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Molecular Biomarkers as Predictors of Treatment Response and Survival Outcomes in Head and Neck Squamous Cell Carcinoma: A Retrospective Cohort Study at a Singapore Tertiary Hospital 预测头颈部鳞状细胞癌治疗反应和生存结果的分子生物标记物:新加坡一家三级医院的回顾性队列研究
Pub Date : 2024-08-09 DOI: 10.59345/sjorl.v2i1.151
Martin Curtis Lee, Nazilah Amir
Introduction: Head and neck squamous cell carcinoma (HNSCC) is a heterogeneous disease with variable treatment responses. Identification of molecular biomarkers could personalize treatment and improve outcomes. Methods: A retrospective cohort study was conducted at a tertiary hospital in Singapore. Patients with HNSCC treated between 2018-2023 were included. Pretreatment tumor biopsies were analyzed for biomarker expression (PD-L1, EGFR, TP53, HPV status) using immunohistochemistry and PCR. Clinical data were collected from medical records. Treatment response, survival, and associations with biomarkers were analyzed. Results: 250 patients were included. PD-L1 expression was associated with improved response to immunotherapy (p = 0.02). EGFR overexpression correlated with worse overall survival (p = 0.01). TP53 mutations were linked to increased locoregional recurrence (p = 0.03). HPV-positive tumors had a better prognosis (p < 0.001). Conclusion: Molecular biomarkers show promise in predicting treatment response and survival in HNSCC. Integration of these markers into clinical practice could facilitate personalized treatment strategies.
简介:头颈部鳞状细胞癌(HNSCC头颈部鳞状细胞癌(HNSCC)是一种异质性疾病,对治疗的反应各不相同。鉴定分子生物标志物可实现个性化治疗并改善疗效。研究方法新加坡一家三级医院开展了一项回顾性队列研究。纳入了2018-2023年间接受治疗的HNSCC患者。使用免疫组化和 PCR 分析治疗前肿瘤活检的生物标记物表达(PD-L1、EGFR、TP53、HPV 状态)。临床数据来自医疗记录。分析治疗反应、存活率以及与生物标记物的关联。结果:共纳入 250 例患者。PD-L1 表达与免疫疗法反应的改善有关(p = 0.02)。表皮生长因子受体(EGFR)过表达与总生存率降低相关(p = 0.01)。TP53突变与局部复发增加有关(p = 0.03)。HPV阳性肿瘤的预后较好(p < 0.001)。结论分子生物标志物有望预测 HNSCC 的治疗反应和生存率。将这些标志物纳入临床实践可促进个性化治疗策略的制定。
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引用次数: 0
Age-related Hearing Loss and Its Correlation with Depression 老年性听力损失及其与抑郁症的相关性
Pub Date : 2023-12-22 DOI: 10.59345/sjorl.v1i2.80
Rohayu Rohayu
Age-related hearing loss (ARHL), commonly referred to as presbycusis, ranks as the third most prevalent health issue among older individuals, following heart disease and arthritis. This is a progressive, symmetrical, age-related sensorineural hearing impairment that primarily affects higher frequencies. This review was aimed to describe age related hearing loss and depression in elder people. Individuals who suffer from tinnitus and experience difficulty discerning speech in noisy environments are at a higher risk of developing paradoxical hypersensitivity to loud sounds. Consequently, individuals with age-related hearing loss (ARHL) experience increased challenges in perceiving consonant sounds inside words. These sounds play a crucial role in conveying the main message of a word, aiding in syllable separation, and indicating word boundaries. Healthcare providers must prioritize the screening and detection of HL (hearing loss) and depression. Initially, primary care providers may be most adept at identifying both hearing loss (HL) and depression.
老年性听力损失(ARHL)通常被称为老花眼,是老年人继心脏病和关节炎之后的第三大健康问题。这是一种进行性、对称性、与年龄相关的感音神经性听力损伤,主要影响较高频率的听力。本综述旨在描述老年人与年龄相关的听力损失和抑郁症。患有耳鸣并在嘈杂环境中辨别语音有困难的人,对响声发生矛盾性过敏的风险较高。因此,老年性听力损失(ARHL)患者在感知单词中的辅音时会遇到更多挑战。这些声音在传达单词的主要信息、帮助音节分离和指示单词边界方面起着至关重要的作用。医疗服务提供者必须优先筛查和检测 HL(听力损失)和抑郁症。起初,初级保健提供者可能最擅长识别听力损失(HL)和抑郁症。
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引用次数: 0
Chronic Suppurative Otitis Media Accompanied by Facial Nerve Paresis: A Case Report 伴有面神经麻痹的慢性化脓性中耳炎:病例报告
Pub Date : 2023-12-22 DOI: 10.59345/sjorl.v1i2.79
Alia Oktarisa, Danisa Siregar
Introduction: Chronic suppurative otitis media (CSOM) is marked by ear discharge (otorrhea) that lasts for more than six to eight weeks, middle ear inflammation that doesn't go away, and a ruptured eardrum. The purpose of this study is to describe examples of CSOM with facial nerve paresis and how such cases are managed. Case presentation: A thirty-year-old man complained to the Mataram Community Health Center two days before admission that his mouth was turning to the left, despite the fact that he was still able to speak well. Additionally, for four months, the patient complained of a constant discharge from the right ear. The fluid that emerges from the ear is sticky, yellow, and odorous; blood is not mixed with it. Upon inspection, a cholesteatoma and a flat-edge attic perforation on the tympanic membrane were discovered, together with a purulent and odorous discharge in the ear canal of the right ear. After a facial nerve examination, it was discovered that the forehead wrinkles were uneven and that the face was asymmetrical, with the right eyebrow unable to be raised. The patient was identified as having peripheral facial nerve paresis and persistent suppurative malignant otitis media of the auricula dextra. The patient is being treated with irrigation of the ear canal with 0.9% NaCl, cleaning of the cholesteatoma, and antibiotic administration: two drops of ofloxacin ear drops given twice a day, three times a day ciprofloxacin tablets 500 mg, three times a day methylprednisolone 16 mg, and advice to undergo a mastoidectomy. Conclusion: Complications including hearing loss, facial nerve palsy, subperiosteal abscess, petrositis, meningitis, cerebral abscess, and labyrinthine fistula are indicated for mastectomy surgical therapy.
导言:慢性化脓性中耳炎(CSOM)的特征是耳部分泌物(耳脓)持续六至八周以上,中耳炎症久治不愈,鼓膜破裂。本研究旨在描述 CSOM 伴有面神经麻痹的病例,以及如何处理此类病例。病例介绍:一名 30 岁的男子在入院前两天向马打兰社区卫生中心抱怨说,尽管他仍然能够很好地说话,但他的嘴却向左偏。此外,四个月来,患者一直抱怨右耳有分泌物流出。耳内流出的液体粘稠、发黄、有异味,其中不混有血液。经检查,发现右耳耳道内有胆脂瘤和鼓膜平缘阁楼穿孔,以及脓性异味分泌物。面神经检查后发现,患者前额皱纹不均匀,面部不对称,右眉无法抬起。经鉴定,患者患有周围面神经麻痹和耳廓外侧持续性化脓性恶性中耳炎。目前正在对患者进行治疗,用 0.9% 氯化钠冲洗耳道,清理胆脂瘤,使用抗生素:每天两次,每次两滴氧氟沙星滴耳液;每天三次,每次 500 毫克环丙沙星片;每天三次,每次 16 毫克甲基强的松龙;并建议患者进行乳突切除术。结论并发症包括听力损失、面神经麻痹、骨膜下脓肿、颅底炎、脑膜炎、脑脓肿和迷走神经瘘,这些都是乳突切除手术治疗的适应症。
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引用次数: 0
Overview of Anatomy and Physiology of Gustatory and Olfactory System 味觉和嗅觉系统解剖学与生理学概述
Pub Date : 2023-12-22 DOI: 10.59345/sjorl.v1i2.93
Tania Arifani
The olfactory system is involved in detecting potential threats in the environment, generating sensations of enjoyment, facilitating proper nourishment, impacting sexual behavior, and regulating mood. Concurrently, the human taste system identifies hydrophilic molecules dissolved in saliva. The purpose of this review was to offer a thorough depiction of the human gustatory and olfactory systems. The various regions of the brain and the taste pathways transmit and receive information through distinct mechanisms. The taste circuits and various regions of the brain interconnect bidirectionally. The peripheral subdivision of the olfactory system consists of the olfactory epithelium and nerve fascicles. On the other hand, the central subdivision includes the olfactory bulb and its links to the central nervous system. Olfactory dysfunction (smell) and gustatory dysfunction (taste) can manifest independently or together. The robust correlation between olfaction and gustation engenders a gustatory feeling. Disruption of a feeling can alter the sense of flavor. Human olfactory and taste senses become less sensitive as they age.
嗅觉系统参与探测环境中的潜在威胁、产生享受的感觉、促进适当的营养、影响性行为和调节情绪。同时,人类的味觉系统还能识别溶解在唾液中的亲水性分子。本综述旨在全面介绍人类的味觉和嗅觉系统。大脑的各个区域和味觉通路通过不同的机制传递和接收信息。味觉回路和大脑各区域之间是双向互联的。嗅觉系统的外围分支由嗅觉上皮和神经束组成。另一方面,中枢分支包括嗅球及其与中枢神经系统的联系。嗅觉功能障碍(嗅觉)和味觉功能障碍(味觉)可以单独或同时出现。嗅觉和味觉之间的紧密联系产生了一种味觉感受。这种感觉的中断会改变味觉。人的嗅觉和味觉会随着年龄的增长而变得不那么敏感。
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引用次数: 0
The Role of Stem Cells in Hearing Restorative Therapy 干细胞在听力恢复疗法中的作用
Pub Date : 2023-12-22 DOI: 10.59345/sjorl.v1i2.94
Rachmat Hidayat
Stem cells play a crucial role in the advancement of restorative hearing therapy, marking the beginning of a new era in the treatment of hearing loss. Researchers are currently focusing on studying many types of stem cells, including mesenchymal stem cells (MSC), embryonic stem cells (ESC), induced pluripotent stem cells (iPSC), neural stem cells (NSC), and otic progenitor cells, in order to restore or enhance hearing function. Stem cells possess the capacity to undergo differentiation into auditory cells, namely hair cells within the cochlea, which serves as the foundation for the restoration of auditory functionality. Stem cells promote the regeneration of nearby tissue, facilitate the development of new auditory cells, and enhance the quality of the ear's mucous membrane, thus establishing a conducive environment for healing. It is the stem cells that make growth factors, which help repair, regeneration, and differentiation of new auditory cells. This creates an ideal environment for cells to multiply. By enabling the creation of customized therapies that can specifically match the unique characteristics of each patient, induced pluripotent stem cells (iPSC) introduce a personalized approach to treating hearing loss.
干细胞在听力恢复疗法的发展中起着至关重要的作用,标志着听力损失治疗新时代的开始。目前,研究人员正专注于研究多种类型的干细胞,包括间充质干细胞(MSC)、胚胎干细胞(ESC)、诱导多能干细胞(iPSC)、神经干细胞(NSC)和耳祖细胞,以恢复或增强听力功能。干细胞具有分化为听觉细胞(即耳蜗内的毛细胞)的能力,这是恢复听觉功能的基础。干细胞能促进附近组织的再生,促进新听觉细胞的发育,提高耳粘膜的质量,从而为愈合创造有利环境。干细胞能制造生长因子,有助于新听觉细胞的修复、再生和分化。这为细胞繁殖创造了理想的环境。诱导多能干细胞(iPSC)可根据每位患者的独特特征,为其量身定制治疗方案,为治疗听力损失提供了一种个性化的方法。
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引用次数: 0
Study of Immunobiological Aspects of Allergic Rhinitis 过敏性鼻炎的免疫生物学研究
Pub Date : 2023-12-19 DOI: 10.59345/sjorl.v1i2.92
Rachmat Hidayat
The condition of allergic rhinitis involves a complex interaction between the immune system and certain allergens. The main process begins with sensitization, in which susceptible individuals develop an immune response to an allergen, often involving the production of IgE specific to that allergen. Mast cells and Th2 cells play a central role in the allergic response, with the release of inflammatory mediators such as histamine, interleukin-4 (IL-4), IL-5, and IL-13. Histamine, produced mainly by mast cells, causes typical symptoms of allergic rhinitis such as a runny nose, itching, sneezing, and nasal congestion. In addition, eosinophils, a specific type of white blood cell, gather in nasal tissues and contribute to chronic inflammation. Activation of eosinophils by cytokines such as IL-5 can cause tissue damage and prolong inflammation. This process creates a cycle of allergic responses that can be amplified with each subsequent exposure to the allergen. Sensitization, IgE production, release of inflammatory mediators, and tissue damage all together form the immunobiology basis of allergic rhinitis.
过敏性鼻炎涉及免疫系统与某些过敏原之间复杂的相互作用。主要过程始于致敏,即易感个体对过敏原产生免疫反应,通常会产生针对该过敏原的特异性 IgE。肥大细胞和 Th2 细胞在过敏反应中起着核心作用,它们会释放组胺、白细胞介素-4 (IL-4)、IL-5 和 IL-13 等炎症介质。组胺主要由肥大细胞产生,会导致过敏性鼻炎的典型症状,如流鼻涕、鼻痒、打喷嚏和鼻塞。此外,嗜酸性粒细胞(一种特殊的白细胞)会聚集在鼻腔组织中,导致慢性炎症。嗜酸性粒细胞被 IL-5 等细胞因子激活后会造成组织损伤,延长炎症时间。这一过程会形成过敏反应的循环,在以后每次接触过敏原时都会加剧。致敏、IgE 生成、炎症介质释放和组织损伤共同构成了过敏性鼻炎的免疫生物学基础。
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引用次数: 0
Overview Aspects of Anatomy and Histology of the Trachea, Pharynx, Larynx, and Esophagus: A Narrative Literature Review 气管、咽部、喉部和食道的解剖学和组织学综述:一篇叙述性文献综述
Pub Date : 2023-04-27 DOI: 10.59345/sjorl.v1i1.35
Mariance, Yoan Levia Magdi
This literature review aimed to describe the anatomical and histological aspects of the trachea, pharynx, larynx, and esophagus. The trachea is a tube-shaped respiratory tract consisting of cartilage and muscle and lined by a pseudostratified columnar ciliated epithelium. The pharynx is a funnel-shaped fibromuscular pouch that is large at the top and narrow at the bottom. This pouch starts at the base of the skull and continues through the esophagus to the level of the sixth cervical vertebra. The laryngopharynx is bordered superiorly by the upper edge of the epiglottis, anteriorly by the larynx, inferiorly by the esophagus, and posteriorly by the cervical vertebrae. The esophagus is a hollow cylindrical organ about 25 cm long and 2 cm in diameter, which extends from the hypopharynx to the cardia of the stomach. The esophagus lies posterior to the heart and trachea, anterior to the vertebrae, and pierces the diaphragmatic hiatus just anterior to the aorta. In conclusion, a thorough understanding of neck anatomy helps establish the diagnosis and management of patients in clinical situations.
本文献综述旨在描述气管,咽,喉和食道的解剖和组织学方面。气管是由软骨和肌肉组成的管状呼吸道,由假层状柱状纤毛上皮内衬。咽是一个漏斗状的纤维肌肉囊,顶部大,底部窄。这个囊从颅底开始,通过食道一直延伸到第六颈椎。喉咽的上缘与会厌的上缘相连,前缘与喉相连,下缘与食道相连,后缘与颈椎相连。食管是一个中空的圆柱形器官,长约25厘米,直径约2厘米,从下咽一直延伸到胃的贲门。食道位于心脏和气管的后面,脊椎骨的前面,穿过主动脉前面的膈肌裂孔。总之,深入了解颈部解剖有助于临床诊断和治疗患者。
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引用次数: 0
The Relationship between Cholesteatoma Stage and Hearing Bone Erosion Degree in Chronic Suppurative Otitis Media Patients with Cholesteatoma at Dr. M. Djamil General Hospital, Padang, Indonesia 印度尼西亚巴东Dr. M. Djamil总医院胆脂瘤合并慢性化脓性中耳炎患者胆脂瘤分期与听力骨侵蚀程度的关系
Pub Date : 2023-04-27 DOI: 10.59345/sjorl.v1i1.31
Bima Riantardo Hafni, Nirza Warto
Introduction: Chronic suppurative otitis media (CSOM) is a chronic inflammation of the middle ear mucosa and mastoid space. Cholesteatoma is an ectopic keratinized epithelial tissue that develops through the mucosa of the middle ear cavity and desquamates, resulting in the accumulation of keratin and epithelial debris. This study aimed to determine the relationship between the stage of cholesteatoma and the degree of erosion of the ossicles in patients CSOM with cholesteatoma at Dr. M. Djamil General Hospital, Padang, Indonesia. Methods: This study was an observational case series study. A total of 70 research subjects were included in this study, and the research subjects met the inclusion criteria. The inclusion criteria in this study were patients with a diagnosis of CSOM with cholesteatoma at Dr. M. Djamil General Hospital, Padang, Indonesia and have complete medical record data. Data analysis was carried out using SPSS software version 25. Correlation analysis between cholesteatoma stage and degree of osseous erosion was performed using the Spearman correlation test, p<0.05. Results: The majority of research subjects were aged 21-30 years (28.6%) and were male (51.4%). Based on clinical symptoms, the majority of patients experience otorrhoea for 5 to 10 years (47.1%), perforated type membrane total tympani (54.3%), degree of erosion of the ossicles type D (48.6%), stage 4 cholesteatoma (61.4%) and granulation tissue (81.4%). Conclusion: There is a relationship between the stage of cholesteatoma and the degree of erosion of the ossicles in patients with CSOM (chronic suppurative otitis media) with cholesteatoma at Dr. M. Djamil General Hospital, Padang, Indonesia.
慢性化脓性中耳炎(CSOM)是一种中耳粘膜和乳突间隙的慢性炎症。胆脂瘤是一种异位角化上皮组织,通过中耳腔粘膜发育并脱落,导致角蛋白和上皮碎片积聚。在印度尼西亚巴东的Dr. M. Djamil总医院,本研究旨在确定胆脂瘤合并CSOM患者的胆脂瘤阶段与听骨侵蚀程度之间的关系。方法:本研究为观察性病例系列研究。本研究共纳入70名研究对象,研究对象均符合纳入标准。本研究的入选标准是在印度尼西亚巴东Dr. M. Djamil总医院诊断为CSOM合并胆脂瘤的患者,并有完整的医疗记录资料。数据分析采用SPSS软件25版。采用Spearman相关检验分析胆脂瘤分期与骨侵蚀程度的相关性,p<0.05。结果:研究对象以21 ~ 30岁为主(28.6%),男性占51.4%。从临床症状来看,大多数患者经历5 ~ 10年耳漏(47.1%),穿孔型膜型全鼓室(54.3%),听骨糜烂程度D型(48.6%),4期胆脂瘤(61.4%)和肉芽组织(81.4%)。结论:在印度尼西亚巴东的Dr. M. Djamil总医院,慢性化脓性中耳炎合并胆脂瘤患者的胆脂瘤分期与听骨糜烂程度有关。
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引用次数: 0
Overview of Sensorineural Deafness Patients at Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia 印度尼西亚巨港市Mohammad Hoesin总医院感音神经性耳聋患者概况
Pub Date : 2023-04-27 DOI: 10.59345/sjorl.v1i1.34
Ahmad Hifni, Abla Ghanie, Lisa Apriyanti
Introduction: Sensorineural deafness is deafness that occurs due to disturbances in the inner ear or in the nerve pathways from the inner ear to the brain. This study aimed to provide an overview of sensorineural deaf patients at Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia. Methods: This study was a descriptive observational study and used secondary data obtained from medical record data at the medical records installation of Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia. A total of 50 research subjects participated in this study, and the research subjects met the inclusion criteria. The inclusion criteria in this study were patients aged > 18 years who were diagnosed with sensorineural hearing loss at Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia, for the January-December 2022 period and had complete medical record data. Results: The majority of research subjects have an age range of > 50 years. Subject the majority of studies have male gender. The majority of research subjects complained of deafness in both ears. The majority of research subjects have a profound hearing threshold. Conclusion: Characteristics of sensorineural deafness at Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia, generally occur at the age of > 50 years, male gender, occurs bilaterally, and has a very poor hearing threshold.
简介:感觉神经性耳聋是由于内耳或从内耳到大脑的神经通路受到干扰而发生的耳聋。本研究旨在提供在印度尼西亚巨港的Dr. Mohammad Hoesin总医院的感觉神经性耳聋患者的概况。方法:本研究是一项描述性观察性研究,使用的二手数据来自印度尼西亚巨港Dr. Mohammad Hoesin总医院医疗档案装置的病历数据。本研究共有50名研究对象参与,研究对象均符合纳入标准。本研究的纳入标准是年龄> 18岁,于2022年1月至12月期间在印度尼西亚巨港Dr. Mohammad Hoesin总医院诊断为感音神经性听力损失的患者,并具有完整的医疗记录数据。结果:大多数研究对象的年龄范围> 50岁。研究对象多数为男性。大多数研究对象都抱怨双耳耳聋。大多数研究对象都有较深的听力阈值。结论:印度尼西亚巨港市Dr. Mohammad Hoesin总医院感音神经性耳聋的特点,一般发生在年龄> 50岁,男性,双侧发生,听力阈值很低。
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引用次数: 0
Characteristics of Acute Pharyngitis at Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia 印度尼西亚巨港市Mohammad Hoesin总医院急性咽炎的特点
Pub Date : 2023-04-27 DOI: 10.59345/sjorl.v1i1.33
Puspa Zuleika, Adelien
Introduction: Pharyngitis presents with a variety of symptoms, including sudden sore throat, fever, headache, lymphadenitis, and sometimes abdominal pain, nausea, fatigue, and/or rash. This study aimed to provide data on the basic characteristics of acute pharyngitis patients at Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia. Methods: This study was a descriptive observational study. This study uses secondary data obtained from medical record data at the medical records installation of Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia. A total of 100 research subjects participated in this study, and the research subjects met the inclusion criteria. The inclusion criteria in this study were patients diagnosed with acute pharyngitis at Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia, for the period January – December 2022 and who have complete medical record data. Observations on sociodemographic data as well as observations on clinical data, were carried out in this study. Univariate data analysis was performed to present the distribution of frequencies and percentages of each variable. Data analysis was carried out using SPSS version 25. Results: The majority of research subjects are in the age range of 0-14 years. The majority of research subjects are female. The majority of research subjects had clinical symptoms of sore throat and difficulty swallowing. The symptoms that arise in acute pharyngitis depend on the microorganisms that accompany it. Acute pharyngitis caused by bacteria is characterized by severe headache, fever or chills, malaise, painful swallowing, vomiting, and possibly coughing but rarely. Conclusion: The characteristics of pharyngitis patients at Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia, are aged 0-14 years with prominent clinical symptoms of sore throat and difficulty swallowing.
简介:咽炎表现为多种症状,包括突然喉咙痛、发烧、头痛、淋巴结炎,有时还会出现腹痛、恶心、疲劳和/或皮疹。本研究旨在提供关于印度尼西亚巨港市穆罕默德·胡森总医院急性咽炎患者基本特征的数据。方法:本研究为描述性观察性研究。本研究使用的二手数据来自印度尼西亚巨港Dr. Mohammad Hoesin总医院医疗档案装置的病历数据。本研究共有100名研究对象参与,研究对象均符合纳入标准。本研究的纳入标准是2022年1月至12月期间在印度尼西亚巨港的Dr. Mohammad Hoesin总医院诊断为急性咽炎的患者,并且具有完整的医疗记录数据。本研究对社会人口统计数据和临床数据进行了观察。进行单变量数据分析,以呈现每个变量的频率和百分比分布。数据分析采用SPSS 25版本。结果:研究对象以0 ~ 14岁为主。大多数研究对象是女性。大多数研究对象有喉咙痛和吞咽困难的临床症状。急性咽炎的症状取决于伴随咽炎的微生物。由细菌引起的急性咽炎的特点是严重头痛、发烧或发冷、不适、吞咽疼痛、呕吐,并可能咳嗽,但很少。结论:印度尼西亚巨港市Dr. Mohammad Hoesin总医院的咽炎患者年龄为0 ~ 14岁,临床表现以喉咙痛、吞咽困难为主。
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引用次数: 0
期刊
Sriwijaya Journal of Otorhinolaryngology
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