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Long-term results of multimodal treatment of the prostate using the Thulium Laser 使用铥激光对前列腺进行多模式治疗的长期结果
Q2 Medicine Pub Date : 2024-07-05 DOI: 10.15386/mpr-2760
Roxana-Andra Coman, D. Leucuța, R. Coman, Carmen Lapusan, D. Stanca, Ioan Coman, N. Al Hajjar
Background and aims. To evaluate a novel multimodal treatment (TLP) that integrates the use of a thulium laser, bipolar transurethral resection of the prostate (TURP), and “button-type” bipolar plasma vaporization for the endoscopic treatment of benign prostatic hyperplasia (BPH). Methods. From March 2018 to December 2021, we prospectively evaluated 220 patients with symptomatic BPH who underwent TLP. Patients were assessed based on the International Prostate Symptom Score (IPSS), quality of life (QoL), maximum urinary flow rate (Qmax), and postvoid residual urine (PVR). Perioperative and postoperative follow-up data were analyzed. Results. The mean age at surgery was 66.74 years (SD 8.21). The median prostate size was 80 (IQR 70 - 110). The median operative time was 45 (IQR 35 - 55) minutes and the hospital stay was 2 (IQR 1 - 2) days. Patients were discharged with the urinary catheter in place, which was removed approximately 7 days after surgery when the histopathological result was discussed with the patient. Postoperatively, IPSS, QoL, Qmax and PVR showed a significant improvement starting at 3 months and continued through the postoperative follow-up visits (6- 12-24-36-48-60 months). Urethral stricture and bladder neck contracture occurred in 1 (0.45%) and 2 (0.91%) patients, respectively. Recurrence of BPH occurred in 2 patients (0.91%) who underwent a second procedure. Conclusions. In conclusion, we report that the multimodal surgical treatment of BPH consisting of combining Thulium laser vaporization, bipolar TURP and plasma vaporization (TLP) represents an efficient and durable therapeutic method for BPH patients with low a complication rate at 5-year follow-up.
背景与目的评估一种新型多模式疗法(TLP),该疗法综合使用了铥激光、双极经尿道前列腺切除术(TURP)和 "按钮式 "双极等离子汽化术,用于良性前列腺增生症(BPH)的内窥镜治疗。方法。从2018年3月到2021年12月,我们对220名接受TLP治疗的有症状良性前列腺增生症患者进行了前瞻性评估。根据国际前列腺症状评分(IPSS)、生活质量(QoL)、最大尿流率(Qmax)和排尿后残余尿(PVR)对患者进行评估。对围手术期和术后随访数据进行了分析。结果手术时的平均年龄为 66.74 岁(SD 8.21)。前列腺大小中位数为 80(IQR 70 - 110)。手术时间中位数为 45 分钟(IQR 35 - 55 分钟),住院时间为 2 天(IQR 1 - 2 天)。患者出院时留置导尿管,术后约 7 天与患者讨论组织病理学结果时拔除导尿管。术后 3 个月开始,IPSS、QoL、Qmax 和 PVR 均有显著改善,并持续到术后随访(6-12-24-36-48-60 个月)。分别有 1 例(0.45%)和 2 例(0.91%)患者出现尿道狭窄和膀胱颈挛缩。接受第二次手术的 2 名患者(0.91%)出现良性前列腺增生复发。结论。总之,我们报告称,铥激光汽化术、双极 TURP 和等离子汽化术(TLP)相结合的良性前列腺增生症多模式手术治疗是良性前列腺增生症患者的一种高效、持久的治疗方法,5 年随访期间并发症发生率较低。
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引用次数: 0
The predictive risk factors associated with non-dipper profile in patients with type 2 diabetes and hypertension 与 2 型糖尿病和高血压患者非糖尿病特征相关的预测性风险因素
Q2 Medicine Pub Date : 2024-07-05 DOI: 10.15386/mpr-2749
V. Manea, D. Leucuța, Călin Pop, Mircea-Ioachim Popescu
Background and aims. The non-dipper status represented by blood pressure reduction by less than 10 percent during sleep is present in about 50 percent of patients with type 2 diabetes (T2D) and hypertension, a pattern associated with more frequent cardiovascular complications and reserved prognosis. This study analyzed the predictive risk factors associated with the different dipper profiles, especially with the nocturnal pattern, following the mean arterial pressure (MAP), the mean heart rate (MHR), and the mean pulse pressure (MPP) in patients with T2D and hypertension, established by ambulatory blood pressure monitoring (ABPM). Method. 166 consecutive patients with type 2 diabetes mellitus and hypertension were included in a cross-sectional study, and they underwent 24-hour ABPM. We excluded patients with secondary hypertension, acute coronary disease and heart failure, with oncologic or endocrine disease. The simple and multiple linear regression models were performed predicting 24-hour, day and night MAP, MHR, and MPP according to various predictors, using software R version 4.3.1. Results. There were 80 non-dippers (48.20%), 57 dippers (34.34%), 22 reverse-dippers (13.25%) and seven extreme-dippers (4.21%). A statistically significant association was observed between MAP 24-hour and total cholesterol (TC) (higher TC values were associated with higher MAP /24 h values): adjusted coefficient B of the regression slope: 0.09, 95% confidence interval CI (0.04- 0.15), p=0.003. In the multivariate analysis: adjusted B: 8.64, 95% CI (-14.67- -2.61), p=0.006, beta-blockers reached the threshold of statistical significance in relation to MHR/24 h, their presence decreasing the heart rate. PP/24 hours was associated in the multivariate analysis with age: adjusted B: 0.45, 95% CI (0.05- 0.85), p=0.28; abdominal circumference: 0.26, 95% CI (0.03-0.49), p=0.028, and total cholesterol: 0.1, 95% CI (0.02-0.17), p=0.013. Diabetic nephropathy was statistically significantly associated with PP/24 h: adjusted B: 10.19, 95% CI (1.24- 19.14), p=0.027. Conclusions. High cholesterol was associated with higher values of MAP and PP. Beta-blocker treatment lowered non-dipper MHR. Age and AC were correlated with increased PP values. These are predictive risk factors associated with the status of non-dippers established by ABPM, and they represent a veritable link to the non-dipper pattern in patients with T2D and hypertension.
背景和目的。约有 50% 的 2 型糖尿病(T2D)和高血压患者存在睡眠时血压降低不足 10% 的非低血压状态,这种模式与更频繁的心血管并发症和预后不良有关。本研究根据动态血压监测(ABPM)确定的 T2D 和高血压患者的平均动脉压(MAP)、平均心率(MHR)和平均脉压(MPP),分析了与不同的降压模式,尤其是夜间模式相关的预测性风险因素。研究方法一项横断面研究纳入了 166 名连续的 2 型糖尿病和高血压患者,他们接受了 24 小时 ABPM 监测。我们排除了继发性高血压、急性冠状动脉疾病、心力衰竭、肿瘤或内分泌疾病患者。使用 R 4.3.1 版软件建立了简单和多元线性回归模型,根据各种预测因素预测 24 小时、白天和夜间的 MAP、MHR 和 MPP。结果80名不浃背者(48.20%)、57名浃背者(34.34%)、22名反向浃背者(13.25%)和 7 名极度浃背者(4.21%)。24 小时血压与总胆固醇(TC)之间存在明显的统计学关联(较高的 TC 值与较高的 24 小时血压值相关):调整后的回归斜率系数 B 为 0.09,95% 置信区间为 0.05:0.09,95% 置信区间 CI (0.04-0.15),P=0.003。在多变量分析中:调整后的 B:8.64,95% 置信区间(-14.67--2.61),P=0.006,β-受体阻滞剂达到了与 MHR/24 小时相关的统计学意义临界值,它们的存在降低了心率。在多变量分析中,PP/24 小时与年龄有关:调整后的 B:0.45,95% CI (0.05-0.85),p=0.28;腹围:0.26,95% CI (0.05-0.85),p=0.006:0.26,95% CI (0.03-0.49),P=0.028;总胆固醇:0.1,95% CI (0.02-0.17),P=0.013。糖尿病肾病与 PP/24 h 有显著的统计学相关性:调整后 B:10.19,95% CI(1.24-19.14),P=0.027。结论高胆固醇与较高的 MAP 和 PP 值有关。β-受体阻滞剂治疗可降低非糖尿病患者的 MHR。年龄和 AC 与 PP 值升高有关。这些都是通过 ABPM 确定的与非糖尿病患者状态相关的预测性风险因素,它们代表了与 T2D 和高血压患者非糖尿病模式的真正联系。
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引用次数: 0
A brief review on the lessons learned from COVID-19 on drug discovery and research. 简要回顾 COVID-19 在药物发现和研究方面的经验教训。
Q2 Medicine Pub Date : 2024-07-01 Epub Date: 2024-07-30 DOI: 10.15386/mpr-2641
Subodh Kumar, Hansraj Kumar, Joonmoni Lahon, Dibyajyoti Saikia

COVID-19 pandemic has taught many lessons regarding drug discovery and development. This review covers these aspects of drug discovery and research for COVID-19 which might be used as a tool for future. It summarizes the positives such as progresses in antiviral drug discovery, drug repurposing, adaptations of clinical trial and its regulations, as well as the negative points such as the need to develop more collaboration among stakeholders and future directions. It also discusses the benefits and limitations of finding new indications for existing drugs, and the lessons learned regarding rigorous and robust clinical trials, pharmacokinetic/pharmacodynamic modelling, as well as combination therapy. The pandemic has also revealed some gaps regarding global collaboration and coordination, data sharing and transparency and equitable distribution. Finally, the review enumerates the future directions and implications of drug discovery and research for COVID-19 and other infectious diseases such as preparedness and resilience, interdisciplinary and integrative approaches, diversity and inclusion, and personalized and precision medicine.

COVID-19 大流行给药物研发带来了许多启示。本综述涵盖了 COVID-19 药物发现和研究的这些方面,可作为未来的工具。它总结了抗病毒药物发现、药物再利用、临床试验及其法规的调整等积极方面,以及利益相关者之间需要开展更多合作和未来发展方向等消极方面。报告还讨论了为现有药物寻找新适应症的益处和局限性,以及在严格和稳健的临床试验、药动学/药效学建模和联合疗法方面的经验教训。这次大流行还揭示了在全球合作与协调、数据共享和透明度以及公平分配方面存在的一些差距。最后,综述列举了针对 COVID-19 和其他传染病的药物发现和研究的未来方向和影响,如防备和恢复能力、跨学科和综合方法、多样性和包容性以及个性化和精准医学。
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引用次数: 0
The familiarity of Romanian psychiatrists with anti-N-methyl-D-aspartate receptor encephalitis: findings from a web-based survey study. 罗马尼亚精神科医生对抗-N-甲基-D-天冬氨酸受体脑炎的熟悉程度:一项网络调查研究的结果。
Q2 Medicine Pub Date : 2024-07-01 Epub Date: 2024-07-30 DOI: 10.15386/mpr-2712
Denis Pavăl, Nicoleta Gherghel-Pavăl, Octavia Oana Căpățînă, Ioana Valentina Micluția

Background and aims: Psychiatrists are often the first to be consulted in patients with anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis. Thus, they need to be aware of clinical features, differential diagnoses, and treatment options for this condition. In this study, we aimed to investigate the familiarity of Romanian psychiatrists with anti-NMDAR encephalitis.

Methods: We recruited psychiatrists from Romania and conducted a cross-sectional observational study by using a web-based survey.

Results: The survey was completed by 111 psychiatrists, of whom 47 (42.34%) were specialists, while 64 (57.66%) were trainees. The median length of training for specialists was ten years (interquartile range - IQR 9.5), while for trainees it was 2.5 years (IQR 3). In total, 31 (27.93%) psychiatrists encountered a case of anti-NMDAR encephalitis, with no significant difference between specialists and trainees. 31 (27.93%) psychiatrists were either unaware of the disorder or only knew its name, while 77 (69.37%) had knowledge of an outline of it. Only 3 (2.7%) psychiatrists had comprehensive knowledge of the disorder. Respondents with a higher awareness level had undergone significantly longer training (p=0.014). Unsurprisingly, having encountered a case significantly influenced awareness levels (p<0.001). There were no significant differences between specialists and trainees regarding specific knowledge about anti-NMDAR encephalitis. However, higher awareness levels and having encountered a case significantly influenced answer accuracy for questions regarding psychiatric presentation and epidemiological features.

Conclusions: Our study indicates that Romanian psychiatrists have suboptimal knowledge of anti-NMDAR encephalitis, highlighting the need for improved awareness of this disorder.

背景和目的:对于抗 N-甲基-D-天冬氨酸受体(抗 NMDAR)脑炎患者,精神科医生往往是首诊医生。因此,他们需要了解这种疾病的临床特征、鉴别诊断和治疗方案。本研究旨在调查罗马尼亚精神科医生对抗 NMDAR 脑炎的熟悉程度:方法:我们招募了罗马尼亚的精神科医生,并通过网络调查开展了一项横断面观察研究:111名精神科医生完成了调查,其中47人(42.34%)为专科医生,64人(57.66%)为实习医生。专科医生的培训时间中位数为 10 年(四分位数间距 - IQR 9.5),而实习医生的培训时间中位数为 2.5 年(四分位数间距 - IQR 3)。共有 31 名(27.93%)精神科医生遇到过抗 NMDAR 脑炎病例,专科医生和实习医生之间没有显著差异。31名(27.93%)精神科医生不了解这种疾病或只知道其名称,而77名(69.37%)医生对这种疾病的概况有所了解。只有 3 名(2.7%)精神科医生对该疾病有全面的了解。认知水平较高的受访者接受培训的时间明显更长(p=0.014)。不足为奇的是,曾经遇到过一个病例对认知水平有显著影响(p结论:我们的研究表明,罗马尼亚精神科医生对抗 NMDAR 脑炎的了解程度不够理想,这凸显了提高对这种疾病认识的必要性。
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引用次数: 0
Hepatic changes following a high-fat diet: effects of Cornus mas and gold nanoparticles phytoreduced with Cornus mas on oxidative stress, inflammation, and histological damage. 高脂饮食后的肝脏变化:山茱萸和山茱萸植物还原金纳米粒子对氧化应激、炎症和组织学损伤的影响。
Q2 Medicine Pub Date : 2024-07-01 Epub Date: 2024-07-30 DOI: 10.15386/mpr-2775
Dalina Diana Zugravu, Stefan Lucian Popa, Andrei-Vasile Pop, Remus Moldovan, Alexandru Flaviu Tăbăran, Luminita David, Simona Valeria Clichici

Background and aims: High fat diet (HFD) can lead to liver injury, through oxidative stress and inflammation. The use of natural compounds with antioxidant and anti-inflammatory properties can have a protective potential. We aimed to investigate the effects of Cornus mas (CM) and gold nanoparticles phytoreduced with CM (GNPsCM) on hepatic alterations induced by HFD in rats.

Methods: Female Sprague Dawley rats were randomly divided into four groups: control, HFD, HFD +CM and HFD + GNPsCM. The high fat diet was administered for 32 weeks and CM and GNPsCM were administered for 4 weeks after the HFD period. The high fat diet induced oxidative stress in liver, with lipid peroxidation and decreased antioxidant capacity, inflammation and minimal histological alterations.

Results: The administration of CM and GNPsCM reduced lipid peroxidation produced by HFD and increased antioxidant potential in liver homogenates, while increasing inflammatory markers. Histological alterations were slightly improved by the intervention of compounds, and hyaluronic acid content of the liver without statistical significance as compared to HFD group.

Conclusion: These findings support the potential of these treatments in addressing liver oxidative stress, mitigating liver damage induced by a high-fat diet. This investigation sheds light on the oxidative stress dynamics and histological alterations associated with high-fat diet-induced liver injury, contributing to our understanding of potential therapeutic interventions.

背景和目的:高脂饮食(HFD)可通过氧化应激和炎症导致肝损伤。使用具有抗氧化和抗炎特性的天然化合物可以起到保护作用。我们旨在研究山茱萸(CM)和用山茱萸还原的金纳米粒子(GNPsCM)对高密度脂蛋白膳食诱导的大鼠肝脏改变的影响:将雌性 Sprague Dawley 大鼠随机分为四组:对照组、HFD 组、HFD +CM 组和 HFD + GNPsCM 组。高脂饮食持续 32 周,在高脂饮食期后的 4 周内服用 CM 和 GNPsCM。高脂饮食会诱发肝脏氧化应激,导致脂质过氧化、抗氧化能力下降、炎症和最小组织学改变:结果:服用中药和 GNPsCM 可减少高脂饮食引起的脂质过氧化反应,提高肝脏匀浆中的抗氧化能力,同时增加炎症指标。与高频分解膳食组相比,这些化合物的干预略微改善了肝脏的组织学改变和透明质酸含量,但无统计学意义:这些发现支持了这些疗法在解决肝脏氧化应激、减轻高脂饮食引起的肝损伤方面的潜力。这项研究揭示了与高脂饮食诱导的肝损伤相关的氧化应激动态和组织学改变,有助于我们了解潜在的治疗干预措施。
{"title":"Hepatic changes following a high-fat diet: effects of <i>Cornus mas</i> and gold nanoparticles phytoreduced with <i>Cornus mas</i> on oxidative stress, inflammation, and histological damage.","authors":"Dalina Diana Zugravu, Stefan Lucian Popa, Andrei-Vasile Pop, Remus Moldovan, Alexandru Flaviu Tăbăran, Luminita David, Simona Valeria Clichici","doi":"10.15386/mpr-2775","DOIUrl":"10.15386/mpr-2775","url":null,"abstract":"<p><strong>Background and aims: </strong>High fat diet (HFD) can lead to liver injury, through oxidative stress and inflammation. The use of natural compounds with antioxidant and anti-inflammatory properties can have a protective potential. We aimed to investigate the effects of <i>Cornus mas</i> (CM) and gold nanoparticles phytoreduced with CM (GNPsCM) on hepatic alterations induced by HFD in rats.</p><p><strong>Methods: </strong>Female Sprague Dawley rats were randomly divided into four groups: control, HFD, HFD +CM and HFD + GNPsCM. The high fat diet was administered for 32 weeks and CM and GNPsCM were administered for 4 weeks after the HFD period. The high fat diet induced oxidative stress in liver, with lipid peroxidation and decreased antioxidant capacity, inflammation and minimal histological alterations.</p><p><strong>Results: </strong>The administration of CM and GNPsCM reduced lipid peroxidation produced by HFD and increased antioxidant potential in liver homogenates, while increasing inflammatory markers. Histological alterations were slightly improved by the intervention of compounds, and hyaluronic acid content of the liver without statistical significance as compared to HFD group.</p><p><strong>Conclusion: </strong>These findings support the potential of these treatments in addressing liver oxidative stress, mitigating liver damage induced by a high-fat diet. This investigation sheds light on the oxidative stress dynamics and histological alterations associated with high-fat diet-induced liver injury, contributing to our understanding of potential therapeutic interventions.</p>","PeriodicalId":18438,"journal":{"name":"Medicine and Pharmacy Reports","volume":"97 3","pages":"318-329"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11370864/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142133106","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
Extra-digestive manifestations of celiac disease. 乳糜泻的消化道外表现。
Q2 Medicine Pub Date : 2024-07-01 Epub Date: 2024-07-30 DOI: 10.15386/mpr-2776
Andrei-Vasile Pop, Stefan-Lucian Popa, Dan L Dumitrascu

Introduction: Celiac disease (CD) is a chronic autoimmune disorder triggered by gluten ingestion in genetically predisposed individuals, presenting with a diverse range of symptoms that extend beyond the gastrointestinal tract. The condition's systemic nature is evidenced by its extra-digestive manifestations, which can affect various organs including the skin, joints, liver, and nervous system.

Methods: This descriptive, retrospective study was conducted at a tertiary care center, focusing on adult patients diagnosed with CD who exhibited extra-digestive symptoms. Data were extracted from medical records of patients admitted between January 1, 2010 and June 30, 2024. Variables included demographic information, primary diagnosis, and associated extra-digestive manifestations. Descriptive statistical methods were employed for data analysis.

Results: The sample included 108 patients with CD, the mean age was 43.21 years, with a predominance of females (76.85%). Iron deficiency anemia was the most common extra-digestive manifestation, affecting 20.37% of patients, followed by hypoproteinemia (18.52%) and Hashimoto's thyroiditis (14.81%). Co-occurrence analysis revealed frequent combinations of conditions, such as anemia with cardiovascular diseases and depressive disorders. Notable associations with neurological conditions like gluten ataxia and peripheral neuropathy were also observed.

Conclusion: This study highlights the extensive extra-digestive manifestations of celiac disease, underscoring its systemic impact. The high prevalence of autoimmune conditions such as Hashimoto's thyroiditis and rheumatoid polyarthritis among CD patients reflects the need for holistic management strategies. Discrepancies between our findings and existing literature, particularly regarding skin and neurological conditions, emphasize the need for further research to better understand these associations and the long-term effects of a gluten-free diet.

导言:乳糜泻(CD)是一种慢性自身免疫性疾病,由遗传易感人群摄入麸质引发,表现出胃肠道以外的多种症状。消化道以外的表现可影响皮肤、关节、肝脏和神经系统等多个器官,这证明了该病的全身性:这项描述性、回顾性研究是在一家三级医疗中心进行的,主要针对确诊为 CD 并表现出消化道外症状的成年患者。研究人员从 2010 年 1 月 1 日至 2024 年 6 月 30 日期间入院患者的病历中提取了数据。变量包括人口统计学信息、主要诊断和相关的消化道外表现。数据分析采用了描述性统计方法:样本包括 108 名 CD 患者,平均年龄为 43.21 岁,女性占多数(76.85%)。缺铁性贫血是最常见的消化道外表现,占 20.37%,其次是低蛋白血症(18.52%)和桥本氏甲状腺炎(14.81%)。共现分析显示,贫血与心血管疾病和抑郁障碍等疾病经常合并出现。此外,还观察到与麸质共济失调和周围神经病变等神经系统疾病的显著关联:本研究强调了乳糜泻在消化道外的广泛表现,突出了其对全身的影响。CD 患者中桥本氏甲状腺炎和类风湿多关节炎等自身免疫性疾病的发病率很高,这反映了采取综合管理策略的必要性。我们的研究结果与现有文献之间存在差异,尤其是在皮肤和神经系统疾病方面,这强调了进一步研究的必要性,以便更好地了解这些关联以及无麸质饮食的长期影响。
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引用次数: 0
Impact of assessing the emotional health status in the management of cancer patients. 评估情绪健康状况对癌症患者管理的影响。
Q2 Medicine Pub Date : 2024-07-01 Epub Date: 2024-07-30 DOI: 10.15386/mpr-2770
Liliana Policiuc, Cecilia Bica, Diana Gulei, Daniel Corneliu Leucuta, Ioana Berindan-Neagoe

Background and aims: This study explores the impact of emotional health on cancer patients, acknowledging the controversies and lack of high-quality data in the field, particularly for rare cancers and younger patients. It highlights the significant prevalence of depression and anxiety among cancer patients, the inadequacies in addressing mental health during and after treatment, and the inconsistencies in prevalence rates due to varying study methodologies. This study unravels the importance of data regarding mental health status in a clinical dataset to accompany the biological sample to be included in a biobank.

Methods: The study utilized a questionnaire to evaluate the opinions of cancer patients, clinicians, and researchers regarding the inclusion of mental health data in clinical datasets accompanying biological samples in biobanks. The study involved 120 participants (40 from each group), and the data were analyzed using statistical methods.

Results: The study found significant differences in the perceived importance of including mental health information among the three groups. Patients showed a higher tendency (87.9%) to consider mental health questions relevant compared to researchers (72.08%) and clinicians (62.08%). The first four questions regarding emotional well-being received the highest positive responses, particularly from patients (94.3%). The findings underline the importance of addressing the mental health of cancer patients, which is often overlooked. The study emphasizes the necessity for integrating mental health data in biobanks and increasing psychological support for cancer patients.

Conclusions: There are clear differences in how patients, researchers, and clinicians value emotional and psychological aspects. The study underscores the need for better education on modern medical practices and the benefits of comprehensive patient care, including mental health considerations.

背景和目的:本研究探讨了情绪健康对癌症患者的影响,承认该领域存在争议且缺乏高质量的数据,尤其是对罕见癌症和年轻患者而言。它强调了抑郁症和焦虑症在癌症患者中的显著患病率、在治疗期间和治疗后心理健康方面的不足,以及因研究方法不同而导致的患病率不一致。本研究揭示了心理健康状况数据在临床数据集中的重要性,这些数据将与生物样本一起纳入生物库:本研究采用问卷调查的方式,评估癌症患者、临床医生和研究人员对将心理健康数据纳入生物库生物样本的临床数据集的看法。研究涉及 120 名参与者(每组 40 人),数据采用统计方法进行分析:研究发现,三组参与者对纳入心理健康信息重要性的认知存在明显差异。与研究人员(72.08%)和临床医生(62.08%)相比,患者(87.9%)更倾向于认为心理健康问题具有相关性。有关情绪健康的前四个问题得到了最积极的回应,尤其是患者(94.3%)。研究结果凸显了解决癌症患者心理健康问题的重要性,而这一问题往往被忽视。研究强调,有必要将心理健康数据纳入生物库,并增加对癌症患者的心理支持:结论:患者、研究人员和临床医生对情感和心理方面的重视程度存在明显差异。这项研究强调,有必要更好地开展现代医疗实践教育,让患者了解全面护理的益处,包括心理健康方面的考虑。
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引用次数: 0
In vitro antimicrobial activity of silver nanoparticles against selected Gram-negative and Gram-positive pathogens. 银纳米粒子对某些革兰氏阴性和革兰氏阳性病原体的体外抗菌活性。
Q2 Medicine Pub Date : 2024-07-01 Epub Date: 2024-07-30 DOI: 10.15386/mpr-2750
Michaela Corina Crisan, Stanca Lucia Pandrea, Luminita Matros, Teodora Mocan, Lucian Mocan
<p><strong>Background and aim: </strong>Infections caused by pathogenic bacteria increase patient morbidity and mortality and significantly raise treatment costs. The use of silver nanoparticles as an alternative treatment for <i>S aureus, E coli, MRSA, E faecalis, K pneumoniae</i> and <i>P aeruginosa</i> indicates their antibacterial effect and prompts medical research to consider the next generation of antibacterial drugs that could change antibiotic therapy. By combining silver nanoparticles with different classes of antibiotics, the antibacterial effect is evidenced by increased values of the inhibition zone compared to the values obtained for some antibiotics commonly used in the treatment of bacterial infections. This study focuses on comparing the antibacterial activity of antibiotics versus antibiotics combined with silver nanoparticles against various bacteria, by comparing inhibition zones obtained for both. We aim to prove that the size of the inhibition zone for antibiotics combined with silver nanoparticles is greater, thus confirming the improved antibacterial effect.</p><p><strong>Metods: </strong>In this study we tested the antibacterial activity of solutions of silver nanoparticles alone or in combination with different antibiotics. We used standard bacterial strains, ATCC, both Gram positive bacteria <i>Staphylococcus aureus</i> ATCC 29213, <i>Enterococcus faecalis</i> ATCC 29212, as well as Gram negative bacteria <i>Escherichia coli</i> ATCC 25922, <i>Pseudomonas aeruginosa</i> ATCC 27853, but also on clinical isolates: a strain MRSA (<i>Methicillin Resistant Staphylococcus aureus</i>) and a PDR strain (pan drug resistant) of <i>Klebsiella pneumoniae</i>. Bacterial identification was performed using Vitek MS analyzer (bioMerieux). Antibiotic susceptibility determination was performed with VITEK2 COMPACT SYSTEM (bio Merieux, Inc Durham NC) with ready to use VITEK AST cards. The interpretation of the results was done in compliance with EUCAST 2023-2024 standards. Testing was performed for several classes of antibiotics, silver nanoparticle solutions in 2 concentrations (10 μg/mL and 100 μg/mL) and for combinations of antibiotics with silver nanoparticle solutions. The diameter of the inhibition zone (ZOI) for silver nanoparticles, antibiotics and silver nanoparticles combined with antibiotic against each bacterium was expressed in millimeters. The Kirby-Bauer disk-diffusion method, in accordance with current EUCAST standards, was used to analyze the antibacterial effect of antibiotics, silver nanoparticles, and antibiotics combined with silver nanoparticles at biocompatible doses of 10 and 100 μg/mL. The experiments were conducted in triplicate, and the results were almost identical.</p><p><strong>Results: </strong>The results of this study show that the silver nanoparticles displayed antibacterial activity, proven by the appearance of the inhibition zone, in various sizes, for all bacteria studied. The antibiotic classes tested
背景和目的:病原菌引起的感染会增加患者的发病率和死亡率,并大幅提高治疗成本。使用银纳米粒子作为金黄色葡萄球菌、大肠杆菌、MRSA、粪大肠杆菌、肺炎双球菌和铜绿假单胞菌的替代治疗方法,表明了其抗菌效果,并促使医学研究考虑下一代抗菌药物,从而改变抗生素疗法。通过将纳米银粒子与不同种类的抗生素相结合,与治疗细菌感染常用的一些抗生素相比,纳米银粒子的抑菌区值增大,从而证明了其抗菌效果。本研究的重点是通过比较抗生素和抗生素与纳米银粒子的抑菌区,比较两者对各种细菌的抗菌活性。我们的目的是证明抗生素与纳米银粒子结合后的抑菌区更大,从而证实其抗菌效果更好:在这项研究中,我们测试了银纳米粒子溶液单独或与不同抗生素结合的抗菌活性。我们使用了 ATCC 标准细菌菌株,包括革兰氏阳性菌金黄色葡萄球菌 ATCC 29213 和粪肠球菌 ATCC 29212,以及革兰氏阴性菌大肠埃希菌 ATCC 25922 和铜绿假单胞菌 ATCC 27853,还使用了临床分离菌株:耐甲氧西林金黄色葡萄球菌 MRSA 菌株和肺炎克雷伯菌 PDR 菌株(泛耐药菌)。细菌鉴定使用 Vitek MS 分析仪(生物梅里埃)进行。抗生素敏感性测定使用 VITEK2 COMPACT 系统(bio Merieux, Inc Durham NC)和即用型 VITEK AST 卡进行。检测结果的解释符合 EUCAST 2023-2024 标准。测试对象包括几类抗生素、两种浓度的纳米银溶液(10 μg/mL 和 100 μg/mL)以及抗生素与纳米银溶液的组合。银纳米粒子、抗生素以及银纳米粒子与抗生素的组合对每种细菌的抑菌区直径(ZOI)以毫米为单位。根据现行的欧盟标准,采用柯比-鲍尔盘扩散法分析抗生素、纳米银微粒以及抗生素与纳米银微粒复配在生物相容性剂量为 10 和 100 μg/mL 时的抗菌效果。实验一式三份,结果基本一致:研究结果表明,银纳米粒子具有抗菌活性,对所有研究细菌都有不同大小的抑制区。测试的抗生素种类包括:β-内酰胺类,第一、第二、第三和第四代头孢菌素类,大环内酯类,氟喹诺酮类,林可酰胺类,氨基糖苷类,糖肽类,四环素类,噁唑烷酮类,磺胺类,利福霉素类,安非他酮类。在检测金黄色葡萄球菌 ATCC 29213 时,头孢菌素类(32.6667 ± 0.701 毫米)、大环内酯类(31.6667 ± 0.701 毫米)和林可霉素类(29.6667 ± 0.701 毫米)的抑菌区最大。在检测 MRSA(内部代码 GR0333)时,氟喹诺酮类(36.3333 ± 0.701 毫米)、林可酰胺类(32.3333 ± 0.701 毫米)、夫西地酸(32.3333 ± 0.701 毫米)和氨基糖苷类(31.3333 ± 0.701 毫米)的银纳米颗粒与抗生素的组合抑制区最大。在检测大肠杆菌 ATCC 25922 时,福斯明的抑菌区最大,为 39 毫米;在检测粪肠杆菌 ATCC 29212 时,氨基糖苷的抑菌区为 19 毫米。对于肺炎双球菌(内部代码 GQ8575),银纳米粒子 100 μg/mL 的抑制区为 12.3333 ± 0.701 毫米,对于铜绿假单胞菌 ATCC 27253 的抑制区为 16 ± 1.214 毫米:使用金属纳米粒子,尤其是银纳米粒子作为具有明确杀菌活性的抗菌剂,促使医学专家考虑采用这种可能改变抗菌疗法的新疗法。对纳米银粒子与不同种类抗生素的体外组合研究表明,这是一种高效、有效的新型抗菌疗法,可用于抗击耐多药细菌。为了避免与传统抗生素相关的抗菌药耐药性问题,有必要了解细菌在金属纳米粒子作用下的适应机制,以便在今后的研究中加以利用。进一步的体外和体内研究将明确评估银纳米粒子的生物相容性和毒性,这将使这些超级纳米材料成为未来的药物。
{"title":"<i>In vitro</i> antimicrobial activity of silver nanoparticles against selected Gram-negative and Gram-positive pathogens.","authors":"Michaela Corina Crisan, Stanca Lucia Pandrea, Luminita Matros, Teodora Mocan, Lucian Mocan","doi":"10.15386/mpr-2750","DOIUrl":"10.15386/mpr-2750","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background and aim: &lt;/strong&gt;Infections caused by pathogenic bacteria increase patient morbidity and mortality and significantly raise treatment costs. The use of silver nanoparticles as an alternative treatment for &lt;i&gt;S aureus, E coli, MRSA, E faecalis, K pneumoniae&lt;/i&gt; and &lt;i&gt;P aeruginosa&lt;/i&gt; indicates their antibacterial effect and prompts medical research to consider the next generation of antibacterial drugs that could change antibiotic therapy. By combining silver nanoparticles with different classes of antibiotics, the antibacterial effect is evidenced by increased values of the inhibition zone compared to the values obtained for some antibiotics commonly used in the treatment of bacterial infections. This study focuses on comparing the antibacterial activity of antibiotics versus antibiotics combined with silver nanoparticles against various bacteria, by comparing inhibition zones obtained for both. We aim to prove that the size of the inhibition zone for antibiotics combined with silver nanoparticles is greater, thus confirming the improved antibacterial effect.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Metods: &lt;/strong&gt;In this study we tested the antibacterial activity of solutions of silver nanoparticles alone or in combination with different antibiotics. We used standard bacterial strains, ATCC, both Gram positive bacteria &lt;i&gt;Staphylococcus aureus&lt;/i&gt; ATCC 29213, &lt;i&gt;Enterococcus faecalis&lt;/i&gt; ATCC 29212, as well as Gram negative bacteria &lt;i&gt;Escherichia coli&lt;/i&gt; ATCC 25922, &lt;i&gt;Pseudomonas aeruginosa&lt;/i&gt; ATCC 27853, but also on clinical isolates: a strain MRSA (&lt;i&gt;Methicillin Resistant Staphylococcus aureus&lt;/i&gt;) and a PDR strain (pan drug resistant) of &lt;i&gt;Klebsiella pneumoniae&lt;/i&gt;. Bacterial identification was performed using Vitek MS analyzer (bioMerieux). Antibiotic susceptibility determination was performed with VITEK2 COMPACT SYSTEM (bio Merieux, Inc Durham NC) with ready to use VITEK AST cards. The interpretation of the results was done in compliance with EUCAST 2023-2024 standards. Testing was performed for several classes of antibiotics, silver nanoparticle solutions in 2 concentrations (10 μg/mL and 100 μg/mL) and for combinations of antibiotics with silver nanoparticle solutions. The diameter of the inhibition zone (ZOI) for silver nanoparticles, antibiotics and silver nanoparticles combined with antibiotic against each bacterium was expressed in millimeters. The Kirby-Bauer disk-diffusion method, in accordance with current EUCAST standards, was used to analyze the antibacterial effect of antibiotics, silver nanoparticles, and antibiotics combined with silver nanoparticles at biocompatible doses of 10 and 100 μg/mL. The experiments were conducted in triplicate, and the results were almost identical.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The results of this study show that the silver nanoparticles displayed antibacterial activity, proven by the appearance of the inhibition zone, in various sizes, for all bacteria studied. The antibiotic classes tested ","PeriodicalId":18438,"journal":{"name":"Medicine and Pharmacy Reports","volume":"97 3","pages":"280-297"},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11370865/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142133104","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
Periodontal changes induced by fixed orthodontic therapy. 固定正畸疗法引起的牙周变化。
Q2 Medicine Pub Date : 2024-07-01 Epub Date: 2024-07-30 DOI: 10.15386/mpr-2725
Alina Cristina Rădeanu, Mihai Surpăţeanu, Cristina Maria Munteanu, Ilona Mihaela Liliac, Alexandru Dan Popescu, Elena Cristina Andrei, Ciprian Laurenţiu Pătru
<p><strong>Background: </strong>Orthodontic therapy is a complex process involving a series of specialists in the dental field: the oral-maxillo-facial surgeon, the periodontologist, sometimes even the prosthetist, implantologist, or general practitioners. The injuries of the oral mucosa induced by orthodontic therapy include gingival overgrowths, traumatic lesions of the oral mucosa, different degrees of periodontal damage manifested by gingival retraction, alveolar bone resorption.</p><p><strong>Methods: </strong>From a total of 327 subjects who came to the Dental Clinic in Craiova 74 subjects were selected, who presented with gingival overgrowth associated with fixed orthodontic therapy. Subjects' age ranged from 14 to 56 years and experienced bleeding and gingival discomfort as well as alterations in physiognomic function. None of the patients included in the study have systemic diseases and are not under medical treatment. The clinical and statistical study took place between May 2022 and December 2023. Each patient was given a personal record containing personal data as well as oral and systemic health status. The examination of the periodontal status aimed at the evaluation of the following indices: assessment of oral hygiene using the OHI-S index and the O'Leary plaque index, assessment of superficial periodontal status using the Löe/Silness gingival inflammation index, periodontometry was performed in order to determine the depth of periodontal pockets, the level of gingival insertion, and the McGaw gingival overgrowth index. OHI-S index comprises two elements: the Debris Index and the Calculus Index. The purpose of our study is to present the incidence of cases of gingival overgrowth induced by fixed orthodontic therapy and to highlight how certain irritating factors can exacerbate the symptoms of gingival overgrowth of orthodontic etiology.</p><p><strong>Results: </strong>The majority of patients were female, aged between 30 and 55 years. Most clinically examined patients have presented with Grade II gingival hyperplasia. Factors that have exacerbated the symptoms of orthodontically induced gingival overgrowth include: incorrectly adapted prosthetic restorations, unpolished massive coronal fillings, root remnants, bacterial plaque, and tartar. Clinical examination of the oral cavity revealed the presence of gingival inflammation (localized or generalized), simple or complicated, treated and untreated odontal lesions, and coronal fillings made of light-curing composite material of significant size, being unfinished and unpolished, sometimes with sharp edges directly injuring the adjacent gingival mucosa, marginally incorrectly adapted prosthetic works. In the case of child and adolescent patients, significant amounts of bacterial plaque and tartar buildup were observed. In most of the cases examined, it was observed that the gingival overgrowth had a firm consistency, pinkish-reddish colour and gingival bleeding was evident during probi
背景:正畸治疗是一个复杂的过程,涉及牙科领域的一系列专家:口腔颌面外科医生、牙周病学家,有时甚至包括修复学家、种植学家或全科医生。正畸治疗引起的口腔黏膜损伤包括牙龈增生、口腔黏膜创伤性病变、不同程度的牙周损伤,表现为牙龈退缩、牙槽骨吸收:从前来克拉约瓦牙科诊所就诊的 327 名受试者中挑选出 74 名牙龈增生并伴有固定正畸治疗的受试者。受试者的年龄从 14 岁到 56 岁不等,均有出血、牙龈不适以及生理功能改变等症状。研究对象中没有人患有系统性疾病,也没有接受治疗。临床和统计研究在 2022 年 5 月至 2023 年 12 月期间进行。每位患者都有一份个人档案,其中包含个人数据以及口腔和全身健康状况。牙周状况检查的目的是评估以下指数:使用 OHI-S 指数和 O'Leary 牙菌斑指数评估口腔卫生状况;使用 Löe/Silness 牙龈炎症指数评估表层牙周状况;进行牙周测量以确定牙周袋深度、牙龈嵌入程度和 McGaw 牙龈增生指数。OHI-S指数包括两个要素:碎屑指数和结石指数。我们研究的目的是介绍固定正畸治疗诱发牙龈增生病例的发病率,并强调某些刺激性因素会如何加重正畸引起的牙龈增生症状:大多数患者为女性,年龄在 30 至 55 岁之间。经临床检查,大多数患者都有二级牙龈增生。导致正畸引起的牙龈增生症状加重的因素包括:不正确的修复体、未抛光的大量冠状填充物、残根、细菌菌斑和牙石。口腔临床检查显示,存在牙龈炎症(局部或全身)、单纯或复杂、治疗过或未治疗过的牙周病损,以及由光固化复合材料制成的大量冠状填充物,这些填充物未经加工和抛光,有时边缘锋利,直接损伤邻近的牙龈粘膜,修复体的调整也不正确。在儿童和青少年患者的病例中,可以观察到大量的细菌菌斑和牙石堆积。在大多数受检病例中,我们观察到牙龈增生呈坚硬状,颜色呈粉红色,探查时牙龈出血明显:结论:正畸导致的牙龈增生会引起一系列重要的牙周变化。值得注意的是,在所研究的大多数病例中,固定正畸治疗引起的牙龈增生与加重其严重程度的有利因素同时存在。在我们的研究中,有利因素包括细菌性牙菌斑和牙结石堆积、边缘锋利的牙周病损、边缘不合适的修复体或大量未完成的牙冠充填。因此,去除这些致病因素不仅有助于改善症状,还能扭转炎症现象。
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引用次数: 0
Therapeutic challenges in temporomandibular disorders. 颞下颌关节紊乱症的治疗难题。
Q2 Medicine Pub Date : 2024-07-01 Epub Date: 2024-07-30 DOI: 10.15386/mpr-2687
Smaranda Buduru, Oana Almăşan, Daniela Condor, Manuela Tăut, Anca Mesaroş, Manuela Manziuc, Andreea Kui

Background and aims: This study aimed at evaluating the etiology and treatment challenges of temporomandibular disorders (TMDs).

Methods: 160 subjects with TMDs, 38 males (23.8%) and 122 females (76.3%) were studied. A personalized coefficient was designated, which included the resolution of the main symptom, correction of secondary symptoms, patient collaboration (emotional parameter), treatment duration, and cost.

Results: The most frequent cause for consultation was muscle impairment (42.5%), or limitation of mouth opening, followed by joint impairment (23.1%). Muscle pain was noticed, particularly in the masseter (57.5%) and lateral pterygoid muscles (51.9%). Tooth pain or gingival retraction was frequently associated with tooth wear (48.1%) and dental abfraction (31.3%). Remote symptomatology was dominated by otologic symptomatology. Iatrogenic etiology was highest (69.4%), followed by untreated missing teeth (66.9%). Treatment options included muscle relaxation, occlusal balancing (equilibration), kinesitherapy, medication, and swallowing re-education. Most patients benefited from four to seven different types of therapy, which resulted in a higher cost and a longer and more uncomfortable treatment. The primary symptom was relieved in 82.3% of cases, with recurrence occurring in 15.7%.

Conclusion: The treatment of temporomandibular joint dysfunction is time-consuming, demanding, and intricate. Most patients required four to seven different types of therapy, which increased the expense, treatment duration, and suffering.

背景与目的本研究旨在评估颞下颌关节紊乱症(TMDs)的病因和治疗难题。方法:研究对象为160名TMDs患者,其中男性38名(23.8%),女性122名(76.3%)。指定了一个个性化系数,其中包括主要症状的缓解、次要症状的纠正、患者合作(情感参数)、治疗时间和费用:最常见的就诊原因是肌肉损伤(42.5%)或张口受限,其次是关节损伤(23.1%)。人们注意到肌肉疼痛,尤其是肌肉肿块(57.5%)和翼外侧肌肉(51.9%)。牙齿疼痛或牙龈萎缩通常与牙齿磨损(48.1%)和牙齿折叠(31.3%)有关。远期症状以耳科症状为主。先天性病因最多(69.4%),其次是未经治疗的缺牙(66.9%)。治疗方法包括肌肉放松、咬合平衡(平衡)、运动疗法、药物治疗和吞咽再教育。大多数患者都从四到七种不同的疗法中获益,这导致了较高的费用以及较长和较不舒适的治疗时间。82.3%的病例主要症状得到缓解,15.7%的病例复发:结论:颞下颌关节功能障碍的治疗耗时长、要求高且复杂。大多数患者需要四到七种不同的治疗方法,这增加了费用、治疗时间和痛苦。
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