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The peculiarities of patients with COVID-19 infection COVID-19感染患者的特点
Pub Date : 2021-12-01 DOI: 10.52418/moldovan-med-j.64-5.21.05
A. Ungurean, A. Malic, T. Osipov, E. Lesnic
Background: The surge demand and decreased availability of the health workers determined the designation of the Clinical Municipal Hospital of Phthisiopneumology (CMHP) into a hospital for the case-management of COVID-19 patients during the period of December 2020 – April 2021 for the treatment of the mild cases. The aim of the study was to assess the main peculiarities of the patients with COVID-19 through a cross-sectional study developed during the period February-April 2021 in the CMHP. Material and methods: A cross-sectional, analytical and prospective study was realized, which included 145 patients with COVID-19 hospitalized in the CMHP during February-April 2021. The inclusion criteria were: patient older 18 years, COVID-19 infection diagnosed by the pulmonologist with the positive polymerase chain reaction result for SARS-CoV-2 (COVID-19) and signed informed consent. Results: The peculiarities of patients with COVID-19 were dominated by the female sex, age over 60 years, residence in the urban districts of Chisinau and the infection acquired in the Republic of Moldova. Common clinical manifestations were: high temperature, profuse sweats, asthenia and headaches, productive cough, dyspnea, loss of smell or taste, and sore throat. The typical radiological findings such ground-glass pattern or consolidation with bilateral multifocal involvement were most frequent. Were cured most of the patients and the death rate was low. Conclusions: Peculiarities and clinical manifestations of the patients admitted in CMHP were typical for the COVID-19 infection. These findings did not show the real outcome of the standard case-management of the COVID-19 due to the restricted admission criteria.
背景:卫生工作者的需求激增和可用性下降决定将市肺结核临床医院(CMHP)指定为2020年12月至2021年4月期间新冠肺炎患者病例管理医院,用于治疗轻症病例。该研究的目的是通过2021年2月至4月期间在CMHP进行的横断面研究,评估新冠肺炎患者的主要特征。材料和方法:进行了一项横断面、分析和前瞻性研究,包括2021年2月至4月期间在CMHP住院的145名新冠肺炎患者。纳入标准为:18岁以上的患者,经肺科医生诊断为新冠肺炎感染,SARS-CoV-2(新冠肺炎)聚合酶链式反应阳性,并签署知情同意书。结果:新冠肺炎患者的特点主要是女性、60岁以上、居住在基希讷乌市区以及在摩尔多瓦共和国感染。常见的临床表现为:高温、大汗淋漓、乏力头痛、生产性咳嗽、呼吸困难、嗅觉或味觉丧失以及喉咙痛。典型的放射学表现,如磨玻璃样或合并双侧多灶受累最为常见。治愈了大多数患者,死亡率很低。结论:CMHP住院患者的特点和临床表现是新冠肺炎感染的典型表现。由于入院标准受到限制,这些发现并没有显示新冠肺炎标准病例管理的真实结果。
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引用次数: 1
Cerebrovascular disease associated with Parkinson’s disease in Moldovan cohort study 摩尔多瓦队列研究中与帕金森病相关的脑血管疾病
Pub Date : 2021-12-01 DOI: 10.52418/moldovan-med-j.64-6.21.06
L. Rotaru
Background: Parkinson’s disease (PD) is frequently associated with brain vascular lesions (BVLs), which may influence the severity of the disease. Material and methods: BVLs on MRI were determined in 78.4% of 111 consecutive PD patients (mean age 64.87 ± 7.69 y.o.; disease duration 50.21 ± 38.61 mo.; 48 women (43.2%), 63 men (56.8%)). Results: White matter lesions were present in 73 patients (p.) (65.77%): 61p. (54.95%) – deep white matter, 46p. (41.44%) – periventricular white matter, and 41p. (36.94%) – both locations. Lacunas were determined in 19p. (17.12%), cerebral fissures deepening – 52p. (46.85) %), perivascular spaces dilation – 34p. (30.63%), ventricular system dilation – 29p. (26.13%). Patients with and without BVLs had similar ages, ages at PD onset and disease duration. They had insignificantly higher Beck (7.26 ± 5.62 vs 6.86 ± 4.34), PDQ39 (Parkinson’s Disease Questionnaire) (59.71 ± 20.38 vs 51.94 ± 27.69) and NMS (Non-Motor Symptoms) (75.06 ± 45.21 vs 71.67 ± 26.35) scores; and lower MoCA (Montreal Cognitive Assessment) scores (21.92 ± 4.25 vs 22.38 ± 4.57). QRISK3 scores (19.68 ± 16.16 vs 12.90 ± 6.58) and levodopa equivalent daily dose (639.98 ± 223.05 vs. 439.69 ± 404.87) were significantly higher in patients with BVLs. Conclusions: Brain vascular lesions were common in our PD patients, and were associated with higher QRISK3 scores and higher levodopa equivalent daily dose, suggesting more disease severity
背景:帕金森病(PD)经常与脑血管病变(BVL)有关,这可能会影响疾病的严重程度。材料和方法:在111例连续PD患者中,78.4%的患者(平均年龄64.87±7.69岁;病程50.21±38.61个月;48名女性(43.2%),63名男性(56.8%))在MRI上检测到BVL。(54.95%)-深白质,46便士。(41.44%)-室周白质和41p。(36.94%)-两个地点。在19p中测定了漆酶。(17.12%),脑裂加深-52p。(46.85)%),血管周围间隙扩张–34p。(30.63%),心室系统扩张-29p。(26.13%)。患有和不患有BVL的患者具有相似的年龄、PD发病年龄和疾病持续时间。他们的Beck(7.26±5.62 vs 6.86±4.34)、PDQ39(帕金森病问卷)(59.71±20.38 vs 51.94±27.69)和NMS(非运动症状)(75.06±45.21 vs 71.67±26.35)得分不显著升高;BVL患者的MoCA(蒙特利尔认知评估)评分较低(21.92±4.25 vs 22.38±4.57)。QRISK3评分(19.68±16.16 vs 12.90±6.58)和左旋多巴等效日剂量(639.98±223.05 vs 439.69±404.87)显著较高。结论:脑血管病变在我们的PD患者中很常见,并且与较高的QRISK3评分和较高的左旋多巴当量日剂量有关,表明疾病更严重
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引用次数: 1
Impact of targeted treatment in non-Hodgkin’s lymphoma with primary lymph node involvement 靶向治疗对原发性淋巴结受累的非霍奇金淋巴瘤的影响
Pub Date : 2021-12-01 DOI: 10.52418/moldovan-med-j.64-5.21.11
V. Tomacinschii, M. Robu, S. Buruiana, Veronica Finciuc, Ana Grecu, Cristina Dudnic, Dumitrita Urescu, Marina Suschevici
Background: Non-Hodgkin’s lymphomas (NHL) are malignant tumors that develop from lymphoid tissue. Primary lymph node (LN) involvement is the most common localization (52-70%). The integration of Rituximab (R) in the NHL treatment represented a turning point. The aim of this study was to evaluate the therapeutic impact of the use of R in combination with conventional polychemotherapeutic (PChT) in the treatment of nodal onset NHL. Material and methods: A descriptive cohort study was performed on 80 patients diagnosed with NHL. Results: In the study participated: men – 39(48.8%), women – 41(51.2%). The mean age of the patients was 56.09 ± 13.6 years. The onset of NHL occurred in peripheral l/n in 85.0% of cases, in mediastinal LN – 7.5%, and abdominals in 7.5%. Stages I-II were identified in 21(26.2%) patients, stages III-IV in 59(73.8%) cases. Aggressive NHLs were diagnosed in 54(67.5%) patients, indolent NHLs in 26(32.5%) cases. In 61(76.3%) patients, first-line R+PChT treatment was applied – group 1(G1), and in 19(23.8%) cases conventional PChT was applied – group 2(G2). The overall response rate (ORR) in G1 was 86.8%, in G2 – 63.1%. Complete remissions (CR) were obtained in G1 in 63.9% of patients, in G2 – 47.3% of cases. Progression-free survival (PFS) in G1 had a median of 20 months, and in G2 the median was 12 months (p <0.05). Conclusions: The use of Rituximab increased the ORR rate (86.8% vs 63.1%), the frequency of CR (63.9% vs 47.3%) and PFS (20 months vs 12 months (p <0.05).
背景:非霍奇金淋巴瘤是由淋巴组织发展而来的恶性肿瘤。原发性淋巴结(LN)受累是最常见的定位(52-70%)。利妥昔单抗(R)在NHL治疗中的整合代表了一个转折点。本研究的目的是评估R与传统多化疗药物(PChT)联合治疗结节性NHL的治疗效果。材料和方法:对80例诊断为NHL的患者进行描述性队列研究。结果:参与研究的男性39人(48.8%),女性41人(51.2%)。患者的平均年龄为56.09±13.6岁。NHL的发作发生在85.0%的外周淋巴结、7.5%的纵隔淋巴结和7.5%的腹部。I-II期21例(26.2%),III-IV期59例(73.8%)。54例(67.5%)患者诊断出侵袭性NHL,26例(32.5%)患者诊断为惰性NHL。在61例(76.3%)患者中,应用一线R+PChT治疗——第1组(G1),在19例(23.8%)患者中应用常规PChT——第2组(G2)。G1期的总有效率(ORR)为86.8%,G2期为63.1%。G1期63.9%的患者获得完全缓解(CR),G2期47.3%。G1期无进展生存期(PFS)的中位数为20个月,G2期为12个月(p<0.05)。结论:使用利妥昔单抗可提高ORR率(86.8%vs 63.1%)、CR频率(63.9%vs 47.3%)和PFS(20个月vs 12个月,p<0.05)。
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引用次数: 1
Clinical-epidemiological aspects of acute coronary syndrome in the morbidity and mortality in the Republic of Moldova 摩尔多瓦共和国急性冠状动脉综合征发病率和死亡率的临床流行病学方面
Pub Date : 2021-12-01 DOI: 10.52418/moldovan-med-j.64-5.21.01
Iana Coropceanu, G. Ciobanu
Background: Acute coronary syndrome (ACS) is associated with high costs of hospital care, frequent recurrences and high risks of sudden death and short-term mortality. Material and methods: The retrospective study was based on the evaluation of 140 patients who met the ACS criteria. Clinical and epidemiological data were obtained based on the analysis of statistical reports of the Ministry of Health during 2016-2020. Results: The mean age of the patients was 65.0 ± 27.7 years. Incidence of acute myocardial infarction (AMI) in the population increased from 4.7 to 5.2 cases per 1000 inhabitants. The study found the following occurrence of risk factors: history of cardiovascular disease – 42 (91.3 %) patients, hypertension in 35 (76.1%), obesity in 21 (45.6%), diabetes mellitus in 14 (30.4%) and smoking in 13 (28.3%). The share of risk factors in the male group was distributed as follows: history of cardiovascular disease – 82 (87.2%) patients, hypertension – 63 (67.1%) patients, smoking – 40 (42.5%) patients, diabetes mellitus – 27 (28.7%) patients and obesity was established in 24 (25.5%) of men. Conclusions: ACS affects men more frequently, compared to women, in a ratio of 2.04:1. People under the age of 65 years constitute 57.5%. The results of the study showed that compared to men, women with ACS were older and had significantly more comorbidities.
背景:急性冠脉综合征(ACS)与医院护理费用高、复发频繁、猝死和短期死亡风险高有关。材料和方法:回顾性研究基于140例符合ACS标准的患者的评价。临床和流行病学数据基于对2016-2020年卫生部统计报告的分析。结果:患者平均年龄65.0±27.7岁。人口中急性心肌梗死(AMI)的发病率从每1000人4.7例增加到5.2例。研究发现以下发生的危险因素:心血管病史42例(91.3%),高血压35例(76.1%),肥胖21例(45.6%),糖尿病14例(30.4%),吸烟13例(28.3%)。男性组的危险因素分布如下:心血管病史82例(87.2%),高血压63例(67.1%),吸烟40例(42.5%),糖尿病27例(28.7%),肥胖24例(25.5%)。结论:与女性相比,ACS对男性的影响更频繁,比例为2.04:1。65岁以下人口占57.5%。研究结果显示,与男性相比,女性ACS患者年龄更大,并且有更多的合并症。
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引用次数: 0
Endourological treatment of non-muscular-invasive bladder tumors 非肌肉浸润性膀胱肿瘤的腔内泌尿外科治疗
Pub Date : 2021-12-01 DOI: 10.52418/moldovan-med-j.64-5.21.06
I. Vladanov
Background: Transurethral resection of the bladder is one of the essential methods in the diagnosis, treatment and management of non-muscularinvasive bladder cancer. The purpose of the procedure is to remove completely all visually detected tumors with a following establishment of a very precise histological diagnosis. The aim of the study is to compare the results of conventional transurethral endoscopic treatment and the En-bloc resection method using different types of energy sources in the treatment of bladder tumors. Material and methods: A total number of 88 patients underwent endourological interventions. Regarding the distribution, 23 patients had conventional transurethral resection, 22 – En-bloc monopolar resection, 21 – En-bloc bipolar resection and 22 – En-bloc with Thu:YAG laser. Clinical data, intraoperative and postoperative data and also the histopathological examination results were compared. Results: The compared groups were heterogeneous by age, sex, tumor characteristic (size, number, location). No significant differences were observed during the operations, comparing the intraoperative and postoperative complications of the studied groups. The detrusor musculature was detected in 74% of cases after conventional transurethral resection, in 91% of cases of En-bloc monopolar resection, in 95% of cases of En-bloc bipolar resection and in 96% of cases of En-bloc Thu:YAG laser. Conclusions: The En-bloc resection technique of non-muscular-invasive bladder tumors is a safe and effective method comparing with the conventional transurethral resection; it allows more favorable postoperative results and obtaining better quality tumor samples which allow establishing correct diagnosis of the disease.
背景:经尿道膀胱切除术是诊断、治疗和治疗非肌源性膀胱癌症的重要方法之一。该手术的目的是完全切除所有肉眼可见的肿瘤,随后建立非常精确的组织学诊断。本研究的目的是比较传统经尿道内窥镜治疗和使用不同类型能量源的整体切除法治疗膀胱肿瘤的结果。材料和方法:共有88名患者接受了泌尿系统内介入治疗。关于分布,23名患者接受了常规经尿道电切术、22-En组单极电切术,21-En组双极电切术和22-En组合Thu:YAG激光电切术。比较临床数据、术中和术后数据以及组织病理学检查结果。结果:比较组在年龄、性别、肿瘤特征(大小、数量、位置)方面存在异质性。比较研究组的术中和术后并发症,在手术过程中没有观察到显著差异。常规经尿道电切术后,74%的病例、91%的En组单极电切术、95%的En组合双极电切术和96%的En集团Thu:YAG激光电切术中检测到逼尿肌组织。结论:与传统的经尿道电切术相比,非肌肉性浸润性膀胱肿瘤整体切除术是一种安全有效的方法;它可以获得更有利的术后结果,并获得更好质量的肿瘤样本,从而能够建立对疾病的正确诊断。
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引用次数: 0
Chondrocytes isolation from hyaline cartilage by continuous monitoring method 用连续监测方法从透明软骨中分离软骨细胞
Pub Date : 2021-12-01 DOI: 10.52418/moldovan-med-j.64-6.21.03
V. Cobzac, L. Verestiuc, M. Jian, V. Nacu
Background: Articular cartilage has poor regenerative capacities. Numerous cartilage repair techniques are known, including implantation of autologous chondrocytes. Material and methods: From 18 rabbits pieces of cartilage were harvested from femoral condyle. Minced cartilage was treated with 0.25% trypsin-EDTA. In the 1st group (n=9) the cartilage was digested with 0.6% collagenase in 15 ml tubes by shaking in incubator at 37°C, 5%CO2 . In the 2nd group (n=9) digestion was performed in 25cm2 cell culture flasks placed on the lateral side, monitoring the process under a microscope after 120 minutes. The isolated cells were cultured to a 80-90% confluence. The chondrocytes were identified using histochemical staining after culturing for 16 days in overconfluence. Results: Chondrocytes isolation in the 1st group lasted a fixed 360 minutes, in the 2nd group – 140±10 minutes. In the 1stgroup were isolated 9.2x104 ±3.1x104 chondrocytes with a viability of 85.36±16.41%, but in the 2nd group – 1.6x105 ±3.4x104 chondrocytes with a viability of 98.09±3.85%. The mean period of cell culture in the 1st group was 15±2 days, in the 2nd group – 11±3 days. In first passage of the 1st group were obtained – 1.2x106 ±4.3x105 chondrocytes and in the 2nd group – 2.92x106 ±3.6x105 chondrocytes. The secreted extracellular matrix by chondrocytes was stained specifically for cartilaginous tissue. Conclusions: The method used for chondrocytes isolation has a direct impact on the number of isolated cells, their viability, but also upon the culture period and the number of cells obtained during the first passage.
背景:关节软骨具有较差的再生能力。许多软骨修复技术是已知的,包括自体软骨细胞植入。材料和方法:取兔股骨髁软骨18块。切碎的软骨用0.25%胰蛋白酶- edta处理。第一组(n=9)在37°C, 5%CO2培养箱中摇晃,用0.6%胶原酶消化15 ml管中的软骨。第二组(n=9)在放置于侧面的25cm2细胞培养瓶中进行消化,120分钟后在显微镜下观察消化过程。将分离的细胞培养到80-90%的汇合度。过融合培养16天后,用组织化学染色鉴定软骨细胞。结果:第一组软骨细胞分离时间固定为360分钟,第二组为- 140±10分钟。第1组分离到9.2 × 104±3.1 × 104软骨细胞,存活率为85.36±16.41%;第2组分离到1.6 × 105±3.4 × 104软骨细胞,存活率为98.09±3.85%。第一组平均细胞培养时间为15±2天,第二组平均细胞培养时间为11±3天。第一组第一代获得- 1.2x106±4.3x105个软骨细胞,第二组获得- 2.92x106±3.6x105个软骨细胞。软骨细胞分泌的细胞外基质染色专门用于软骨组织。结论:软骨细胞分离的方法直接影响到分离细胞的数量、生存能力,也影响到培养时间和第一次传代获得的细胞数量。
{"title":"Chondrocytes isolation from hyaline cartilage by continuous monitoring method","authors":"V. Cobzac, L. Verestiuc, M. Jian, V. Nacu","doi":"10.52418/moldovan-med-j.64-6.21.03","DOIUrl":"https://doi.org/10.52418/moldovan-med-j.64-6.21.03","url":null,"abstract":"Background: Articular cartilage has poor regenerative capacities. Numerous cartilage repair techniques are known, including implantation of autologous chondrocytes. Material and methods: From 18 rabbits pieces of cartilage were harvested from femoral condyle. Minced cartilage was treated with 0.25% trypsin-EDTA. In the 1st group (n=9) the cartilage was digested with 0.6% collagenase in 15 ml tubes by shaking in incubator at 37°C, 5%CO2 . In the 2nd group (n=9) digestion was performed in 25cm2 cell culture flasks placed on the lateral side, monitoring the process under a microscope after 120 minutes. The isolated cells were cultured to a 80-90% confluence. The chondrocytes were identified using histochemical staining after culturing for 16 days in overconfluence. Results: Chondrocytes isolation in the 1st group lasted a fixed 360 minutes, in the 2nd group – 140±10 minutes. In the 1stgroup were isolated 9.2x104 ±3.1x104 chondrocytes with a viability of 85.36±16.41%, but in the 2nd group – 1.6x105 ±3.4x104 chondrocytes with a viability of 98.09±3.85%. The mean period of cell culture in the 1st group was 15±2 days, in the 2nd group – 11±3 days. In first passage of the 1st group were obtained – 1.2x106 ±4.3x105 chondrocytes and in the 2nd group – 2.92x106 ±3.6x105 chondrocytes. The secreted extracellular matrix by chondrocytes was stained specifically for cartilaginous tissue. Conclusions: The method used for chondrocytes isolation has a direct impact on the number of isolated cells, their viability, but also upon the culture period and the number of cells obtained during the first passage.","PeriodicalId":32733,"journal":{"name":"The Moldovan Medical Journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45860330","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: 1
The incidence of uterine abnormalities 子宫异常的发生率
Pub Date : 2021-12-01 DOI: 10.52418/moldovan-med-j.64-5.21.08
Constantin Toncoglaz, Serghei Toncoglaz, Alina Toncoglaz
Background: Congenital uterine abnormalities result from abnormal formation, fusion or resorption of the Mullerian ducts during fetal life. These abnormalities have been associated with an increased rate of miscarriage, preterm birth, and other fetal adverse outcomes. Material and methods: Was performed a clinical observational retrospective study of uterine malformations, diagnosed in the Republic of Moldova. Pelvic MRI (1.5-3 tesla) with contrast and without were examined, from 01.01.2016 to 20.11.2016. During this time, 190 MRIs were performed according to the program, 167 MRIs were included in the study, 23 MRIs were excluded, having total or partial hysterectomy performed. The age of the examined persons is between 81 years and 6 months. Results: 15 uterine malformations were detected, which represent 11.13%. Among the uterine abnormalities were detected 6 cases of bicorn uterus, 3 cases of didelph uterus, 2 cases of uterine agenesis and septate uterus and one case of arcuate uterus, and unicorn. Conclusions: In this study it was determined that the prevalence of uterine malformations in an unselected population in the Republic of Moldova is 11.13%, and that of the septate uterus is 1.2%, data that are similar and correspond to the international literature.
背景:先天性子宫异常是由于胎儿期穆勒管形成、融合或吸收异常引起的。这些异常与流产、早产和其他胎儿不良后果的发生率增加有关。材料和方法:对摩尔多瓦共和国诊断的子宫畸形进行临床观察回顾性研究。从2016年1月1日至2016年11月20日,检查了带对比剂和不带对比剂的骨盆MRI(1.5-3特斯拉)。在此期间,根据该计划进行了190次核磁共振成像,167次核磁共振纳入研究,23次核磁共振被排除在外,进行了全子宫切除术或部分子宫切除术。被检查者的年龄在81岁到6个月之间。结果:发现子宫畸形15例,占11.13%,其中双角子宫6例,双足子宫3例,子宫发育不全和间隔子宫2例,弓形子宫和独角兽各1例。结论:在这项研究中,摩尔多瓦共和国未经选择的人群中子宫畸形的患病率为11.13%,隔膜子宫的患病率是1.2%,这些数据与国际文献相似且一致。
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引用次数: 0
The effect of diabetes mellitus on evolution and outcome of tuberculosis in a prospective study 一项前瞻性研究:糖尿病对结核病演变和转归的影响
Pub Date : 2021-12-01 DOI: 10.52418/moldovan-med-j.64-5.21.03
A. Malic, E. Lesnic
Background: In the Republic of Moldova almost 5% of the cases with tuberculosis are diagnosed annually among diabetic patients. The aim of this study was to assess the impact of diabetes mellitus on the evolution and anti-tuberculosis treatment effectiveness in a prospective study. Material and methods: A prospective, longitudinal and case-control study, which included a total number of 252 patients diagnosed with pulmonary tuberculosis and distributed in a study group, consisting of 93 patients diagnosed with diabetes mellitus and a control group, consisting of 159 patients without glycemic disorders, was performed. Results: This study identified that one half of the group with diabetes was detected by active screening and one third received anti-tuberculous treatment before actual episode. A similar rate of diabetic and non-diabetic patients was microbiologically positive, as well confirmed with drug-resistance. The anti-tuberculous treatment effectiveness was lower in diabetic patients, the death rate and the low treatment outcome (lost to follow-up and failed) were higher than in non-diabetic patients. The main causes of unfavorable evolution were: glycemic disorders (hyperglycemia), diabetes complications and the history of the anti-tuberculous treatment in the anamnesis. Conclusions: The individualized approach and a tight follow-up should be performed regularly in all patients with glycemic disorders and tuberculosis for the improvement of the disease outcome.
背景:在摩尔多瓦共和国,每年在糖尿病患者中诊断出的结核病病例几乎占5%。本研究的目的是在一项前瞻性研究中评估糖尿病对发展和抗结核治疗效果的影响。材料与方法:前瞻性、纵向、病例对照研究,共纳入252例肺结核患者,分为研究组(糖尿病患者93例)和对照组(无血糖障碍患者159例)。结果:本研究发现,一半的糖尿病患者通过主动筛查被发现,三分之一的糖尿病患者在实际发病前接受了抗结核治疗。糖尿病和非糖尿病患者微生物学阳性的比例相似,也证实有耐药性。糖尿病患者的抗结核治疗效果较低,死亡率和低治疗效果(失访和失败)高于非糖尿病患者。不利进展的主要原因是:血糖紊乱(高血糖)、糖尿病并发症和患者在痴呆时曾接受过抗结核治疗。结论:所有血糖障碍合并结核病患者均应采取个体化治疗方法,并定期进行严密随访,以改善疾病预后。
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引用次数: 0
The role of boron in the functioning of the osteoarticular system 硼在骨关节系统功能中的作用
Pub Date : 2021-12-01 DOI: 10.52418/moldovan-med-j.64-5.21.14
Maria-Victoria Racu, I. R. Scorei, Iurie Pinzaru
Background: Boron was classified by the World Health Organization as ‘possible essential elements for human health’. It can be found in different forms in the environment, has beneficial effects on bones and its deprivation can impair calcium and magnesium metabolism and bone development, their health and maintenance. Dietary boron supplementation can help prevent and manage degenerative and inflammatory bones and articular diseases, such as arthritis, osteoarthritis, rheumatoid arthritis and osteoporosis. Relevant articles were identified in PubMed, Google Scholar, ProQuest, and Scopus databases published until June 2021, describing the role of boron in the functioning of the osteoarticular system. Conclusions: From organic and inorganic boron forms that can enter the human body, organic plant based boron compounds are highly bioavailable. In the functioning of the osteoarticular system boron acts by regulation of calcium and magnesium metabolism, enhancing the vitamin D activation process and influencing serum steroid hormone levels. A boron intake equal to or higher than 3 mg per day can help prevent/or correct arthritis, osteoporosis and osteoarthritis. Calcium fructoborate can reduce pain, joint discomfort and increase endogenous vitamin D level in patients with osteoarthritis. Boron may play a role in pathophysiology of rheumatoid arthritis and its severity and a supplementation with boron element may be useful.
背景:硼被世界卫生组织列为"可能对人类健康至关重要的元素"。它可以在环境中以不同的形式存在,对骨骼有有益的影响,它的剥夺会损害钙和镁的代谢和骨骼的发育,它们的健康和维持。膳食中补充硼有助于预防和控制退行性和炎症性骨骼和关节疾病,如关节炎、骨关节炎、类风湿性关节炎和骨质疏松症。相关文章已在PubMed、谷歌Scholar、ProQuest和Scopus数据库中找到,发表时间截止到2021年6月,描述了硼在骨关节系统功能中的作用。结论:有机植物基硼化合物具有较高的生物利用度,可以从有机和无机形式进入人体。在骨关节系统的功能中,硼通过调节钙和镁的代谢,增强维生素D的激活过程和影响血清类固醇激素水平而起作用。每天摄入等于或高于3毫克的硼有助于预防或纠正关节炎、骨质疏松症和骨关节炎。果糖硼酸钙可以减轻骨关节炎患者的疼痛、关节不适并增加内源性维生素D水平。硼可能在类风湿关节炎及其严重程度的病理生理中起作用,补充硼元素可能是有用的。
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引用次数: 1
Sevoflurane anesthesia: impact on postoperative cognitive dysfunction 七氟醚麻醉对术后认知功能障碍的影响
Pub Date : 2021-12-01 DOI: 10.52418/moldovan-med-j.64-6.21.09
Victoria Rusu
Background: Sevoflurane is the inhalational anesthetic agent that is used widely in operating room. It is currently the most commonly used inhalation anesthetic in operating rooms. A series of studies on animal and human model detected the association of intraoperative use of sevoflurane and postoperative cognitive dysfunction (POCD) manifestation. On the other hand other studies demonstrate the same POCD associated with intravenous agents. Relevant multicentric trials got the reasons to suspect other key factors in developing postoperative cognitive dysfunction. Conclusions: The intra-anesthetic use of sevoflurane has been associated for a long time with the higher incidence of POCD. The mechanism was not identified, and the theory of neuroinflammation remained the main key of pathophysiological reaction that leads to cognitive dysfunction. Recent multicentre trial gives reliable information that the use of intravenous anesthetic agents is associated with the same POCD. Neuroinflammation remains to be the mediator of cognitive disorders, and apparently IL-6 keeps a major role in them. Future studies are needed to be conducted to identify the role of anesthetic agents in determining the neuroinflammation.
背景:七氟醚是一种广泛应用于手术室的吸入麻醉药。它是目前手术室中最常用的吸入麻醉剂。一系列关于动物和人类模型的研究检测了术中使用七氟醚与术后认知功能障碍(POCD)表现之间的关系。另一方面,其他研究证明了与静脉注射药物相关的相同POCD。相关的多中心试验有理由怀疑术后认知功能障碍的其他关键因素。结论:长期以来,七氟烷的麻醉内使用与POCD的高发病率有关。其机制尚未确定,神经炎症理论仍然是导致认知功能障碍的病理生理反应的主要关键。最近的多中心试验提供了可靠的信息,即静脉麻醉药的使用与相同的POCD有关。神经炎症仍然是认知障碍的介质,显然IL-6在其中发挥着重要作用。未来需要进行研究,以确定麻醉剂在确定神经炎症中的作用。
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The Moldovan Medical Journal
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