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A case report of malignant peripheral nerve sheath tumour of the left thigh and popliteal fossa with lungs, spleen, and brain dissemination related to neurofibromatosis type 1 1型神经纤维瘤病伴左大腿及腘窝恶性周围神经鞘肿瘤伴肺、脾、脑播散1例
Q4 Medicine Pub Date : 2022-01-01 DOI: 10.5937/scriptamed53-32417
Sanja Petković, S. Petković, Ljiljana Tadić-Latinović, J. Berendika, B. Tubić, S. Jungić
A malignant peripheral nerve sheath tumour (MPNST) is a highly aggressive sarcoma. This disease develops in a number of people with neurofibromatosis type 1 (NF1), which is a common genetic disease. The paper presents a patient with typical manifestations of a malignant tumour of the peripheral nerve sheath, in the form of a large tumour of primary localisation in the distal part of the left thigh and left popliteal fossa and with significant dissemination into the lung parenchyma, which was accompanied by respiratory risk. The first operation of the tumour was done four years earlier, after which the patient did not come for regular check-ups. Nine cycles of chemotherapy were performed by Doxorubicin / Ifosfamide / Mesna protocol with clinical improvement and stabilisation, but without a significant impact on the dynamics of the disease and the overall survival was 14 months. It is of utmost importance to early recognise clinical presentation of the malignant form of this tumour and active supervision of a patient with a benign form by experts. In this way, it is possible to apply the optimal treatment modality in a timely manner.
恶性周围神经鞘肿瘤(MPNST)是一种高度侵袭性肉瘤。这种疾病发生在许多1型神经纤维瘤病(NF1)患者身上,这是一种常见的遗传性疾病。本文报告一例典型的外周神经鞘恶性肿瘤,肿瘤大,原发于左大腿远端及左腘窝,扩散至肺实质,伴有呼吸风险。第一次肿瘤手术是在四年前做的,之后病人没有定期检查。采用阿霉素/异环磷酰胺/ Mesna方案化疗9个周期,临床改善和稳定,但对疾病动态无显著影响,总生存期为14个月。这是至关重要的早期认识临床表现的恶性形式的这种肿瘤和良性形式的患者积极监督的专家。这样,就有可能及时应用最优的治疗方式。
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引用次数: 0
Technical innovation of Ervin G Erdös: A mechanical transducer for isotonic muscle contractions Ervin G的技术革新Erdös:一种等张力肌肉收缩的机械换能器
Q4 Medicine Pub Date : 2022-01-01 DOI: 10.5937/scriptamed53-36101
R. Igić
Let me explain the principle of bioassay. It is an analytical method for determination of the relative strength (concentration or potency) of a substance by comparing its effect on a test organism (living animal, cells or tissues) with that of a standard preparation. Bioassays are used in pharmacology mainly to determine the concentrations of hormones or drugs, eg biologically active peptides, acetylcholine, catecholamines, prostaglandins, histamine and prostacyclin. However, there are other forms of bioassay in which one can use isolated tissues and determine actions of their nerves, such as the nerve to the diaphragm from rats. Bioassays may also be done in vivo in individual humans. The assessment of drug effects in humans is designated by clinical pharmacologists as a clinical trial. Such trials often require hundreds or sometimes thousands of patients in order to test efficacy and safety of any new drug before it can be marketed. If the human investigations produce unexpected results, quite different of those obtained in the animal experiments the trials must be redesigned, to examine why and how this occurred. There are many examples of how such discoveries resulted in new clinically useful medications (eg, discovery antihypertensive effect of beta-adrenergic blocking agents).6 Accordingly, the pharmacologists have the bioassays, as a tool, which help them in the discovery process. I wrote on the renowned pharmacologist Professor Ervin G Erdös and his scientific opus in my reminiscence article written on the occasion of his death in 2019.1 When I attended the Fourth International Congress in Pharmacology in Basel in 1969, Dr Ervin G Erdös invited me to join his laboratory. Thus, in April 1970, I arrived in Oklahoma City as a Fulbright Fellow to work with him for two years. Later on, as a visiting scientist I frequently worked in his research laboratories in Dallas and Chicago and we shared research interests through visits across the Atlantic between the former Yugoslavia and the United States.2, 3
让我来解释一下生物测定法的原理。这是一种通过比较其对被试生物(活的动物、细胞或组织)与标准制剂的作用来测定物质相对强度(浓度或效价)的分析方法。生物测定法在药理学中主要用于测定激素或药物的浓度,如生物活性肽、乙酰胆碱、儿茶酚胺、前列腺素、组胺和前列环素。然而,还有其他形式的生物测定,其中人们可以使用分离的组织并确定其神经的作用,例如来自大鼠的横膈膜神经。生物测定也可在人体内进行。临床药理学家将药物对人体的作用评估称为临床试验。这种试验通常需要数百甚至数千名患者,以便在任何新药上市之前测试其有效性和安全性。如果人体研究产生了意想不到的结果,与动物实验中获得的结果完全不同,则必须重新设计试验,以检查这种情况发生的原因和方式。有许多这样的发现如何导致新的临床有用药物的例子(例如,发现-肾上腺素能阻滞剂的降压作用)因此,药理学家有生物测定作为一种工具,这有助于他们在发现过程中。我于2019年在著名药理学家Ervin G教授去世之际写了一篇关于他的文章Erdös和他的科学著作19.1 1969年我参加在巴塞尔举行的第四届国际药理学大会时,Ervin G博士Erdös邀请我加入他的实验室。因此,1970年4月,我以富布赖特研究员的身份来到俄克拉荷马城,和他一起工作了两年。后来,作为一名访问科学家,我经常在他位于达拉斯和芝加哥的研究实验室工作,并通过在前南斯拉夫和美国之间跨越大西洋的访问,我们分享了研究兴趣
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引用次数: 0
A case of COVID-19 presenting as acute liver failure 1例新冠肺炎表现为急性肝衰竭
Q4 Medicine Pub Date : 2022-01-01 DOI: 10.5937/scriptamed53-41392
P. Nawghare, S. Nair, Shubham Jain, S. Bansal, S. Chandnani, S. Rathi, P. Rathi
Although children with COVID-19 make up a small proportion of patients and have milder symptoms than adults, liver damage is a well-documented side effect of COVID-19 infection. Most liver damage caused by COVID-19 is modest. In this report, a case of a 6-year-old child who was hospitalised to a paediatric intensive care unit (PICU) with COVID-19 manifested as acute liver failure is described.
尽管感染COVID-19的儿童只占患者的一小部分,症状也比成人轻,但肝脏损伤是COVID-19感染的一个充分记录的副作用。大多数由COVID-19引起的肝损伤是轻微的。在本报告中,描述了一例6岁儿童因COVID-19入院儿科重症监护病房(PICU),表现为急性肝衰竭。
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引用次数: 0
Mechanisms for the development of heart failure and improvement of cardiac function by angiotensin-converting enzyme inhibitors 血管紧张素转换酶抑制剂对心力衰竭发展和心功能改善的机制
Q4 Medicine Pub Date : 2022-01-01 DOI: 10.5937/scriptamed53-36256
S. Bhullar, A. Shah, N. Dhalla
Angiotensin-converting enzyme (ACE) inhibitors, which prevent the conversion of angiotensin I to angiotensin II, are well-known for the treatments of cardiovascular diseases, such as heart failure, hypertension and acute coronary syndrome. Several of these inhibitors including captopril, enalapril, ramipril, zofenopril and imidapril attenuate vasoconstriction, cardiac hypertrophy and adverse cardiac remodeling, improve clinical outcomes in patients with cardiac dysfunction and decrease mortality. Extensive experimental and clinical research over the past 35 years has revealed that the beneficial effects of ACE inhibitors in heart failure are associated with full or partial prevention of adverse cardiac remodeling. Since cardiac function is mainly determined by coordinated activities of different subcellular organelles, including sarcolemma, sarcoplasmic reticulum, mitochondria and myofibrils, for regulating the intracellular concentration of Ca2+ and myocardial metabolism, there is ample evidence to suggest that adverse cardiac remodelling and cardiac dysfunction in the failing heart are the consequence of subcellular defects. In fact, the improvement of cardiac function by different ACE inhibitors has been demonstrated to be related to the attenuation of abnormalities in subcellular organelles for Ca2+-handling, metabolic alterations, signal transduction defects and gene expression changes in failing cardiomyocytes. Various ACE inhibitors have also been shown to delay the progression of heart failure by reducing the formation of angiotensin II, the development of oxidative stress, the level of inflammatory cytokines and the occurrence of subcellular defects. These observations support the view that ACE inhibitors improve cardiac function in the failing heart by multiple mechanisms including the reduction of oxidative stress, myocardial inflammation and Ca2+-handling abnormalities in cardiomyocytes.
血管紧张素转换酶(ACE)抑制剂可以阻止血管紧张素I向血管紧张素II的转化,在治疗心血管疾病(如心力衰竭、高血压和急性冠状动脉综合征)方面众所周知。其中一些抑制剂包括卡托普利、依那普利、雷米普利、佐非普利和咪咪普利,可减轻血管收缩、心脏肥厚和不良心脏重构,改善心功能障碍患者的临床结果,降低死亡率。在过去的35年里,大量的实验和临床研究表明,ACE抑制剂在心力衰竭中的有益作用与完全或部分预防不良心脏重构有关。由于心功能主要由不同的亚细胞细胞器(包括肌膜、肌浆网、线粒体和肌原纤维)协调活动来调节细胞内Ca2+浓度和心肌代谢,有充分的证据表明,衰竭心脏的不良心脏重构和心功能障碍是亚细胞缺陷的结果。事实上,不同的ACE抑制剂对心功能的改善已被证明与亚细胞细胞器中Ca2+处理、代谢改变、信号转导缺陷和衰竭心肌细胞基因表达变化的异常衰减有关。各种ACE抑制剂也被证明可以通过减少血管紧张素II的形成、氧化应激的发展、炎症细胞因子的水平和亚细胞缺陷的发生来延缓心力衰竭的进展。这些观察结果支持了ACE抑制剂通过多种机制改善心力衰竭心功能的观点,包括减少氧化应激、心肌炎症和心肌细胞中Ca2+处理异常。
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引用次数: 2
Assessment of factors influencing the patient's perception of teledentistry services 影响患者对远程牙科服务认知的因素评估
Q4 Medicine Pub Date : 2022-01-01 DOI: 10.5937/scriptamed53-41336
R. Oktaviani, Iwan Dewanto
Background/Aim: The trend of using teledentistry increased significantly during the pandemic. Many studies have analysed patients' perceptions of teledentistry, but no studies have examined the factors that influence these perceptions. Aim of this study was to determine the factors that influenced the patient's perception of teledentistry. Methods: This type of research was a descriptive analysis with a cross sectional design. A total of 170 respondents filled out a questionnaire containing sociodemographic data and statements with a Likert scale related to the five perceptual domains of teledentistry. The data were analysed for correlation test with SPSS and model test with SEM-PLS. Results: There were only two factors, namely age and level of education that appear as factors that affect the patient's perception with a correlation significance value of 0.001 for age and 0.005 for education. The value of the correlation coefficient was positive, which means that the higher the age and level of education, there was a greater tendency for perceived value to be more strongly agreed. These results were reinforced by the results of the coefficient values on the SEM-PLS model test which were positive and significant, namely 0.311. The results of the goodness of fit analysis in this study were in the moderate category with a value of 0.265. However, the imbalance in the number of respondents in each sociodemographic group makes the results of this study less representative. Conclusion: There was a significant positive correlation between the level of education and the perception of teledentistry. This means that the higher a person's education level, the better his perception of teledentistry. Age had a significant positive correlation and influence with the patient's perception of teledentistry.
背景/目的:大流行期间使用远程牙科的趋势显著增加。许多研究分析了患者对远程牙科的看法,但没有研究调查影响这些看法的因素。本研究的目的是确定影响患者远牙学知觉的因素。方法:采用横断面设计的描述性分析。共有170名受访者填写了一份问卷,其中包含社会人口统计数据和与远程牙科五个感知领域相关的李克特量表。数据分析采用SPSS进行相关检验,SEM-PLS进行模型检验。结果:影响患者感知的因素只有年龄和受教育程度两个因素,年龄和受教育程度的相关显著值分别为0.001和0.005。相关系数为正,即年龄越高、受教育程度越高,对感知价值的认同倾向越强。SEM-PLS模型检验的系数值为正且显著,即0.311,进一步强化了这些结果。本研究的拟合优度分析结果为中等,为0.265。然而,在每个社会人口群体的受访者数量的不平衡使得本研究的结果不太具有代表性。结论:受教育程度与远程牙科感知存在显著正相关。这意味着一个人的教育水平越高,他对远程牙科的感知就越好。年龄与患者的远牙学知觉有显著的正相关和影响。
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引用次数: 0
Knowledge, attitudes and practices of parents regarding antibiotic use among children: Differences between urban and rural areas in the Republic of Srpska 父母对儿童抗生素使用的知识、态度和做法:斯普斯卡共和国城乡地区的差异
Q4 Medicine Pub Date : 2022-01-01 DOI: 10.5937/scriptamed53-35502
B. Mijovic, Jela Aćimović, Jelena Đaković-Dević, Julija Kralj, Bojan Joksimović, Vesna Lučić-Samardžija, Mirjana Đermanović, Vesna Vujić-Aleksić, B. Zeljković, Snežana Perić-Simić
Background/Aim: Antibiotic use and resistance represent a growing public health issue, with a specific risk of uncontrolled use of antibiotics in children. The aim of the study was to examine differences in parental knowledge, attitudes and practices about antibiotic use in children between urban and rural areas of the Republic of Srpska. Methods: A cross-sectional study was conducted among 1459 parents of children under 6 years of age, out of which 1201 (82.3 %) lived in urban areas while 258 (17.7 %) lived in rural areas. The research is conducted among parents who brought their children to the selected primary healthcare centres and among parents of children in preschool institutions. Results: The majority of respondents (98.4 %) state that doctors are their main source of information. Only 61.2 % of respondents precisely know which drug is an antibiotic when offered different drugs and respondents from rural areas (54.3 %) more often (p = 0.012) gave more accurate answers when compared to respondents from urban areas (37.3 %). Among parents, 86 % agree with the statement that improper use of antibiotics reduces their effectiveness and leads to bacterial resistance, regardless of groups. More than a half of respondents (52.4 %) do not think that children with flu or common cold symptoms recover faster when they receive antibiotics, significantly more respondents from urban areas (p = 0.001). Respondents from rural areas significantly more often believe that antibiotics can produce harmful effects compared to respondents from urban areas (p = 0.049). Respondents from rural areas significantly more often think that antibiotic use can prevent complications caused by inflammation of the upper respiratory tract (p = 0.006). Parents from rural areas give their children antibiotics without a paediatrician's recommendation significantly more often (4.3 %) compared to respondents from urban areas (0.6 %) (p < 0.001). Conclusion: There are differences in parental knowledge, attitudes and practices regarding antibiotic use and antimicrobial resistance among parents in rural and urban areas. There is need for additional education of parents and for greater engagement of paediatricians in providing guidance and explanations regarding the use of antibiotics.
背景/目的:抗生素使用和耐药性是一个日益严重的公共卫生问题,在儿童中不加控制地使用抗生素具有特殊风险。这项研究的目的是调查斯普斯卡共和国城市和农村地区父母对儿童使用抗生素的知识、态度和做法的差异。方法:对1459名6岁以下儿童家长进行横断面调查,其中1201名(82.3%)生活在城市,258名(17.7%)生活在农村。这项研究是在带孩子到选定的初级保健中心的父母和学龄前机构的儿童父母中进行的。结果:绝大多数受访者(98.4%)表示医生是他们的主要信息来源。当提供不同的药物时,只有61.2%的应答者准确地知道哪种药物是抗生素,农村应答者(54.3%)比城市应答者(37.3%)给出的答案更准确(p = 0.012)。在家长中,86%的人同意不当使用抗生素会降低其有效性并导致细菌耐药的说法,无论群体如何。超过一半的答复者(52.4%)不认为有流感或普通感冒症状的儿童在接受抗生素治疗后恢复得更快,来自城市地区的答复者明显更多(p = 0.001)。与城市地区的答复者相比,农村地区的答复者明显更多地认为抗生素会产生有害影响(p = 0.049)。农村地区的应答者明显更多地认为使用抗生素可以预防上呼吸道炎症引起的并发症(p = 0.006)。农村地区的父母在没有儿科医生建议的情况下给孩子使用抗生素的情况(4.3%)明显高于城市地区(0.6%)(p < 0.001)。结论:城乡家长对抗菌药物使用和耐药性的知识、态度和行为存在差异。有必要对家长进行进一步教育,并让儿科医生更多地参与提供有关抗生素使用的指导和解释。
{"title":"Knowledge, attitudes and practices of parents regarding antibiotic use among children: Differences between urban and rural areas in the Republic of Srpska","authors":"B. Mijovic, Jela Aćimović, Jelena Đaković-Dević, Julija Kralj, Bojan Joksimović, Vesna Lučić-Samardžija, Mirjana Đermanović, Vesna Vujić-Aleksić, B. Zeljković, Snežana Perić-Simić","doi":"10.5937/scriptamed53-35502","DOIUrl":"https://doi.org/10.5937/scriptamed53-35502","url":null,"abstract":"Background/Aim: Antibiotic use and resistance represent a growing public health issue, with a specific risk of uncontrolled use of antibiotics in children. The aim of the study was to examine differences in parental knowledge, attitudes and practices about antibiotic use in children between urban and rural areas of the Republic of Srpska. Methods: A cross-sectional study was conducted among 1459 parents of children under 6 years of age, out of which 1201 (82.3 %) lived in urban areas while 258 (17.7 %) lived in rural areas. The research is conducted among parents who brought their children to the selected primary healthcare centres and among parents of children in preschool institutions. Results: The majority of respondents (98.4 %) state that doctors are their main source of information. Only 61.2 % of respondents precisely know which drug is an antibiotic when offered different drugs and respondents from rural areas (54.3 %) more often (p = 0.012) gave more accurate answers when compared to respondents from urban areas (37.3 %). Among parents, 86 % agree with the statement that improper use of antibiotics reduces their effectiveness and leads to bacterial resistance, regardless of groups. More than a half of respondents (52.4 %) do not think that children with flu or common cold symptoms recover faster when they receive antibiotics, significantly more respondents from urban areas (p = 0.001). Respondents from rural areas significantly more often believe that antibiotics can produce harmful effects compared to respondents from urban areas (p = 0.049). Respondents from rural areas significantly more often think that antibiotic use can prevent complications caused by inflammation of the upper respiratory tract (p = 0.006). Parents from rural areas give their children antibiotics without a paediatrician's recommendation significantly more often (4.3 %) compared to respondents from urban areas (0.6 %) (p < 0.001). Conclusion: There are differences in parental knowledge, attitudes and practices regarding antibiotic use and antimicrobial resistance among parents in rural and urban areas. There is need for additional education of parents and for greater engagement of paediatricians in providing guidance and explanations regarding the use of antibiotics.","PeriodicalId":33497,"journal":{"name":"Scripta Medica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81172855","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
The effect of sulphate-sulphide mineral baths on blood glucose level in patients with knee osteoarthritis 硫酸-硫化物矿泉浴对膝关节骨关节炎患者血糖水平的影响
Q4 Medicine Pub Date : 2022-01-01 DOI: 10.5937/scriptamed53-41890
Tatjana Erceg-Rukavina, Dragana Dragičević-Cvjetković, Dragana Đurić, M. Stojiljković, R. Škrbić
Background/Aim: Type 2 diabetes is a common comorbidity in patients with knee osteoarthritis. Bearing in mind that obesity and insulin resistance are risk factors for the development of knee osteoarthritis, physical therapy and balneotherapy containing hydrogen sulphide (H2S) has a positive effect on the functional and metabolic status of these patients. This work was aimed to investigate the effect of sulphate-sulphide-rich mineral baths containing H2S on the level of serum glucose in patients with knee osteoarthritis. Methods: An open prospective randomised clinical trial included patients suffering from stage I and II of the knee osteoarthritis. Patients were divided into two groups of 40 subjects each: control group and experimental group. All subjects underwent inpatient physical treatment consisting of kinesitherapy and transcutaneous electrical nerve stimulation (TENS) 6 days a week. Patients from experimental group, in addition to all the mentioned treatments, also took sulphate-sulphide mineral water baths once a day for 30 minutes for 7 days, unlike the patients from control group who took tap water baths, according to the same schedule. The level of serum glucose was monitored in all patients on admission, after discharge and 6 months after the treatment. The Student t-test was used for statistical data processing and p < 0.05 was considered as statistically significant. Results: Study included 80 patients of both sexes, with an average age of 67.00 ± 5.75 years. All patients had elevated serum glucose values on admission. The initial levels of glycaemia in the control and experimental groups were not significantly different (6.99 ± 1.95 and 7.88 ± 1.90 mmol/L, respectively). At discharge, patients who performed balneotherapy had a statistically significant decrease in serum glucose values compared to patients from the control group (by 1.84 vs 0.26 mmol/L, p < 0.001). This effect did not persist six months after the end of the treatment (p > 0.05). Conclusion: The application of balneotherapy with sulphate-sulphide mineral baths containing H2S as a potent gas transmitter significantly reduces serum glucose levels in patients with knee osteoarthritis.
背景/目的:2型糖尿病是膝关节骨关节炎患者常见的合并症。考虑到肥胖和胰岛素抵抗是膝骨关节炎发展的危险因素,含硫化氢(H2S)的物理治疗和水疗对这些患者的功能和代谢状态有积极的影响。本研究旨在探讨含硫化氢的富硫酸盐-硫化物矿泉浴对膝关节骨关节炎患者血清葡萄糖水平的影响。方法:一项开放的前瞻性随机临床试验纳入了I期和II期膝骨关节炎患者。将患者分为两组,每组40例:对照组和实验组。所有受试者均接受住院物理治疗,包括运动疗法和经皮神经电刺激(TENS),每周6天。实验组患者在上述治疗方法的基础上,还采用硫酸-硫化物矿泉水浴,与对照组采用自来水浴不同,每天1次,每次30分钟,连续7天。所有患者入院时、出院后及治疗后6个月监测血糖水平。统计学数据处理采用学生t检验,以p < 0.05为差异有统计学意义。结果:纳入患者80例,男女均可,平均年龄67.00±5.75岁。所有患者入院时血糖值均升高。对照组和试验组初始血糖水平无显著差异(分别为6.99±1.95和7.88±1.90 mmol/L)。出院时,与对照组患者相比,接受浴疗治疗的患者血清葡萄糖值有统计学意义的降低(1.84 vs 0.26 mmol/L, p < 0.001)。这种效果在治疗结束后6个月没有持续(p < 0.05)。结论:应用含H2S的硫酸盐-硫化物矿泉浴治疗可显著降低膝关节骨关节炎患者的血清葡萄糖水平。
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引用次数: 0
New approaches in management and treatment of 'Hidradenitis suppurativa' 化脓性汗腺炎的管理与治疗新途径
Q4 Medicine Pub Date : 2022-01-01 DOI: 10.5937/scriptamed53-36048
Vesna Gajanin, Nikola Baroš, G. Marošević, Đuka Ninković-Baroš, Jagoda Balaban
Background / Aim: Hidradenitis suppurativa (HS) is a chronic inflammatory disease that most often affects apocrine gland-bearing areas of the skin. The treatment depends on the severity of the clinical presentation. The paper objective was to present new modalities in management and treatment of HS. Methods: The subjects in this research included the patients suffering from the severe form of HS, who were treated in the University Clinical Centre of the Republic of Srpska for the past three years. The effect of treatment of HS were monitored. In four patients, biologic therapy with adalimumab or adalimumab biosimilars was administered, while four patients received radiotherapy and 17 of them, were treated surgically. Depending on the type of treatment, the effects of therapy were monitored after 6-12 weeks by using clinical examination and by assessing the disease stage according to the Hurley staging. Due to a small number of subjects, especially in patients treated with biologic and radiotherapy, it was not possible to perform any statistical analysis and the results were presented by description, in tables and photographs. Results: Biologic therapy: Adalimumab was administered subcutaneously 80 mg, twice a month. After 12 weeks, in 4 patients was observed a regression of changes by 60-70 % when compared to previous skin changes. Radiotherapy: the total radiation dose was 5 Gy, distributed in 5 or 10 fractions. After 12 weeks an improvement by 60-70 % was observed. Surgical treatment: after 6-8 weeks, the patients were fully recovered. Conclusions: Application of biologic and radiotherapy after 12 weeks had similar results, ie it brought to regression of changes by 60-70 %. The best results were achieved after surgical treatment of HS.
背景/目的:化脓性汗腺炎(HS)是一种慢性炎症性疾病,最常影响皮肤的大汗腺。治疗取决于临床表现的严重程度。本文的目的是提出管理和治疗HS的新方法。方法:本研究的对象为近三年在塞族共和国大学临床中心接受治疗的重症HS患者。观察治疗HS的效果。在4例患者中,给予阿达木单抗或阿达木单抗生物类似药的生物治疗,而4例患者接受放疗,其中17例患者接受手术治疗。根据治疗类型,在6-12周后通过临床检查和根据Hurley分期评估疾病分期来监测治疗效果。由于受试者数量少,特别是接受生物和放射治疗的患者,因此无法进行任何统计分析,结果以描述、表格和照片的形式呈现。结果:生物治疗:阿达木单抗皮下注射80 mg,每月2次。12周后,有4例患者与之前的皮肤变化相比,皮肤变化消退了60- 70%。放疗:总放射剂量为5 Gy,按5或10个分量分布。12周后观察到改善60- 70%。手术治疗:6-8周后,患者完全康复。结论:12周后应用生物制剂与放疗效果相似,均可使病变恢复60- 70%。手术治疗HS效果最好。
{"title":"New approaches in management and treatment of 'Hidradenitis suppurativa'","authors":"Vesna Gajanin, Nikola Baroš, G. Marošević, Đuka Ninković-Baroš, Jagoda Balaban","doi":"10.5937/scriptamed53-36048","DOIUrl":"https://doi.org/10.5937/scriptamed53-36048","url":null,"abstract":"Background / Aim: Hidradenitis suppurativa (HS) is a chronic inflammatory disease that most often affects apocrine gland-bearing areas of the skin. The treatment depends on the severity of the clinical presentation. The paper objective was to present new modalities in management and treatment of HS. Methods: The subjects in this research included the patients suffering from the severe form of HS, who were treated in the University Clinical Centre of the Republic of Srpska for the past three years. The effect of treatment of HS were monitored. In four patients, biologic therapy with adalimumab or adalimumab biosimilars was administered, while four patients received radiotherapy and 17 of them, were treated surgically. Depending on the type of treatment, the effects of therapy were monitored after 6-12 weeks by using clinical examination and by assessing the disease stage according to the Hurley staging. Due to a small number of subjects, especially in patients treated with biologic and radiotherapy, it was not possible to perform any statistical analysis and the results were presented by description, in tables and photographs. Results: Biologic therapy: Adalimumab was administered subcutaneously 80 mg, twice a month. After 12 weeks, in 4 patients was observed a regression of changes by 60-70 % when compared to previous skin changes. Radiotherapy: the total radiation dose was 5 Gy, distributed in 5 or 10 fractions. After 12 weeks an improvement by 60-70 % was observed. Surgical treatment: after 6-8 weeks, the patients were fully recovered. Conclusions: Application of biologic and radiotherapy after 12 weeks had similar results, ie it brought to regression of changes by 60-70 %. The best results were achieved after surgical treatment of HS.","PeriodicalId":33497,"journal":{"name":"Scripta Medica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87136167","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
Use of an ultrashort-acting selective β1-adrenergic receptor antagonist esmolol in ear, nose and throat surgery 超短效选择性β1-肾上腺素受体拮抗剂艾司洛尔在耳鼻喉外科中的应用
Q4 Medicine Pub Date : 2022-01-01 DOI: 10.5937/scriptamed53-37135
D. Lončar-Stojiljković, Ž. Maksimović, M. Đurić
Background / Aim: The concept of general balanced anaesthesia was devised in order to assure cardiovascular stability and fast post-anaesthesia recovery. This clinical trial was organised in order to investigate the parameters of cardiovascular function and emergence from anaesthesia in elective ear, nose and throat (ENT) surgery patients. Methods: A total of 40 ASA I and II patients of both sexes scheduled for elective ENT surgery were randomly divided into two equal groups. Both groups received a continuous IV infusion of glucose 5 % solution and in the esmolol group this infusion also contained esmolol. Esmolol infusion rate was 0.3 mg/kg/min during the first 5 min and thereafter 0.1 mg/kg/min. In critical phases of anaesthesia and operation (induction, intubation, first incision, surgical manipulations, wound suture, extubation), systolic and diastolic blood pressure were monitored. Recovery after anaesthesia was assessed based on times of eye opening on command, spontaneous eye opening and regaining of full orientation. Increases in cardiovascular parameters by 20 % of the baseline values or more were treated with IV boluses of fentanyl, alone or with droperidol and, if necessary, by adding isoflurane 0.5 % to the inhalational mixture. Consumption of drugs was recorded. Results: Esmolol assured stable values of cardiovascular parameters that were in most critical phases of anaesthesia and operation lower than in the control group. The duration of anaesthesia did not differ between the groups. In the esmolol group, lower consumption of fentanyl, droperidol and sevoflurane was registered. Patients in the esmolol group emerged from anaesthesia faster than patients in the control group. Conclusion: Continuous IV infusion of esmolol assures better cardiovascular stability, necessitates lower consumption of analgesics and anaesthetics and results in faster emergence from general anaesthesia in elective ENT surgery.
背景/目的:为了保证心血管的稳定和麻醉后的快速恢复,设计了全身平衡麻醉的概念。本临床试验旨在研究选择性耳鼻喉手术患者的心血管功能参数和麻醉后的恢复情况。方法:择期行耳鼻喉科手术的ASA I、II级患者40例,男女均可,随机分为两组。两组均连续静脉输注5%葡萄糖溶液,艾司洛尔组也输注艾司洛尔。艾司洛尔输注速率前5min为0.3 mg/kg/min,后5min为0.1 mg/kg/min。在麻醉和手术的关键阶段(诱导、插管、首次切口、手术操作、伤口缝合、拔管),监测收缩压和舒张压。麻醉后的恢复情况根据命令睁眼次数、自发睁眼次数和恢复完全定向的次数进行评估。心血管参数增加基线值的20%或更多时,用静脉注射芬太尼或与氟哌啶醇联合治疗,必要时在吸入混合物中加入0.5%的异氟醚。记录了药物的消耗情况。结果:与对照组相比,艾司洛尔在麻醉和手术最关键阶段的心血管参数值较稳定。两组间麻醉持续时间无差异。在艾司洛尔组,芬太尼、氟哌啶和七氟醚的用量较低。艾司洛尔组麻醉恢复速度快于对照组。结论:连续静脉滴注艾司洛尔可提高心血管稳定性,减少镇痛药和麻醉药的使用,有利于择期耳鼻喉外科全麻恢复。
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引用次数: 0
Relationship Between ABO Blood group Phenotypes and nCOVID-19 Susceptibility – A Retrospective Observational Study ABO血型表型与新冠肺炎易感性的关系——一项回顾性观察研究
Q4 Medicine Pub Date : 2021-01-04 DOI: 10.21203/rs.3.rs-39611/v2
S. Bhandari, A. Shaktawat, A. Tak, J. Shukla, J. Gupta, Bhoopendra Patel, Shivankan Kakkar, A. Dube, Sunita Dia, Mahendra Dia, T. Wehner
Background: Since the outbreak of coronavirus disease-19 research has been continued to explore multiple facets of the disease. The objective of the present study is to evaluate the relationship between blood group phenotypes and COVID-19 susceptibility.Methods: In this hospital based, retrospective observational study 132 COVID-19 patients were enrolled from SMS Medical Hospital in Jaipur, India after receiving approval from the institutional ethics committee. The ABO, Rh and Kell blood group phenotypes along with demographic data of the patients were recorded. The observed proportions of ‘A’ , ‘B’, ‘AB’, ‘O’, ‘Rh’, and ‘Kell’ blood groups in COVID-19 patients were compared against the expected proportions (the null hypothesis) of the general population using Pearson’s chi-squared test and partition analysis.Results: There were significant differences between observed and expected frequency for the ABO and Kell blood phenotypes. Further partition analysis of ABO phenotypes showed that the group ‘A’ phenotypes were more susceptible to COVID-19. The Kell negatives were also more susceptible. The blood groups ‘AB’, ‘B’, ‘O’, and ‘Rh’ showed no significant difference for susceptibility to COVID-19.Conclusion: The study shows a relationship between ABO, Rh, and Kell blood groups and COVID-19 susceptibility. The application of these relationships in clinics should be explored in future studies.
背景:自2019冠状病毒病爆发以来,研究一直在不断探索该疾病的多个方面。本研究的目的是评估血型表型与COVID-19易感性之间的关系。方法:以医院为基础,经机构伦理委员会批准,从印度斋浦尔SMS医院招募132例COVID-19患者进行回顾性观察研究。记录患者的ABO、Rh、Kell血型表型及人口统计学数据。使用Pearson卡方检验和分割分析,将COVID-19患者中A、B、AB、O、Rh和Kell血型的观察比例与一般人群的预期比例(零假设)进行比较。结果:ABO和Kell血型的观察频率与预期频率有显著差异。进一步的ABO表型分割分析显示,A型组更容易感染COVID-19。凯尔阴性的人也更容易受到影响。“AB”、“B”、“O”和“Rh”血型对COVID-19的易感性无显著差异。结论:本研究显示ABO、Rh和Kell血型与COVID-19易感性相关。这些关系在临床中的应用有待于进一步的研究。
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引用次数: 3
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Scripta Medica
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