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Health issues caused by of eating disorders 饮食失调引起的健康问题
Pub Date : 2023-11-23 DOI: 10.53453/ms.2023.11.4
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引用次数: 0
Case of hepatic alveolar echinococcosis 肝泡棘球蚴病病例
Pub Date : 2023-11-23 DOI: 10.53453/ms.2023.11.6
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引用次数: 0
Borderline personality disorder differential diagnosis copy 边缘型人格障碍鉴别诊断副本
Pub Date : 2023-11-23 DOI: 10.53453/ms.2023.11.5
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引用次数: 0
Primary Orbital Myxoid Liposarcoma 原发性眼眶黏液样脂肪肉瘤
Pub Date : 2023-11-08 DOI: 10.3390/medsci11040072
Miguel Armando Benavides-Huerto, Lourdes Páramo-Figueroa, Daniel Moreno-Páramo, Francisco Alejandro Lagunas-Rangel
Although liposarcoma is the most prevalent soft tissue sarcoma in adults, head and neck liposarcomas are rare and account for less than 5% of all liposarcomas. The primary orbital location is even more exceptional, with fewer than 100 cases documented in the medical literature. Given the scarcity of cases of orbital liposarcoma and the limited familiarity of physicians and pathologists with this pathology, there is an increased risk of non-diagnosis or misdiagnosis, which may lead to inappropriate patient management. To address these challenges, we present a case of primary orbital myxoid liposarcoma and subsequently discuss the primary findings of this case based on the evidence documented in the medical literature. This comprehensive text is designed to serve as a valuable resource for healthcare professionals and pathologists, with the goal of promoting both clinical suspicion and accurate diagnosis and treatment of this rare condition in future cases.
虽然脂肪肉瘤是成人中最常见的软组织肉瘤,但头颈部脂肪肉瘤很少见,占所有脂肪肉瘤的不到5%。原发眼眶位置更为特殊,在医学文献中记录的病例不到100例。由于眼窝脂肪肉瘤病例的稀少以及医生和病理学家对这种病理的熟悉程度有限,因此未诊断或误诊的风险增加,这可能导致患者管理不当。为了解决这些挑战,我们提出了一例原发性眼眶黏液样脂肪肉瘤,并随后根据医学文献中的证据讨论了该病例的主要发现。这个全面的文本旨在作为一个宝贵的资源,为医疗保健专业人员和病理学家,以促进临床怀疑和准确的诊断和治疗这种罕见的情况下,在未来的情况下的目标。
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引用次数: 0
Occupational Therapy Interventions in Patients with Frontotemporal Dementia: A Systematic Review 额颞叶痴呆患者的职业治疗干预:一项系统综述
Pub Date : 2023-11-06 DOI: 10.3390/medsci11040071
Pinelopi Vlotinou, Anna Tsiakiri, Georgia Detsaridou, Alexandrina Nikova, Dimitrios Tsiptsios, Konstantinos Vadikolias, Nikolaos Aggelousis
Frontotemporal dementia (FTD) is a neurodegenerative disorder characterized by progressive impairments in behavior, executive function, and language, primarily affecting individuals under the age of 65. This disorder is associated with expressive and receptive anomia, word comprehension deficits, and behavioral symptoms such as apathy, loss of empathy, and disinhibition, all of which closely correlate with functional impairment in daily activities. Despite substantial efforts, research on occupational therapy (OT) interventions has yet to demonstrate clear benefits in managing the disease. The aim of this study is to investigate OT interventions and assess their efficacy, with a specific focus on individuals suffering from FTD. We systematically conducted searches on two databases, namely Medline and Science Direct, spanning a ten-year period from 2003 to 2023, in accordance with the PRISMA guidelines. Eleven studies met the inclusion criteria. OT interventions targeted both patients and caregivers and yielded significant positive improvements in their lives. A key focus of these interventions was to teach acceptable alternatives to the behaviors exhibited by FTD patients, as these behaviors are strongly influenced by the disease itself. OT contributes positively to enhancing the quality of life of FTD patients and alleviating the caregiving burden experienced by those providing long-term care to these patients.
额颞叶痴呆(FTD)是一种以行为、执行功能和语言的进行性损伤为特征的神经退行性疾病,主要影响65岁以下的个体。这种障碍与表达性和接受性失范、文字理解缺陷以及行为症状(如冷漠、移情丧失和去抑制)相关,所有这些都与日常活动中的功能障碍密切相关。尽管付出了巨大的努力,但对职业治疗(OT)干预的研究尚未证明在控制疾病方面有明显的益处。本研究的目的是研究OT干预措施并评估其疗效,并特别关注患有FTD的个体。根据PRISMA指南,我们系统地对Medline和Science Direct两个数据库进行了检索,时间跨度为2003年至2023年的10年。11项研究符合纳入标准。OT干预针对患者和护理人员,并对他们的生活产生了显著的积极改善。这些干预措施的一个关键重点是教导FTD患者表现出的可接受的替代行为,因为这些行为受到疾病本身的强烈影响。OT对提高FTD患者的生活质量和减轻长期照护者的护理负担有积极的作用。
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引用次数: 0
Alveolar Hyperoxia and Exacerbation of Lung Injury in Critically Ill SARS-CoV-2 Pneumonia 重症SARS-CoV-2肺炎患者肺泡高氧与肺损伤加重
Pub Date : 2023-11-01 DOI: 10.3390/medsci11040070
Ahilanandan Dushianthan, Luke Bracegirdle, Rebecca Cusack, Andrew F. Cumpstey, Anthony D. Postle, Michael P. W. Grocott
Acute hypoxic respiratory failure (AHRF) is a prominent feature of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) critical illness. The severity of gas exchange impairment correlates with worse prognosis, and AHRF requiring mechanical ventilation is associated with substantial mortality. Persistent impaired gas exchange leading to hypoxemia often warrants the prolonged administration of a high fraction of inspired oxygen (FiO2). In SARS-CoV-2 AHRF, systemic vasculopathy with lung microthrombosis and microangiopathy further exacerbates poor gas exchange due to alveolar inflammation and oedema. Capillary congestion with microthrombosis is a common autopsy finding in the lungs of patients who die with coronavirus disease 2019 (COVID-19)-associated acute respiratory distress syndrome. The need for a high FiO2 to normalise arterial hypoxemia and tissue hypoxia can result in alveolar hyperoxia. This in turn can lead to local alveolar oxidative stress with associated inflammation, alveolar epithelial cell apoptosis, surfactant dysfunction, pulmonary vascular abnormalities, resorption atelectasis, and impairment of innate immunity predisposing to secondary bacterial infections. While oxygen is a life-saving treatment, alveolar hyperoxia may exacerbate pre-existing lung injury. In this review, we provide a summary of oxygen toxicity mechanisms, evaluating the consequences of alveolar hyperoxia in COVID-19 and propose established and potential exploratory treatment pathways to minimise alveolar hyperoxia.
急性缺氧性呼吸衰竭(Acute respiratory failure, AHRF)是严重急性呼吸综合征冠状病毒2型(SARS-CoV-2)重症的一个突出特征。气体交换损伤的严重程度与较差的预后相关,需要机械通气的AHRF与大量死亡率相关。持续的气体交换受损导致低氧血症通常需要长时间给予高分数的吸入氧(FiO2)。在SARS-CoV-2 AHRF中,全身血管病变伴肺微血栓形成和微血管病变进一步加剧了肺泡炎症和水肿引起的气体交换不良。毛细血管充血伴微血栓形成是死于2019冠状病毒病(COVID-19)相关急性呼吸窘迫综合征的患者肺部常见的尸检结果。需要高FiO2才能使动脉低氧血症和组织缺氧正常化,这可能导致肺泡高氧。这反过来又会导致局部肺泡氧化应激并伴有炎症、肺泡上皮细胞凋亡、表面活性剂功能障碍、肺血管异常、吸收不张和先天免疫损伤,易发生继发性细菌感染。虽然氧气是一种挽救生命的治疗方法,但肺泡高氧可能会加剧原有的肺损伤。在这篇综述中,我们总结了氧毒性机制,评估了COVID-19中肺泡高氧的后果,并提出了已建立的和潜在的探索性治疗途径,以尽量减少肺泡高氧。
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引用次数: 0
Major Adverse Cardiac and Cerebrovascular Events in Geriatric Patients with Obstructive Sleep Apnea: An Inpatient Sample Analysis 老年阻塞性睡眠呼吸暂停患者的主要不良心脑血管事件:住院患者样本分析
Pub Date : 2023-10-30 DOI: 10.3390/medsci11040069
Rupak Desai, Sai Priyanka Mellacheruvu, Sai Anusha Akella, Adil Sarvar Mohammed, Pakhal Saketha, Abdul Aziz Mohammed, Mushfequa Hussain, Aamani Bavanasi, Jyotsna Gummadi, Praveena Sunkara
Background: Obstructive sleep apnea (OSA) is associated with an increased risk of major cardiac and cerebrovascular events (MACCE). However, data on the burden and predictors of MACCE in geriatric patients with OSA (G-OSA) remain limited. Methods: Using the National Inpatient Sample from 2018, we identified G-OSA admissions (age ≥ 65 years) and divided them into non-MACCE vs. MACCE (all-cause mortality, stroke, acute myocardial infarction, and cardiac arrest). We compared the demographics and comorbidities in both cohorts and extracted the odds ratio (multivariate analysis) of MACCE and associated in-hospital mortality. Results: Out of 1,141,120 geriatric obstructive sleep apnea G-OSA admissions, 9.9% (113,295) had MACCE. Males, Asians, or the Pacific Islander/Native American race, and patients from the lowest income quartile revealed a higher MACCE rate. Significant clinical predictors of MACCE in elderly OSA patients on multivariable regression analysis in decreasing odds were pulmonary circulation disease (OR 1.47, 95% CI 1.31–1.66), coagulopathy (OR 1.43, 95% CI 1.35–1.50), peripheral vascular disease (OR 1.34, 95% CI 1.28–1.40), prior sudden cardiac arrest (OR 1.34, 95% CI 1.11–1.62), prior myocardial infarction (OR 1.27, 95% CI 1.22–1.33), fluid and electrolyte imbalances (OR 1.25, 95% CI 1.20–1.29), male sex (OR 1.22, 95% CI-1.18–1.26), hyperlipidemia (OR 1.20, 95% CI 1.16–1.24), low household income (OR 1.19, CI 1.13–1.26), renal failure (OR 1.15, 95% CI 1.12–1.19), diabetes (OR 1.14, 95% CI 1.10–1.17), metastatic cancer (OR 1.14, 95% CI 1.03–1.25), and prior stroke or TIA (OR 1.12, 95% CI 1.07–1.17) (All p value < 0.05). Conclusions: This study emphasizes the significant association between obstructive sleep apnea (OSA) and major cardiac and cerebrovascular events (MACCE) in the geriatric population. Among the elderly OSA patients, a substantial 9.9% were found to have MACCE, with specific demographics like males, Asian or Pacific Islander/Native American individuals, and those from the lowest income quartile being particularly vulnerable. The study sheds light on several significant clinical predictors, with pulmonary circulation disease, coagulopathy, and peripheral vascular disease topping the list. The highlighted predictors provide valuable insights for clinicians, allowing for better risk stratification and targeted interventions in this vulnerable patient cohort. Further research is essential to validate these findings and inform how tailored therapeutic approaches for geriatric OSA patients can mitigate MACCE risk. Clinical Implications: Elderly individuals with a high risk for MACCE should undergo routine OSA screening using tools like the sensitive STOP-BANG Questionnaire. Implementing CPAP treatment can enhance cardiovascular outcomes in these patients.
背景:阻塞性睡眠呼吸暂停(OSA)与主要心脑血管事件(MACCE)的风险增加有关。然而,关于老年OSA (G-OSA)患者MACCE负担和预测因素的数据仍然有限。方法:使用2018年的全国住院患者样本,我们确定了G-OSA入院患者(年龄≥65岁),并将其分为非MACCE和MACCE(全因死亡率、卒中、急性心肌梗死和心脏骤停)。我们比较了两个队列的人口统计学和合并症,并提取了MACCE和相关住院死亡率的优势比(多变量分析)。结果:在1,141,120例入院的老年阻塞性睡眠呼吸暂停G-OSA患者中,9.9%(113,295)患有MACCE。男性、亚洲人、太平洋岛民/美洲原住民以及收入最低的四分之一的患者显示出较高的MACCE率。多变量回归分析显示,老年OSA患者MACCE的显著临床预测因子为肺循环疾病(OR 1.47, 95% CI 1.31-1.66)、凝血功能障碍(OR 1.43, 95% CI 1.35-1.50)、周围血管疾病(OR 1.34, 95% CI 1.28-1.40)、既往心脏骤停(OR 1.34, 95% CI 1.11-1.62)、既往心肌梗死(OR 1.27, 95% CI 1.22 - 1.33)、体液和电解质失衡(OR 1.25, 95% CI 1.20-1.29)、男性(OR 1.22, 95% CI-1.18 - 1.26)、高脂血症(OR 1.20, 95% CI 1.16-1.24)、家庭收入低(OR 1.19, CI 1.13-1.26)、肾功能衰竭(OR 1.15, 95% CI 1.12 - 1.19)、糖尿病(OR 1.14, 95% CI 1.10-1.17)、转移性癌症(OR 1.14, 95% CI 1.03-1.25)、既往卒中或TIA (OR 1.12, 95% CI 1.07-1.17)(均p值<0.05)。结论:本研究强调了阻塞性睡眠呼吸暂停(OSA)与老年人群主要心脑血管事件(MACCE)之间的显著关联。在老年OSA患者中,高达9.9%的人被发现患有MACCE,其中有特定的人口统计数据,如男性,亚洲或太平洋岛民/美洲原住民,以及收入最低的四分之一的人特别容易受到伤害。这项研究揭示了几个重要的临床预测因素,其中肺循环疾病、凝血功能障碍和周围血管疾病高居榜首。突出显示的预测因子为临床医生提供了有价值的见解,允许在这一弱势患者队列中进行更好的风险分层和有针对性的干预。进一步的研究是必要的,以验证这些发现,并为老年OSA患者量身定制的治疗方法如何降低MACCE风险提供信息。临床意义:MACCE高风险的老年人应使用敏感的STOP-BANG问卷等工具进行常规OSA筛查。实施CPAP治疗可以改善这些患者的心血管预后。
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引用次数: 0
Epidemiological Profile of Ophir Loyola Cancer Hospital: A Snapshot of the Incidence of Solid Neoplasms in the Eastern Amazon Ophir Loyola肿瘤医院的流行病学概况:东亚马逊地区实体肿瘤发病率的快照
Pub Date : 2023-10-27 DOI: 10.3390/medsci11040068
Juliana Ramos Chaves, Mateus Itiro Tamazawskas Otake, Diego Di Felipe Ávila Alcantara, Rosilene Silva Lima, Ana Paula Borges de Souza, Janaina Silva da Costa Rodrigues, Margareth Maria Braun Guimarães Imbiriba, Rommel Mario Rodriguez Burbano
Background: Solid neoplasms have a heterogeneous incidence worldwide and in Brazil. Thus, the region delimited by the Legal Amazon has a distinct epidemiological profile. In Pará, Ophir Loyola Cancer Hospital(OLCH) accounts for 71.11% of hospital visits in the state. Methods: This was an ecological, exploratory, and mixed descriptive studythat investigated the epidemiological profile of patients with cancer treated at OLCH from January to December 2020. Sociodemographic data at admission were the primary variables, which were analyzed according to spatial distribution. Results: In this study, the data of 2952 patients were analyzed, with the majority being between the ages of 50 and 79 years (62.47%), female (59.49%), and diagnosed but without previous treatment (87.30%). The most common cancers were breast (16.50%), cervical (13.40%), stomach (8.98%), and prostate (7.72%). Of the 12 integration regions, Guajará had the highest number of referrals (49.86%), followed by Guamá (12.94%) and Caeté River (8.98%). Conclusion: The profile of care at OLCH showed a high incidence of solid malignancies compared to that in other regions of Brazil, indicating environmental and sociocultural influences on the carcinogenic profile present in the eastern Amazon.
背景:实体瘤在世界范围和巴西有不同的发病率。因此,法定亚马逊河所划定的区域具有独特的流行病学特征。在parar, Ophir Loyola癌症医院(OLCH)占该州医院就诊人数的71.11%。方法:这是一项生态、探索性和混合描述性研究,调查了2020年1月至12月在OLCH接受治疗的癌症患者的流行病学概况。入院时社会人口学数据为主要变量,按空间分布进行分析。结果:本研究共分析2952例患者的资料,其中年龄在50 ~ 79岁之间的占62.47%,女性占59.49%,确诊但未治疗的占87.30%。最常见的癌症是乳腺癌(16.50%)、宫颈癌(13.40%)、胃癌(8.98%)和前列腺癌(7.72%)。在12个整合区中,转诊人数最多的是瓜哈尔(49.86%),其次是瓜阿姆(12.94%)和caet河(8.98%)。结论:与巴西其他地区相比,OLCH的护理概况显示实体恶性肿瘤的发病率较高,这表明环境和社会文化对亚马逊东部地区的致癌概况有影响。
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引用次数: 0
Thiamine deficiency among intensive care unit patients - literature review 重症监护病房患者的硫胺素缺乏症-文献综述
Pub Date : 2023-06-26 DOI: 10.53453/ms.2023.6.6
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引用次数: 0
Recent diagnostic and treatment options for immunoglobulin A nephropathy - literature review 免疫球蛋白A肾病的最新诊断和治疗方案-文献综述
Pub Date : 2023-06-26 DOI: 10.53453/ms.2023.6.2
{"title":"Recent diagnostic and treatment options for immunoglobulin A nephropathy - literature review","authors":"","doi":"10.53453/ms.2023.6.2","DOIUrl":"https://doi.org/10.53453/ms.2023.6.2","url":null,"abstract":"","PeriodicalId":18539,"journal":{"name":"Medical Sciences","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73011094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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