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Environmental Related Risk Factors to Road Traffic Accidents in Ilam, Iran 伊朗伊拉姆地区道路交通事故的环境相关风险因素
Pub Date : 2019-06-01 DOI: 10.5455/medarh.2019.73.169-172
Marzieh Mansoori Jalilian, H. Safarpour, J. Bazyar, Meysam Safi Keykaleh, Leila Malekyan, A. Khorshidi
Introduction: Road traffic injuries (RTIs) are the most serious health issue in the world and the main cause of death after the first year of birth. Environmental factors are among the most important and effective aspects of RTIs occurrences and their human consequences. Aim: This study aimed to identify the environmental factors associated with road traffic accidents (RTAs) in Ilam province. Methods: All crash data in Ilam province in 2012 were investigated. RTI’s data was collected using COM 114 form which included some human, environmental and vehicle related factors. Through Chi-Square test and logistic regression model, the association between environmental factors and RTIs was examined. For all statistical analyses we used the package Stata 13.1. Results: A total of 2314 traffic accidents were investigated. The highest 1659 (72.3%) and lowest 19 (0.83%) frequency of RTAs occurred during day and sunrise respectively. The majority of RTAs took place in July and September. The maximum number of RTAs was when the day was clear (91.7%) 2103 and the minimum when it was cloudy (3.5%) 81. A significant relationship was found between fatal RTAs and factors such as; the sort of the road, the hindered visibility, the location of the accident, the accidents’ place, the climate, and lighting of the day (P<0.05). The adjusted chance of traffic accidents causing death or injuries in main streets was 9.7 times more than in highways; in sidetracks it was 3.54 times more. And when it was cloudy, the chance was 2.60 times more than when was clear (P<0.05). Conclusion: Regarding the standards of road construction, development of the roads, and educating drivers how to adjust their driving behavior to the environment and road conditions could have a great role in decreasing RTAs causing death or injury.
导言:道路交通伤害是世界上最严重的健康问题,也是婴儿出生一年后死亡的主要原因。环境因素是rti发生及其人类后果的最重要和最有效的方面之一。目的:本研究旨在找出与伊拉姆省道路交通事故(RTAs)相关的环境因素。方法:对2012年伊拉姆省所有交通事故数据进行调查。RTI的数据采用COM 114表格收集,其中包括一些与人为、环境和车辆相关的因素。通过卡方检验和logistic回归模型,检验环境因素与rti的相关性。对于所有的统计分析,我们使用Stata 13.1包。结果:共调查交通事故2314起。白天和日出时段rta频次分别最高1659例(72.3%)和最低19例(0.83%)。大多数区域贸易协定发生在7月和9月。晴天时rta数量最多(91.7%)2103个,多云时最少(3.5%)81个。致死性rta与以下因素有显著关系:道路类型、能见度障碍、事故发生地点、事故发生地点、气候和当天的光照(P<0.05)。调整后的主干道交通事故伤亡概率是高速公路的9.7倍;在侧轨上,这个数字是3.54倍。多云时的概率是晴天的2.60倍(P<0.05)。结论:提高道路建设标准,发展道路,教育驾驶员如何根据环境和道路状况调整驾驶行为,对减少交通事故造成的伤亡有重要作用。
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引用次数: 10
Radiographic, Bone Densitometry and Clinic Outcomes Assessments in Femoral Shaft Fractures Fixed by Plating or Locking Retrograde Nail 钢板或逆行钉固定股骨干骨折的x线片、骨密度测定及临床疗效评估
Pub Date : 2019-06-01 DOI: 10.5455/medarh.2019.73.195-200
G. Rollo, M. Bisaccia, G. Rinonapoli, A. Caraffa, V. Pace, J. Irimia, Enio de Cruto, Olga Bisaccia, Giuseppe Pica, D. Tarantino, L. Meccariello
Introduction: Distal femoral shaft fractures are characterized by increasing incidence and complexity and are still considered a challenging problem (high morbidity and mortality). No consensus on best surgical option has been achieved. Aim: This study aims is to investigate radiographic, mineral bone densitometry and clinical outcomes of locking retrograde intramedullary (LRN) nailing and anatomical locking plate to surgically treat distal femoral shaft fractures in young adults based on the hypothesis that there is no statistical difference among the two surgical options in terms of results (radiographic, bone densitometry and outcomes assessment). Methods: Retrospective study: 30 patients divided into 2 groups (Group 1 LRN, Group 2 Nailing). Average age was 42.67±18.32 for Group 1 and 42.84 ±18.32 for Group 2 (range of age 18-65 for both groups). Gender Ratio (male: female) was 2.75 (11:4) for both Group 1 and 2. AO Classification, NUSS and RUSH score, VAS, Dexa scans, plain radiographs were used. Evaluation endpoint: 12 months after surgery (mean follow up 16.24). Results: No statistical difference in terms of surgery time, transfusions, wound healing. Similar results with regard to average time of bone healing, RUSH scores, VAS, regression between RUSH and VAS, average correlation clinical-radiographic results and patients outcomes. Only one patient of each group had reduction of mineral bone densitometry values. Conclusion: No statistical difference about the use of LNR or Nailing for treatment of distal femur shaft fractures in terms of radiographic, bone densitometry and outcomes has been found accordingly to our results. Good subjective and objective results are provided by both techniques. The choice among the two techniques must be based on surgeons’ experience, indications and subjective patients’ aspects. The absence of relevant similar data in the published literature does not allow definitive validation (or rejection) of our hypothesis. A more powered study with bigger cohort is needed for definitive validation.
股骨远端骨折的特点是发病率和复杂性不断增加,并且仍然被认为是一个具有挑战性的问题(高发病率和死亡率)。对于最佳手术方案尚未达成共识。目的:本研究的目的是在假设两种手术方案在结果(影像学、骨密度和结果评估)方面没有统计学差异的基础上,探讨锁定逆行髓内钉(LRN)和解剖锁定钢板手术治疗年轻成人股骨干远端骨折的x线片、矿物骨密度和临床结果。方法:回顾性研究:30例患者分为2组(1组LRN, 2组钉钉)。组1平均年龄为42.67±18.32岁,组2平均年龄为42.84±18.32岁(年龄范围18 ~ 65岁)。第一组和第二组男女性别比均为2.75(11:4)。采用AO分级、NUSS和RUSH评分、VAS、Dexa扫描、x线平片。评估终点:术后12个月(平均随访16.24例)。结果:两组手术时间、输血量、创面愈合情况无统计学差异。在平均骨愈合时间、RUSH评分、VAS、RUSH和VAS之间的回归、平均相关临床放射学结果和患者预后方面的结果相似。两组均有1例骨密度值下降。结论:LNR与钉内固定治疗股骨远端骨干骨折在影像学、骨密度及预后方面均无统计学差异。这两种技术都提供了良好的主观和客观结果。两种技术的选择必须基于外科医生的经验、适应证和患者的主观方面。在已发表的文献中缺乏相关的类似数据,因此不能对我们的假设进行明确的验证(或拒绝)。需要一项更有力、更大规模的研究来进行明确的验证。
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引用次数: 13
Heritability of Craniofacial Characteristics in Twins - Cephalometric Study 双胞胎颅面特征的遗传性-头测量研究
Pub Date : 2019-06-01 DOI: 10.5455/medarh.2019.73.205-208
A. Tiro, V. Džemidžić, Samra Salaga-Nefic, Ismeta Redžić, E. Nakaš
Introduction: The growth and development of the craniofacial complex are under the influence of genetic and environmental factors, which determine its morphological and functional characteristics. Twin studies provide significant insight into how many genetic and environmental factors determine dental and craniofacial characteristics. Aim: The aim of the study was to determine the genetic influence on craniofacial complex using a twin study model. Methods: The study sample comprised 52 pairs of twins who were referred to the Orthodontic Department, School of Dental medicine, University of Sarajevo. Informed consent was obtained by the parents of the children included in the study. Twenty pairs of twins were diagnosed as monozygotic while 32 pairs were diagnosed as dizygotic. Zygosity was diagnosed by physical characteristics similarity. Nineteen variables were measured: 10 dental variables, 9 cephalometric. Results: Based on the findings of this study, t-test showed significant genetic effect on the length of cranial base (p = 0.03), corpus of maxilla (p = 0.02) and mandibular length (p = 0.03), and also for B-angle (p = 0.04). Environmental factors are more involved in determining dental traits (e.g., the inclination of the incisors). Conclusion: There is a significant genetic effect on the linear cephalometric variables: the length of the cranial base, maxillary length and mandibular length.
颅面复合体的生长发育受遗传和环境因素的影响,决定了颅面复合体的形态和功能特征。双胞胎研究提供了有多少遗传和环境因素决定牙齿和颅面特征的重要见解。目的:本研究的目的是利用双胞胎研究模型确定遗传对颅面复合体的影响。方法:研究样本包括萨拉热窝大学口腔医学院正畸科的52对双胞胎。参与研究的儿童的父母获得了知情同意。20对双胞胎被诊断为同卵双胞胎,32对被诊断为异卵双胞胎。合子性的诊断依据是体质特征的相似性。测量了19个变量:10个牙齿变量,9个头侧变量。结果:根据本研究结果,t检验显示遗传对颅底长度(p = 0.03)、上颌骨长度(p = 0.02)和下颌长度(p = 0.03)以及b角(p = 0.04)有显著影响。环境因素在决定牙齿特征(例如,门牙的倾斜度)方面更为重要。结论:颅底长度、上颌长度和下颌长度对头颅线性测量变量有显著的遗传影响。
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引用次数: 11
Lasik as a Solution for High Hypermetropia Lasik治疗高度远视
Pub Date : 2019-06-01 DOI: 10.5455/medarh.2019.73.191-194
Alma Biscevic, Ajla Pidro, M. Pjano, Senad Grišević, Nina Žiga, Maja Bohac
Aim: To evaluate safety and efficacy of Laser in situ Keratomileusis (LASIK) procedure for the correction of high hypermetropia. Methods: Retrospective study of 160 patients (266 eyes) who underwent LASIK procedure for the correction of hypermetropia between +3.00 and +7.00 diopters(D) and cylinder up to 2.00D from January 2013 and August 2015. All ablations were performed with Wavelight Allegretto Eye-Q400Hzexcimer laser (Alcon, Forth Worth, TX, USA) with aberration free module and were centered on a corneal vertex. All flaps were made with Moria M2 (Moria, Antony, France) mechanical microkeratome (90μm head). Preoperative and postoperative uncorrected and corrected distant visual acuity (UDVA, CDVA), spherical equivalent (SE) and a berrometry for 5mm pupil were measured. Measurements were taken at 1 week, 1,3,6 and 12 months after the surgery. Wilcoxon Signed Ranks Test was used for statistical analysis. Results: Postoperative UDVA was lower than preoperative CDVA at 1 week(p=0.001), at 1 month there was no difference (p=0.099), and at 3,6 and 12 months UDVA was better (p<0.0001). Preoperative SE was 4.69±1.20D (+3.75 to +7.50D). At 1 week SE was 0.03±0.67D (-0.50 to +0.63D), while at 1 year regressed to 0.58±0.56D (+0.25 to +0.88D). Sphere shifted from negative values targeted in treatment planning to compensate for regression to positive values. There was significant difference in SE at every time point (p<0.0005). There was a significant increase in coma (p<0.0001), trefoil (p<0.0001, p=0.0006) and spherical aberration (p=0.022, p=0.0052) at 1 week and 1 month postoperatively, without change throughout the rest of follow up. Conclusion: LASIK for high hypermetropia showed satisfactory results in postoperative refraction with reasonable regression without significant loss of lines of visual acuity. However, more test are necessary to asses optical quality.
目的:评价激光原位角膜磨磨术(LASIK)矫正高度远视的安全性和有效性。方法:回顾性分析2013年1月至2015年8月行LASIK手术矫正+3.00 ~ +7.00屈光度、柱面≥2.00屈光度的远视患者160例(266眼)。所有消融均使用wavight Allegretto eye - q400hz准分子激光器(Alcon, Forth Worth, TX, USA)进行,具有无像差模块,并以角膜顶点为中心。所有皮瓣均采用Moria M2 (Moria, Antony, France)机械微角化组(90μm头)制作。测量术前、术后未矫正和矫正的远视灵敏度(UDVA、CDVA)、球面等效度(SE)和5mm瞳孔光度计。分别于术后1周、1、3、6、12个月进行测量。采用Wilcoxon sign Ranks检验进行统计分析。结果:术后1周UDVA低于术前CDVA (p=0.001), 1个月无差异(p=0.099), 3、6、12个月UDVA优于术前(p<0.0001)。术前SE为4.69±1.20D (+3.75 ~ +7.50D)。1周时SE为0.03±0.67D (-0.50 ~ +0.63D), 1年时SE为0.58±0.56D (+0.25 ~ +0.88D)。Sphere从治疗计划中的负值偏移,以补偿回归到正值。各时间点SE差异均有统计学意义(p<0.0005)。术后1周和1个月患者的昏迷(p<0.0001)、三叶草(p<0.0001, p=0.0006)和球差(p=0.022, p=0.0052)均显著升高,其余随访时间无变化。结论:LASIK治疗高度远视效果满意,术后屈光恢复合理,无明显的视敏线损失。然而,需要更多的测试来评估光学质量。
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引用次数: 7
A Self-Reported Study Toward Melanoma Knowledge, Protective Behavior and Personal Risk Among Nursing Faculty Students at AAB University of Kosovo 科索沃AAB大学护理系学生黑色素瘤知识、保护行为和个人风险自我报告研究
Pub Date : 2019-06-01 DOI: 10.5455/medarh.2019.73.201-204
Sidita Sopjani, I. Sopjani, Ormen Dushi
Introduction: In nowadays, melanoma is one of the major problems of public health all over the world. In Kosovo, the incidence of melanoma has shown irregular tendency with significant increases and decreases in the last five years. Aim: The aim of this paper was to detect the knowledge level of nursing students in Kosovo’s University (AAB University) regarding melanoma and its risk factors; to evaluate their knowledge about the protection and prevention methods of melanoma as one of the main topics of dermatology and major problems of public health worldwide nowadays. Of a great importance, it was to evaluate the necessity of establishing a dermatology course in nursing curricula in Kosovo universities, as nurses have a key role in educating and promoting health in the population. Methods: The training was conducted through slides, photos, videos and a questionnaire was used to collect the data before and after training. Data analysis was run through SPSS program version 20.0. Data were expressed through mean values and standard deviations. T-test, Anova and regression analysis were performed to test the relationship between the protective behaviors, knowledge, personal risk and level of concern. Results: Results indicated a low level of knowledge and a fairly poor protective behavior among the participants. Conclusion: On-going training and enrichment of school curricula emerged as an intervention to increase the awareness of the students toward potential risks of melanoma and ultimate change in the protective behavior.
目前,黑色素瘤是全球公共卫生的主要问题之一。在科索沃,黑色素瘤的发病率在过去五年中呈不规则趋势,有显著的增减。目的:了解科索沃大学(AAB University)护生对黑色素瘤及其危险因素的认知水平;评估他们对黑色素瘤的保护和预防方法的知识,黑色素瘤是当今皮肤病学的主要话题之一,也是世界范围内公共卫生的主要问题。非常重要的是,评估在科索沃大学护理课程中开设皮肤病学课程的必要性,因为护士在教育和促进人口健康方面发挥着关键作用。方法:采用幻灯片、照片、视频等形式进行培训,并采用问卷调查的方式收集培训前后的数据。数据分析采用SPSS 20.0软件进行。数据以平均值和标准差表示。采用t检验、方差分析和回归分析检验保护行为、知识、个人风险与关注水平之间的关系。结果:结果表明,参与者的知识水平较低,保护行为相当差。结论:持续的培训和丰富的学校课程是一种干预措施,可以提高学生对黑色素瘤潜在风险的认识,并最终改变保护行为。
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引用次数: 0
The Scanty Knowledge of Endoscopic Third Ventriculostomy in Infants 婴儿第三脑室内窥镜造瘘术的知识不足
Pub Date : 2019-06-01 DOI: 10.5455/medarh.2019.73.187-190
Rami Y. Alqroom, M. Al-Khawaldeh, Basel Makhamreh, F. Sha'ban, Feras Haddad, Hussam Abu-nowar, Basel Younes, N. Khasawneh, A. Shurbaji
Introduction: Hydrocephalus (HCP) remains one of the commonest pathologies treated in developing countries. Endoscopic third ventriculostomy (ETV) has become the alternative to shunt-divergen procedures in the treatment of many pathologies of the cerebral fluid in the brain. Age has been considered a limitation to perform the procedure, we started to perform ETV In younger patients earlier than many other units. Objectives: In this study, we demonstrate the overall efficacy of ETV in infants younger than 1-year of age and to subsequently report the outcome of this procedure. Methods: From 2000 till 2016 we have performed a total of 386 cases of ETV of all ages. 71-cases were infants (below 1-year of age). Our study was undertaken to evaluate these cases. Patients were divided into two subgroups according to the cause of hydrocephalus; obstructive HCP, communicating HCP. Results: Mean time for follow up was 52 months. Mean age at surgery was 137days (7- 351days). The population included 31-females and 40-males, while10 infants were premature. Success rates were; 91.6%, 63.6% correspond to each sub-group with an overall success rate of 73.24%. Conclusion: ETV in infants is feasible, technically more demanding. Success rate justifies the procedure to be performed in such age group of patients. ETV can be used, attentively, in cases of hydrocephalus associated with MMC, morbidity and mortality does not differ from the general population.
脑积水(HCP)仍然是发展中国家治疗的最常见的病理之一。内镜下第三脑室造口术(ETV)已成为分流手术的替代方案,用于治疗许多脑内脑液病变。年龄被认为是实施该手术的一个限制因素,我们开始在年轻患者中实施ETV,比许多其他单位都要早。目的:在这项研究中,我们证明了ETV在1岁以下婴儿中的总体疗效,并随后报告了该手术的结果。方法:自2000年至2016年,我们共对386例各年龄段的ETV进行了手术。1岁以下婴幼儿71例。我们的研究是为了评估这些病例。根据脑积水的病因将患者分为两个亚组;阻塞性HCP,通讯性HCP。结果:平均随访时间52个月。平均手术年龄为137天(7 ~ 351天)。研究对象中有31名女性和40名男性,10名婴儿是早产儿。成功率为;91.6%, 63.6%对应于每个子组,总体成功率为73.24%。结论:婴幼儿ETV是可行的,但技术要求较高。成功率证明了在这一年龄组的患者中进行手术的合理性。ETV可用于与MMC相关的脑积水病例,其发病率和死亡率与一般人群没有差异。
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引用次数: 0
Cytomegalovirus Infection in Pregnancy - Our Experiences 妊娠期巨细胞病毒感染-我们的经验
Pub Date : 2019-06-01 DOI: 10.5455/medarh.2019.73.149-153
H. Porobić-Jahić, F. Skokić, S. Ahmetagić, Dilista Piljić, Rahima Jahić, Jasminka Petrović
Introduction: Cytomegalovirus (CMV) infection is ubiquitous. It affects all age groups, and its clinical picture ranges from mild to severe, especially as a congenital infection in neonates. Aim: To determine frequency of CMV infection in pregnant women in Tuzla Canton (TC) and the risk factors that lead to the infection. Methods: This prospective study included 300 pregnant women from TC aged 18 to 42 years. CMV serology was performed on all participants, and in case of acute infection additionally IgG avidity test. Participants also completed the questionnaire on the risk factors for CMV infection. Results: The median age of the 300 women was 28 ±4.97 years. There were 161participants (53.6%) who classified their environment as urban and 295 (98.33%) were married. More than half of the women had completed secondary school 168 (56%). Positive IgG antibodies to CMV had 280 (93.0%) women. Positive IgM and IgG antibodies had 9 (3.0%) participants, but all of them had high IgG avidity, which indicates reinfection or recurrent CMV infection. There was a statistically significant higher number of seropositive participants living in rural areas than those living in urban areas (p= 0.048). Also, there was significantly higher percentage of positive anti-CMV IgG in pregnant women with lower education (p=0.04). Conclusion: In our region there is high seropositivity rates of IgG antibodies to CMV in pregnant women. No case of primary CMV infection was proven. The risk factors for CMV infection have been proven to be rural environment and lower level of education.
巨细胞病毒(CMV)感染是普遍存在的。它影响所有年龄组,其临床表现从轻微到严重不等,特别是作为新生儿的先天性感染。目的:了解图兹拉州(TC)孕妇巨细胞病毒(CMV)感染的频率及导致感染的危险因素。方法:本前瞻性研究纳入300名年龄在18 ~ 42岁的TC孕妇。对所有参与者进行巨细胞病毒血清学检查,急性感染时进行IgG抗体检测。参与者还完成了巨细胞病毒感染危险因素的问卷调查。结果:300例女性的中位年龄为28±4.97岁。其中161人(53.6%)生活环境为城市,295人(98.33%)已婚。一半以上的妇女完成了中学教育(56%)。CMV IgG抗体阳性280例(93.0%)。IgM和IgG抗体阳性9例(3.0%),但IgG抗体均高,提示再感染或复发性CMV感染。生活在农村地区的血清阳性参与者人数显著高于生活在城市地区的参与者(p= 0.048)。受教育程度越低的孕妇抗巨细胞病毒IgG阳性比例越高(p=0.04)。结论:本地区孕妇巨细胞病毒IgG抗体血清阳性率较高。未发现原发性巨细胞病毒感染病例。农村环境和教育水平较低是CMV感染的危险因素。
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引用次数: 8
The New Method of Pocket Forming for Breast Implant Placement in Augmentation Mammaplasty: Dual Plane Subfascial 双平面筋膜下隆乳袋形成新方法
Pub Date : 2019-06-01 DOI: 10.5455/medarh.2019.73.178-182
Reuf Karabeg, Malik Jakirlić, A. Karabeg, Danijela Crnogorac, I. Aslani
Introduction: Breast augmentation is one of the most frequently performed aesthetic surgical procedures in the world. The most important preoperative decisions which influence the final appearance of the augmented breast are the breast implant pocket choice and selection of the most appropriate implant. Described pocket locations are subglandular, subfascial, partially retropectoral, totally submuscular and dual plane. Aim: We have introduced a new method of pocket forming for implant placement, which is combination of Tebbett’s dual-plane 2 or 3 and Graf’s subfascial. We named it as dual plane subfascial. Methods: Between January 2016 and April 2018, total of 27 patients were operated using dual plane subfascial breast augmentation. The pinch test in the medial pole less than 2,0 cm and in upper pole less than 2,5 cm are indications for this technique. In our modification, in primary cases a dissected flap in front of muscle is fasciocutaneous (not cutaneous as in Tebbett’s technique). It will be finally located caudally of pectoral muscle and in front of the lower pole of implant. Fasciocutaneous flap in primary cases and two independent levels of soft tissue coverage (fascial and cutaneous) in secondary cases (subglandular to dual plane subfascial conversion) in front of the lower pole of implants provide better coverage than cutaneous flap alone. Results: Hematoma and infection did not occur in any patient in our study. A capsular contracture grade I/II without the need for reoperation occurred in two patients. In one patient with secondary augmentation minimal bottoming out was noticed (before reoperation patient had significant bottoming out deformity). Minimal palpability of implants is recorded in three patients. Conclusion: Dual plane subfascial is a good option in primary breast augmentation with a well set indication especially in the breasts with the upper pinch test less than 25 mm and medial pinch test less than 20 mm. The idea can be followed even in secondary breast augmentation (subglandular to dual plane subfascial conversion). There is additional soft tissue in front of the implant which led to a less implant palpability, especially in thin patient with smaller amount of subcutaneous fat.
简介:隆胸是世界上最常见的美容外科手术之一。影响隆胸最终外观的最重要的术前决定是乳房植入物口袋的选择和选择最合适的植入物。所描述的口袋位置为腺下、筋膜下、部分背侧、完全肌下和双平面。目的:我们介绍了一种新的种植体口袋形成方法,即Tebbett的2或3双平面与Graf的筋膜下结合。我们称之为双平面筋膜下。方法:2016年1月至2018年4月,共27例患者行双平面筋膜下隆胸手术。内极小于2 0 cm和上极小于2.5 cm的捏试是该技术的适应症。在我们的修改中,在原发性病例中,肌前的剥离皮瓣是筋膜皮肤皮瓣(而不是Tebbett技术中的皮肤皮瓣)。它最终会位于胸肌的尾部和假体的下极前面。原发性病例的筋膜皮瓣和继发性病例的两个独立的软组织覆盖层(筋膜和皮肤)(腺下到双平面筋膜下转换)在植入物的下极前提供比单独的皮肤皮瓣更好的覆盖。结果:本组患者未发生血肿和感染。2例患者发生I/II级包膜挛缩,无需再次手术。在一例二次隆胸患者中,发现最小的底出(再手术前患者有明显的底出畸形)。三名患者记录了植入物的最小可触性。结论:双平面筋膜下隆乳是一种较好的选择,适应证较好,尤其适用于乳房上部捏片小于25mm,内侧捏片小于20mm的隆乳。这个想法甚至可以在二次隆胸(腺下到双平面筋膜下转换)中遵循。植入物前面有额外的软组织,这导致植入物的可触性较低,特别是在皮下脂肪较少的瘦患者中。
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引用次数: 6
Serum Creatinine and Occurrence and Severity of Coronary Artery Disease 血清肌酐与冠状动脉疾病的发生和严重程度
Pub Date : 2019-06-01 DOI: 10.5455/medarh.2019.73.154-156
B. Bagheri, Najme Radmard, Atena Faghani-Makrani, M. Rasouli
Introduction: The risk for cardiovascular disease is increased in all stages of the impairment of renal function. It is proposed that serum creatinine is a marker of diabetes and coronary artery disease (CAD) as well as the kidney function. Aim: to study the association of serum creatinine with the likelihood and severity of CAD. The study population consisted of 262 males and 266 females who were classified as CAD cases and controls according to the results of coronary angiography. Results: Patients with CAD compared with the controls had increased levels of serum urea and creatinine. Serum creatinine showed significant positive correlation with male sex, hypertension and negative correlation with total- and HDL-cholesterol and apoAI. Serum urea, uric acid and potassium were the major determinants of creatinine. All hematological parameters were strong negative correlates of creatinine. None of markers of inflammation had significant correlation with creatinine. Creatinine was associated significantly with the prevalence [odds ratio of 1.79 (1.47-2.20), p<0.001] and severity of CAD [F(3,528)= 3.0, p=0.03]. Serum creatinine was excluded from the regression equation after adjustment for major risk factors. Conclusion: Serum creatinine has significant association with CAD, but the correlation is not independent. Creatinine have significant association with markers of kidney function and body water status, but not with markers of inflammation and insulin function.
在肾功能损害的所有阶段,心血管疾病的风险都增加。认为血清肌酐是糖尿病、冠心病和肾功能的标志。目的:探讨血清肌酐水平与冠心病发生可能性及严重程度的关系。研究人群包括262名男性和266名女性,根据冠状动脉造影结果分为冠心病病例和对照组。结果:与对照组相比,冠心病患者血清尿素和肌酐水平升高。血清肌酐与男性、高血压呈显著正相关,与总胆固醇、高密度脂蛋白胆固醇、apoAI呈显著负相关。血清尿素、尿酸和钾是肌酐的主要决定因素。所有血液学参数与肌酐呈强负相关。炎症指标与肌酐均无显著相关性。肌酐与冠心病的患病率[比值比为1.79 (1.47-2.20),p<0.001]和严重程度[F(3,528)= 3.0, p=0.03]显著相关。校正主要危险因素后,将血清肌酐从回归方程中剔除。结论:血清肌酐与冠心病有显著相关性,但相关性不是独立的。肌酐与肾功能和体内水分状况的标志物有显著相关性,但与炎症和胰岛素功能的标志物无显著相关性。
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引用次数: 20
The Mean Platelet Volume in the Prognosis of Coronary Artery Disease Severity and Risk Stratification of Acute Coronary Syndromes 平均血小板体积与冠状动脉疾病严重程度的预后及急性冠状动脉综合征的危险分层
Pub Date : 2019-04-01 DOI: 10.5455/medarh.2019.73.76-80
I. Vogiatzis, Antonis Samaras, S. Grigoriadis, E. Sdogkos, Kostantinos Koutsampasopoulos, I. Bostanitis
Introduction: Platelets play a crucial role in thrombotic episodes. Mean Platelet Volume (MPV) is the primary indicator of platelet’s activation; its measurement is easy and time-effective. Aim: We tested the hypothesis that MPV is correlated with SYNTAX score in patients that suffered from an Acute Coronary Syndrome (ACS). Material and Methods: One hundred and four (104) patients (79 male–25 female, mean age 64.2±11.1 years), who were hospitalized for an ACS and underwent coronary angiography, were included in the study. Syntax score, as an indicator of the severity of coronary artery disease (CAD), was calculated. We tried to investigate the correlation between the first measured MPV, CRP, Creatinine and high sensitivity Troponin with the Syntax score of the patient and the association of MPV and a possible Major Advanced Cardiac Event (MACE) during hospitalization. Results: The patients were divided into four groups according to the SYNTAX score: Group A (SYNTAX score: 0, n=12), group B: Mild CAD (SYNTAX score: 1–22, n=68), group C: Moderate CAD (SYNTAX score: 23–32, n=12), and group D: Severe CAD (SYNTAX score: ≥ 33, n=12). Four patients (3.8%) developed a MACE during their hospitalization. MPV was significantly correlated to Syntax score (r=0.658, p<0.001) and was found to be an independent predictor factor of MACE with HR=6.8 (95% Confidence Interval 1.46-33.36). The cut-off value of MPV was 7.5 with a sensitivity of 98% and a specificity of 30.8%. Conclusion: We determined a positive correlation between MPV and Syntax score, transforming this simple test in a possible factor of risk stratification in ACS.
血小板在血栓性发作中起着至关重要的作用。平均血小板体积(MPV)是血小板活化的主要指标;它的测量简单且具有时效性。目的:我们检验急性冠脉综合征(ACS)患者MPV与SYNTAX评分相关的假设。材料与方法:104例因ACS住院并行冠状动脉造影的患者(男79例,女25例,平均年龄64.2±11.1岁)纳入研究。计算语法评分,作为冠状动脉疾病(CAD)严重程度的指标。我们试图研究首次测量的MPV、CRP、肌酐和高敏感性肌钙蛋白与患者句法评分的相关性,以及MPV与住院期间可能发生的严重晚期心脏事件(MACE)的关系。结果:根据SYNTAX评分将患者分为四组:A组(SYNTAX评分0,n=12), B组:轻度CAD (SYNTAX评分1-22,n=68), C组:中度CAD (SYNTAX评分23-32,n=12), D组:重度CAD (SYNTAX评分≥33,n=12)。4名患者(3.8%)在住院期间发生MACE。MPV与句法评分显著相关(r=0.658, p<0.001),是MACE的独立预测因子,HR=6.8(95%可信区间1.46 ~ 33.36)。MPV的临界值为7.5,敏感性为98%,特异性为30.8%。结论:我们确定MPV与句法评分呈正相关,将这一简单的测试转变为ACS风险分层的可能因素。
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引用次数: 15
期刊
Medical Archives
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