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The Impact of Medical Nutritional Therapy on the Efficacy of Premix Insulin in Glycemic Control in Patients with Type 2 Diabetes. 药物营养治疗对预混胰岛素控制2型糖尿病患者血糖效果的影响
Pub Date : 2023-03-01 DOI: 10.5455/msm.2023.35.13-17
Senada Husaric, Azra Avdic Salihovic, Nedzad Kadric, Samra Iljazovic-Topic, Jasmina Pasic, Anida Divanovic

Background: Medical nutritional therapy (MNT) is a key component in the treatment of Diabetes mellitus (DM). MNT is completely individual and should be present in the treatment of diabetes from the very beginning, continuously with pharmacological therapy, taking into account lifestyle, dietary habits and the type of antidiabetic therapy. Mistakes that are made when planning the diet are the absence of individual adjustment of the diet, which means that the number and time of meals, as well as the amount of UH per meal, is not adjusted to the patients' oral or insulin therapy according to their pharmacokinetics and pharmacodynamics.

Objective: This study investigated the effect of MNT with reduced carbohydrate content (MNT M-ADA) on the efficacy of human and analogue premix insulin in patients with T2DM.

Methods: Subjects were randomized into two groups (human and analog premix insulins), and then each group into two subgroups of 30 subjects each. One subgroup each on therapy with human and analog biphasic insulins was educated about MNT and learned to count UH, and then they applied MNT M-ADA for 24 weeks, unlike the other two subgroups. In this review, we present only the subgroup analysis on human and analog premix insulins that applied MNT M-ADA (200 g UH/day). Efficacy outcomes in the analysis of these subgroups were estimated changes in each subgroup from baseline to end point (week 24) and differences between subgroups at the end of the study in levels of glycated hemoglobin (HbA1c), self-measured glucose values (SMBG) and frequency of hypoglycemia.

Results: Both subgroups of subjects with MNT M-ADA improved glycemic control, which was assessed by improvements in HBA1C, SMBG levels, without an increase in the frequency of hypoglycemia, but at the end of the study there was no statistically significant difference in the mentioned parameters between the subgroups.

Conclusion: The effectiveness of MNT M-ADA in people with T2DM did not depend on the type of insulin, both insulin regimens are effective if the amount of ingested UH is taken into account.

背景:医学营养治疗(MNT)是糖尿病(DM)治疗的关键组成部分。MNT完全是个体化的,应该从一开始就出现在糖尿病的治疗中,持续使用药物治疗,同时考虑到生活方式、饮食习惯和抗糖尿病治疗的类型。在计划饮食时所犯的错误是缺乏对饮食的个人调整,这意味着进餐的次数和时间,以及每餐UH的量,没有根据患者的药代动力学和药效学来调整患者的口服或胰岛素治疗。目的:探讨低碳水化合物MNT (MNT M-ADA)对T2DM患者人胰岛素和类似物预混胰岛素疗效的影响。方法:将受试者随机分为人胰岛素和模拟胰岛素预混剂两组,每组分为2个亚组,每组30例。与其他两个亚组不同,分别接受人胰岛素和模拟双相胰岛素治疗的一个亚组接受了MNT和UH计数的教育,然后他们应用MNT M-ADA治疗24周。在这篇综述中,我们只介绍了应用MNT M-ADA (200 g UH/天)的人和模拟预混胰岛素的亚组分析。这些亚组分析的疗效结果是估计每个亚组从基线到终点(第24周)的变化,以及研究结束时亚组间糖化血红蛋白(HbA1c)水平、自测血糖值(SMBG)和低血糖发生频率的差异。结果:MNT - M-ADA患者的两个亚组均改善了血糖控制,通过HBA1C、SMBG水平的改善来评估,低血糖发生率未增加,但在研究结束时,亚组间上述参数无统计学差异。结论:MNT - M-ADA对T2DM患者的疗效与胰岛素类型无关,如果考虑到UH的摄入量,两种胰岛素方案都是有效的。
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引用次数: 0
The Role of the Temporary Contracting and Visiting Doctor Program in Supporting the Health System during and after COVID-19 Pandemic in Saudi Arabia. 临时签约和访问医生计划在沙特阿拉伯COVID-19大流行期间和之后支持卫生系统的作用。
Pub Date : 2023-03-01 DOI: 10.5455/msm.2023.35.53-57
Faisal S Alenezi, Aeshah I Alsagheir, Lamya M Alzubaidi, Wijdan S Al-Saedi, Saleh S Alharbi, Muna H Hassanein, Tareef Y Alaama

Background: Adequate supply of health workforce with proper skills is essential to deliver appropriate health services in normal times and during disasters.

Objective: To describe the role of the Saudi Temporary Contracting and Visiting Doctors Program in the provision of critical care during COVID-19 pandemic, and in the clearance of the surgical backlog thereafter.

Methods: We reviewed reports of General Directorate of Health Services and Saudi Ministry of Health annual statistical books to obtain the following data: number of temporary healthcare professionals contracted from 2019 to 2022; number of intensive care unit beds before and during COVID-19 pandemic; volume of elective surgeries before, during and after COVID-19 pandemic.

Results: In 2020, intensive care unit beds increased from 6341 to 9306 in governmental hospitals in response to COVID-19 pandemic. A total of 3539 temporary healthcare professionals were recruited from April to August 2020 to contribute towards staffing the added beds. During the recovery period from COVID-19 pandemic, 4322 and 4917 temporary health care professionals were recruited in 2021and 2022 respectively. Elective surgeries volume increased from 5074 in September 2020 to 17533 in September 2021 to 26242 in September 2022, surpassing the volume of surgeries in pre-COVID-19 period.

Conclusions: In response to COVID-19 pandemic, and through the existing temporary contracting program, the Saudi Ministry of Health was able to recruit temporary staff of verified credentials in a timely manner, to supplement the existing staff, for activation of the newly added intensive care unit beds, and for clearing the resulting surgical backlog.

背景:要在正常时期和灾害期间提供适当的卫生服务,必须有足够的具备适当技能的卫生工作人员。目的:描述沙特临时签约和访问医生计划在COVID-19大流行期间提供重症监护以及之后清除手术积压方面的作用。方法:我们查阅了沙特卫生服务总局和卫生部年度统计手册的报告,获得以下数据:2019 - 2022年签约的临时卫生专业人员人数;COVID-19大流行之前和期间重症监护病房床位数量;在COVID-19大流行之前、期间和之后的选择性手术数量。结果:2020年,政府医院重症监护病房床位从6341张增加到9306张。从2020年4月至8月,共招募了3539名临时保健专业人员,为增加的床位提供人员。在2019冠状病毒病大流行恢复期,2021年和2022年分别招募了4322名和4917名临时卫生保健专业人员。择期手术从2020年9月的5074例增加到2021年9月的17533例,再到2022年9月的26242例,超过了疫情前的手术量。结论:为应对COVID-19大流行,通过现有的临时承包计划,沙特卫生部能够及时招募身份验证的临时工作人员,以补充现有工作人员,激活新增的重症监护病房床位,并清理由此导致的手术积压。
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引用次数: 0
Cognitive Imapirment in Multiple Sclerosis: Relation to Dysability, Duration and Type of Disease. 多发性硬化症的认知功能障碍:与残疾、病程和疾病类型的关系。
Pub Date : 2023-03-01 DOI: 10.5455/msm.2023.35.23-27
Selma Sabanagic-Hajric, Amra Memic-Serdarevic, Gorana Sulejmanpasic, Dzenita Salihovic-Besirovic, Avdo Kurtovic, Nermina Bajramagic, Enra Mehmedika-Suljic

Background: Cognitive dysfunctions are often presented as a symptom in multiple sclerosis which is associated with both structural and functional imapirments of neuronal networks in the brain.

Objective: The aim of the study was to evaluate the influence of dysability, duration and type of disesase on cognitive functions in multiple sclerosis patients.

Methods: This study included 60 MS patients treated at the Department of Neurology, Clinical Center University of Sarajevo. Inclusion criteria were clinically definite diagnosis of multiple sclerosis, 18 years of age or older and were able to give written informed consent. Cognitive function was evaluated by the Montreal Cognitive Assessment (MoCa) screening test. Mann-Whitney and Kruskal-Wallis test were used for comparisons between clinical characteristics and MoCa test scores.

Results: Out of 63.33% of patients had EDSS <=4.5. Disease lasted longer than 10 years in 30% of patients. 80% had relapsing-remitting MS and 20% had secondary progressive MS. 84,2 % of patients with EDSS ≤ 4.5 had cognitive dysfunction. Higher disability (rho=0,306, p<0,05), progressive type of disease (rho=0,377, p< 0,01) and longer disease duration (rho=0,282, p<0,05) were associated with worse overall cognitive functions. Level of disability showed statistical significant correlation with the executive functions and language domains of cognition (p<0.01). Longer disease duration was significant correlated with executive functions (p<0,01) and language domains (p<0,01), while progressive type of disease was signifacant correlated only with executive functions domain (p<0,01). MoCa score variables did not show a statistically significant difference in relation to the number of relapses per year and the use of imunoterapy. Statistically significant negative correlation was obtained between executive functions domain and level of disability, disease duration and progressive type of disease, while language domain significantly correlated only with disability level and progressive type of disease.

Conclusion: High percentage of MS patients has cognitive impairment. Patients with higher disability were presented with lower cognitive abilities, especially in executive functions and language domains. Higher frequency of cognitive impairment were presented in progessive forms of disaese and longer disease duration with strong influence on executive functions domains of cognition.

背景:认知功能障碍通常是多发性硬化症的一种症状,多发性硬化症与大脑神经网络的结构和功能缺陷有关。目的:探讨多发性硬化症患者的认知功能障碍、病程及疾病类型对认知功能的影响。方法:本研究纳入在萨拉热窝大学临床中心神经内科治疗的60例多发性硬化症患者。纳入标准为临床明确诊断为多发性硬化症,年龄在18岁及以上,并能够给予书面知情同意。认知功能通过蒙特利尔认知评估(MoCa)筛查试验进行评估。使用Mann-Whitney和Kruskal-Wallis检验比较临床特征和MoCa测试分数。结果:63.33%的MS患者存在EDSS。结论:MS患者存在认知功能障碍的比例较高。残疾程度高的患者认知能力较低,尤其是在执行功能和语言领域。在疾病的进展形式中出现认知障碍的频率较高,病程较长,对认知的执行功能领域有强烈的影响。
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引用次数: 0
Frequency of Urinary Tract Infection When Diagnosing Vesico Uretheral Reflux in Children in Tuzla Canton. 图兹拉县儿童在诊断膀胱尿道反流时尿路感染的发生率
Pub Date : 2023-03-01 DOI: 10.5455/msm.2023.35.4-7
Evlijana Zulic, Devleta Hadzic, Almira Cosickic, Nedima Atic, Amela Selimovic, Dzenana Ostrvica

Background: Vesicoureteral reflux (VUR) represents the return of urine from the bladder into the ureter and the renal canal system. Reflux can occur only on one or both kidneys. VUR most often occurs due to an incompetent ureterovesical junction, which consequently leads to hydronephrosis and dysfunction of the lower parts of the urinary system.

Objective: The aim of the study was to determine the frequency of urinary infection when diagnosing vesicouretheral reflux in children in the Tuzla Canton, in the five-year period from 01.01.2016 to 01.01.2021.

Methods: Through a retrospective study, we analyzed data from 256 children with vesiocouretheral reflux (VUR), examined in the Nephrology Outpatient Clinic, Clinic for Children's Diseases, University Clinical Center Tuzla, in the period from 01.01.2016 to 01.01.2021, from early neonatal to 15 years of age. The age and gender of children, the most common symptoms of urinary tract infections during the detection of VUR, and the degree of VUR were analyzed.

Results: From 256 children with VUR, 54% were male and 46% female. The highest prevalence of VUR was in the age group 0-2 years, and the lowest in the age of children > 15 years. There was no statistically significant difference between the groups of our respondents in relation to age groups, nor in relation to the gender of the children. Statistically significantly more children were without nonspecific symptoms and with asymptomatic bacteriuria in the group without UTI symptoms in children with VUR compared to the group with UTI symptoms in children with VUR. Pathological urine culture between the groups was without a statistically significant difference.

Conclusion: Although urinary tract infection in children is common, the possibility of permanent consequences should always be kept in mind if VUR is not diagnosed and treated in time.

背景:膀胱输尿管反流(VUR)是指尿液从膀胱返回输尿管和肾管系统。反流可能只发生在一个肾脏,也可能发生在两个肾脏。VUR 最常发生的原因是输尿管膀胱连接处功能不全,从而导致肾积水和泌尿系统下部功能障碍:本研究旨在确定 2016 年 1 月 1 日至 2021 年 1 月 1 日五年间图兹拉州儿童在诊断膀胱尿道反流时发生泌尿系统感染的频率:通过回顾性研究,我们分析了2016年1月1日至2021年1月1日期间在图兹拉大学临床中心儿童疾病诊所肾脏病门诊接受检查的256名膀胱尿道反流(VUR)患儿的数据,患儿年龄从新生儿早期到15岁。研究分析了患儿的年龄和性别、发现 VUR 期间最常见的尿路感染症状以及 VUR 的程度:结果:在256名VUR患儿中,54%为男性,46%为女性。0-2 岁年龄组的 VUR 患病率最高,15 岁以上年龄组的患病率最低。我们的受访者群体在年龄组和性别上没有明显的统计学差异。据统计,与有尿路感染症状的儿童组相比,无尿路感染症状的儿童组中没有非特异性症状和无症状菌尿的儿童明显较多。各组之间的病理尿培养差异无统计学意义:结论:虽然儿童尿路感染很常见,但如果不及时诊断和治疗,就有可能造成永久性后果。
{"title":"Frequency of Urinary Tract Infection When Diagnosing Vesico Uretheral Reflux in Children in Tuzla Canton.","authors":"Evlijana Zulic, Devleta Hadzic, Almira Cosickic, Nedima Atic, Amela Selimovic, Dzenana Ostrvica","doi":"10.5455/msm.2023.35.4-7","DOIUrl":"10.5455/msm.2023.35.4-7","url":null,"abstract":"<p><strong>Background: </strong>Vesicoureteral reflux (VUR) represents the return of urine from the bladder into the ureter and the renal canal system. Reflux can occur only on one or both kidneys. VUR most often occurs due to an incompetent ureterovesical junction, which consequently leads to hydronephrosis and dysfunction of the lower parts of the urinary system.</p><p><strong>Objective: </strong>The aim of the study was to determine the frequency of urinary infection when diagnosing vesicouretheral reflux in children in the Tuzla Canton, in the five-year period from 01.01.2016 to 01.01.2021.</p><p><strong>Methods: </strong>Through a retrospective study, we analyzed data from 256 children with vesiocouretheral reflux (VUR), examined in the Nephrology Outpatient Clinic, Clinic for Children's Diseases, University Clinical Center Tuzla, in the period from 01.01.2016 to 01.01.2021, from early neonatal to 15 years of age. The age and gender of children, the most common symptoms of urinary tract infections during the detection of VUR, and the degree of VUR were analyzed.</p><p><strong>Results: </strong>From 256 children with VUR, 54% were male and 46% female. The highest prevalence of VUR was in the age group 0-2 years, and the lowest in the age of children > 15 years. There was no statistically significant difference between the groups of our respondents in relation to age groups, nor in relation to the gender of the children. Statistically significantly more children were without nonspecific symptoms and with asymptomatic bacteriuria in the group without UTI symptoms in children with VUR compared to the group with UTI symptoms in children with VUR. Pathological urine culture between the groups was without a statistically significant difference.</p><p><strong>Conclusion: </strong>Although urinary tract infection in children is common, the possibility of permanent consequences should always be kept in mind if VUR is not diagnosed and treated in time.</p>","PeriodicalId":18358,"journal":{"name":"Materia Socio-Medica","volume":"35 1","pages":"4-7"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/71/6b/MSM-35-4.PMC10122522.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9759188","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
Behavioral and Knowledge Patterns Regarding the Use of Antibiotics Among Urban and Rural Population in Bosnia and Herzegovina-a Cross-sectional Study. 波斯尼亚和黑塞哥维那城乡居民使用抗生素的行为和知识模式--一项横断面研究。
Pub Date : 2023-03-01 DOI: 10.5455/msm.2023.35.33-41
Monika Glibić, Leonora Bedeković, Mirko Maglica, Ilija Marijanović, Damir Vukoja

Background: Antimicrobial resistance imposes one of the leading global health issues and is strongly associated with the overuse and misuse of antimicrobials.

Objective: The present study aimed to determine the level of knowledge, attitudes, and behavior regarding the use of antibiotics among urban and rural population in the southeastern European country of Bosnia and Herzegovina.

Methods: A cross-sectional questionnaire-based study was conducted by convenience sampling technique among people who visited health centers, malls, and also online. In total, 1057 questionnaires were completed, of which 920 were completed in the city of Mostar (i.e. urban area), while 137 in the municipality of Grude (i.e., rural area). Descriptive statistical analysis was performed to process the results.

Results: Participants from Mostar had better knowledge about antibiotics (p = 0.031) and a higher level of education (p = 0.001). Women showed markedly better knowledge in the group of urban area responders (p = 0.004). Improper use of antibiotics was more common among respondents from Grude; they tend to use antibiotics more frequently and almost half of them are prone to self-medication (p = 0.017). Overall, those classified with adequate knowledge showed less tendency to irregular antibiotic intake. Having a medical worker in a family was significantly associated with better knowledge regarding antibiotics, while educational level was not.

Conclusion: Although a significant number of respondents showed adequate knowledge about the use of antibiotics, there were noticeable irregular behavioral patterns, while significant differences between urban and rural population were detected as well. Further analysis is required to access the whole specter of the issue and to initiate policies directed toward reducing inappropriate use of antibiotics and bacterial resistance to these medications.

背景:抗菌药耐药性是全球主要健康问题之一,与过度使用和滥用抗菌药密切相关:本研究旨在确定欧洲东南部国家波斯尼亚和黑塞哥维那的城市和农村人口对使用抗生素的认识水平、态度和行为:方法:采用方便抽样技术,对前往医疗中心、商场和网上购物的人群进行了横断面问卷调查。总共完成了 1057 份问卷,其中 920 份在莫斯塔尔市(即城市地区)完成,137 份在格鲁德市(即农村地区)完成。对调查结果进行了描述性统计分析:来自莫斯塔尔的参与者对抗生素的了解程度更高(p = 0.031),受教育程度更高(p = 0.001)。在城市地区的受访者中,女性对抗生素的了解程度明显更高(p = 0.004)。在格鲁德的受访者中,抗生素使用不当的情况更为普遍;他们往往更频繁地使用抗生素,而且近一半的人容易自行用药(p = 0.017)。总体而言,知识充足的受访者较少出现不规范使用抗生素的情况。家庭中有医务人员与更好地了解抗生素知识有很大关系,而受教育程度则没有关系:结论:尽管相当多的受访者对抗生素的使用有足够的了解,但仍存在明显的不规范行为模式,城市和农村人口之间也存在显著差异。需要进行进一步分析,以了解这一问题的整体情况,并启动相关政策,减少抗生素的不当使用和细菌对这些药物的耐药性。
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引用次数: 0
Management of Post-LASIK Ectasia. lasik术后扩张的处理。
Pub Date : 2023-03-01 DOI: 10.5455/msm.2023.35.73-78
Maja Bohac, Alma Biscevic, Melisa Ahmedbegovic-Pjano, Mateja Jagic, Doria Gabric, Selma Lukacevic, Ivana Mravicic

Background: Corneal ectasia is a sight-threatening complication of corneal refractive surgery characterized by progressive steepening and thinning of the cornea and subsequent loss of best-corrected visual acuity.

Objective: To report the clinical outcomes following treatment of post-laser in situ keratomileusis (LASIK) induced ectasia.

Methods: This is a retrospective case series of 7 patients (10 eyes) which developed post-LASIK ectasia. In these cases of postoperative ectasia, the presented clinical signs were either forme fruste keratoconus, thin cornea, posterior elevation map value > +15.0µm, or residual stromal bed < 300µm. All cases were treated with either collagen crosslinking (CXL) alone or combined with PRK or CXL and phakic intraocular implant using the Dresden protocol and a slight modification thereof. In all cases, the flap was created using the Moria M2 mechanical microkeratome (average flap thickness 118.15±12.88µm), and refractive error was corrected using the Wavelight Allegretto excimer laser.

Results: Average preoperative corrected visual acuity (CDVA) was 0.75 (±0.26) Snellen. Postoperative CDVA significantly increased to 0.86 (±0.13) Snellen (p=0.04, paired t-test). One eye lost three lines of its baseline CDVA (before ectasia), while all other eyes regained lines of CDVA. All cases remained stable during the follow-up.

Conclusion: Several surgical procedures are used for the management of corneal ectasia. However, the best surgical approach should be determined based on the state of progression of the disease. Although ectasia remains a potentially devastating complication after refractive surgery, most patients can regain functional visual acuity with appropriate management, and corneal transplantation is infrequently indicated.

背景:角膜扩张是角膜屈光手术的一种威胁视力的并发症,其特征是角膜逐渐变陡和变薄,随后丧失最佳矫正视力。目的:报道激光原位角膜磨除术(LASIK)术后角膜扩张的临床疗效。方法:回顾性分析7例(10眼)lasik术后扩张的病例。这些病例术后扩张的临床表现为圆锥角膜形成结痂,角膜薄,后仰角图值> +15.0µm,或残留间质床< 300µm。所有病例均采用胶原交联(CXL)单独或联合PRK或CXL和有晶状体眼内植入物治疗,采用德累斯顿方案并稍作修改。所有病例均采用Moria M2机械微角膜切片(皮瓣平均厚度118.15±12.88µm),并采用waveight Allegretto准分子激光矫正屈光不正。结果:术前平均矫正视力(CDVA)为0.75(±0.26)Snellen。术后CDVA显著升高至0.86(±0.13)Snellen (p=0.04,配对t检验)。一只眼睛失去了三条基线CDVA线(扩张前),而其他所有眼睛都恢复了CDVA线。所有病例在随访期间保持稳定。结论:几种手术方法可用于治疗角膜扩张。然而,最好的手术方法应根据疾病的进展情况来确定。虽然屈光手术后瞳孔扩张仍然是一个潜在的破坏性并发症,但大多数患者通过适当的治疗可以恢复功能性视力,角膜移植并不常见。
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引用次数: 2
Acquisition of New Philips Affiniti 30 Vascular Color Doppler Ultrasound Device - Cost Benefit Analysis to Reduce Cardiosurgical Patients' Treatment. 收购新的飞利浦Affiniti 30血管彩色多普勒超声设备-成本效益分析,以减少心脏手术患者的治疗。
Pub Date : 2023-03-01 DOI: 10.5455/msm.2023.35.65-72
Alen Karic, Adisa Oprasic-Dzordic, Ervin Busevac, Alma Krajnovic, Nabil Naser, Izet Masic

Background: Cerebrovascular accidents (CVI) are considered the second most serious complication in cardiac surgery patients with a frequency of 10%. By preventing complications of surgical treatment, using a Color Doppler ultrasound (CDU) device, in the population of cardiac surgery patients, the unplanned costs of prolonged postoperative treatment would be reduced.

Objective: To prove that the acquisition and use of the newly developed CDU device "Affinit 30" is completely economical, profitable and medically justified.

Methods: Numerical parameters of the treatment of cardiovascular patients were analyzed (number of procedures, number of days in the intensive care unit, cost of additional consultative services of the clinic for radiology and neurology), and the calculated economic value of the potential investment, as well as the cost of preventing surgical complications, by purchasing and installing a new modern CDU device.

Results: The profitability of the investment was assessed using the economic parameters Net Present Value (NPV) of the investment, Internal rate of return (IRR) and Profitability Index (PI). A mathematical calculation with the given parameters yields NPV = 948,850 KM and IRR of 273% when applied to the given parameters. The PI value is 12.6, which matches the previously calculated NPV and IRR values.

Conclusion: The acquisition and use of the newly developed CDU device "Affinit 30" is economically profitable and medically justified. This is shown by the calculated values of the economic parameters Net Present Value of the investment (NPV), Internal rate of return (IRR) and the Profitability Index (PI).

背景:脑血管意外(CVI)被认为是心脏手术患者的第二大并发症,发生率为10%。在心脏手术患者中使用彩色多普勒超声(CDU)设备,通过预防手术治疗并发症,可以减少术后延长治疗的计划外费用。目的:证明新开发的CDU装置Affinit 30的获取和使用是完全经济、有利可图和医学上合理的。方法:通过购买和安装新的现代CDU设备,分析心血管患者治疗的数值参数(手术次数、重症监护天数、门诊放射学和神经病学额外咨询服务费用),计算潜在投资的经济价值,以及预防手术并发症的成本。结果:利用投资净现值(NPV)、内部收益率(IRR)和盈利能力指数(PI)等经济参数对投资的盈利能力进行了评估。在给定参数下进行数学计算,NPV = 948,850 KM, IRR为273%。PI值为12.6,与之前计算的NPV和IRR值相匹配。结论:新研制的CDU装置Affinit 30具有经济效益和医学合理性。这是由经济参数的计算值投资的净现值(NPV),内部收益率(IRR)和盈利能力指数(PI)显示。
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引用次数: 0
Pregabalin in the Treatment of Peripheral and Central Chronic Neuropathic Pain. 普瑞巴林治疗外周和中枢慢性神经性疼痛。
Pub Date : 2023-03-01 DOI: 10.5455/msm.2023.35.42-47
Besim Prnjavorac, Suljo Kunic, Natasa Pejanovic-Skobic, Nermina Polimac Gorana, Dragana Zirojevic, Samra Kadic Vukas, Merita Tiric Campara, Amira Skopljak

Background: Pregabalin is a first-line therapy of pain with additional positive effects on the states of depression and anxiety that often occur in patients with chronic pain, thus improving their quality of life.

Objective: The aim of this study was to demonstrate the efficacy of pregabalin in reducing neuropathic pain and improving quality of life in patients with peripheral and central chronic neuropathic pain in Bosnia and Herzegovina. Also, the aim was to monitor the safety of therapy with pregabalin.

Methods: The study included patients with neuropathic pain lasting more than 3 months. Based on the underlying disease, patients were divided into 5 groups: DM-patients with diabetes mellitus, M-patients after stroke, D-patients with lower back pain, MS-patients with multiple sclerosis, and P group-patients with spinal cord injury. During the baseline visit, the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) was used to assess neuropathic pain. During two follow-up visits (1.5 and 3 months after baseline), the 36-Item Short-Form Health Survey (SF 36) was used to assess the effectiveness of therapy on quality of life. The safety of the treatment was evaluated by monitoring the incidence of adverse drug reactions.

Results: The study included 125 patients. During treatment with pregabalin, there was a statistically significant reduction in pain intensity in the DM, M, D and MS groups. In group P, the decrease in pain intensity was not statistically significant (p = 0.070). There was a significant improvement in different parameters of the quality of life in all analyzed groups, with the most prominent effects in the DM group. The effectiveness of treatment was rated as "good" and "very good" in more than 70% of subjects in each group. The expected side effects of treatment were recorded in 27.1% of patients in the DM group, in 20.0% in the M group and in 22.2% in the MS group. Unexpected side effects of treatment were observed in one patient (2.1%) in the DM group. Assessment of tolerability of the applied treatment showed "good" and "very good" response in 68.7% of patients in DM group, 73.3% in M group, 74.5% in D group, 88.9% in MS group and 85.8% in P group.

Conclusion: Pregabalin is a safe and effective drug in treatment of neuropathic pain of different etiology.

背景:普瑞巴林是一种治疗疼痛的一线药物,对慢性疼痛患者经常出现的抑郁和焦虑状态有额外的积极作用,从而改善他们的生活质量。目的:本研究的目的是证明普瑞巴林在减轻周围和中枢慢性神经性疼痛患者神经性疼痛和改善生活质量方面的疗效。同时,目的是监测普瑞巴林治疗的安全性。方法:研究对象为持续3个月以上的神经性疼痛患者。根据基础疾病将患者分为糖尿病dm组、脑卒中后m组、腰痛d组、多发性硬化症ms组、脊髓损伤P组。在基线访问期间,使用利兹神经性症状和体征评估(LANSS)来评估神经性疼痛。在两次随访期间(基线后1.5个月和3个月),采用36项简短健康调查(SF 36)来评估治疗对生活质量的有效性。通过监测药物不良反应的发生率来评价治疗的安全性。结果:纳入125例患者。在普瑞巴林治疗期间,DM、M、D和MS组疼痛强度均有统计学意义的降低。P组疼痛强度降低,差异无统计学意义(P = 0.070)。各分析组患者的生活质量各参数均有显著改善,其中以DM组效果最显著。在每组中,超过70%的受试者的治疗效果被评为“良好”和“非常好”。DM组中27.1%的患者出现了预期的治疗副作用,M组为20.0%,MS组为22.2%。DM组有1例(2.1%)出现治疗意外副作用。应用耐受性评价中,DM组68.7%、M组73.3%、D组74.5%、MS组88.9%、P组85.8%的患者反应为“良好”和“非常好”。结论:普瑞巴林是一种安全有效的治疗不同病因神经性疼痛的药物。
{"title":"Pregabalin in the Treatment of Peripheral and Central Chronic Neuropathic Pain.","authors":"Besim Prnjavorac,&nbsp;Suljo Kunic,&nbsp;Natasa Pejanovic-Skobic,&nbsp;Nermina Polimac Gorana,&nbsp;Dragana Zirojevic,&nbsp;Samra Kadic Vukas,&nbsp;Merita Tiric Campara,&nbsp;Amira Skopljak","doi":"10.5455/msm.2023.35.42-47","DOIUrl":"https://doi.org/10.5455/msm.2023.35.42-47","url":null,"abstract":"<p><strong>Background: </strong>Pregabalin is a first-line therapy of pain with additional positive effects on the states of depression and anxiety that often occur in patients with chronic pain, thus improving their quality of life.</p><p><strong>Objective: </strong>The aim of this study was to demonstrate the efficacy of pregabalin in reducing neuropathic pain and improving quality of life in patients with peripheral and central chronic neuropathic pain in Bosnia and Herzegovina. Also, the aim was to monitor the safety of therapy with pregabalin.</p><p><strong>Methods: </strong>The study included patients with neuropathic pain lasting more than 3 months. Based on the underlying disease, patients were divided into 5 groups: DM-patients with diabetes mellitus, M-patients after stroke, D-patients with lower back pain, MS-patients with multiple sclerosis, and P group-patients with spinal cord injury. During the baseline visit, the Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) was used to assess neuropathic pain. During two follow-up visits (1.5 and 3 months after baseline), the 36-Item Short-Form Health Survey (SF 36) was used to assess the effectiveness of therapy on quality of life. The safety of the treatment was evaluated by monitoring the incidence of adverse drug reactions.</p><p><strong>Results: </strong>The study included 125 patients. During treatment with pregabalin, there was a statistically significant reduction in pain intensity in the DM, M, D and MS groups. In group P, the decrease in pain intensity was not statistically significant (p = 0.070). There was a significant improvement in different parameters of the quality of life in all analyzed groups, with the most prominent effects in the DM group. The effectiveness of treatment was rated as \"good\" and \"very good\" in more than 70% of subjects in each group. The expected side effects of treatment were recorded in 27.1% of patients in the DM group, in 20.0% in the M group and in 22.2% in the MS group. Unexpected side effects of treatment were observed in one patient (2.1%) in the DM group. Assessment of tolerability of the applied treatment showed \"good\" and \"very good\" response in 68.7% of patients in DM group, 73.3% in M group, 74.5% in D group, 88.9% in MS group and 85.8% in P group.</p><p><strong>Conclusion: </strong>Pregabalin is a safe and effective drug in treatment of neuropathic pain of different etiology.</p>","PeriodicalId":18358,"journal":{"name":"Materia Socio-Medica","volume":"35 1","pages":"42-47"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3e/ef/MSM-35-42.PMC10122530.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9759187","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: 3
Domestic Violence During Women's Life in Developing Countries. 发展中国家妇女生活中的家庭暴力。
Pub Date : 2023-03-01 DOI: 10.5455/msm.2023.35.58-64
Christaki Christaki, Orovou Orovou, Dagla Dagla, Sarantaki Sarantaki, Moriati Moriati, Kirkou Kirkou, Antoniou Antoniou

Background: The lack of information relating to the definitive factors causing domestic violence has resulted in the lack of sound and effective programs; this makes the need for further research in domestic violence more imperative.

Objective: The aim of this systematic review is to investigate the factors and impacts of domestic violence in developing countries.

Methods: This study is a significant contribution to the existing literature, based on the use of data from the international literature of the last ten years and the evaluation of the degree that the domestic violence affects the lives of women both at an individual as well as a community level. Studies related to the scope of this review from international databases (Google Scholar, PubMed and Scopus) were used. The inclusion criteria comprised studies in English, published between 2012 and 2022 and studies which, apart from the prevalence or types of domestic violence investigated social factors related to violence in women of different ages in developing countries.

Results: The results of the study showed that partners-husbands are the main perpetrators of domestic violence. The prevalence of domestic violence ranged between 29.4% and 73.78%, with the highest prevalence observed in Bangladesh.

Conclusion: The factors affecting domestic violence were the young age of marriage, the low education level, non-proper execution of household chores, financial issues, patriarchic families, non-proper cooking according to the husband's desire, dowry issues, giving birth to a girl, poverty, women's work but also women's unemployment, other children in the family and their neglect according to the husband, husband's unemployment and the personal experiences of domestic violence for both partners. In addition, significant risk factors were the husband's addiction to substances and the wife's refusal for sex.

背景:由于缺乏与造成家庭暴力的决定性因素有关的信息,导致缺乏健全和有效的方案;这使得进一步研究家庭暴力的必要性更加迫切。目的:本系统综述的目的是调查发展中国家家庭暴力的因素及其影响。方法:本研究是对现有文献的重大贡献,基于近十年国际文献数据的使用,并评估家庭暴力在个人和社区层面对妇女生活的影响程度。与本综述范围相关的研究来自国际数据库(Google Scholar、PubMed和Scopus)。纳入标准包括2012年至2022年期间发表的英文研究,以及除家庭暴力的流行程度或类型外,调查与发展中国家不同年龄妇女暴力有关的社会因素的研究。结果:研究结果表明,伴侣—丈夫是家庭暴力的主要施暴者。家庭暴力的发生率在29.4%至73.78%之间,其中孟加拉国的发生率最高。结论:影响家庭暴力的因素有:结婚年龄小、受教育程度低、家务做得不好、经济问题、父权制家庭、不按丈夫的意愿做饭、嫁妆问题、生女孩、贫困、妇女工作但也有妇女失业、家庭中其他孩子以及丈夫对他们的忽视、丈夫的失业以及双方的个人家庭暴力经历。此外,重要的风险因素是丈夫吸毒成瘾和妻子拒绝性行为。
{"title":"Domestic Violence During Women's Life in Developing Countries.","authors":"Christaki Christaki,&nbsp;Orovou Orovou,&nbsp;Dagla Dagla,&nbsp;Sarantaki Sarantaki,&nbsp;Moriati Moriati,&nbsp;Kirkou Kirkou,&nbsp;Antoniou Antoniou","doi":"10.5455/msm.2023.35.58-64","DOIUrl":"https://doi.org/10.5455/msm.2023.35.58-64","url":null,"abstract":"<p><strong>Background: </strong>The lack of information relating to the definitive factors causing domestic violence has resulted in the lack of sound and effective programs; this makes the need for further research in domestic violence more imperative.</p><p><strong>Objective: </strong>The aim of this systematic review is to investigate the factors and impacts of domestic violence in developing countries.</p><p><strong>Methods: </strong>This study is a significant contribution to the existing literature, based on the use of data from the international literature of the last ten years and the evaluation of the degree that the domestic violence affects the lives of women both at an individual as well as a community level. Studies related to the scope of this review from international databases (Google Scholar, PubMed and Scopus) were used. The inclusion criteria comprised studies in English, published between 2012 and 2022 and studies which, apart from the prevalence or types of domestic violence investigated social factors related to violence in women of different ages in developing countries.</p><p><strong>Results: </strong>The results of the study showed that partners-husbands are the main perpetrators of domestic violence. The prevalence of domestic violence ranged between 29.4% and 73.78%, with the highest prevalence observed in Bangladesh.</p><p><strong>Conclusion: </strong>The factors affecting domestic violence were the young age of marriage, the low education level, non-proper execution of household chores, financial issues, patriarchic families, non-proper cooking according to the husband's desire, dowry issues, giving birth to a girl, poverty, women's work but also women's unemployment, other children in the family and their neglect according to the husband, husband's unemployment and the personal experiences of domestic violence for both partners. In addition, significant risk factors were the husband's addiction to substances and the wife's refusal for sex.</p>","PeriodicalId":18358,"journal":{"name":"Materia Socio-Medica","volume":"35 1","pages":"58-64"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/60/a1/MSM-35-58.PMC10122524.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9743698","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: 1
Genetically Homogeneous or Heterogeneous Population - Distribution of the Recessive Allele in Selected Qualitative Characteristics of Selected Working-Age Population Sample. 遗传上同质或异质的群体——在选定的工作年龄群体样本中选定的质量特征中隐性等位基因的分布。
Pub Date : 2023-03-01 DOI: 10.5455/msm.2023.35.8-12
Azra Metovic, Jasmin Musanovic, Almira Lujinovic, Esad Pepic, Jelena Prstojevic-Kovacevic

Background: The genetic structure of each population can be explained according to the frequency of genes and their allelic variants, genotypes, and phenotypes.

Objective: To analyze the genetic heterogeneity of the working-age population from the area of Sarajevo Canton based on classic genetic markers. The studied parameters of genetic heterogeneity were assessed by the relative frequency of the recessive allele for static-morphological traits (earlobe shape, chin shape, hairiness of the middle digital phalanx, bending of the distal phalanx of the little finger and digital index) and dynamic-morphological traits (rolling of the tongue into a groove, extensibility of the proximal thumb knuckle, extensibility of the distal thumb knuckle, the way the forearms are crossed, and the way the fists are made).

Results: The results of the t-test showed a significant difference in the manifestation of the recessive homozygote for the observed parameters of qualitative variation in the subsamples of men and women. Only for two traits (attached earlobe and hyperextensibility of the distal knuckle of the thumb). The selected sample represent a relatively genetically homogenous population.

Conclusion: This study serves as a valuable source of data for future research and the formation of a genetic database in Bosnia and Herzegovina.

背景:每个群体的遗传结构可以根据基因的频率及其等位变异、基因型和表型来解释。目的:利用经典遗传标记分析萨拉热窝州地区劳动年龄人口的遗传异质性。通过静态形态性状(耳垂形状、下巴形状、中指指骨多毛、小指远端指骨弯曲和指指指数)和动态形态性状(舌卷成沟状、拇指近端指关节可伸性、拇指远端指关节可伸性、前臂交叉方式等)隐性等位基因的相对频率来评估遗传异质性的研究参数。以及拳头的制作方式)。结果:t检验结果显示,男性和女性亚样本中观察到的定性变异参数的隐性纯合子表现有显著差异。只有两个特征(耳垂附着和拇指远端指节过伸)。所选的样本代表了一个遗传上相对同质的群体。结论:本研究为今后的研究和在波斯尼亚和黑塞哥维那建立遗传数据库提供了宝贵的数据来源。
{"title":"Genetically Homogeneous or Heterogeneous Population - Distribution of the Recessive Allele in Selected Qualitative Characteristics of Selected Working-Age Population Sample.","authors":"Azra Metovic,&nbsp;Jasmin Musanovic,&nbsp;Almira Lujinovic,&nbsp;Esad Pepic,&nbsp;Jelena Prstojevic-Kovacevic","doi":"10.5455/msm.2023.35.8-12","DOIUrl":"https://doi.org/10.5455/msm.2023.35.8-12","url":null,"abstract":"<p><strong>Background: </strong>The genetic structure of each population can be explained according to the frequency of genes and their allelic variants, genotypes, and phenotypes.</p><p><strong>Objective: </strong>To analyze the genetic heterogeneity of the working-age population from the area of Sarajevo Canton based on classic genetic markers. The studied parameters of genetic heterogeneity were assessed by the relative frequency of the recessive allele for static-morphological traits (earlobe shape, chin shape, hairiness of the middle digital phalanx, bending of the distal phalanx of the little finger and digital index) and dynamic-morphological traits (rolling of the tongue into a groove, extensibility of the proximal thumb knuckle, extensibility of the distal thumb knuckle, the way the forearms are crossed, and the way the fists are made).</p><p><strong>Results: </strong>The results of the t-test showed a significant difference in the manifestation of the recessive homozygote for the observed parameters of qualitative variation in the subsamples of men and women. Only for two traits (attached earlobe and hyperextensibility of the distal knuckle of the thumb). The selected sample represent a relatively genetically homogenous population.</p><p><strong>Conclusion: </strong>This study serves as a valuable source of data for future research and the formation of a genetic database in Bosnia and Herzegovina.</p>","PeriodicalId":18358,"journal":{"name":"Materia Socio-Medica","volume":"35 1","pages":"8-12"},"PeriodicalIF":0.0,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ec/21/MSM-35-8.PMC10122533.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9743702","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
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Materia Socio-Medica
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