与 C 组进行比较,C 组包括在晕厥室成立前接受评估的患者。结果:A 组(n = 133)和 B 组(n = 63)的诊断率没有差异(74% 对 76%,p = 0.22)。A 组和 B 组在年龄(67.3 ± 16.9 岁对 48.3 ± 19.1 岁,P < 0.001)和晕厥原因(A 组 69% 为心源性晕厥,B 组 77% 为反射性晕厥,P < 0.001)方面存在明显差异。在 A 组和 B 组中,分别有 55% 和 19% 的患者通过心电图确诊(P < 0.001)。A 组的诊断时间为 4.2 ± 2.7 个月,B 组为 7.5 ± 5.6 个月(P < 0.001)。C 组的诊断率为 57.9%,心电图诊断率为 18.3%。结论根据临床和心电图特征有选择性地使用循环记录仪可提高结构化晕厥单元方法的有效性,并进一步节约财政资源。
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引用次数: 0
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