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Can artificial intelligence algorithms recognize knee arthroplasty implants from X-ray radiographs? 人工智能算法能否从 X 光片中识别膝关节置换植入物?
Pub Date : 2023-10-27 DOI: 10.38053/acmj.1356979
Fatih Gölgelioğlu, Aydoğan Aşkin, Mehmet Cihat Gündoğdu, Mehmet Fatih Uzun, Bige Kağan Dedetürk, Mustafa Yalın
Aims: This study aimed to investigate the use of a convolutional neural network (CNN) deep learning approach to accurately identify total knee arthroplasty (TKA) implants from X-ray radiographs. Methods: This retrospective study employed a deep learning CNN system to analyze pre-revision and post-operative knee X-rays from TKA patients. We excluded cases involving unicondylar and revision knee replacements, as well as low-quality or unavailable X-ray images and those with other implants. Ten cruciate-retaining TKA replacement models were assessed from various manufacturers. The training set comprised 69% of the data, with the remaining 31% in the test set, augmented due to limited images. Evaluation metrics included accuracy and F1 score, and we developed the software in Python using the TensorFlow library for the CNN method. A computer scientist with AI expertise managed data processing and testing, calculating specificity, sensitivity, and accuracy to assess CNN performance. Results: In this study, a total of 282 AP and lateral X-rays from 141 patients were examined, encompassing 10 distinct knee prosthesis models from various manufacturers, each with varying X-ray counts. The CNN technique exhibited flawless accuracy, achieving a 100% identification rate for both the manufacturer and model of TKA across all 10 different models. Furthermore, the CNN method demonstrated exceptional specificity and sensitivity, consistently reaching 100% for each individual implant model. Conclusion: This study underscores the impressive capacity of deep learning AI algorithms to precisely identify knee arthroplasty implants from X-ray radiographs. It highlights AI’s ability to detect subtle changes imperceptible to humans, execute precise computations, and handle extensive data. The accurate recognition of knee replacement implants using AI algorithms prior to revision surgeries promises to enhance procedure efficiency and outcomes.
目的:本研究旨在调查卷积神经网络 (CNN) 深度学习方法的使用情况,以便从 X 光片中准确识别全膝关节置换术 (TKA) 植入物。 方法:这项回顾性研究采用深度学习 CNN 系统分析了 TKA 患者术前和术后的膝关节 X 光片。我们排除了涉及单髁膝关节置换术和翻修膝关节置换术的病例、低质量或无法获得的 X 光图像以及使用其他植入物的病例。我们评估了来自不同制造商的十种十字韧带固定 TKA 置换模型。训练集包括 69% 的数据,其余 31% 的数据为测试集,由于图像有限,测试集的数据有所增加。评估指标包括准确率和 F1 分数,我们使用 TensorFlow 库在 Python 中开发了用于 CNN 方法的软件。一位具有人工智能专业知识的计算机科学家负责管理数据处理和测试,计算特异性、灵敏度和准确性,以评估 CNN 的性能。 结果本研究共检查了 141 名患者的 282 张 AP 和侧位 X 光片,包括来自不同制造商的 10 种不同膝关节假体型号,每种型号的 X 光片数量各不相同。CNN 技术表现出完美无瑕的准确性,对所有 10 种不同型号的 TKA 制造商和型号的识别率均达到 100%。此外,CNN 方法还表现出卓越的特异性和灵敏度,对每种假体型号的识别率始终保持在 100%。 结论本研究强调了深度学习人工智能算法从 X 光片中精确识别膝关节置换植入物的惊人能力。它凸显了人工智能检测人类难以察觉的细微变化、执行精确计算和处理大量数据的能力。在翻修手术前使用人工智能算法准确识别膝关节置换植入物有望提高手术效率和效果。
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引用次数: 0
Single-center experience of cubital tunnel syndrome surgery performing transposition or internal neurolysis with external decompression under regional intravenous anesthesia technique 在区域静脉麻醉技术下进行肘管综合征手术的单中心经验:转位或内神经切除加外部减压术
Pub Date : 2023-10-27 DOI: 10.38053/acmj.1344313
Ali Güler
Aims: To share the 7-year experience of a single center in the application of regional intravenous anesthesia (RIVA) for surgical treatment of cubital tunnel syndrome (CTS) caused by compression of the ulnar nerve in the elbow region. Methods: A total of 100 patients with CTS who were operated with the RIVA technique at a single center between 2012 and 2019 were retrospectively analyzed. In the RIVA technique, after providing venous drainage in the operated side arm, the double cuff tourniquet was inflated in the upper arm, and anesthesia was provided by administering a 30-40 mL solution of 2% lidocaine (3 mg/kg) diluted in 1% saline through the intravenous catheter. The surgical methods applied (transposition or internal neurolysis with external decompression), demographic data, preoperative and postoperative visual analog scale (VAS) scores for pain were compared. Results: Out of 100 patients, 30 patients underwent surgical transposition (group 1) while internal neurolysis with external decompression was performed in 70 patients (group 2). The mean age of patients in groups 1 and 2 was 66.3±12.1 and 60.6±11.7 years, respectively. Women accounted for 73.3% of patients in group 1 and 87.1% of patients in group 2. The left side was affected in 18 (60%) patients in group 1 and 42 (60%) patients in group 2. In group 1, the mean postoperative 3rd-week VAS score (1.96±0.76) was significantly lower than the mean preoperative VAS score (7.46±0.93; p
目的:分享一个中心在应用区域静脉麻醉(RIVA)手术治疗因肘部尺神经受压引起的肘管综合征(CTS)方面的 7 年经验。 手术方法回顾性分析了2012年至2019年期间在一个中心接受RIVA技术手术的100例CTS患者。在RIVA技术中,在手术侧手臂进行静脉引流后,在上臂充气双袖带止血带,通过静脉导管注入30-40 mL用1%生理盐水稀释的2%利多卡因(3 mg/kg)溶液进行麻醉。比较了所采用的手术方法(转位或内神经切除加外部减压)、人口统计学数据、术前和术后疼痛视觉模拟量表(VAS)评分。 结果如下在 100 名患者中,30 名患者接受了手术转位(第 1 组),70 名患者接受了内神经切除加外部减压术(第 2 组)。第一组和第二组患者的平均年龄分别为(66.3±12.1)岁和(60.6±11.7)岁。第一组和第二组患者的平均年龄分别为(66.3±12.1)岁和(60.6±11.7)岁,女性分别占 73.3%和 87.1%。第一组和第二组患者中有 18 人(60%)左侧受累,42 人(60%)左侧受累。
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引用次数: 0
Predialysis education program and early vascular access: a single center experience 透析前教育计划和早期血管通路:单个中心的经验
Pub Date : 2023-10-27 DOI: 10.38053/acmj.1331260
Mahmud Islam, Kenan Evren Öztop
Aims: The main objective of this study is to investigate the impact of a pre-dialysis education program on the selection of vascular access during the initiation of maintenance hemodialysis therapy and the short-term impact of this education on patient outcomes. Methods: The data were collected from two different times in the past from patients under maintenance hemodialysis: the first group consisted of a group of patients who received a predialysis education program (intervention group) from a dedicated nephrologist, and the second group included those who did not undergo a control program (control group). Predialysis education program involved six modules addressing understanding kidney disease, diet, and nutrition, treatment options for end-stage kidney disease, dialysis procedures, medication management, and self-care/independence. Patients aged ≥18 years were enrolled in the study. The patients were compared according to their clinical status during the onset of maintenance hemodialysis, including vascular access type, serum potassium level, previous hospitalization, and urgent hemodialysis need. Additionally, the hospitalization and infection rates within 6 months following the onset of maintenance hemodialysis were compared. P
目的:本研究的主要目的是调查透析前教育计划对开始维持性血液透析治疗期间选择血管通路的影响,以及这种教育对患者预后的短期影响。 研究方法收集了过去两个不同时间段接受维持性血液透析患者的数据:第一组包括接受了由专职肾病专家提供的透析前教育计划的患者(干预组),第二组包括未接受对照计划的患者(对照组)。透析前教育计划包括六个模块,分别涉及了解肾病、饮食和营养、终末期肾病的治疗方案、透析程序、药物管理和自我护理/独立。年龄≥18 岁的患者参加了这项研究。根据患者在开始维持性血液透析时的临床状态,包括血管通路类型、血清钾水平、既往住院情况和紧急血液透析需求,对患者进行了比较。此外,还比较了维持性血液透析开始后 6 个月内的住院率和感染率。P
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引用次数: 0
Hemoglobin red cell distribution width ratio as a prognostic marker in patients with locally advanced lung adenocarcinoma 血红蛋白红细胞分布宽度比作为局部晚期肺腺癌患者的预后指标
Pub Date : 2023-10-27 DOI: 10.38053/acmj.1322201
Hasret Gizem Kurt, Ayperi Öztürk, Figen ÖZTÜRK ERGÜR
Aims: Hemoglobin/red cell distribution width ratio (HRR) has been defined as an effective prognostic factor in various malignancies. The aim of this study is to investigate the prognostic role of HRR in locally advanced lung adenocarcinoma. Methods: 626 patients diagnosed with locally advanced lung adenocarcinoma were screened. The best cut-off point of HRR for overall survival (OS) and progression free survival (PFS) was determined by ROC analysis. A HRR cut-off value was determined, patients were classified as having lower or higher HRR. Both groups’ clinical, demographic, laboratory values were compared. To identify independent predictors of prognosis, multivariate cox regression analysis was used. Results: A total of119 patients were included. The best cut-off point of HRR in determining OS was 0.963%.HRR below the cut-off value increased mortality by 2.2fold.The group with HRR
目的:血红蛋白/红细胞分布宽度比(HRR)已被定义为各种恶性肿瘤的有效预后因素。本研究旨在探讨 HRR 在局部晚期肺腺癌中的预后作用。 方法:筛选出 626 例确诊为局部晚期肺腺癌的患者。通过ROC分析确定HRR对总生存期(OS)和无进展生存期(PFS)的最佳临界点。确定了 HRR 临界值后,患者被分为 HRR 较低和较高两组。比较两组患者的临床、人口统计学和实验室数值。为了确定预后的独立预测因素,采用了多变量考克斯回归分析。 结果共纳入 119 名患者。确定 OS 的最佳 HRR 临界点为 0.963%。
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引用次数: 0
Evaluation of cardiovascular risk factors, prevalence and determinants of coronary artery disease in renal transplant patients: a single center experience 评估肾移植患者的心血管风险因素、冠心病发病率和决定因素:单中心经验
Pub Date : 2023-10-27 DOI: 10.38053/acmj.1350404
Betul Cengiz ElçioĞlu, Yasemin Demi̇rci̇, Mert Pehlivan Altin, Erol Gürsoy, V. Aytekin, S. Aytekin
Aims: Cardiovascular disease is the leading cause of morbidity and mortality in renal transplant patients. In our study, we aimed to determine the cardiovascular (CV) risk factors, the prevalence and determinants of coronary artery disease (CAD) in patients who underwent kidney transplantation in our center. Methods: One hundred sixty nine patients who underwent kidney transplantation in our center were included in the study retrospectively. Demographic and clinical characteristics of the patients, cardiac evaluation findings and further examination results were scanned from the database of our center. Results: The mean age of the patients was 42.86±12.97 years and 43.19% were female. The most common etiological factors for the development of end-stage renal disease were hypertension (HT) and diabetes mellitus (DM). Ninety seven patients (57.4%) were undergoing dialysis, 4 of whom were on peritoneal dialysis. Renal transplant was performed from a cadaver in two patients and from a living donor in the other patients. CAD was detected in 29 patients (17.15%). The most prevalent CV risk factors were HT and hyperlipidemia (HL). Multivariate logistic regression analysis revealed that age, DM, HL and dialysis history were independent risk factors for the development of CAD. In the postoperative follow-ups, no death or acute coronary syndrome was observed during the hospitalization period. Conclusion: Prevalence of CV risk factors is high in renal transplant candidates. Our findings support the need for a detailed cardiac evaluation and effective management of CV risk factors in patients preparing for kidney transplantation.
目的:心血管疾病是肾移植患者发病和死亡的主要原因。在我们的研究中,我们旨在确定在本中心接受肾移植的患者的心血管(CV)风险因素、冠状动脉疾病(CAD)的患病率和决定因素。 方法本研究采用回顾性方法纳入了 169 名在本中心接受肾移植手术的患者。从本中心的数据库中扫描患者的人口统计学和临床特征、心脏评估结果和进一步检查结果。 研究结果患者的平均年龄为(42.86±12.97)岁,43.19%为女性。终末期肾病最常见的病因是高血压(HT)和糖尿病(DM)。97名患者(57.4%)正在接受透析,其中4人接受腹膜透析。两名患者的肾移植是从尸体上移植的,另一名患者的肾移植是从活体捐献者身上移植的。29名患者(17.15%)被检测出患有CAD。最常见的冠心病风险因素是高热和高脂血症(HL)。多变量逻辑回归分析显示,年龄、DM、HL 和透析史是发生 CAD 的独立危险因素。在术后随访中,住院期间未发现死亡或急性冠脉综合征。 结论肾移植候选者中冠心病风险因素的发生率很高。我们的研究结果支持了对准备接受肾移植的患者进行详细的心脏评估和有效管理冠心病风险因素的必要性。
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引用次数: 0
Evaluation of distribution and susceptibility of microorganisms isolated from joint fluid cultures: five-year data 评估从关节液培养物中分离出的微生物的分布和敏感性:五年数据
Pub Date : 2023-10-27 DOI: 10.38053/acmj.1342396
Halil Er, Özlem Koca, Nevgün Sepin Özen
Aims: Septic arthritis is joint inflammation. It is an orthopedic emergency that requires prompt diagnosis and treatment. In this study, it was aimed to examine the distribution and antibiotic resistance profiles of microorganisms isolated from joint fluid samples taken from patients who applied to the orthopedic clinic of our hospital in the last five years. Methods: In our study, 1162 joint fluid samples were sent to the medical microbiology laboratory of our hospital from the orthopedics and traumatology clinic between January 01, 2018 and December 31, 2022. Joint fluid samples taken from clinically appropriate patients under sterile conditions were incubated in a BacT/Alert 3D (Biomerieux, France) culture device. Bacteria isolated from 164 specimens with growth detected, were identified by matrix-mediated laser desorption/ionization-time-of-flight mass spectrometry (MALDI-TOF MS) based VITEK MS (Biomerieux, France). Antibiotic susceptibility tests were performed on the VITEK 2 Compact (Biomerieux, France) device. Results: Staphylococcus aureus (S. aureus) (29.3%) and coagulase negative Staphylococci (CNS) (29.3%) were the most commonly grown microorganisms. Other microorganisms grown were Streptococcus spp. (9.1%), Enterococcus spp. (6.1%), Pseudomonas aeruginosa (P. aeuruginosa) (7.3%), Escherichiae coli (E. coli) (4.3%) and Klebsiella pneumoniae (K. pneumoniae) (4.3%). When antibiotic susceptibility results were evaluated according to EUCAST restricted reporting criteria, linezolid in Gram-positive strains, amikacin in Enterobacterales, colistin and tigecycline in nonfermentative Gram-negative bacteria were found to be the most susceptible antibiotics. Conclusion: The continuous change in antibiotic susceptibility profiles in joint infections, the long duration of treatment and follow-up, and the increase in polymicrobial infections require regular monitoring of culture and antibiotic susceptibility tests. In our study, the distribution of microorganisms isolated from joint fluid samples of our hospital and the determination of antibiotic resistance profiles will contribute to the clinician in terms of guiding empirical treatment.
目的:化脓性关节炎是一种关节炎症。它是骨科急症,需要及时诊断和治疗。本研究旨在检测过去五年中从本院骨科门诊就诊患者的关节液样本中分离出的微生物的分布和抗生素耐药性情况。 研究方法在我们的研究中,2018 年 1 月 1 日至 2022 年 12 月 31 日期间,骨科和创伤科门诊向我院医学微生物实验室送检了 1162 份关节液样本。在无菌条件下从临床合适的患者身上采集的关节液样本在 BacT/Alert 3D (法国 Biomerieux 公司)培养装置中进行培养。通过基于 VITEK MS(法国生物梅里埃公司)的基质介导激光解吸/电离飞行时间质谱法(MALDI-TOF MS),对从 164 份样本中分离出并检测到生长的细菌进行鉴定。抗生素药敏试验在 VITEK 2 Compact(法国 Biomerieux 公司)设备上进行。 检测结果最常生长的微生物是金黄色葡萄球菌(S. aureus)(29.3%)和凝固酶阴性葡萄球菌(CNS)(29.3%)。其他微生物包括链球菌(9.1%)、肠球菌(6.1%)、绿脓杆菌(7.3%)、大肠埃希氏菌(4.3%)和肺炎克雷伯菌(4.3%)。根据欧盟抗菌药物委员会(EUCAST)限制性报告标准对抗生素药敏结果进行评估后发现,革兰氏阳性菌株中的利奈唑胺、肠杆菌科细菌中的阿米卡星、非发酵革兰氏阴性菌中的可乐定和替加环素是最易感的抗生素。 结论关节感染中抗生素药敏谱的不断变化、治疗和随访时间的延长以及多微生物感染的增加都要求对培养和抗生素药敏试验进行定期监测。在我们的研究中,从本院关节液样本中分离出的微生物的分布情况以及抗生素耐药谱的测定将有助于临床医生指导经验性治疗。
{"title":"Evaluation of distribution and susceptibility of microorganisms isolated from joint fluid cultures: five-year data","authors":"Halil Er, Özlem Koca, Nevgün Sepin Özen","doi":"10.38053/acmj.1342396","DOIUrl":"https://doi.org/10.38053/acmj.1342396","url":null,"abstract":"Aims: Septic arthritis is joint inflammation. It is an orthopedic emergency that requires prompt diagnosis and treatment. In this study, it was aimed to examine the distribution and antibiotic resistance profiles of microorganisms isolated from joint fluid samples taken from patients who applied to the orthopedic clinic of our hospital in the last five years. Methods: In our study, 1162 joint fluid samples were sent to the medical microbiology laboratory of our hospital from the orthopedics and traumatology clinic between January 01, 2018 and December 31, 2022. Joint fluid samples taken from clinically appropriate patients under sterile conditions were incubated in a BacT/Alert 3D (Biomerieux, France) culture device. Bacteria isolated from 164 specimens with growth detected, were identified by matrix-mediated laser desorption/ionization-time-of-flight mass spectrometry (MALDI-TOF MS) based VITEK MS (Biomerieux, France). Antibiotic susceptibility tests were performed on the VITEK 2 Compact (Biomerieux, France) device. Results: Staphylococcus aureus (S. aureus) (29.3%) and coagulase negative Staphylococci (CNS) (29.3%) were the most commonly grown microorganisms. Other microorganisms grown were Streptococcus spp. (9.1%), Enterococcus spp. (6.1%), Pseudomonas aeruginosa (P. aeuruginosa) (7.3%), Escherichiae coli (E. coli) (4.3%) and Klebsiella pneumoniae (K. pneumoniae) (4.3%). When antibiotic susceptibility results were evaluated according to EUCAST restricted reporting criteria, linezolid in Gram-positive strains, amikacin in Enterobacterales, colistin and tigecycline in nonfermentative Gram-negative bacteria were found to be the most susceptible antibiotics. Conclusion: The continuous change in antibiotic susceptibility profiles in joint infections, the long duration of treatment and follow-up, and the increase in polymicrobial infections require regular monitoring of culture and antibiotic susceptibility tests. In our study, the distribution of microorganisms isolated from joint fluid samples of our hospital and the determination of antibiotic resistance profiles will contribute to the clinician in terms of guiding empirical treatment.","PeriodicalId":307693,"journal":{"name":"Anatolian Current Medical Journal","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139312653","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
Exploring the impacts of Pycnogenol on pentraxin-3 levels in the heart tissue of rats administered with gentamicin 探索 Pycnogenol 对使用庆大霉素的大鼠心脏组织中戊沙星-3 水平的影响
Pub Date : 2023-10-27 DOI: 10.38053/acmj.1328767
Tolga Çakmak
Aims: The present study explored if pentraxin-3 (PTX-3) levels, which would be boosted due to cardiac damage by gentamicin, can be regressed thanks to Pycnogenol, which was also previously shown to have desirable impacts on cardiovascular diseases. Methods: In the study, we recruited 28 8-10-week-old male Sprague-Dawley rats into four groups: control, gentamicin, gentamycin+Pycnogenol, and Pycnogenol. We stained the tissue samples with hematoxylin-eosin and Masson’s trichome dye for histopathological analysis. Then, malondialdehyde (MDA) levels were measured using the spectrophotometric technique. In addition, we measured PTX-3 levels in the heart tissues by an immunohistochemical method. Results: We discovered the heart tissue samples of the rats in the control and Pycnogenol groups were histologically normal. As well as mononuclear cell increase and degeneration of cardiac muscle cells, we observed mild congestion in the gentamicin group compared to the control group. Despite more significant damage to the heart tissue in the gentamicin+Pycnogenol group compared to the control group, we found that the histopathological damage regressed in this group compared to the gentamicin group. While PTX-3 immunoreactivity was similar between the control and Pycnogenol groups, it was significantly elevated in the gentamicin group compared to the control group (p < 0.001). Moreover, the gentamicin+Pycnogenol group had decreased PTX-3 immunoreactivity than the gentamicin group. While MDA values followed a similar pattern between the control and Pycnogenol groups, these values were found to be significantly increased in the gentamicin group compared to the control group (p < 0.001). These values, however, were decreased in the gentamicin+Pycnogenol group compared to the gentamicin group. Conclusion: In a nutshell, the present study was able to demonstrate that gentamicin may lead to cardiac damage by boosting PTX-3 levels and that the damage can be regressed thanks to the Pycnogenol treatment.
目的:本研究探讨了庆大霉素对心脏的损害会导致五胜霉素-3(PTX-3)水平升高,而 Pycnogenol(碧萝原醇)之前也被证明对心血管疾病有良好的影响)是否能使五胜霉素-3(PTX-3)水平下降。 研究方法在研究中,我们招募了 28 只 8-10 周大的雄性 Sprague-Dawley 大鼠,分为四组:对照组、庆大霉素组、庆大霉素+碧萝芷组和碧萝芷组。我们用苏木精-伊红和马森毛状体染料对组织样本进行染色,以进行组织病理学分析。然后,使用分光光度法测量丙二醛(MDA)水平。此外,我们还采用免疫组化方法测定了心脏组织中 PTX-3 的水平。 结果我们发现对照组和疲乐振组大鼠的心脏组织样本在组织学上是正常的。与对照组相比,我们观察到庆大霉素组出现轻度充血以及单核细胞增多和心肌细胞退化。尽管与对照组相比,庆大霉素+酚苄醇组的心脏组织损伤更为严重,但我们发现与庆大霉素组相比,酚苄醇组的组织病理学损伤有所减轻。虽然 PTX-3 免疫反应在对照组和百球酚组之间相似,但与对照组相比,庆大霉素组的 PTX-3 免疫反应明显升高(p < 0.001)。此外,庆大霉素+碧萝芷组的 PTX-3 免疫反应比庆大霉素组低。虽然对照组和疲乐振组的 MDA 值模式相似,但与对照组相比,庆大霉素组的 MDA 值显著增加(p < 0.001)。然而,与庆大霉素组相比,庆大霉素+碧萝芷组的这些数值有所下降。 结论总之,本研究能够证明庆大霉素可通过提高 PTX-3 水平导致心脏损伤,而 Pycnogenol 治疗可使损伤得到缓解。
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引用次数: 0
Inquiring about the link between urotensin-II and coronary collateral development in coronary artery patients with and without diabetes 探究患有和未患有糖尿病的冠状动脉患者体内尿促性素-II 与冠状动脉侧支发展之间的联系
Pub Date : 2023-10-27 DOI: 10.38053/acmj.1330608
Yasin Karakuş, Nusret Açikgöz
Aims: Coronary collateral circulation consists of vascular channels activated to maintain perfusion in major epicardial coronary arteries in severe stenosis or occlusion. Yet, coronary collateral development (CCD) in diabetic patients was previously proven to be poor. Urotesin-II (U-II) is famous for being the most potent vasoconstrictor agent, and plasma levels are known to elevate in diabetic patients and play an important role in diabetic complications. In this study, we inquired about the link between U-II levels and the development of coronary collaterals between diabetic and non-diabetic patients with coronary artery disease (CAD). Methods: We recruited 31 diabetic and 30 non-diabetic patients with 95% or more coronary artery stenosis or occlusion and considered Rentrop’s classification for grading collaterals. In this sense, while Rentrop grades 0-1 are regarded as poor CCD, Rentrop grades 2-3 correspond to well-developed collaterals. Moreover, we compared the patients’ serum levels of U-II by the degree of CCD. Results: The findings revealed that demographic characteristics did not significantly differ between the groups (p >0.05). Although CCD seemed worse in diabetic patients than those without diabetes (DM), the finding was not statistically significant. However, the diabetic patients had significantly higher U-II levels than non-diabetic patients (388.1±314.2 vs. 229.8±216.9, p=0.026). Despite not being significant, U-II levels were higher in patients with poor CCD than those with well-developed collaterals in the non-diabetic group (370.6±298; 178.6±158.3, p=0.2). In the diabetic group, on the other hand, U-II levels were significantly higher in patients with poor CCD and significantly lower in patients with good CCD (582.7±316.4 and 180.4±121.6, respectively; p
目的:冠状动脉侧支循环是在心外膜主要冠状动脉严重狭窄或闭塞时为维持灌注而激活的血管通道。然而,糖尿病患者的冠状动脉侧支发育(CCD)以前被证明很差。尿囊素-II(U-II)是最有效的血管收缩剂,众所周知,糖尿病患者血浆中的尿囊素-II水平会升高,并在糖尿病并发症中扮演重要角色。在这项研究中,我们探究了糖尿病和非糖尿病冠状动脉疾病(CAD)患者的 U-II 水平与冠状动脉瓣膜发展之间的联系。 研究方法我们招募了 31 名糖尿病患者和 30 名非糖尿病患者,这些患者的冠状动脉狭窄或闭塞程度达到或超过 95%。从这个意义上讲,Rentrop 0-1 级被认为是不良的 CCD,而 Rentrop 2-3 级则对应于发达的袢。此外,我们还根据 CCD 的程度比较了患者血清中的 U-II 水平。 结果研究结果显示,两组患者的人口统计学特征无明显差异(P>0.05)。虽然糖尿病患者的 CCD 似乎比非糖尿病(DM)患者更严重,但这一结果在统计学上并不显著。然而,糖尿病患者的 U-II 水平明显高于非糖尿病患者(388.1±314.2 vs. 229.8±216.9,P=0.026)。在非糖尿病组中,CCD 较差的患者的 U-II 水平(370.6±298;178.6±158.3,P=0.2)高于脉络发达的患者,尽管差异不明显。另一方面,在糖尿病组中,CCD 差的患者 U-II 水平明显较高,而 CCD 好的患者 U-II 水平明显较低(分别为 582.7±316.4 和 180.4±121.6;P=0.2)。
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引用次数: 0
Evaluation of immunochromatography method in the diagnosis of cystic echinococcosis 对免疫层析法诊断囊性棘球蚴病的评估
Pub Date : 2023-10-27 DOI: 10.38053/acmj.1345403
Özlem Koca, Özgül Çetinkaya, Aylin Erman Daloğlu, Y. Çekin, Hatice Özen
Aims: Echinococcus granulosus is the causative agent of hydatid cyst, or cystic echinococcosis (CE), with its current name. Echinococcus granulosus is a zoonotic cestode; commonly found in humans and farm animals. In cystic echinococcosis infection, transmission occurs by oral ingestion of parasite eggs excreted in infected dog feces. The larval form is responsible for the formation of slowly growing cysts in the organs and tissues of mammals such as humans, sheep, goats and cattle. In this study, it was aimed to compare indirect hemagglutination (IHA) and immunochromatographic (ICT) methods from the sera of patients with suspected CE and to evaluate serological tests based on imaging and clinical diagnosis. Methods: Between 31 October 2022 and 31 January 2023, blood samples of 95 patients with suspected CE from different units of our hospital and for whom IHA was routinely requested were included in the study prospectively. VIRAPID® Hydatidosis (Vircell, Granada, Spain) test using the immunochromatographic method and ELI.H.A. Echinococcus (ELITech Microbio, France) test was studied in accordance with the manufacturer’s instructions. Results: Based on clinical and imaging methods of 95 patients included in our study, 64 (63.1%) were diagnosed with hydatid cyst. Based on imaging and clinical diagnosis; sensitivity, specificity, positive predictive value and negative predictive values were calculated as 81.3%, 96.8%, 98.1%, 71.4% for the IHA test, and were calculated as 75.0%, 93.5%, 96.6%, 64.4% for the ICT test, respectively. Good agreement was found between the two tests (percent agreement=68.0%; kappa value=0.682; p
目的:颗粒棘球蚴是包虫囊肿或囊性棘球蚴病(CE)的病原体。颗粒棘球蚴是一种人畜共患病绦虫,常见于人类和农场动物。在囊性棘球蚴病感染中,传播途径是口服受感染犬粪便中排出的寄生虫卵。幼虫在人、绵羊、山羊和牛等哺乳动物的器官和组织中形成缓慢生长的囊肿。本研究旨在比较间接血凝法(IHA)和免疫层析法(ICT)检测疑似 CE 患者血清的方法,并根据影像学和临床诊断对血清学检测进行评估。 方法:在 2022 年 10 月 31 日至 2023 年 1 月 31 日期间,本研究前瞻性地纳入了 95 例疑似 CE 患者的血样,这些患者来自本院不同科室,且常规要求进行 IHA 检测。根据制造商的说明,采用免疫层析法对 VIRAPID® 水肿病(Vircell,西班牙格拉纳达)进行检测,并对 ELI.H.A.棘球蚴(ELITech Microbio,法国)进行检测。 结果:根据临床和影像学方法,95 名患者中有 64 人(63.1%)被确诊为包虫囊肿。根据成像和临床诊断,IHA 检验的灵敏度、特异性、阳性预测值和阴性预测值分别为 81.3%、96.8%、98.1% 和 71.4%,ICT 检验的灵敏度、特异性、阳性预测值和阴性预测值分别为 75.0%、93.5%、96.6% 和 64.4%。两种测试结果具有良好的一致性(一致性百分比=68.0%;卡帕值=0.682;P<0.05)。
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引用次数: 0
The diagnostic accuracy of coronary angiography to detect left anterior descending artery myocardial bridging in coronary artery bypass grafting: a retrospective single-center study 冠状动脉旁路移植术中冠状动脉造影检测左前降支动脉心肌桥接的诊断准确性:一项回顾性单中心研究
Pub Date : 2023-10-27 DOI: 10.38053/acmj.1309538
Sameh Alagha
Aims: The left anterior descending artery is the most involved vessel in the myocardial bridging of the coronary arteries. Revascularization of the left anterior descending artery (LAD) is considered an essential component of coronary artery bypass grafting (CABG) procedures. This study aims to evaluate the correlation between angiographic views of the coronary artery and intraoperative findings of the left anterior descending artery myocardial bridge (LADMB). Methods: The records of patients who underwent the CABG procedure between January 2015 and October 2022 were reviewed retrospectively. A total of 349 patients who had LADMB on coronary angiography (CAG) images and/or intraoperatively were evaluated. Patients were divided into two groups. The CAG group (n=50) consisted of patients with angiographic LADMB, and the CABG group (n=40) consisted of patients with LADMB that was detected intraoperatively. The correlation between myocardial bridge signs of the LAD in CAG and intraoperative observations was investigated. Results: In the coronary angiography group, 50 patients had signs of depression on coronary angiography, of whom 35 had LADMB intraoperatively. In the CABG group, 40 patients were found to have a myocardial bridge intraoperatively, and 5 had normal CAG images. The prevalence of LADMB was 11.5%. The sensitivity of CAG was 87.5%, the specificity was 95.15%, the positive predictive value was 70%, and the negative predictive value was 98.32%. Conclusion: The myocardial bridge signs of the LAD on CAG correlate with intraoperative observations with high sensitivity and specificity.
目的:左前降支动脉是参与冠状动脉心肌桥接最多的血管。左前降支动脉(LAD)的血管重建被认为是冠状动脉旁路移植术(CABG)的重要组成部分。本研究旨在评估冠状动脉血管造影视图与术中发现的左前降支动脉心肌桥(LADMB)之间的相关性。 方法回顾性分析2015年1月至2022年10月期间接受CABG手术的患者记录。共评估了 349 例在冠状动脉造影(CAG)图像和/或术中发现 LADMB 的患者。患者分为两组。CAG组(50人)为血管造影显示LADMB的患者,CABG组(40人)为术中发现LADMB的患者。研究了CAG和术中观察到的LAD心肌桥征之间的相关性。 结果:在冠状动脉造影组中,有 50 名患者在冠状动脉造影时出现凹陷征象,其中有 35 名患者在术中出现 LADMB。在 CABG 组中,40 名患者术中发现有心肌桥,5 名患者的 CAG 图像正常。LADMB 的发生率为 11.5%。CAG 的敏感性为 87.5%,特异性为 95.15%,阳性预测值为 70%,阴性预测值为 98.32%。 结论CAG 上的 LAD 心肌桥征与术中观察结果相关,具有较高的灵敏度和特异性。
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Anatolian Current Medical Journal
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