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Brain magnetic resonance spectroscopy in migraine 偏头痛的脑磁共振波谱
Pub Date : 2021-01-01 DOI: 10.5633/AMM.2021.0210
F. Petrović, D. Stojanov, Aleksandra Aracki-Trenkic, J. Petrović, Marta Petrović, S. Janković
Migraine is a common neurological disorder that is characterized by episodes of moderate to severe headache. Magnetic resonance spectroscopy (MRS) is a noninvasive method that enables in vivo studying of tissue metabolism by utilizing the magnetic properties of certain atomic nuclei, mainly hydrogen (1H) and phosphorous (31P). 1H-MRS is most commonly used to measure the concentration of gamma aminobutyric acid (GABA), glutamate, phosphocreatine (PCr), creatine, choline, N-acetylaspartate (NAA), myo-inositol, aspartate and lactate. 31P-MRS enables noninvasive in vivo measuring of concentration of compounds containing phosphorus nuclei. This allows the measurement of metabolites involved in brain energy metabolism including concentrations of phosphocreatine (PCr), inorganic phosphate, creatine, adenosine diphosphate (ADP) and adenosine triphosphate (ATP). 1H-MRS studies reported significant differences in levels of GABA, glutamate, lactate and NAA between migraine patients and controls, measured in various brain regions, while most of the studies found no significant differences in levels of myo-inositol, choline and total creatine. The main consistent findings using 31P-MRS are concomitantly decreased PCr and increased inorganic phosphate, that is, a decreased PCr/inorganic phosphate ratio, as well as decreased magnesium measured in cortical regions of migraine patients. For identifying a biomarker in migraine it is necessary for future Mrs studies to obtain additional information of the ictal state in migraine as well as before and after interventions. Severity of the disease (disease duration and migraine attack frequency) has to be taken into account to detect possible correlation with Mrs findings which also needs further research.
偏头痛是一种常见的神经系统疾病,其特征是中度至重度头痛发作。磁共振波谱(MRS)是一种非侵入性的方法,利用某些原子核的磁性,主要是氢(1H)和磷(31P),可以在体内研究组织代谢。1H-MRS最常用于测量γ氨基丁酸(GABA)、谷氨酸、磷酸肌酸(PCr)、肌酸、胆碱、n -乙酰天冬氨酸(NAA)、肌醇、天冬氨酸和乳酸的浓度。31P-MRS能够无创地在体内测量含磷核化合物的浓度。这允许测量涉及脑能量代谢的代谢物,包括磷酸肌酸(PCr)、无机磷酸盐、肌酸、二磷酸腺苷(ADP)和三磷酸腺苷(ATP)的浓度。1H-MRS研究报告了偏头痛患者和对照组在不同脑区测量的GABA、谷氨酸、乳酸和NAA水平的显著差异,而大多数研究发现肌醇、胆碱和总肌酸水平没有显著差异。使用31P-MRS的主要一致发现是伴随PCr减少和无机磷酸盐增加,即PCr/无机磷酸盐比率降低,以及偏头痛患者皮质区域测量的镁减少。为了确定偏头痛的生物标志物,有必要在未来的Mrs研究中获得偏头痛的临界状态以及干预前后的额外信息。必须考虑到疾病的严重程度(病程和偏头痛发作频率),以检测与Mrs结果的可能相关性,这也需要进一步的研究。
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引用次数: 2
ACUTE PANCREATITIS IN PREGNANCY — FROM ETIOPATHOGENESIS TO THERAPY 妊娠期急性胰腺炎——从发病到治疗
Pub Date : 2020-09-15 DOI: 10.5633/amm.2020.0306
Snežana Tešić-Rajković, Biljana Radovanović-Dinić
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引用次数: 0
LAPAROSCOPIC RADICAL PROSTATECTOMY: A SINGLE CENTER EXPERIENCE 腹腔镜根治性前列腺切除术:单中心经验
Pub Date : 2020-09-15 DOI: 10.5633/amm.2020.0302
B. Shabani, S. Gurmeshevski, G. Petrushevska, S. Dohcev, S. Stavridis, O. Stankov
Minimally invasive techniques including robotic-assisted and laparoscopic radical prostatectomy have become the preferred approach for operative treatment of prostate cancer. The aim of this study was to evaluate and compare results of laparoscopic radical prostatectomy (LRP) and open retropubic radical prostatectomy (ORRP) for localised prostate cancer, in terms of safety, eficacy and oncological outcome. A total of 123 radical prostatectomies (RPs) for low-risk localised prostate cancer were performed between January 2016 and June 2019 at the University Clinic of Urology Skopje. Of these, 61 (49.6%) were LRP and 62 (50.4%) ORRP, mean patients age was 54 years (33 to 67) Indications for operative procedure included: pathohistological finding of prostate cancer, age ≤ 70 years, PSA<10ng/ml, Gleson score ≤ 7 (3+3 or 3+4), negative bone scintigraphy, stage ≤T2a, N0, M0. All patients were assessed regarding the demographic data, PSA level, Gleason score, operative time, conversion to open surgery for LRP, blood loss, intra and post operative complications, catheter removal, number blood transfusion, hospital stay and oncological outcomes. LRP proved superior to ORRP, resulting in shorter operating time, less blood loss (p < 0.5), shorter time to resumption of oral intake, shorter postoperative hospital stay (p < 0.5), and less analgesic requirements. In terms of oncological outcomes, we observed less positive margins in the LRP group (p < 0.5). Our results indicate that although both operative techniques represent safe procedures, offering good qualiy of operation, in our series, LRP was superior in terms of safety, eficacy and oncological outcomes. Acta Medica Medianae 2020;59(3):xx-xx.
包括机器人辅助和腹腔镜根治性前列腺切除术在内的微创技术已成为前列腺癌手术治疗的首选方法。本研究的目的是评估和比较腹腔镜根治性前列腺切除术(LRP)和开放式耻骨后根治性前列腺切除术(ORRP)治疗局限性前列腺癌的安全性、有效性和肿瘤预后。2016年1月至2019年6月,斯科普里泌尿外科大学诊所共进行了123例低风险局部前列腺癌根治性前列腺切除术(RPs)。其中LRP 61例(49.6%),ORRP 62例(50.4%),平均年龄54岁(33 ~ 67岁)。手术指征:前列腺癌病理发现,年龄≤70岁,PSA<10ng/ml, Gleson评分≤7(3+3或3+4),骨显像阴性,分期≤T2a, N0, M0。评估所有患者的人口学数据、PSA水平、Gleason评分、手术时间、LRP转为开放手术、出血量、术中及术后并发症、拔管次数、输血次数、住院时间和肿瘤预后。LRP优于ORRP,手术时间更短,出血量更少(p < 0.5),恢复口服摄入时间更短,术后住院时间更短(p < 0.5),镇痛需求更少。在肿瘤预后方面,我们观察到LRP组的阳性边缘较少(p < 0.5)。我们的研究结果表明,尽管两种手术技术都是安全的,提供了良好的手术质量,但在我们的研究中,LRP在安全性、有效性和肿瘤预后方面更胜一筹。医学杂志,2020;59(3):xx-xx。
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引用次数: 0
MORGAGNI HERNIA IN THE ADULT PATIENT: A CASE REPORT 成人MORGAGNI疝1例
Pub Date : 2020-09-15 DOI: 10.5633/amm.2020.0315
V. Joksimović, N. Jankulovski, S. Antović, S. Jović, M. Joksimović
Congenital diaphragmatic hernias (CDHs) occur from a disruption in the muscular formation of the diaphragm, resulting in herniation of abdominal contents into the thoracic cavity (12). First described by Giovanni Batista Morgagni, the anteromedial sternocostal location of diaphragmatic hernia through the defect located between the muscle fibres of the xiphisternum and the costal margin is a rare type of CDH and accounts for only 2% to 3% of cases of all CDHs. In the neonatal patients, the most common symptoms are pulmonary hypertension and respiratory distress, and in adult patients, these are dyspnea, cough, chest pain and obstruction symptoms. In this case report, the patient (male, 66 years) reported one month lasting tachycardia, upper abdominal pain and discomfort, claiming certain alleviation of the symptoms in upright position. He had medical history of cardiac disease. The diagnosis was presumed on plain radiogram of the thorax and it was confirmed with CT scan of thorax and abdomen. The patient was treated surgically with primary closure of the diaphragmatic defect. Acta Medica Medianae 2020;59(3):108-111.
先天性膈疝(CDHs)发生于膈肌形成中断,导致腹部内容物突出进入胸腔(12)。首先由Giovanni Batista Morgagni描述,膈疝的胸骨前内侧肋部位置穿过位于西腓肌纤维和肋缘之间的缺损,是一种罕见的CDH类型,仅占所有CDH病例的2%至3%。新生儿患者最常见的症状是肺动脉高压和呼吸窘迫,成年患者则有呼吸困难、咳嗽、胸痛和阻塞症状。在本病例报告中,患者(男,66岁)报告了持续一个月的心动过速、上腹部疼痛和不适,声称直立姿势的症状有所缓解。他有心脏病史。根据胸部的平片放射图推测诊断,并通过胸部和腹部的CT扫描予以确认。该患者接受了膈肌缺损一期闭合术的治疗。2020年医学杂志;59(3):108-111。
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引用次数: 0
DEVELOPMENT OF BIOACTIVE CELLULOSE SULFATES FOR BIOMEDICAL APPLICATIONS 生物医学用途的生物活性硫酸盐纤维素的开发
Pub Date : 2020-09-15 DOI: 10.5633/amm.2020.0308
T. Groth, C. Willems, Kai Zhang, S. Fischer
Cellulose is the most abundant biomolecule on earth. Chemical derivatives of cellulose have found multitude of uses in industrial and biotechnological applications. Cellulose sulfates (CS) represent a class of water-soluble derivatives that have been employed in industrial application, but not yet in medicine. Here derivatives with different degree of sulfation of anhydroglucose unit (AGU) of cellulose have been studied toward anticoagulant effects and modulating effects of growth factors with heparin-binding domains like fibroblast growth factor 2 (FGF-2). The results show that CS of higher sulfation degree have an anti-coagulant activity comparable to that of heparin with cooperative action to anti-thrombin III that inhibits thrombin and Factor Xa activity making CS interesting for anticoagulant coating of blood-contacting medical devices. Furthermore, the studies show that CS with comparable sulfation degree to heparin have a promoting activity on the mitogenic effect of FGF-2 shown in cell culture studies that indicate their application as coatings of implant materials or component of tissue engineering scaffolds in the area of traumatology and regenerative medicine. Acta Medica Medianae 2020;59(3):56-67.
纤维素是地球上最丰富的生物分子。纤维素的化学衍生物在工业和生物技术方面有许多用途。纤维素硫酸盐(CS)是一类水溶性衍生物,已用于工业应用,但尚未用于医学。本文研究了纤维素的无水葡萄糖单元(AGU)不同磺化程度的衍生物对肝素结合域生长因子如成纤维细胞生长因子2 (FGF-2)的抗凝血作用和调节作用。结果表明,高磺化度的CS具有与肝素相当的抗凝血活性,并与抑制凝血酶和Xa因子活性的抗凝血酶III协同作用,使CS成为血液接触医疗器械抗凝血涂层的兴趣所在。此外,研究表明,在细胞培养研究中,与肝素磺化程度相当的CS对FGF-2的有丝分裂作用具有促进作用,这表明它们在创伤学和再生医学领域可作为植入材料的涂层或组织工程支架的组成部分。媒介医学学报,2020;59(3):56-67。
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引用次数: 1
PROSTATE SPECIFIC ANTIGEN VERSUS COMBINATION OF PROSTATE SPECIFIC ANTIGEN AND ALKALINE PHOSPHATASE IN PREDICTION OF PROSTATE CARCINOMA BONE METASTASES DETECTED WITH BONE SCINTIGRAPHY 前列腺特异性抗原与前列腺特异性抗原联合碱性磷酸酶对骨显像预测前列腺癌骨转移的影响
Pub Date : 2020-09-15 DOI: 10.5633/amm.2020.0310
M. Stevic, M. Vlajković, Marko Kojić, Filip Veličković, N. Topić, D. Basic
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引用次数: 0
VALUE OF HAEMATOLOGICAL AND SERUM BIOCHEMICAL PARAMETERS IN THE PREDICTION OF PERINATAL OUTCOME IN PREECLAMPSIA 血液学和血清生化参数在预测先兆子痫围产期结局中的价值
Pub Date : 2020-09-15 DOI: 10.5633/amm.2020.0304
Jelena Milošević-Stevanović, Dragana Radović-Janošević, J. Popović, M. Stefanović, R. Kutlesic, A. Petrič, M. Stanojević
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引用次数: 2
ANTIBIOTIC RESISTANCE THREATS IN PATIENTS WITH INDWELLING URINARY CATHETERS: BACTERIAL SPECTRUM, INFECTION RATES AND THE EMERGENCE OF MULTIDRUG RESISTANT AND EXTENSIVELY DRUG RESISTANT STRAINS 留置导尿患者的抗生素耐药威胁:细菌谱、感染率以及多重耐药和广泛耐药菌株的出现
Pub Date : 2020-09-15 DOI: 10.5633/amm.2020.0312
M. Potić, A. Skakić, M. Djordjevic
The extent of antimicrobial resistance has become a global threat and according to the World Health Organization latest reports on this issue, 21 st century could mark the end of the antibiotic era. Catheter-associated urinary tract infections are the leading cause of healthcare- associated bacteremia and a major source of resistant gram-negative organisms. This paper focuses on antibacterial resistance of bacterial species isolated from the urine samples of bacteriuric patients. In this study we examined urine cultures of patients with indwelling urethral catheters hospitalized for operative treatment who are at a higher risk for the emergency due to difficult to eradicate pathogens. We assessed underlying primary health conditions, comorbidities and infection risk factors in an attempt to relate them with rates of resistance. The results of susceptibility testing among positive urine isolates revealed high rates of resistance to β-lactamase inhibitors, third-generation cephalosporins, fluoroquinolones and trimethoprim-sulfamethoxazole alongside with combined resistance to third-generation cephalosporins, fluoroquinolones and aminoglycosides. Multi-drug resistant strains were isolated regardless of clinically apparent symptoms and signs of the infection with catheterization duration being the dominant factor in comparison to the severity of primary disease and comorbidities. Administration of empirical therapy failed to address resistance patterns of detected pathogens. Catheterization due to strictly defined indications, reduction of catheter presence duration and choice of therapeutic agent in accordance with susceptibility testing are currently best available strategies both for prevention and therapy. Acta Medica Medianae 2020;59(3):90-97. catheter, multi-drug
抗菌素耐药性的程度已成为全球威胁,根据世界卫生组织关于这一问题的最新报告,21世纪可能标志着抗生素时代的终结。导尿管相关性尿路感染是保健相关菌血症的主要原因,也是耐药革兰氏阴性菌的主要来源。本文对从细菌性尿尿患者尿液中分离出的细菌种类的耐药性进行了研究。在这项研究中,我们检查了留置导尿管住院接受手术治疗的患者的尿液培养,这些患者由于难以根除病原体而具有较高的急诊风险。我们评估了潜在的初级健康状况、合并症和感染危险因素,试图将它们与耐药率联系起来。尿中阳性分离株药敏试验结果显示,对β-内酰胺酶抑制剂、第三代头孢菌素、氟喹诺酮类药物和甲氧苄啶-磺胺甲恶唑的耐药率较高,对第三代头孢菌素、氟喹诺酮类药物和氨基糖苷类药物的联合耐药率较高。无论感染的临床症状和体征如何,均分离出多重耐药菌株,与原发疾病和合并症的严重程度相比,置管时间是主要因素。经验性治疗未能解决检测到的病原体的耐药模式。导尿由于严格定义的适应症,减少导管存在时间和根据敏感性试验选择治疗剂是目前预防和治疗的最佳策略。医学学报,2020;59(3):90-97。导管,多种药物
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引用次数: 0
SURGICAL MANAGEMENT OF LIP CANCER: A 5 YEAR EXPERIENCE 唇癌手术治疗5年经验
Pub Date : 2020-09-15 DOI: 10.5633/amm.2020.0309
Stefan Mladenović, P. Kovacevic, A. Višnjić
Lip cancer is a common malignancy of the oral cavity as it accounts for 25% of them and contributes ~ 12% to all tumors of the head and neck region. The most frequent lip carcinomas are squamous cell carcinoma (SCC), basal cell carcinoma (BCC), and basosquamous carcinoma (BSC). The aim of this study was to describe clinical characteristics of tumors, surgical technique, and outcomes after lip cancer surgery performed at the University Clinical Center Niš. We conducted a single institution retrospective study including patients who consecutively underwent surgery for carcinoma of the lip at the Clinic of Plastic and Reconstructive Surgery, Clinical Center Niš, in the 5-year period. A total of 32 patients with lip cancer were included in the study. Nineteen (59%) patients were male and 13 (41%) were female. There were 20 cases of SCC, 11 with BCC and one with BSC. The mean patient age was 73.44 (SD 9.95) at the time of primary examination. Tumors were excised with a minimum surgical margin of 5 mm. Surgical treatment depended on the size of the tumor and its localization. Different surgical techniques were used for reconstructions of the lip defects after tumor removal. Thirty one percent of patients had postoperative complications., There was no recurrence of tumors or tumor related deaths during the follow-up of patients. In patients who had a wider resection of tissue and a more complex reconstruction technique performed, the possibility of occurrence of early postoperative complications is greater.
癌症是一种常见的口腔恶性肿瘤,占口腔恶性肿瘤的25%,占头颈部所有肿瘤的12%。最常见的唇癌是鳞状细胞癌、基底细胞癌和基底鳞状细胞癌。本研究的目的是描述肿瘤的临床特征、手术技术和在尼什大学临床中心进行的唇癌症手术后的结果。我们进行了一项单一机构的回顾性研究,包括在5年内在Niš临床中心整形重建外科诊所连续接受唇癌手术的患者。共有32名癌症患者被纳入研究。19名(59%)患者为男性,13名(41%)患者为女性。SCC 20例,BCC 11例,BSC 1例。初次检查时患者的平均年龄为73.44岁(标准差9.95)。肿瘤被切除,最小手术边缘为5毫米。手术治疗取决于肿瘤的大小及其定位。采用不同的手术技术重建肿瘤切除后的唇部缺损。31%的患者有术后并发症。,在患者随访期间,没有肿瘤复发或肿瘤相关死亡。对于组织切除范围更广、重建技术更复杂的患者,术后早期并发症发生的可能性更大。
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引用次数: 0
COMPLEMENTARY AND ALTERNATIVE MEDICINE IN SERBIA: A LITERATURE REVIEW 补充和替代医学在塞尔维亚:文献综述
Pub Date : 2020-09-15 DOI: 10.5633/amm.2020.0313
Marina Luketina-Šunjka, N. Rančić, S. Subotić, M. Jakovljevic
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引用次数: 1
期刊
Acta Medica Medianae
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