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First experiences with the use of targeted and immunotherapy in the treatment of cutaneous melanoma: A single centre experience 首次使用靶向和免疫疗法治疗皮肤黑色素瘤:单一中心经验
Q4 Medicine Pub Date : 2022-01-01 DOI: 10.5937/scriptamed53-35184
J. Berendika, S. Jungić, B. Tubić, I. Rakita, M. Vještica, D. Đokanović, Z. Gojković, Nikolina Mirčeta, Sanja Petković, Vanda Marković-Peković
Background / Aim: Up until ten years ago stage four melanoma was considered a disease with extremely poor prognosis. Standard therapy during this period of time was dacarbazine chemotherapy. Patients with better performance status were treated with immunotherapy cytokine IL-2. In the last ten years eight medications have been approved by the FDA for the therapy of melanoma. The goal of this study was to determine objective response rate (ORR), median overall survival (OS), median progression free survival (PFS) and safety in patients with advanced and metastatic cutaneous melanoma treated with targeted therapy and immunotherapy at the University Clinical Centre of the Republic of Srpska (Centre). Methods: A non-randomised observational retrospective/prospective trial was conducted to investigate first experiences with the use of targeted therapy and immunotherapy at the Centre and compare the results with the literature data. A total of 23 patients received BRAF targeted therapy for the treatment of metastatic cutaneous melanoma in the first line of treatment. Nine patients received vemurafenib, fourteen patients received a combination of BRAF/MEK inhibitor. Nine patients were treated with pembrolizumab immunotherapy. The trial was performed in a period from May 2017 until December 2020. Results: In patients receiving vemurafenib ORR was 44.4 %, median PFS was 5 months (95 % CI, 1 to 11) and the median OS was 9 months (95 % CI, 2 to 17). In the vemurafenib/cobimetinib group ORR was 71.4 %. Median PFS was 9 months and median OS was 12 months. ORR in patients receiving pembrolizumab was 22.9 %, median PFS was 3 months (95 % CI, 1 to 11) and the median OS was 4.5 months (95 % CI, 2 to 12). Results in all three groups were inferior compared to the results from the literature except for ORR in patients receiving vemurafenib and vemurafenib/cobimetinib. Adverse events were tolerable and manageable and were similar to those described in the literature. Conclusion: Based on the experience with the targeted and immunotherapy in the Centre, which was presented in this study, it was concluded that in conditions when there is limited access to drugs, the greatest benefit have the patients who meet the inclusion criteria in clinical trials.
背景/目的:直到十年前,四期黑色素瘤被认为是一种预后极差的疾病。这段时间的标准治疗是达卡巴嗪化疗。表现较好的患者给予免疫治疗细胞因子IL-2。在过去的十年里,FDA已经批准了八种治疗黑色素瘤的药物。本研究的目的是确定在塞族共和国大学临床中心(中心)接受靶向治疗和免疫治疗的晚期和转移性皮肤黑色素瘤患者的客观缓解率(ORR)、中位总生存期(OS)、中位无进展生存期(PFS)和安全性。方法:进行了一项非随机观察性回顾性/前瞻性试验,调查该中心首次使用靶向治疗和免疫治疗的经验,并将结果与文献数据进行比较。共有23例患者在一线治疗中接受了BRAF靶向治疗转移性皮肤黑色素瘤。9例患者接受vemurafenib治疗,14例患者接受BRAF/MEK抑制剂联合治疗。9例患者接受派姆单抗免疫治疗。该试验在2017年5月至2020年12月期间进行。结果:在接受vemurafenib治疗的患者中,ORR为44.4%,中位PFS为5个月(95% CI, 1至11),中位OS为9个月(95% CI, 2至17)。vemurafenib/cobimetinib组ORR为71.4%。中位PFS为9个月,中位OS为12个月。接受派姆单抗治疗的患者ORR为22.9%,中位PFS为3个月(95% CI, 1至11),中位OS为4.5个月(95% CI, 2至12)。除了接受vemurafenib和vemurafenib/cobimetinib的患者的ORR外,所有三组的结果都低于文献中的结果。不良事件是可容忍的和可控的,与文献中描述的相似。结论:根据本研究中介绍的中心靶向和免疫治疗的经验,得出的结论是,在药物可及性有限的情况下,符合临床试验纳入标准的患者获益最大。
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引用次数: 0
Simple trachelectomy following neoadjuvant chemotherapy in cervical cancer over 2 cm in size: A case report and review of literature 2 cm以上宫颈肿瘤新辅助化疗后单纯性气管切除术1例报告及文献复习
Q4 Medicine Pub Date : 2022-01-01 DOI: 10.5937/scriptamed53-39686
A. Mandić, B. Gutic, M. Davidović-Grigoraki, Đorđe Petrović, N. Šolajić, Gabrijel-Stefan Nađ
In the past few decades fertility preservation has emerged as a treatment modality for cervical cancer patients. Different surgical methods have been described, such as open or minimally invasive trachelectomy and gross cervical conisation combined with laparoscopic lymphadenectomy. A thirty-year-old nulliparous woman with uterine cervical cancer FIGO stage IB2 (classification from 2009) underwent neoadjuvant chemotherapy. After three cycles of chemotherapy with cisplatin and iphosphamide there was no colposcopic findings of cervical invasion, therefore a conservative surgery was performed. The patient underwent laparoscopic pelvic lymphadenectomy, cervical amputation and the endocervical curettage. The histopathology confirmed a complete response to chemotherapy.
在过去的几十年里,保留生育能力已经成为宫颈癌患者的一种治疗方式。不同的手术方法已被描述,如开放或微创气管切除术和大体宫颈清扫联合腹腔镜淋巴结切除术。一例30岁未生育女性宫颈癌FIGO分期IB2期(2009年分类)行新辅助化疗。顺铂和异磷酰胺化疗3个周期后,阴道镜未见宫颈侵犯,因此行保守手术。患者行腹腔镜盆腔淋巴结切除术、宫颈截肢和宫颈刮除术。组织病理学证实对化疗完全有效。
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引用次数: 0
Factors associated with frequency of ectopic pregnancy 与异位妊娠频率相关的因素
Q4 Medicine Pub Date : 2022-01-01 DOI: 10.5937/scriptamed53-35117
Miroslav Popović, Tanja Milić-Radić
Background/Aim: Ectopic pregnancy is defined as a pregnancy outside the uterine cavity, most often in the fallopian tube. It is a life-threatening condition and requires early diagnosis and adequate care. Aim of this study was to examine the frequency of ectopic pregnancy, as well as the influence of parity, age of patients and previous in vitro fertilisation (IVF) procedure on the occurrence of ectopic pregnancy. Methods: A retrospective research was conducted in the Clinic for Gynaecology and Obstetrics of the University Clinical Centre of the Republic of Srpska from 1st of January 2016 up to 31 of December 2018, which included 125 hospitalised patients with a confirmed diagnosis of ectopic pregnancy. Data on the age of patients , parity and previous IVF, as well as the method of treatment of patients with ectopic pregnancy were analysed and compared. Results: In the observed period, there were a total of 9781 births and in the same period, 125 patients with a diagnosis of ectopic pregnancy were hospital-ised, which is 1.27 %. Pregnancy did not occur after IVF. Laparoscopy and drug therapy are represented almost equally, depending on the clinical picture and the wishes of the patients and open access was represented only sporadically. Conclusion: According to this research, the onset of ectopic pregnancy is not affected by age, parity and previous IVF, which does not fit into the results of world research. The most common form of treatment in our country is both lap-aroscopy and medical approach and open access occurs only sporadically, which fits into the recommendations of the relevant guides.
背景/目的:宫外孕是指宫腔外的妊娠,最常发生在输卵管内。这是一种危及生命的疾病,需要早期诊断和适当的护理。本研究旨在探讨异位妊娠的发生频率,以及胎次、患者年龄和既往体外受精(IVF)手术对异位妊娠发生的影响。方法:回顾性研究2016年1月1日至2018年12月31日在斯普斯卡共和国大学临床中心妇产科诊所进行的回顾性研究,其中包括125例确诊为异位妊娠的住院患者。对异位妊娠患者的年龄、胎次、既往体外受精情况及治疗方法进行分析比较。结果:观察期内共分娩9781例,同期诊断为异位妊娠住院125例,占1.27%。体外受精后未发生妊娠。腹腔镜和药物治疗几乎是平等的,取决于临床情况和患者的意愿,开放访问只是零星的代表。结论:根据本研究,异位妊娠的发生不受年龄、胎次及既往体外受精的影响,与国际上的研究结果不符。在我国,最常见的治疗形式是腹腔镜检查和医疗方法,而开放获取只是偶尔发生,这符合相关指南的建议。
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引用次数: 0
Challenges of antiretroviral therapy among children in Free State Province, South Africa 南非自由邦省儿童抗逆转录病毒治疗的挑战
Q4 Medicine Pub Date : 2022-01-01 DOI: 10.5937/scriptamed53-39572
A. Olaleye, Y. Tsibolane, Lydia Van-Turha, Sibongile Monareng, P. Chikobvu, M. Boleme, Celicia M. Serenata
Background/Aim: Antiretroviral therapy (ART) is an important intervention for survival among children in Sub Saharan Africa where HIV infection rates are comparatively high. Only few studies have explored issues relating to paediatric ART initiation and maintenance. This study was conducted to explore the perceptions and experiences of trained professional nurses regarding paediatric ART. Methods: Six focus group discussions (FGDs) were conducted among trained professional nurses in selected health facilities in Free State Province, South Africa. Verbatim transcripts were analysed with a thematic approach. Results: The participants of this study reported counselling as an important component of paediatric ART in health facilities. The problem of non-disclosure, migration, incomplete records from referral health facilities, inadequate health workforce and difficulty in record keeping were cited as barriers against paediatric ART. Conclusion: This study showed that initiation and adherence to antiretroviral therapy among eligible children faces a significant challenge.
背景/目的:在艾滋病毒感染率相对较高的撒哈拉以南非洲地区,抗逆转录病毒治疗(ART)是一项重要的儿童生存干预措施。只有少数研究探讨了与儿科抗逆转录病毒治疗开始和维持有关的问题。本研究旨在探讨训练有素的专业护士对儿科抗逆转录病毒治疗的看法和经验。方法:在南非自由州省选定的卫生机构中,对经过培训的专业护士进行了六次焦点小组讨论(fgd)。用专题方法对逐字抄本进行了分析。结果:本研究的参与者报告说,咨询是卫生设施中儿科抗逆转录病毒治疗的一个重要组成部分。不披露、移徙、转诊卫生设施记录不完整、卫生人力不足和记录保存困难等问题被认为是阻碍儿科抗逆转录病毒治疗的障碍。结论:这项研究表明,在符合条件的儿童中,抗逆转录病毒治疗的开始和坚持面临着重大挑战。
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引用次数: 0
Allergic contact dermatitis caused by dexpanthenol confirmed with open application test: A case report 开放应用试验证实乙炔醇致过敏性接触性皮炎1例
Q4 Medicine Pub Date : 2022-01-01 DOI: 10.5937/scriptamed53-37442
Marijana Smiljić, Baroš Ninković, Boško Trifunović
Topical medications and cosmetic products contain many allergens that can trigger allergic contact dermatitis. One of the most frequent ingredients is dexpanthenol (bepanthen, panthenol). A case of a 19-year-old female patient is presented, with a 2-year history of continuous episodes of contact allergic reactions with positive open application test to dexpanthenol, after other dermatoses and allergens were excluded.
局部药物和化妆品含有许多可引发过敏性接触性皮炎的过敏原。最常见的成分之一是葡聚糖醇(豆聚糖,泛醇)。本文报告1例19岁女性患者,排除其他皮肤病和过敏原后,连续2年接触性过敏反应,开放应用试验阳性。
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引用次数: 0
Public pharmacies on the territory of Bosnia and Herzegovina over the Austro-Hungarian rule 奥匈帝国统治时期波斯尼亚-黑塞哥维那境内的公共药房
Q4 Medicine Pub Date : 2022-01-01 DOI: 10.5937/scriptamed53-39934
Vanda Marković-Peković
Background/Aim: With the adoption of legislation over the Austro-Hungarian rule (1878-1918) apothecary in Bosnia and Herzegovina (B&H) became a regulated profession, which enabled the arrival of graduated pharmacists. The aim of the paper was to present in which towns on the B&H territory public pharmacies were opened over this period and their owners. Methods: A retrospective and descriptive research was conducted at the Archives of the Republic of Srpska, the Museum of the Republic of Srpska and the Archives of Bosnia and Herzegovina. The method of the qualitative secondary data analysis was applied. Results: With the arrival of Masters of Pharmacy from all parts of the Austro-Hungary, an increasing number of public pharmacies began to open. Concessions for the opening pharmacies were initially granted to foreigners and among the settlers, pharmacists there were mostly Czechs, Croats, Poles, Hungarians, Slovaks, who completed pharmacy studies at universities in Vienna, Zagreb, Prague, Lviv, Graz, Innsbruck, Krakow. In the beginning, there were no locally educated pharmacists and the first appeared at the end of the 19th and the beginning of the 20th century. During this period at least one pharmacy was opened in many towns, two worked in Banja Luka, Mostar, Tuzla and Bijeljina and seven in Sarajevo. In the first years, each pharmacy was staffed by only one pharmacist and over time there were more pharmacy staff in the pharmacies. Twenty years after the occupation, public pharmacies owned by Masters of Pharmacy were opened in thirty three towns around B&H and in 1918 there were forty eight public pharmacies in thirty eight towns. Conclusion: The number of public pharmacies and qualified pharmacy staff in B&H increased over the Austro-Hungarian rule from 1878 to 1918, which contributed to the improvement of the profession, health and social conditions in the country during this period.
背景/目的:随着对奥匈帝国统治(1878-1918)的立法的通过,波斯尼亚和黑塞哥维那(B&H)的药剂师成为一个受监管的职业,这使得毕业药剂师的到来。本文的目的是介绍在B&H领土上的公共药房在这一时期和他们的所有者开放的城镇。方法:对斯普斯卡共和国档案馆、斯普斯卡共和国博物馆和波斯尼亚和黑塞哥维那档案馆进行回顾性和描述性研究。采用定性二次资料分析方法。结果:随着奥匈帝国各地药学硕士的到来,越来越多的公立药房开始开业。开办药房的特许权最初是给外国人的,在定居者中,药剂师大多是捷克人、克罗地亚人、波兰人、匈牙利人、斯洛伐克人,他们在维也纳、萨格勒布、布拉格、利沃夫、格拉茨、因斯布鲁克、克拉科夫等地的大学完成了药剂学的学习。起初,当地没有受过教育的药剂师,第一次出现是在19世纪末和20世纪初。在此期间,在许多城镇至少开了一家药房,在巴尼亚卢卡、莫斯塔尔、图兹拉和比耶利纳开了两家,在萨拉热窝开了七家。在最初的几年里,每个药房只有一名药剂师,随着时间的推移,药房里的药学人员越来越多。占领20年后,药学硕士拥有的公共药房在B&H周围的33个城镇开业,到1918年,38个城镇共有48家公共药房。结论:在1878年至1918年奥匈帝国统治期间,B&H的公共药房和合格的药房工作人员的数量有所增加,这有助于在此期间改善该国的专业、卫生和社会条件。
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引用次数: 0
'In vitro' assessments of microencapsulated viable cells as a result of primary bile acid-encapsulated formulation for inflammatory disorders “体外”评估微囊化活细胞作为原发性胆汁酸囊化制剂治疗炎症性疾病的结果
Q4 Medicine Pub Date : 2022-01-01 DOI: 10.5937/scriptamed53-36574
A. Mooranian, Melissa Jones, Daniel Walker, C. Ionescu, S. Wagle, B. Kovacevic, Jacqueline Chester, Thomas Foster, Edan Johnston, M. Mikov, H. Al‐Salami
Background / Aim: Metformin is widely used in type 2 diabetes and exhibits many positive biological effects on pancreatic b-cells and muscle cells, such as supporting insulin release by b-cells and glucose uptake by muscle cells and reducing oxidative stress, particularly due to diabetes-associated hyperglycaemia. Interestingly, for type 1 diabetes, transplantation of healthy b-cells has been proposed as a novel way to replace insulin therapy. Recently, bile acid-formulations containing transplantable b-cells showed best stability. Hence, this study aimed to explore the effects of metformin-bile acid formulations in b-cell encapsulation and on the biological activities of b-cells and muscle-cells. Methods: Two sets of biological effects were examined, using metformin-bile acid formulations, on encapsulated b-cells and on muscle cells exposed to the formulations. Results: Various encapsulated b-cell formulations' cell viability, insulin levels, cellular oxidative stress, cellular inflammatory profile and bioenergetics at the normoand hyperglycaemic states showed differing results based upon the metformin concentration and the inclusion or absence of bile acid. Similar effects were observed with muscle cells. Low ratios of metformin and bile acids showed best biological effects, suggesting a formulation dependent result. The formulations' positive effects were more profound at the hyperglycaemic state suggesting efficient cell protective effects. Conclusion: Overall, metformin had positive impacts on the cells in a concentration-dependent manner, with the addition of chenodeoxycholic acid further improving results.
背景/目的:二甲双胍广泛应用于2型糖尿病,对胰腺b细胞和肌肉细胞有许多积极的生物学作用,如支持b细胞释放胰岛素和肌肉细胞摄取葡萄糖,减少氧化应激,特别是糖尿病相关的高血糖。有趣的是,对于1型糖尿病,健康b细胞移植被认为是替代胰岛素治疗的一种新方法。最近,含有可移植b细胞的胆汁酸制剂显示出最好的稳定性。因此,本研究旨在探讨二甲双胍-胆汁酸制剂在b细胞包封过程中对b细胞和肌肉细胞生物活性的影响。方法:采用二甲双胍-胆汁酸制剂对包膜的b细胞和暴露于该制剂的肌肉细胞进行两组生物学效应检测。结果:不同包封的b细胞制剂在正常和高血糖状态下的细胞活力、胰岛素水平、细胞氧化应激、细胞炎症谱和生物能量学显示出基于二甲双胍浓度和胆汁酸包含或不包含的不同结果。在肌肉细胞中也观察到类似的效果。低比例的二甲双胍和胆汁酸表现出最好的生物学效果,提示配方依赖的结果。在高血糖状态下,该制剂的积极作用更为深远,表明其具有有效的细胞保护作用。结论:总体而言,二甲双胍对细胞有正向影响,且呈浓度依赖性,添加鹅去氧胆酸进一步改善了效果。
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引用次数: 1
Oncological safety of breast conserving surgery in breast cancer 保乳手术治疗乳腺癌的肿瘤安全性
Q4 Medicine Pub Date : 2022-01-01 DOI: 10.5937/scriptamed53-38929
A. Guzijan, R. Gajanin, J. Ćulum, Z. Gojković, Ljubiša Preradović, D. Roganović
Background/Aim: Breast-conserving surgery is a type of surgery used as a treatment option for breast cancer. It was introduced at the end of the 20th century following and in accordance with relevant clinical studies. With heightened public awareness of breast cancer and the introduction of new diagnostic procedures, despite the proven oncological safety of this type of surgery, a growing number of women choose to undergo total mastectomy. The aim of this study was to confirm the oncological safety of breast-conserving surgery performed on breast cancer patients at the University Clinical Centre of the Republic of Srpska. Methods: This study analysed 305 female patients with I and II stage of breast cancer, operated on between March 2009 and December 2013. One group of patients underwent breast-conserving surgery (BCS), followed by adjuvant radiation therapy and the other total mastectomy (MX). The patients were followed up for 5 years after the surgery. Analysed herein were the local-regional recurrence, distant metastases, disease-free survival and overall survival rates. Results: After a five-year follow-up, the local-regional recurrence rate for patients in the BCS group was 4.3 %, while for the MX group it was 4.2 %. The overall survival rate of patients in the BCS group was 90.9 %, as opposed to 89.1 % for MX patients. Conclusion: After a five-year follow-up, no statistically significant difference was observed between the two groups of patients regarding the local-regional recurrence (p = 0.967) and overall survival rates (p = 0.610). Breast-conserving surgery is an oncologically safe surgical treatment for breast cancer.
背景/目的:保乳手术是乳腺癌的一种治疗选择。它是在20世纪末根据相关临床研究引进的。随着公众对乳腺癌认识的提高和新诊断方法的引入,尽管这种手术的肿瘤安全性已得到证实,但越来越多的女性选择接受全乳切除术。这项研究的目的是确认在斯普斯卡共和国大学临床中心对乳腺癌患者进行保乳手术的肿瘤学安全性。方法:对2009年3月至2013年12月间接受手术治疗的305例ⅰ期和ⅱ期女性乳腺癌患者进行分析。一组患者接受保乳手术(BCS),随后进行辅助放射治疗和另一组全乳切除术(MX)。术后随访5年。本文分析了局部区域复发率、远处转移率、无病生存率和总生存率。结果:经过5年随访,BCS组局部-区域复发率为4.3%,MX组为4.2%。BCS组患者的总生存率为90.9%,而MX组患者的总生存率为89.1%。结论:经5年随访,两组患者局部区域复发率(p = 0.967)、总生存率(p = 0.610)差异无统计学意义。保乳手术是一种肿瘤安全的乳腺癌手术治疗方法。
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引用次数: 0
Effect of hydrogen sulphide containing mineral water on experimental osteoporosis in rats 含硫化氢矿泉水对实验性骨质疏松大鼠的影响
Q4 Medicine Pub Date : 2022-01-01 DOI: 10.5937/scriptamed53-41462
T. Popović, L. Amidžić, Mile Čeko, S. Markovic, R. Škrbić
Background/Aim: Sulphur mineral water is widely used in the treatment of musculoskeletal diseases. Hydrogen sulphide is an important regulator of bone metabolism and its application in the treatment of osteoporosis is intensively researched. The aim of this study was to analyse biochemical and histological effects of H2S containing mineral water of "Mlječanica" spring on ovariectomy-induced experimental osteoporosis in rats. Methods: In this experiment a 14-week-old Wistar female rats were used. The animals undergone bilateral ovariectomy (OVX groups) as an experimental model for oestrogen-deficient osteoporosis. After six weeks, animals were divided into control and the experimental group. Rats from the experimental group treated with H2S (SW group) containing mineral water ad libitum during five weeks. Biochemical parameters for monitoring sulphur water effects were concentration in serum of osteocalcin, alkaline phosphatase, calcium and phosphorus. Histological analyses of the left tibia coloured with haematoxylin-eosin were carried out. Results: Regarding the biochemical parameters, a statistically significant increase was observed in the OVX group for osteocalcin, alkaline phosphatase calcium and phosphorus compared to the sham-operated (CNT) group (p < 0.01). In SW + OVX, alkaline phosphatase was statistically significantly decreased (p < 0.01) and serum osteocalcin and phosphorus increased (p < 0.01). Calcium values were increased without significance. In the OVX + SW group, histological analyses showed numerous osteoblasts along the trabecular endosteum and the growth of young chondrocytes in the central bone zone and their migration to the peripheral parts. Conclusion: Drinking the H2S containing "Mlječanica" mineral water has led to decreased alkaline phosphatase, increased osteocalcin and phosphorus concentration in serum and stimulated the bone reparation in osteoporotic rats.
背景/目的:含硫矿泉水广泛应用于肌肉骨骼疾病的治疗。硫化氢是一种重要的骨代谢调节剂,其在骨质疏松症治疗中的应用研究日益深入。本研究的目的是分析含H2S的“麦jeanica”泉矿泉水对大鼠卵巢切除所致实验性骨质疏松症的生化和组织学影响。方法:选用14周龄Wistar雌性大鼠。这些动物接受了双侧卵巢切除术(OVX组)作为雌激素缺乏性骨质疏松症的实验模型。六周后,将动物分为对照组和实验组。实验组大鼠给予含矿泉水的H2S (SW组)随意灌胃5周。监测硫水效应的生化指标为血清骨钙素、碱性磷酸酶、钙、磷浓度。用血红素-伊红染色左胫骨进行组织学分析。结果:在生化指标方面,OVX组骨钙素、碱性磷酸酶钙、磷较假手术(CNT)组升高有统计学意义(p < 0.01)。SW + OVX组碱性磷酸酶显著降低(p < 0.01),血清骨钙素和磷显著升高(p < 0.01)。钙值升高无显著性。在OVX + SW组中,组织学分析显示大量成骨细胞沿骨小梁内皮生长,年轻软骨细胞在中央骨区生长并向外周部分迁移。结论:饮用含H2S的“mljeanica”矿泉水可降低骨质疏松大鼠的碱性磷酸酶,提高血清中骨钙素和磷的浓度,促进骨修复。
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引用次数: 1
Unintentional injuries of children and adolescents treated in emergency medical services: A cross-sectional study 急诊医疗服务中儿童和青少年意外伤害的横断面研究
Q4 Medicine Pub Date : 2022-01-01 DOI: 10.5937/scriptamed53-40755
Duška Jović, B. Skela-Savič, Snežana Petrović-Tepić, D. Knezevic, Aleksandar Tepić, M. Burgic-Radmanovic, Daniela Dobrovoljski, Nataša Egeljić-Mihailović
Background/Aim: Unintentional injuries among children and adolescents have become a common issue in public healthcare. The study objective was to analyse the characteristics and identify predictors associated with unintentional injuries in children and adolescents treated in emergency medical services (EMS) in the Republic of Srpska, Bosnia and Herzegovina. Methods: A cross-section study with retrospective analysis of WebMedic e-database from 14 EMS, in the period between January 2018 and December 2020 was conducted. Research included patients with unintentional injuries, aged ≤ 19 years, of both sexes. For comparison between groups, Chi-squared and multivariate logistic regression were used in risk factor analysis. Results: A total of 1,856 cases were identified, most injuries resulted from falls (46.7 %) and traffic injuries (26.9 %). Boys were significantly more affected by injuries than girls (p < 0.001). Falls were the major cause for reporting to EMS among age groups of children (0-9 years) and adolescents (10-14 years), whereas injuries in traffic were dominant in adolescents aged 15 to 19. The most common injuries were head injuries (35.7 %). Risk factors of unintentional injuries were age (p < 0.001), sex (p = 0.046), weekday (p = 0.016), winter (p = 0.014), body region (head, abdomen, lower and upper limbs (p < 0.001), thorax (p = 0.009)). Conclusions: There were significant differences in characteristics of unintentional injuries according to age and sex. Chances for occurrence of unintentional injuries among children increased with their age, especially for boys. These differences might indicate areas where preventive measures should be undertaken.
背景/目的:儿童和青少年的意外伤害已成为公共卫生保健中的一个普遍问题。研究目的是分析波斯尼亚和黑塞哥维那斯普斯卡共和国接受紧急医疗服务(EMS)治疗的儿童和青少年的特点并确定与意外伤害相关的预测因素。方法:对2018年1月至2020年12月14家EMS的WebMedic电子数据库进行横断面研究和回顾性分析。研究对象包括年龄≤19岁的男女非故意伤害患者。危险因素分析采用卡方和多因素logistic回归进行组间比较。结果:共发现1856例,其中跌倒损伤占46.7%,交通损伤占26.9%。男孩明显比女孩更容易受伤(p < 0.001)。在儿童(0-9岁)和青少年(10-14岁)年龄组中,跌倒是向EMS报告的主要原因,而在15至19岁的青少年中,交通伤害占主导地位。最常见的损伤是头部损伤(35.7%)。意外伤害的危险因素为年龄(p < 0.001)、性别(p = 0.046)、工作日(p = 0.016)、冬季(p = 0.014)、身体部位(头、腹、下肢、上肢(p < 0.001)、胸腔(p = 0.009)。结论:不同年龄、性别的意外伤害特点有显著差异。随着年龄的增长,儿童发生意外伤害的机会增加,尤其是男孩。这些差异可能表明应该采取预防措施的领域。
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Scripta Medica
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