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Cytokine profile in critically ill and/or injured patients with secondary sepsis - influence of different pathogens 继发脓毒症的危重病人和/或受伤病人的细胞因子谱——不同病原体的影响
4区 医学 Q4 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-01-01 DOI: 10.2298/vsp230105054d
Snezana Djukic, Aleksandar Pavlovic, Aleksandra Ilic, Aleksandar Bozovic, Gojko Igrutinovic, Miljana Nikolic, Mirjana Vujacic, Ivan Stanojevic
Background/Aim. The role of the complex sepsis-related immune response has not been fully clarified, and still remains a subject matter of investigations. Nowadays, sepsis is considered a dynamic syndrome characterised by many, often antagonistic, phenomena from hyperinflammation to anergy, or immunoparalysis. On the basis of pro- and anti-inflammatory mediators in the critically ill with sepsis, the aim of the study was to determine whether the cytokine profile differs according to the type of bacterial causative agent, as well as to assess the prognostic value regarding the outcome. The outcome measure has been hospital mortality. Methods. Blood serum samples have been taken from 125 critically ill patients with severe secondary sepsis as a consequence of peritonitis, pancreatitis, or trauma, who had been admitted to the surgical intensive care unit (SICU). The average age of the patients was 57.7?17.3. Of the total number of patients, 84 (67,2%) were males, and 41 (32,8%) were females. The levels of pro-inflammatory ? interleukin 1-alpha (IL-1?), IL-1?, IL-6, IL-8, IL-12?70, IL-17?, tumor necrosis factor alpha (TNF?), interferon-gamma (IFN-?), interferon-gamma-inducible protein-10 (IP 10), monocyte chemoattractant protein-1(MCP-1), macrophage inflammatory protein alpha and beta (MIP-1? and MIP-1?), as well as anti-inflammatory mediators IL-4, IL-10, IL-13, IL-27, IL-31 and IL-33 were determined at three time intervals - on the day of admission (the first day), and then on the third and fifth day. Through standard microbiological analyses, the type of the bacterial causative agent has been determined. Results. On the third day of measurement, significant differences in the cytokine levels with regard to the nature of bacteremia were determined in all pro- and anti-inflammatory cytokines, except for IL-8. Generally, the lowest levels were observed in patients with polymicrobial blood culture. On the first and fifth days of measurement, no significant differences in the cytokine levels with regard to the nature of bacteriemia was found. The only significant predictor of the lethal outcome on the first measurement day was IL-17?, AUR ROC of 0,665 (95% confidence interval of 0,519-0,791, ?=0.034) with secondary sepsis as a complication of peritonitis. Conclusion. According to the type of the bacterial causative agent, the lowest levels of cytokines have been observed in patients with the polymicrobial blood culture. IL- 17? is a good predictor of the outcome in patients with peritonitis as an underlying condition of secondary sepsis. The low level of IL-17? in these patients predicted a lethal outcome on the first day of measurement. On the other hand, the levels of other cytokines correlated with the outcome only on the fifth day of measurement, and they were higher in survivors than in non-survivors.
背景/目的。复杂的败血症相关免疫反应的作用尚未完全澄清,仍然是一个调查的主题。如今,脓毒症被认为是一种动态综合征,其特征是许多,通常是拮抗的现象,从过度炎症到能量不足,或免疫麻痹。在危重症伴脓毒症患者的促炎和抗炎介质的基础上,研究的目的是确定细胞因子谱是否因细菌病原体的类型而不同,并评估其预后价值。结果衡量标准是住院死亡率。方法。从125例因腹膜炎、胰腺炎或创伤而患有严重继发性脓毒症的危重患者中采集了血清样本,这些患者已被送入外科重症监护病房(SICU)。患者平均年龄57.7 ~ 17.3岁。其中男性84例(67.2%),女性41例(32.8%)。促炎因子的水平?白细胞介素1- α (IL-1?)il-6 il-8 il-12 ?70, IL-17 ?、肿瘤坏死因子α (TNF?)、干扰素γ (IFN-?)、干扰素γ诱导蛋白-10 (ip10)、单核细胞趋化蛋白-1(MCP-1)、巨噬细胞炎症蛋白α和β (MIP-1?)和MIP-1),以及抗炎介质IL-4、IL-10、IL-13、IL-27、IL-31和IL-33在入院当天(第一天)、第3天和第5天三个时间间隔检测。通过标准的微生物学分析,确定了细菌病原体的类型。结果。在测量的第三天,除IL-8外,所有促炎性和抗炎性细胞因子的水平与菌血症的性质有显著差异。一般来说,多微生物血培养的患者血清中含量最低。在测量的第一天和第五天,没有发现细胞因子水平与菌血症的性质有显著差异。IL-17是第一个测量日致死性结局的唯一显著预测因子。, AUR ROC为0.665(95%可信区间为0.519 - 0.791,?=0.034),继发性败血症为腹膜炎的并发症。结论。根据细菌病原体的类型,多微生物血培养患者的细胞因子水平最低。IL - 17吗?是一个很好的预测预后的病人腹膜炎作为继发性败血症的潜在条件。IL-17水平低?在这些患者中,在测量的第一天就预测了致命的结果。另一方面,其他细胞因子的水平仅在测量的第五天与结果相关,并且幸存者的水平高于非幸存者。
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引用次数: 0
Increased concentration of tumour necrosis factor alpha in the plasma of glaucoma patients 青光眼患者血浆中肿瘤坏死因子α浓度升高
4区 医学 Q4 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-01-01 DOI: 10.2298/vsp230725062t
Marija Trenkic, Tatjana Jevtovic-Stoimenov, Jelena Basic, Jelena Vasilijevic, Dragana Ristic, Milan Trenkic, Aleksandar Veselinovic, Marija Cvetanovic
Background/Aim. Changes in the concentration of various mediators of inflammation and immune response in blood, aqueous humor, or eye tissues support the theory of inflammation and immune system activity in the pathogenesis of openangle glaucoma. Inflammatory biomarkers have a great potential for application in clinical practice. We investigated the plasma concentrations of tumor necrosis factor alpha (TNF-?) in patients with open-angle glaucoma and controls without glaucoma, and examined a correlation between plasma TNF-? levels in glaucoma patients and their clinical parameters. Methods. The present study included 87 participants (87 eyes) divided into three groups: 35 subjects (35 eyes) with primary open-angle glaucoma with elevated intraocular pressure - hypertension glaucoma (POAG-HTG), 23 subjects (23 eyes) with pseudoexfoliative open-angle glaucoma (XFG), and 29 subjects in the control group matched with the patient groups in terms of age and sex. We performed a complete clinical examination including standard automated perimetry and determination of changes in the participant's repeated visual field, and optical coherence tomography and determination of retinal peripapillary nerve fiber thickness (RNFL). The concentration of circulating TNF-? in participants? plasma was measured using commercial immunoadsorption enzyme tests (ELISA). Results. The concentrations of TNF-? in the plasma of glaucoma patients (POAG-HTG 2.04?1.98 pg/mL and XFG 2.05?1.48 pg/mL) were significantly higher than in healthy subjects (1.43?2.00 pg/mL, p<0.05). No statistically significant correlations of TNF-? concentration with any of the clinical parameters including IOP, C/D, MD, RNFL Avg, RNFL Sup and RNFL Inf were found in any of the groups of patients with glaucoma. Conclusion. The concentration of the pro-inflammatory cytokine, TNF-?, in the plasma is significantly higher in glaucoma patients compared to nonglaucomatous subjects, and confirms the role of the inflammation in the pathogenesis of glaucoma, as one of noninflammatory ocular diseases. The plasma concentration of TNF-? does not correlate with any of the examined clinical parameters; hence, it cannot be considered a measure of progression and damage in glaucoma.
背景/目的。血液、房水或眼组织中各种炎症和免疫反应介质浓度的变化支持炎症和免疫系统活性在开角型青光眼发病机制中的理论。炎症生物标志物在临床实践中具有很大的应用潜力。我们研究了开角型青光眼患者和非青光眼对照组的血浆肿瘤坏死因子α (TNF-?)浓度,并检测了血浆TNF-?青光眼患者的水平及其临床参数。方法。本研究共纳入87例受试者(87只眼),分为3组:原发性开角型青光眼伴高眼压-高血压青光眼(POAG-HTG) 35例(35只眼),假性剥脱性开角型青光眼(XFG) 23例(23只眼),对照组29例(年龄和性别与患者组相匹配)。我们进行了完整的临床检查,包括标准的自动视野检查和确定参与者重复视野的变化,光学相干断层扫描和确定视网膜乳头周围神经纤维厚度(RNFL)。循环TNF-?在参与者吗?采用商业免疫吸附酶试验(ELISA)测定血浆。结果。TNF-?青光眼患者血浆中POAG-HTG (2.04 ~ 1.98 pg/mL)和XFG (2.05 ~ 1.48 pg/mL)显著高于健康人(1.43 ~ 2.00 pg/mL, p < 0.05)。TNF-?每组青光眼患者的IOP、C/D、MD、RNFL Avg、RNFL Sup、RNFL Inf等临床参数的浓度均不一致。结论。促炎细胞因子TNF-?在青光眼患者血浆中,与非青光眼受试者相比,其血浆中含量明显增高,证实了炎症在青光眼发病机制中的作用,作为非炎症性眼部疾病之一。血浆中TNF-?与检查的任何临床参数无关;因此,它不能被认为是青光眼进展和损害的衡量标准。
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引用次数: 0
Prevalence of computer vision syndrome in computer users: A systematic review and meta-analysis 计算机使用者中计算机视觉综合征的患病率:一项系统回顾和荟萃分析
IF 0.2 4区 医学 Q4 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-01-01 DOI: 10.2298/vsp220301024d
Vanja Dimitrijević, Ivana Todorovic, Biljana Viduka, Igor Lavrnić, D. Viduka
Background/Aim. The visual and health problems associated with the use of computers and other digital devices are known as Computer Vision Syndrome (CVS). Advances in technology has led to increased use of computers so the prevalence of these symptoms is increasing. The aim of this study was to calculate the overall prevalence of CVS and CVS symptoms using meta-analysis. Methods. This study has been developed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement. Four databases were searched for articles collection: PubMed, Cochrane Library, Web of Science, and Google Scholar were searched. The key search terms were: Computer vision syndrome, computer users, digital eyestrain, headache, dry eyes, red eyes, eyestrain, neck pain, back pain, and shoulder pain. The articles included in our study were limited to original articles written only in English that met the following inclusion criteria: 1) the research had to include computer users; 2) as a result, the prevalence of CVS or the prevalence of any of the symptoms of CVS had to be measured. Results. A systematic search of four electronic databases was conducted on July 2021. 43 articles were fully reviewed and 20 of them were included in the meta-analysis. The total overall prevalence for all studies was calculated to be 74.4%, while the prevalence for individual symptoms was: headache at 43%, dry eyes at 24.4%, eyestrain at 29%, red eyes at 20.7%, and neck, back, or shoulder pain at 46.3%. Conclusion. The results obtained are worrying and point to a necessity of multidisciplinary approach to solving CVS-related problems.
背景/目的。与使用计算机和其他数字设备相关的视觉和健康问题被称为计算机视觉综合征(CVS)。科技的进步导致电脑使用的增加,因此这些症状的患病率也在增加。本研究的目的是使用荟萃分析计算CVS的总体患病率和CVS症状。方法。本研究是根据系统评价和荟萃分析的首选报告项目(PRISMA)声明进行的。检索了四个数据库:PubMed、Cochrane Library、Web of Science和谷歌Scholar。关键搜索词是:电脑视觉综合症,电脑使用者,数码眼疲劳,头痛,眼睛干涩,眼睛发红,眼疲劳,颈部疼痛,背部疼痛和肩部疼痛。本研究纳入的文章仅限于满足以下纳入标准的纯英文原创文章:1)研究必须包括计算机用户;2)因此,必须测量CVS的患病率或任何CVS症状的患病率。结果。2021年7月对四个电子数据库进行了系统检索。43篇文章被全面审查,其中20篇被纳入meta分析。所有研究的总总患病率计算为74.4%,而个别症状的患病率为:头痛占43%,眼睛干涩占24.4%,眼疲劳占29%,眼睛发红占20.7%,颈、背或肩痛占46.3%。结论。获得的结果令人担忧,并指出解决cvs相关问题的多学科方法的必要性。
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引用次数: 0
Evaluation of the impacted maxillary canines position, determination of the possible indicators of the impaction difficulty and the risk factors for adjacent teeth root resorption 评估上颌阻生牙的位置,确定阻生困难的可能指标及邻牙根吸收的危险因素
IF 0.2 4区 医学 Q4 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-01-01 DOI: 10.2298/vsp220329010p
Tina Pajević, Dina Vasović, J. Juloski, L. Vucić, B. Glišić
Background/Aim. An impacted tooth is a tooth that could not erupt and take its place in the dental row. Impacted maxillary canines are a very frequent problem in the orthodontic practices. They are the second most impacted teeth, right after the third molars. The aim of this cross-sectional study was to evaluate the two-dimensional and three-dimensional position of the impacted maxillary canines as well as to make a descriptive study analysis of possible indicators of the impaction difficulty and risk factors for adjacent tooth root resorption. Methods. 94 subjects with 116 diagnosed maxillary canines impaction (CI) were included in the investigation. The two-dimensional position of the impacted canines (IC) was evaluated on the panoramic projection of the cone beam computed tomography (CBCT) images. Canine position (CP) to the X, Y and Z-axis was measured and scored using the novel classification system that incorporates three-dimensional information of CBCT imaging, the KPG index. Based on the KPG index value, impaction was defined as easy, moderate, difficult, and extremely difficult. Descriptive variables (gender, side of impaction, etc.) and numeric variables [age, canine distance to the occlusal plane (OccP), etc.] were tested with multiple logistic regression as potential predictors of the impaction difficulty and possible risk factors. Results. The mean age of the subjects was 19.8?5.2 years. The impactions were twice as more prevalent in females, compared to males. Most impactions were unilateral (71.4%) in palatal position. Adjacent root resorption was present in 27.3% cases of impaction, and the central incisor was mostly affected. More than half of impactions were of moderate level. In univariable analysis, canine distance to sagittal medial line (SML), canine angulation (CA) to SML and OccP and CA to first premolar were significant in impaction difficulty prediction. Multivariable analysis showed that CA to the first premolar could be a risk factor for adjacent root resorption. Conclusion. Most of the impacted maxillary canines were in palatal position, with KPG index value of moderate difficulty. Beside the position to the OccP and SML, CA to the first premolar should be estimated, as a part of diagnostic procedures, to evaluate the risk of adjacent root resorption, to prevent resorption and to decide on the treatment plan.
背景/目的。阻生牙是一颗不能长出并在牙齿排中占据位置的牙齿。上颌埋伏牙是正畸治疗中常见的问题。它们是第二大受影响的牙齿,仅次于第三颗臼齿。本横断面研究的目的是评估阻生上颌尖牙的二维和三维位置,并对阻生困难的可能指标和邻牙根吸收的危险因素进行描述性研究分析。方法:94例诊断为上颌犬牙嵌塞(CI)的患者116例。在圆锥束ct (CBCT)全景投影图像上评估埋伏犬(IC)的二维位置。犬位(CP)的X, Y和z轴测量和评分使用新的分类系统,结合CBCT成像的三维信息,KPG指数。根据KPG指数值,将撞击定义为容易、中等、困难和极困难。描述性变量(性别、嵌塞部位等)和数值变量(年龄、犬与咬合面距离(OccP)等)作为嵌塞困难和可能危险因素的潜在预测因素,采用多元logistic回归进行检验。结果。受试者平均年龄19.8 ~ 5.2岁。这种影响在女性中的普遍程度是男性的两倍。大多数嵌塞发生在腭位单侧(71.4%)。27.3%的嵌塞病例出现邻根吸收,其中中切牙受影响最大。超过一半的撞击是中度的。单变量分析中,尖牙到矢状内侧线(SML)的距离、尖牙到矢状内侧线(SML)的角度、OccP和CA到第一前磨牙的角度是预测嵌塞困难的重要因素。多变量分析表明,第一前磨牙的CA可能是邻根吸收的危险因素。结论。上颌阻生犬齿多位于腭位,KPG指数值为中等难度。作为诊断程序的一部分,除了评估前磨牙和前磨牙的位置外,还应评估第一前磨牙的CA,以评估邻根吸收的风险,防止吸收,并决定治疗计划。
{"title":"Evaluation of the impacted maxillary canines position, determination of the possible indicators of the impaction difficulty and the risk factors for adjacent teeth root resorption","authors":"Tina Pajević, Dina Vasović, J. Juloski, L. Vucić, B. Glišić","doi":"10.2298/vsp220329010p","DOIUrl":"https://doi.org/10.2298/vsp220329010p","url":null,"abstract":"Background/Aim. An impacted tooth is a tooth that could not erupt and take its place in the dental row. Impacted maxillary canines are a very frequent problem in the orthodontic practices. They are the second most impacted teeth, right after the third molars. The aim of this cross-sectional study was to evaluate the two-dimensional and three-dimensional position of the impacted maxillary canines as well as to make a descriptive study analysis of possible indicators of the impaction difficulty and risk factors for adjacent tooth root resorption. Methods. 94 subjects with 116 diagnosed maxillary canines impaction (CI) were included in the investigation. The two-dimensional position of the impacted canines (IC) was evaluated on the panoramic projection of the cone beam computed tomography (CBCT) images. Canine position (CP) to the X, Y and Z-axis was measured and scored using the novel classification system that incorporates three-dimensional information of CBCT imaging, the KPG index. Based on the KPG index value, impaction was defined as easy, moderate, difficult, and extremely difficult. Descriptive variables (gender, side of impaction, etc.) and numeric variables [age, canine distance to the occlusal plane (OccP), etc.] were tested with multiple logistic regression as potential predictors of the impaction difficulty and possible risk factors. Results. The mean age of the subjects was 19.8?5.2 years. The impactions were twice as more prevalent in females, compared to males. Most impactions were unilateral (71.4%) in palatal position. Adjacent root resorption was present in 27.3% cases of impaction, and the central incisor was mostly affected. More than half of impactions were of moderate level. In univariable analysis, canine distance to sagittal medial line (SML), canine angulation (CA) to SML and OccP and CA to first premolar were significant in impaction difficulty prediction. Multivariable analysis showed that CA to the first premolar could be a risk factor for adjacent root resorption. Conclusion. Most of the impacted maxillary canines were in palatal position, with KPG index value of moderate difficulty. Beside the position to the OccP and SML, CA to the first premolar should be estimated, as a part of diagnostic procedures, to evaluate the risk of adjacent root resorption, to prevent resorption and to decide on the treatment plan.","PeriodicalId":23531,"journal":{"name":"Vojnosanitetski pregled","volume":"1 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68338317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Solid ectopic cervical thymus in an infant: A case report 婴儿实性子宫颈胸腺异位1例
IF 0.2 4区 医学 Q4 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-01-01 DOI: 10.2298/vsp221205020v
A. Vlahović, Mila Živković, Velibor Majic, Zorka Badnjar-Ilic, N. Begović, I. Dizdarević
Introduction. Ectopic cervical thymus tissue results from incomplete migration of the thymic primordia during embryogenesis. It is asymptomatic in most of the cases, however, in 10% of patients there are different kind of symptoms. Case report. A 4-month-old boy was referred to our clinic, for the evaluation of a growing large neck mass on the right side that has been present since birth. Physical examination revealed a painless, soft, moderately mobile, and irregular round solid neck mass localized on the right side, in front of the sternocleidomastoid muscle, below the parotid gland, and above the carotid lodge. The mass was 40 x 32 x15 mm in diameter. Following the clinical, ultrasonographic and magnetic resonance imaging findings, we suspected that it was an ectopic cervical thymus. Surgical excision was done. The pathology report confirmed the presence of the ectopic cervical thymic tissue with Hassall?s corpuscles. The postoperative course was unremarkable and the wound healed well. Furthermore, clinical, immunological, and echography 6-month follow-up was unremarkable. Conclusion. The congenital cervical ectopic thymus is a rare congenital anomaly, however it should be considered in the differential diagnosis of neck masses.
介绍。宫颈胸腺组织异位是由胚胎发生时胸腺原基迁移不完全引起的。在大多数情况下,它是无症状的,然而,在10%的患者有不同的症状。病例报告。一个4个月大的男孩被转介到我们的诊所,以评估自出生以来一直存在的右侧颈部肿块。体格检查发现一无痛、柔软、活动适度、不规则的圆形实性颈部肿块,位于右侧胸锁乳突肌前方、腮腺下方、颈动脉上方。肿块直径为40 × 32 × 15毫米。根据临床,超声和磁共振成像的结果,我们怀疑这是一个异位的宫颈胸腺。手术切除。病理报告证实了宫颈胸腺组织异位的存在。小体。术后病程无明显变化,伤口愈合良好。此外,临床、免疫学和超声随访6个月无显著差异。结论。先天性颈异位胸腺是一种罕见的先天性异常,但在颈部肿块的鉴别诊断中应予以考虑。
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引用次数: 0
Assessment of location and anatomical characteristics of lingual foramen using cone beam computed tomography 锥束计算机断层扫描评价舌孔的位置和解剖特征
IF 0.2 4区 医学 Q4 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-01-01 DOI: 10.2298/vsp221208009v
S. Veličković, Stevo Matijević, Bojan Jovičić, M. Bubalo, Momir Stevanović, M. Vasovic
Background/Aim. A lingual foramen (LF) is a small opening on the lingual surface of the mandible, which is most frequently located in the middle of the anterior part of the mandible and which shows significant variations in its location, size and number. The aim of this study was to assess the location and anatomical characteristics of LF using cone beam computed tomography (CBCT). Methods. The research was designed as a retrospective study in which 99 CBCT scans were analysed. The analysis covered the number of LF, their location in relation to the teeth and the mandibular region itself, diameter, distance from the alveolar ridge crest, distance from the inferior border of the mandible, distance from the tooth apex and position in relation to the tooth apex. Results. The average frequency of LF per patient was 2.4 1.2. The largest number of LF were localised in the region of lower central incisors. Out of the total number of LF, 82.5% of LF belonged to median lingual foramen (MLF), while 17.5% belonged to lateral lingual foramen (LLF). In 63.2% cases, LF had a diameter of ?1mm, whereas in 98.3% cases it was localised below the tooth apex. There is a statistically significant difference in the distance of LF from the alveolar ridge crest and the LF diameter in relation to gender (p = 0.019; p = 0.008). Conclusion. LF can be reliably localised and visualised by means of CBCT. It is recommended that CBCT scanning of the mandible should be used while planning an oral surgical procedure and implant placement in order to prevent injuries of the neurovascular bundle which passes through LF.
背景/目的。舌孔(LF)是下颌骨舌面上的一个小开口,最常位于下颌骨前部的中部,其位置、大小和数量变化显著。本研究的目的是利用锥形束计算机断层扫描(CBCT)评估LF的位置和解剖特征。方法。该研究是一项回顾性研究,其中分析了99个CBCT扫描。分析LF的数量,它们相对于牙齿和下颌骨本身的位置,直径,到牙槽嵴的距离,到下颌骨下缘的距离,到牙尖的距离以及相对于牙尖的位置。结果。每例患者发生LF的平均频率为2.4 - 1.2次。下中切牙区是LF发生最多的区域。在所有的LF中,82.5%属于舌中孔(MLF), 17.5%属于舌外侧孔(LLF)。在63.2%的病例中,LF的直径为1mm,而98.3%的病例定位于牙尖以下。肺泡嵴距肺泡嵴的距离和肺泡嵴直径与性别的关系有统计学意义(p = 0.019;P = 0.008)。结论。通过CBCT可以可靠地定位和可视化LF。建议在计划口腔外科手术和种植体放置时使用下颌骨CBCT扫描,以防止穿过LF的神经血管束损伤。
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引用次数: 0
Pancreatic panniculitis associated with periampullary duodenal diverticulum: A case report 胰膜炎合并壶腹周围十二指肠憩室1例
IF 0.2 4区 医学 Q4 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-01-01 DOI: 10.2298/vsp230626043t
Tanja Tirnanić, T. Radevic, Andrea Djordjevic, N. Petrov, Z. Mijuskovic
Introduction. Pancreatic panniculitis is a rare type of lobular panniculitis that manifests as painful erythematous nodules on the skin of the lower extremities. Subcutaneous fat necrosis caused by the release of pancreatic enzymes is the underlying cause of the disease, affecting around 2 to 3% of patients with pancreatic diseases. Case report. We present a case of a 58-year-old male patient who exhibited painful erythematous nodules on the lower extremities and trunk. Laboratory results revealed increased levels of pancreatic enzymes, amylase, and lipase, as well as heightened levels of glucose and inflammation markers. The histological analysis of the skin lesion biopsy revealed the presence of predominantly lobular panniculitis in the hypodermis, areas of fatty tissue necrosis/saponification, and remnants of adipocytes (??ghost cells??). Abdominal CT scan demonstrated periampullary diverticulum of the duodenum, with no signs of pancreatitis or other pancreatic abnormalities. Esophagogastroduodenoscopy showed a wide opening of the periampullary diverticulum in the D2 segment of the duodenum. The patient was successfully treated with pancreatin therapy, resulting in a significant reduction of skin lesions and decreased levels of pancreatic enzymes. Conclusion. Pancreatic panniculitis can be caused by periampullary duodenal diverticula that exert pressure on the pancreatic duct, leading to elevated levels of pancreatic enzymes. Symptomatic duodenal diverticula may be treated with operative or non-operative measures, depending on the individual characteristics of the patient. Treatment of pancreatic panniculitis primarily involves addressing any underlying medical condition.
介绍。胰膜炎是一种罕见的小叶性胰膜炎,表现为下肢皮肤上疼痛的红斑结节。胰腺酶释放引起的皮下脂肪坏死是该疾病的根本原因,影响约2%至3%的胰腺疾病患者。病例报告。我们提出一个58岁的男性病人谁表现出疼痛的红斑结节在下肢和躯干。实验室结果显示胰腺酶、淀粉酶和脂肪酶水平升高,葡萄糖和炎症标志物水平升高。皮肤病变活检的组织学分析显示,皮下主要存在小叶性泛膜炎,脂肪组织坏死/皂化区域和脂肪细胞残余(?? ?)鬼细胞? ?)。腹部CT扫描显示壶腹周围十二指肠憩室,无胰腺炎或其他胰腺异常征象。食管胃十二指肠镜显示十二指肠D2段壶腹周围憩室开口较大。患者成功地接受了胰酶治疗,导致皮肤病变显著减少,胰酶水平降低。结论。胰膜炎可由壶腹周围十二指肠憩室对胰管施加压力,导致胰酶水平升高引起。症状性十二指肠憩室可采用手术或非手术治疗,这取决于患者的个体特征。胰膜炎的治疗主要包括解决任何潜在的医疗状况。
{"title":"Pancreatic panniculitis associated with periampullary duodenal diverticulum: A case report","authors":"Tanja Tirnanić, T. Radevic, Andrea Djordjevic, N. Petrov, Z. Mijuskovic","doi":"10.2298/vsp230626043t","DOIUrl":"https://doi.org/10.2298/vsp230626043t","url":null,"abstract":"Introduction. Pancreatic panniculitis is a rare type of lobular panniculitis that manifests as painful erythematous nodules on the skin of the lower extremities. Subcutaneous fat necrosis caused by the release of pancreatic enzymes is the underlying cause of the disease, affecting around 2 to 3% of patients with pancreatic diseases. Case report. We present a case of a 58-year-old male patient who exhibited painful erythematous nodules on the lower extremities and trunk. Laboratory results revealed increased levels of pancreatic enzymes, amylase, and lipase, as well as heightened levels of glucose and inflammation markers. The histological analysis of the skin lesion biopsy revealed the presence of predominantly lobular panniculitis in the hypodermis, areas of fatty tissue necrosis/saponification, and remnants of adipocytes (??ghost cells??). Abdominal CT scan demonstrated periampullary diverticulum of the duodenum, with no signs of pancreatitis or other pancreatic abnormalities. Esophagogastroduodenoscopy showed a wide opening of the periampullary diverticulum in the D2 segment of the duodenum. The patient was successfully treated with pancreatin therapy, resulting in a significant reduction of skin lesions and decreased levels of pancreatic enzymes. Conclusion. Pancreatic panniculitis can be caused by periampullary duodenal diverticula that exert pressure on the pancreatic duct, leading to elevated levels of pancreatic enzymes. Symptomatic duodenal diverticula may be treated with operative or non-operative measures, depending on the individual characteristics of the patient. Treatment of pancreatic panniculitis primarily involves addressing any underlying medical condition.","PeriodicalId":23531,"journal":{"name":"Vojnosanitetski pregled","volume":"1 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68340844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cellular cryobiology - a review of basic concepts and "operating-design" of cryopreserved cells 细胞低温生物学-对低温保存细胞的基本概念和“操作设计”的综述
IF 0.2 4区 医学 Q4 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-01-01 DOI: 10.2298/vsp230711044b
B. Balint, M. Pavlovic, D. Abazovic, Sanja Toroman, Radica Grubovic-Rastvorceva, Marija Dinic, M. Todorovic-Balint
nema
nema
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引用次数: 0
Psychologists as emergency first responders during pandemic 心理学家作为流行病期间的紧急第一响应者
4区 医学 Q4 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-01-01 DOI: 10.2298/vsp230202055d
Abhijit Deshpande, Anita Pesic, Ole Boe, Andrzej Piotrowski, Samir Rawat
nema
尼玛
{"title":"Psychologists as emergency first responders during pandemic","authors":"Abhijit Deshpande, Anita Pesic, Ole Boe, Andrzej Piotrowski, Samir Rawat","doi":"10.2298/vsp230202055d","DOIUrl":"https://doi.org/10.2298/vsp230202055d","url":null,"abstract":"nema","PeriodicalId":23531,"journal":{"name":"Vojnosanitetski pregled","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136005541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The effect of different types of storage solutions on saphenous vein endothelial integrity in diabetic patients undergoing CABG 不同类型储存液对糖尿病冠脉搭桥患者隐静脉内皮完整性的影响
4区 医学 Q4 MEDICINE, GENERAL & INTERNAL Pub Date : 2023-01-01 DOI: 10.2298/vsp230312051k
Aleksandar Kamenov, Vladimir Stojiljkovic, Aleksandar Petrovic, Milan Lazarevic, Mladjan Golubovic, Velimir Peric, Marija Stosic, Goran Radenkovic, Ivan Nikolic, Vladimir Petrovic, Sasa Zivic, Dragan Milic
Background/Aim. Taking in consideration the justified popularity of total arterial revascularization (TAR), the saphenous vein graft (SVG) is still one of the most utilized conduits in coronary artery bypass grafting (CABG). One of the determining factors of this conduit`s durability is its endothelial integrity at the time of surgery. The aim of the study was to investigate the effect of different storage solutions on SVG endothelial integrity in patients with diabetes mellitus (DM) type 2 and non-DM patients undergoing CABG. The solutions under evaluation were heparinized saline solution (0.9% NaCl), heparinized autologous whole blood, Bretschneider solution (HTK) and fresh frozen plasma solution (FFP). Methods. Forty patients were included in this study and were divided into two groups. Group A with 23 DM patients and group B with 17 non DM patients. The effects of these solutions were examined by immunohistochemical dyeing of CD34 antibodies and morphometric comparison in histologic samples of DM patients undergoing CABG between the 07.2021. and 09.2022. with samples provided by non-DM patients. Research was conducted in the facilities of the Cardiac Surgery Clinic, UCC Nis and the Department of Histology and Embryology Laboratory. Results. In this study the FFP solution showed the most prominent positive effect on preservation of Saphenous Venous Graft (SVG) endothelial integrity with the average cell integrity preservation of 92.20%. Bretschneider's solution was found to be the least effective with an endothelial cell preservation integrity of 26.77%. There was no marked no statistically significant difference in results from group A and B. Conclusion. There was a noticeable contrast in preserving SVG endothelial integrity between the two patient groups, type 2 DM and non-DM patients, although it was not statistically significant. The storage solution with the most beneficial effect on SVG endothelial integrity preservation was the FFP solution when harvested via conventional open method in CABG.
背景/目的。考虑到全动脉重建术(TAR)的合理普及,隐静脉移植(SVG)仍然是冠状动脉旁路移植术(CABG)中应用最多的导管之一。导管耐久性的决定因素之一是手术时其内皮的完整性。本研究旨在探讨不同储存溶液对2型糖尿病(DM)和非DM行冠脉搭桥患者SVG内皮完整性的影响。评价溶液为肝素化生理盐水(0.9% NaCl)、肝素化自体全血、Bretschneider溶液(HTK)和新鲜冷冻血浆溶液(FFP)。方法。本研究共纳入40例患者,分为两组。A组糖尿病患者23例,B组非糖尿病患者17例。通过CD34抗体的免疫组化染色和形态学比较,对2007年7月至2021年7月间行CABG的DM患者的组织学样本进行检测。和09.2022。样本由非糖尿病患者提供。研究在心脏外科诊所、UCC Nis和组织学和胚胎学实验室进行。结果。在本研究中,FFP溶液对隐静脉移植物(SVG)内皮完整性的保存效果最为显著,平均细胞完整性保存率为92.20%。Bretschneider溶液效果最差,内皮细胞保存完整性为26.77%。A组与b组结果无明显统计学差异。2型糖尿病和非糖尿病两组患者在保持SVG内皮完整性方面存在显著差异,但无统计学意义。对SVG内皮完整性保存最有利的保存溶液是在CABG中采用常规开放式方法收获的FFP溶液。
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