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The Relation Between Depressive Symptoms and Self-Care in Patients with Diabetes Mellitus Type 2 in Kosovo 科索沃地区2型糖尿病患者抑郁症状与自我护理的关系
Pub Date : 2016-12-01 DOI: 10.5455/medarh.2016.70.425-428
I. Sopjani, Shemsedin Vehapi, D. Gorani, M. Imeri, Sidita Vitoja, S. Tahiri
Background: The depression is a significant problem in patients with diabetes. This research is the first of it’s kind conducted in the Republic of Kosovo to determine the prevalence of depression diagnosed in people with diabetes mellitus type 2 (DMT2) and interrelation between depressive symptoms and behavior of diabetes self-care (glucose monitoring, exercise, diet, and self- health care). Methods: Research was conducted in the University Clinical Center of Kosovo (UCCK), in Pristine. The sample consisted of 200 individuals. Data collection was done through structured questionnaires. HANDS (Harvard Department of Psychiatry / National Depression Screening Day Scale) questionnaire was used to assess depressive symptoms and DSMQ (The Diabetes Self-Management Questionnaire) was used to assess self-care behavior. Data analysis was run through SSPS program, version 21. Results: The results showed that the prevalence of depression in diabetic patients was 66.5% in Kosovo. Being a woman, a resident of rural areas or with low level of education, there were significant predictors and were associated with increased chance of developing the symptoms of major depression. Significant relations were found between major depression and physical activity (p<0.05). While between major depression and management of blood glucose level, dietary control and self health care, no significant correlation was found. Conclusion: This paper concluded the involvement of psychological aspect in health care plan for diabetics, in order to reduce the number of individuals affected by depression, to diagnose and to treat these individuals for a better quality of life.
背景:抑郁症是糖尿病患者的一个重要问题。本研究首次在科索沃共和国进行,旨在确定2型糖尿病(DMT2)患者中抑郁症的患病率,以及抑郁症状与糖尿病自我保健行为(血糖监测、运动、饮食和自我保健)之间的相互关系。方法:研究在科索沃大学临床中心(UCCK)进行。样本由200人组成。通过结构化问卷收集数据。采用哈佛精神病学系/国家抑郁症筛查日量表(HANDS)问卷评估抑郁症状,采用糖尿病自我管理问卷(DSMQ)评估自我护理行为。数据分析是通过SSPS程序运行的,版本21。结果:科索沃地区糖尿病患者抑郁症患病率为66.5%。女性、农村居民或受教育程度较低的人有显著的预测因素,并与出现重度抑郁症症状的机会增加有关。重度抑郁与体力活动有显著相关(p<0.05)。重度抑郁与血糖水平管理、饮食控制和自我保健之间无显著相关性。结论:本文总结了心理因素在糖尿病患者保健计划中的作用,以减少抑郁症患者的数量,提高患者的生活质量。
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引用次数: 5
Dilemma: Correlation Between Serum Level of Hepcidin and IL-6 in Anemic Myeloma Patients 困境:贫血性骨髓瘤患者血清Hepcidin和IL-6水平的相关性
Pub Date : 2016-12-01 DOI: 10.5455/medarh.2016.70.429-432
Lejla Ibričević-Balić, E. Ićindić-Nakas, S. Hasić, E. Kiseljaković, A. Sofo-Hafizović, Sefkija Balic
Introduction: Anemia occurs in 60% to 80 % of patients with newly diagnosed myeloma multiplex (MM). The cause of anemia in MM is probably multi factorial and involved among the others hepcidin and some cytokines, especially interleukine-6. Anemia in MM is one of the risk factor used in Durie-Salmon classification for staging and prognostic score. Treatment options are set according to this score with most significant impact on survival. Aim: To estimate baseline level of serum hepcidin, IL-6 and iron metabolism markers in anemic MM patients, possible role of hepcidin and its interaction with IL-6. Methods: 27 patients with newly diagnosed MM were enrolled in this observational, prospective study and age, gender matched 60 healthy controls. Erythrocyte count, hemoglobin, serum hepcidin, interleukin-6, iron, ferritin and transferrin were measured. Results: Anemia was diagnosed in 70% of MM patients. Serum hepcidin was significantly higher in MM group (55.5 ng/mL) than in control 5.9 ng/mL (p=0000). In myeloma patients serum IL-6 was 3.59 pg/mL, anemic 3.80 pg/mL, non-anemic 0.33 pg/mL, without significant difference. It was not found significant correlation between hepcidin and IL-6 in anemic myeloma patients. Conclusion: High level of hepcidin probably causes anemia in MM but its high expression is not due only to IL-6.
简介:60%至80%的新诊断多发性骨髓瘤(MM)患者出现贫血。MM贫血的病因可能是多因素的,与hepcidin和一些细胞因子,特别是白细胞介素-6有关。MM贫血是Durie-Salmon分级用于分期和预后评分的危险因素之一。根据对生存影响最大的评分设置治疗方案。目的:探讨贫血MM患者血清hepcidin、IL-6及铁代谢指标的基线水平,探讨hepcidin在贫血MM患者血清中可能的作用及其与IL-6的相互作用。方法:27例新诊断的MM患者加入了这项观察性、前瞻性研究,60名年龄、性别匹配的健康对照。测定红细胞计数、血红蛋白、血清hepcidin、白细胞介素-6、铁、铁蛋白、转铁蛋白。结果:70%的MM患者诊断为贫血。MM组血清hepcidin (55.5 ng/mL)显著高于对照组(5.9 ng/mL) (p=0000)。骨髓瘤患者血清IL-6为3.59 pg/mL,贫血患者为3.80 pg/mL,非贫血患者为0.33 pg/mL,差异无统计学意义。贫血性骨髓瘤患者hepcidin与IL-6无明显相关性。结论:hepcidin的高表达可能是MM贫血的主要原因,但其高表达并不仅仅与IL-6有关。
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引用次数: 5
Days of Academy of Medical Sciences of B&H 2016 and The First Mediterranean Seminar on Science Writing, Editing and Publishing (SWEP 2016) 2016年B&H医学科学院日及首届地中海科学写作、编辑和出版研讨会(SWEP 2016)
Pub Date : 2016-12-01 DOI: 10.5455/medarh.2016.70.477-478
I. Masic
Sarajevo, Bosnia and Herzegovina, from 2nd to 3rd December 2016, was host of one of the most exciting meetings in Mediterranean area The First Mediterranean Seminar on Science Writing, Editing & Publishing (SWEP 2016). It was organized by Academy of Medical Sciences of Bosnia and Herzegovina, running concurrent sessions as part of its Annual Meeting titled “Days of Academy of Medical Sciences of Bosnia and Herzegovina Theory and Practice in Science Communication and Scientometrics”. On the first day, twenty speakers from Croatia, Serbia, Macedonia, Albania, Bosnia & Herzegovina, Slovakia and the UK (Asim Kurjak, Milivoj Boranić, Doncho Donev, Osman Sinanović, Miro Jakovljević, Enver Zerem, Dejan Milošević, Silva Dobrić, Martin Rusnak, Srećko Gajović, Izet Mašić, Armen Yuri Gasparyan, Šekib Sokolović, Nermin Salkić, Selma Uzunović, Admir Kurtčehajić, Edin Begić and Floreta Kurti) had a range of presentations about scientific and publishing integrity, principles of scientific communication and unethical behavior in science and publishing, as well as strategic approaches and directions to prevent, detect and manage fraud and misconduct in scientific publishing. Some of speakers are also editors of journals like Medical Archives, Croatian Medical Journal, Vojnosanitetski Pregled, Psychiatria Danubina, Acta Informatica Medica, Materia Socio-Medica, The Donald School Journal of Ultrasound in Obstetrics and Gynecology, Acta Medica Saliniana, Macedonian Journal of Medical Sciences and Medicinski Glasnik. MEETING REPORT
2016年12月2日至3日,波斯尼亚和黑塞哥维那萨拉热窝主办了地中海地区最激动人心的会议之一——首届地中海科学写作、编辑和出版研讨会(SWEP 2016)。会议由波斯尼亚和黑塞哥维那医学科学院组织,作为其题为"波斯尼亚和黑塞哥维那医学科学院科学传播和科学计量学理论与实践日"的年度会议的一部分,同时举行会议。第一天,来自克罗地亚、塞尔维亚、马其顿、阿尔巴尼亚、波斯尼亚和黑塞哥维那、斯洛伐克和英国的20位演讲者(Asim Kurjak、Milivoj boraniki、Doncho Donev、Osman sinanoovic、Miro jakovljeviki、Enver Zerem、Dejan Milošević、Silva dobriki、Martin Rusnak、Srećko gajoviki、Izet Mašić、Armen Yuri Gasparyan、Šekib sokoloviki、Nermin salkiki、Selma uzunoviki、Admir kurt ehajiki、Edin begiki和Floreta Kurti)就科学和出版的公正性进行了一系列演讲。科学和出版中的科学传播和不道德行为原则,以及预防、检测和管理科学出版中的欺诈和不当行为的战略方法和方向。有些发言者还是《医学档案》、《克罗地亚医学杂志》、《Vojnosanitetski preglad》、《多努比纳精神病学》、《信息医学学报》、《社会医学材料》、《唐纳德学院妇产科超声杂志》、《盐碱地医学学报》、《马其顿医学科学杂志》和《Medicinski Glasnik》等杂志的编辑。会议报告
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引用次数: 0
The Correlation Between Prostate Volume in Patients with Benign Prostatic Hyperplasia in Relation to Erectile Dysfunction 良性前列腺增生患者前列腺体积与勃起功能障碍的关系
Pub Date : 2016-12-01 DOI: 10.5455/medarh.2016.70.449-452
Amel Kardasevic, S. Miličević
Introduction: The exact etiology of lower urinary tract symptoms caused by benign prostatic hyperplasia (BPH) has not yet been determined, and the etiology of erectile dysfunction (ED) is often multicausal and includes organic and/or psychogenic causes, as well as their combinations. Although the relation of BPH, and thus the volume of the prostate (VP) with ED is indisputable, precise mechanisms of integration are still under examination. Goal: The objective was to evaluate the correlation between prostate volume and degree of erectile dysfunction in patients with symptoms of lower urinary tract caused by benign prostatic hyperplasia. Material and Methods. 150 subjects with BPH, and before starting the BPH treatment, which can affect the sexual function, were divided into three groups: 50 patients with prostate volume of 30 to 40 ml (group A), 50 patients with a volume of 40 to 60 ml (group B) and 50 patients with prostate volume above 60 ml (group C). Quantification of erectile function is performed in all respondents by International Index of Erectile Function with five questions (IIEF-5). Results: The mean IIEF-5 in group A was 20.52 points with a standard deviation of 3.22, in group B 17.08 points with a standard deviation of 4.10, while in group C 10.78 points, with a standard deviation of 3.29. Comparing the results of a statistical analysis from all three groups of patients with the degree of ED, Group A had the highest value of IIEF-5, group C the lowest mean value of IIEF-5. The results of ANOVA (F=96.375, p=0.000) indicated that there was a statistically significant difference (p<0.05) between groups at high values of IIEF-5. Additional analysis by Turkey test revealed that there was a statistically significant difference between the first and second groups (p=0.000 <0.05), the first and third groups (p=0.000 <0.05) and the second and third groups (p=0.000 <0.05). Results of Fisher’s exact test (p=0.000) confirmed that there was a statistically significant relationship (p<0.05) between prostate volume and the degree of erectile function. Results of Spearman correlation (ρ=-0.720; p=0.000) showed that prostate volume is negatively correlated with IIEF-5 score with a reliability of 99% (p<0.05), or that increase in the volume of the prostate reduces the IIEF score. Conclusion: Results of IIEF-5 score are inversely proportional to the volume of the prostate or the prostate volume increase, the more severe erectile dysfunction, because the increase in prostate volume leads to a decline in IIEF score.
导读:良性前列腺增生(BPH)引起的下尿路症状的确切病因尚未确定,而勃起功能障碍(ED)的病因通常是多原因的,包括器官和/或心理原因,以及它们的组合。尽管前列腺增生和前列腺体积(VP)与ED的关系是无可争议的,但确切的整合机制仍在研究中。目的:目的是评价前列腺增生引起的下尿路症状患者前列腺体积与勃起功能障碍程度的相关性。材料与方法:150例前列腺增生患者,在开始前列腺增生治疗前,前列腺增生会影响性功能,将其分为前列腺体积30 ~ 40ml的50例(A组)、前列腺体积40 ~ 60ml的50例(B组)和前列腺体积60ml以上的50例(C组)。所有应答者均采用国际勃起功能指数5题(IIEF-5)对勃起功能进行量化。结果:A组IIEF-5平均为20.52分,标准差为3.22;B组平均为17.08分,标准差为4.10;C组平均为10.78分,标准差为3.29。比较三组患者ED程度的统计分析结果,a组患者IIEF-5最高,C组患者IIEF-5平均值最低。方差分析(F=96.375, p=0.000)显示,IIEF-5高值组间差异有统计学意义(p<0.05)。经土耳其检验分析,第一组与第二组、第一组与第三组(p=0.000 <0.05)、第二组与第三组(p=0.000 <0.05)差异有统计学意义(p=0.000 <0.05)。Fisher精确检验结果(p=0.000)证实前列腺体积与勃起功能程度有统计学意义(p<0.05)。Spearman相关结果(ρ=-0.720;p=0.000)表明前列腺体积与IIEF-5评分呈负相关,可靠性为99% (p<0.05),即前列腺体积的增加会降低IIEF评分。结论:IIEF-5评分结果与前列腺体积成反比,或者前列腺体积增大,勃起功能障碍越严重,因为前列腺体积增大导致IIEF评分下降。
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引用次数: 8
Echocardiographic Parameters as Life Quality Predictors in Patients After Myocardial Infarction Treated with Different Methods 超声心动图参数作为不同方法治疗心肌梗死患者生活质量的预测指标
Pub Date : 2016-12-01 DOI: 10.5455/medarh.2016.70.419-424
A. Džubur, M. Mekić, S. Pesto, Naser Nabil
Introduction: Cardiovascular diseases are the leading cause of death in most countries. The aim was to examine the quality of life and to determine the differences in the quality of life in patients one year after myocardial infarction and the relationship between quality of life and echocardiographic parameters in these patients. Material and Methods: The research was a prospective, clinical, epidemiological study and was conducted at the Clinic of Cardiology, University Clinical Center Sarajevo (UCCS). The research was conducted on a sample of 160 patients who had acute myocardial infarction, which are based on the therapeutic procedures divided into four groups. The average age in the total sample was 54.9±8.8 years (range 37-76 years). The research was conducted one year after myocardial infarction (I group of subjects) or 12 months after PCI therapeutic procedures (II and III group of respondents) or coronary artery bypass surgery (IV group of respondents). Results: Comparison of the mean scores of scales in SF-36 questionnaire showed that the highest total score had patients in the group II 67.3±15.2, and the lowest in the group I 57.8±21.4. The increase in ejection fraction leads to a statistically significant increase in quality of life scores at all subscales, in all groups, so that EF has the greatest impact on the quality of life in all respondents. Statistically significant differences in the effects of mitral regurgitation in particular groups have been recorded only in the case of the mental health scale. Conclusions: Ejection fraction has the greatest impact on the quality of life in all patients, regardless of the type of medical treatment.
在大多数国家,心血管疾病是导致死亡的主要原因。目的是检查生活质量,确定心肌梗死患者一年后生活质量的差异,以及这些患者的生活质量与超声心动图参数之间的关系。材料和方法:该研究是一项前瞻性临床流行病学研究,由萨拉热窝大学临床中心(UCCS)心脏病学诊所进行。该研究以160例急性心肌梗死患者为样本,根据治疗方法分为四组。总样本平均年龄为54.9±8.8岁(37 ~ 76岁)。该研究是在心肌梗死(I组受试者)后一年或PCI治疗(II和III组受访者)或冠状动脉搭桥手术(IV组受访者)后12个月进行的。结果:SF-36量表平均得分比较,总得分最高的为ⅱ组(67.3±15.2),最低的为ⅰ组(57.8±21.4)。射血分数的增加导致所有分组中所有亚量表的生活质量得分在统计学上显著增加,因此EF对所有受访者的生活质量影响最大。只有在心理健康量表的情况下,特定群体中二尖瓣反流的影响才有统计学上的显著差异。结论:无论何种治疗方式,射血分数对所有患者的生活质量影响最大。
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引用次数: 2
Juvenile Trabecular Ossifying Fibroma of the Maxilla: a Case Report 青少年上颌骨小梁骨化性纤维瘤1例
Pub Date : 2016-12-01 DOI: 10.5455/medarh.2016.70.470-472
S. Aboujaoude, G. Aoun
Introduction: Juvenile ossifying fibromas are uncommon benign tumors. Their aggressiveness added to their high tendency to recur, provoke real diagnostic and therapeutic challenges for the dental practitioner and make a postoperative follow-up over the years indispensable. Case report: In this report, we present a case of a seven-year-old girl presented with a swelling in the face at the upper right maxillary region. After clinical, radiological, and histopathological examinations the diagnosis of trabecular juvenile ossifying fibroma was made. The lesion was surgically excised and followed up for two years with no evidence of recurrence.
幼年骨化纤维瘤是一种少见的良性肿瘤。他们的攻击性增加了他们的高复发倾向,给牙科医生带来了真正的诊断和治疗挑战,并使术后随访多年不可或缺。病例报告:在这个报告中,我们提出了一个7岁的女孩的情况下,在上颌区域的右上方肿胀的脸。经临床、影像学及组织病理学检查,诊断为小梁骨化性纤维瘤。手术切除病变,随访2年,无复发迹象。
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引用次数: 8
Influence of Prognostic Factors for Recurrence of Adenocarcinoma of the Stomach 影响胃腺癌复发预后因素的研究
Pub Date : 2016-12-01 DOI: 10.5455/medarh.2016.70.441-444
I. Mehmedagić, S. Hasukić, Mirha Agić, N. Kadrić, Ismar Hasukić
Introduction: Gastric cancer is the second most important neoplasm in the world. Surgical resection is the treatment of choice for gastric cancer, and recognized by the International Union against Cancer (International Union Against Cancer – UICC) TNM classification of the parameters of the tumor and lymph node. Prognostic factors related to characteristics of the tumor by histopathologic findings have an impact on the planning of the operation. According to the results of most studies it is possible to predict survival and recurrence based on histological type and TNM classification of tumors on the one hand and the surgical procedure on the other. Aim: The aim of the research was to analyze prognostic factors that influenced the frequency of recurrence in gastric surgery patients. Patients and methods: The five year study covered a population of 100 treated patients of adenocarcinoma of the stomach at the Department of Surgery, University Clinical Center Tuzla. The first group were characteristics of tumors in patients with gastric adenocarcinoma. Lymphadenectomy and splenectomy, types of surgery were the second group of prognostic factors. Results: Histological type and TNM stage of tumor as prognostic factors had a significant impact on local tumor recurrence. The type of surgery had no statistically significant value for tumor recurrence (p = 0.7520). Conclusion: Statistical analysis of prognostic factors related to histopathologic characteristics of tumors and the type of surgery gave the results that had an impact on recurrence in gastric surgery patients. The most important prognostic factors were TNM stage of tumor and histological type of tumor that influenced the incidence of recurrence.
导读:胃癌是世界上第二大肿瘤。手术切除是胃癌的治疗选择,并被国际抗癌联盟(International Union against cancer - UICC) TNM所认可的肿瘤及淋巴结的分类参数。与肿瘤的组织学特征相关的预后因素对手术计划有影响。根据大多数研究的结果,一方面可以根据肿瘤的组织学类型和TNM分类,另一方面可以根据手术方式来预测生存和复发。目的:分析影响胃手术患者复发率的预后因素。患者和方法:这项为期五年的研究涵盖了图兹拉大学临床中心外科治疗的100名胃腺癌患者。第一组为胃腺癌患者的肿瘤特征。淋巴结切除和脾切除是影响预后的第二组因素。结果:肿瘤的组织学类型和TNM分期作为预后因素对局部肿瘤复发有显著影响。手术方式对肿瘤复发的影响无统计学意义(p = 0.7520)。结论:统计分析与肿瘤组织病理特征及手术方式相关的预后因素,得出对胃手术患者复发有影响的结果。影响复发率最重要的预后因素是肿瘤的TNM分期和肿瘤的组织学类型。
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引用次数: 3
Vascular Lipoleiomyoma of the Uterus: an Unusual Case 子宫血管性脂肪肌瘤:一例罕见病例
Pub Date : 2016-12-01 DOI: 10.5455/medarh.2016.70.473-476
V. Chibisheva, V. Antovska, M. Trajanova, D. Dabeski, R. Jovanovic, Ivana Kijajova
Introduction: Uterine lipoleiomyomas are a rare type of uterine myomas, which have been seldom diagnosed and are less known and still unusual. Histologically they are composed of smooth muscle cells with multiple fat cells and fibrous tissue. Their pathogenesis is still a stigmata and their preoperative diagnosis is still questionable. Case report history: A 39-year old woman presented at the University clinic for obstetrics and gynecology with complaints of a mild low abdominal and pelvic pain, increased frequency of vaginal bleeding and abdominal distension. Ultrasound examination showed dislocated uterus by a large semisolid tumor, located between the uterus and the urinary bladder. This mass was not well defined and had great vascularity. Pelvic computerized tomography revealed a large heterogeneous tumor located behind the bladder, measuring 8.5x7.5cm in size, making compression on the other pelvic organs. Conclusion: We should pay more attention on the preoperative imaging studies, in order to select patients who require surgery and further treatment more appropriately.
子宫脂质肌瘤是一种罕见的子宫肌瘤类型,很少被诊断出来,鲜为人知,仍然是罕见的。组织学上由平滑肌细胞、多个脂肪细胞和纤维组织组成。其发病机制仍是一个污点,其术前诊断仍有疑问。病例报告史:一名39岁女性在大学妇产科诊所就诊,主诉轻度下腹部和盆腔疼痛,阴道出血和腹胀频率增加。超声检查显示子宫脱位,子宫和膀胱之间有一个大的半实体瘤。肿块界限不清,有大量血管。盆腔计算机断层扫描显示膀胱后方有一个巨大的异质肿瘤,大小为8.5x7.5cm,压迫盆腔其他器官。结论:术前应重视影像学检查,以便更恰当地选择需要手术及进一步治疗的患者。
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引用次数: 3
Relationship of Plasma Adiponectin and Waist-hip Ratio with Coronary Artery Disease 血浆脂联素、腰臀比与冠心病的关系
Pub Date : 2016-12-01 DOI: 10.5455/medarh.2016.70.413-418
P. Rashiti, S. Elezi, I. Behluli, Sefedin Muçaj
Background: This study aimed to investigate correlation between adiponectin and waist-hip-ratio with severity of coronary artery disease (CAD). There is uncertainty about the association between circulating concentrations of adiponectin and CAD. Methods: We enrolled eighty-two consecutive patients undergoing non-urgent coronary angiography for CAD survey. According to the angiography results, the patients were divided into two groups in 1:1 ratio patients admitted with a diagnosis of CAD and non-CAD. We conducted hospital based research, involving study group with documented angiographically CAD, and control group without evidence of CAD. Angiograms were also quantified for the extent and severity of CAD by the Gensini scoring system. We measured baseline adiponectin levels in stored serum samples of all patients, anthropometric and biochemical risk factors were assessed in both groups. Results: The presence of CAD was associated with current smoking, male gender, waist–hip ratio (WHR) and left ventricular ejection fraction (LVEF). Baseline adiponectin concentrations correlated significantly in terms of the lipid parameters, positively with HDL cholesterol concentrations (r=0.327, P=0.028, P<0.05) and serum triglyceride concentrations were correlated negatively (r=-0.513, P<0.001). No significant difference between median adiponectin levels at baseline was observed between cases and controls. Conclusion: There is a significant positive correlation between waist–hip ratio and presence and severity of coronary artery disease. In conclusion, there is a significant positive correlation between adiponectin and Gensini score among Kosovar patients.
背景:本研究旨在探讨脂联素和腰臀比与冠心病(CAD)严重程度的相关性。循环脂联素浓度与冠心病之间的关系尚不确定。方法:我们招募了82例连续接受非紧急冠状动脉造影的冠心病患者。根据血管造影结果将诊断为CAD和非CAD的患者按1:1的比例分为两组。我们进行了以医院为基础的研究,包括有冠心病血管造影记录的研究组和无冠心病证据的对照组。血管造影也通过Gensini评分系统量化CAD的程度和严重程度。我们测量了所有患者储存的血清样本中的基线脂联素水平,并评估了两组患者的人体测量和生化危险因素。结果:冠心病的发生与吸烟史、男性、腰臀比(WHR)和左心室射血分数(LVEF)有关。基线脂联素浓度与血脂参数显著相关,与HDL胆固醇浓度呈正相关(r=0.327, P=0.028, P<0.05),血清甘油三酯浓度呈负相关(r=-0.513, P<0.001)。基线时脂联素水平中位数在病例和对照组之间无显著差异。结论:腰臀比与冠心病的存在及严重程度呈正相关。综上所述,科索沃患者的脂联素与Gensini评分之间存在显著的正相关。
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引用次数: 7
CSF–Related Complications After Intradural Spinal Tumor Surgery: Utility of an Autologous Fat Graft 脊髓硬膜内肿瘤手术后csf相关并发症:自体脂肪移植的应用
Pub Date : 2016-12-01 DOI: 10.5455/medarh.2016.70.460-465
K. Arnautović, M. Kovačević
Object: The incidence of cerebrospinal fluid (CSF)-related complications after intradural spinal tumor (IST) surgery is high and reported in up to 18% of patients. However, no efficient way to prevent those complications has been reported so far. Treating these complications may require prolonged bed rest, re-exploration, external lumbar drain, use of antibiotics, and possible precipitation of other complications. To alleviate the risk of CSF-related complications, we prospectively adopted the intraoperative use of autologous fat grafting after IST surgery. Methods: This is a perspective analysis of 37 cases (out of 40 cases series) that a prospective use of abdominal fat autograft was applied during dural closure. After the tumor was resected and the dura closed, we used the Valsalva maneuver to ensure watertight closure. CSF leak was prevented with the enforcement of suture with a fat autograft as necessary. In addition a thin layer of fat tissue was then placed over the dura to obliterate any dead space. Fibrin glue was then applied over the graft. Filling the dead space with the fat graft prevented a low-pressure space in which CSF could pool and form a pseudomeningocele. Results: After adopting the fat autograft technique, we did not observe any post-surgery CSF-related complications in any of these patients. Conclusions: The prospective use of autologous fat grafting can ensure watertight dural closure and obliterate the dead space created during surgical exposure and bone removal. This technique significantly reduces, and may completely eliminate, postoperative CSF-related complications in patients with ISTs.
目的:硬膜内脊髓肿瘤(IST)手术后脑脊液(CSF)相关并发症的发生率高,据报道高达18%的患者。然而,目前还没有有效的方法来预防这些并发症。治疗这些并发症可能需要长时间卧床休息,重新探查,腰椎外引流,使用抗生素,并可能沉淀其他并发症。为了减轻csf相关并发症的风险,我们前瞻性地采用IST术后术中自体脂肪移植。方法:这是对37例(40例系列)的前瞻性使用腹部脂肪自体移植应用于硬脑膜闭合的前瞻性分析。在切除肿瘤并闭合硬脑膜后,我们使用Valsalva手法确保水密闭合。必要时采用自体脂肪移植术进行缝合以防止脑脊液泄漏。此外,在硬脑膜上放置一层薄薄的脂肪组织,以消除任何死区。然后将纤维蛋白胶涂在移植物上。用脂肪移植物填充死腔,阻止了脑脊液聚集形成假性脑膜膨出的低压腔。结果:采用自体脂肪移植技术后,我们未观察到任何患者的术后csf相关并发症。结论:自体脂肪移植术的应用前景广阔,可保证硬脑膜的水密闭合,消除手术暴露和去骨过程中造成的死腔。该技术可显著减少并可能完全消除ist患者术后csf相关并发症。
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引用次数: 28
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