Medicina Clinica Practica最新文献

英文中文

Double orifice mitral valve associated with bicuspid aortic valve 伴有主动脉瓣双尖瓣的二尖瓣双瓣口

Q4 Medicine

Medicina Clinica Practica

Pub Date : 2024-08-27 DOI: 10.1016/j.mcpsp.2024.100467

Consuelo Orihuela-Sandoval , Edgar García-Cruz , José Miguel Torres-Martel , Daniel Manzur-Sandoval

引用次数: 0

Flourishing through continuous medical education: Empowering medical educators 通过继续医学教育蓬勃发展：增强医学教育工作者的能力

Q4 Medicine

Medicina Clinica Practica

Pub Date : 2024-07-23 DOI: 10.1016/j.mcpsp.2024.100460

Heather A. Billings , Juliana M. Kling , Devyani Lal , Jon T. Nordrum , Mira T. Keddis

引用次数: 0

Cutaneous sarcoidosis 皮肤肉样瘤病

Q4 Medicine

Medicina Clinica Practica

Pub Date : 2024-07-19 DOI: 10.1016/j.mcpsp.2024.100455

Jullio C. Salas-Alanís , Mauricio Salas-Garza , María G. Moreno-Treviño , Luis C. Mata-Meléndez , Raymundo Garza-Martínez , Gerardo Rivera-Silva

引用次数: 0

Neurofibromatosis tipo 1 en paciente puérpera 一名产后患者的 1 型神经纤维瘤病

Q4 Medicine

Medicina Clinica Practica

Pub Date : 2024-07-19 DOI: 10.1016/j.mcpsp.2024.100454

Sergia Daniela Rosales Castro , Olman Daniel Gradis Santos , Ana María Enríquez Martínez , Shirley Andino Moya

引用次数: 0

Experiencia clínica con la combinación de cinarizina y dimenhidrinato en el tratamiento del vértigo de origen diverso en atención primaria: una serie de casos 联合使用辛那利定和地美海明治疗初级保健中各种原因引起的眩晕的临床经验：一个病例系列

Q4 Medicine

Medicina Clinica Practica

Pub Date : 2024-07-15 DOI: 10.1016/j.mcpsp.2024.100457

David Martín-Enguix , Amara Helena Aladel Ponce , Sandra Albamonte Navarro , José Miguel Álvarez Cabo , José Miguel Fernández Rodríguez , José Ignacio González Lillo , Judith Norma Montoya Fernández del Campo , Manuel Ruiz Cuetos

Introduction and objectives

Dizziness, including vertigo, imbalance, and presyncope, affects 15–20% of adults, increasing the risk of falls, especially in the elderly. The interaction between signals from the peripheral vestibular system, vestibular nuclei, and the central nervous system, modulated by neurotransmitters such as glutamate, acetylcholine, and glycine, along with histamine, adrenaline, and noradrenaline, is crucial for balance. Dizziness arises when vestibular information does not match other sources and can be associated with various neurological, psychiatric, respiratory, or infectious conditions. Current treatment is based on rest, particle replacement maneuvers and medications such as betahistine and sedatives, but the fixed combination of cinnarizine and dimenhydrinate has proven effective in clinical trials, effectively treating vertigo of various origins by acting on peripheral and central vestibular systems.

Patients

We present 7 clinical cases, in which we have used the same treatment with cinnarizine and dimenhydrate at fixed doses of 20/40 mg.

Results

The combination of cinnarizine and dimenhydrinate proved effective in managing a variety of vestibular disorders, including recurrent benign paroxysmal positional vertigo, vestibular migraine, Meniere's syndrome, and presbivestibulopathy. Patients experienced improvement in vestibular symptoms, such as dizziness, vertigo, and imbalance, proving to be a safe and effective drug, demonstrating in some cases the resolution of symptoms in patients previously treated with other therapies.

Conclusion

The versatility of the combination allows its use in the treatment of vertigo of various origins, making it a comprehensive and valuable option for situations where the precise diagnosis of the causes of vertigo is not clear.

导言和目的头晕，包括眩晕、失衡和晕厥前兆，影响着 15-20% 的成年人，增加了跌倒的风险，尤其是老年人。来自外周前庭系统、前庭神经核和中枢神经系统的信号在谷氨酸、乙酰胆碱和甘氨酸等神经递质以及组胺、肾上腺素和去甲肾上腺素的调节下相互作用，对平衡至关重要。当前庭信息与其他来源的信息不一致时，就会产生头晕，可能与各种神经、精神、呼吸或感染性疾病有关。目前的治疗方法主要是休息、微粒替代操作以及服用倍他司汀和镇静剂等药物，但辛纳利嗪和二苯海拉明的固定组合已在临床试验中证明有效，通过作用于外周和中枢前庭系统，有效治疗各种原因引起的眩晕。结果事实证明，联合使用辛那利定和二苯海拉明能有效治疗多种前庭疾病，包括复发性良性阵发性位置性眩晕、前庭性偏头痛、美尼尔氏综合征和前驱体病。患者的头晕、眩晕和失衡等前庭症状得到了改善，证明这是一种安全有效的药物，在某些病例中，之前接受过其他疗法治疗的患者的症状也得到了缓解。

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引用次数: 0

Comparing clonidine and dexmedetomidine effects in the treatment of opiate withdrawal syndrome in poisoned patients 比较氯咪替丁和右美托咪定在治疗中毒患者阿片类药物戒断综合征中的效果

Q4 Medicine

Medicina Clinica Practica

Pub Date : 2024-07-10 DOI: 10.1016/j.mcpsp.2024.100458

Azadeh Memarian , Mahdiye Abiyarghamsari , Shahin Shadnia , Babak Mostafazadeh , Peyman Erfan Talab Evini , Mahdiye Golestani Fard , Mitra Rahimi

Background

While opiate withdrawal syndrome (OWS) typically resolves within a few weeks, the discomfort in the initial days after discontinuing opioid use is intense. In this study, we compared the effects of 2 drugs, clonidine and dexmedetomidine, for treating OWS in patients admitted to the Toxicology ICU at Loghman-e Hakim Hospital.

Methods

We collected patient information for individuals diagnosed with OWS in this clinical trial study. Fifty-two patients, matched based on the type of drug use (methadone, opiate, heroin), were included and divided into 2 groups. We compared the clinical effects of 2 drugs, dexmedetomidine and clonidine, on OWS symptoms using the Clinical Opiate Withdrawal Scale (COWS). The dexmedetomidine group received a dosage of 0.5 mcg/kg/h continuous IV infusion; not to exceed 24 h, while the clonidine group received 1.2 mg per day for 24 h. We completed the COWS standard checklist and compared the results after 0, 12, and 24 h.

Results

At Zero hours' patients who were administered dexmedetomidine had a significantly higher average COWS score of 0.684, compared to a score of 0.053 for patients who received clonidine (p-value = .000201). At the 12-h, the distinction between the 2 treatment groups was no longer statistically significant, as evidenced by a p-value of .162829 (dexmedetomidine: 0.105 vs. clonidine: 0.000).

Conclusions

The results suggest that dexmedetomidine is superior to clonidine in reducing withdrawal symptoms. The study found that both medications had a significant decrease in COWS scores over time, indicating their effectiveness in alleviating withdrawal symptoms as time passed.

背景虽然阿片类药物戒断综合征（OWS）通常会在几周内缓解，但停用阿片类药物后最初几天的不适感非常强烈。在这项研究中，我们比较了克洛尼定和右美托咪定这两种药物对治疗 Loghman-e Hakim 医院毒理重症监护室收治的 OWS 患者的效果。根据使用药物的类型（美沙酮、鸦片制剂、海洛因）进行配对后，52 名患者被纳入其中并分为两组。我们使用临床阿片类药物戒断量表（COWS）比较了右美托咪定和氯尼替丁这两种药物对 OWS 症状的临床效果。右美托咪定组接受的剂量为 0.5 毫克/千克/小时，持续静脉注射；不超过 24 小时；而氯尼丁组每天接受 1.2 毫克，持续 24 小时。我们完成了 COWS 标准检查表，并对 0、12 和 24 小时后的结果进行了比较。结果在 0 小时后，使用右美托咪定的患者 COWS 平均得分为 0.684，明显高于使用氯尼替丁的患者 0.053（P 值 = 0.000201）。12 小时后，两组治疗之间的差异不再具有统计学意义，p 值为 0.162829（右美托咪定：0.105 vs. 氯尼替丁：0.000）。研究发现，随着时间的推移，这两种药物的 COWS 分数都有显著下降，这表明它们在缓解戒断症状方面的有效性。

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引用次数: 0

Apocrine miliaria 脓肿

Q4 Medicine

Medicina Clinica Practica

Pub Date : 2024-07-10 DOI: 10.1016/j.mcpsp.2024.100456

Jullio C. Salas-Alanís , Mauricio Salas-Garza , María G. Moreno-Treviño , Raymundo Garza-Martínez , José G. Silva-Hernández , Gerardo Rivera-Silva

引用次数: 0

Melatonin treatment in patients with atypical facial pain: A randomized, double-blind, placebo-controlled clinical trial 褪黑素治疗非典型面部疼痛患者：随机、双盲、安慰剂对照临床试验

Q4 Medicine

Medicina Clinica Practica

Pub Date : 2024-07-01 DOI: 10.1016/j.mcpsp.2024.100430

Tahereh Nosratzehi

Background

The present study was carried out to evaluate the effect of melatonin and placebo in the patients with atypical facial pain (AFP).

Method

This double blind randomized controlled study was carried out on 30 patients who were suffering from AFP. During this period, patients were divided in 2 study and control groups. Then, they were treated with melatonin. Melatonin group used four 3-mg daily and placebo group received 4 placebo which were similar in size, shape, color with melatonin until the end of treatment, and then the severity of burning sensation was measured by physician. Sleep quality was measured using the visual analog scale using the Petersburg questionnaire.

Result

The results of the present study show that the use of melatonin and placebo in patients with AFP reduces sensation and improves their sleep quality, although it may not reduce it completely. In this study, severity of burning was 5.71 ± 1.42 after treatment in the study group and 5.93 ± 2.65 in the control group, which was not statistically significant (p = .46). The mean score of sleep before treatment was not significantly different between the study (9 ± 1.23) and the control (8 ± 1.56) groups. The mean score of sleep after treatment between the study group (8 ± 1.45) and the control group (7 ± 1.23) was not significantly different (p = .43).

Conclusion

According to the result of the study, melatonin was not superior placebo in treatment of AFP.

背景本研究旨在评估褪黑素和安慰剂对非典型面部疼痛（AFP）患者的影响。方法本研究对 30 名 AFP 患者进行了双盲随机对照研究。在此期间，患者被分为研究组和对照组。研究组使用褪黑素治疗。褪黑素组每天使用 4 个 3 毫克的褪黑素，安慰剂组每天使用 4 个大小、形状、颜色与褪黑素相似的安慰剂，直到治疗结束，然后由医生测量灼烧感的严重程度。本研究结果表明，褪黑素和安慰剂可减轻 AFP 患者的灼烧感，并改善其睡眠质量，但未必能完全减轻。在本研究中，研究组治疗后灼烧感的严重程度为 5.71 ± 1.42，对照组为 5.93 ± 2.65，差异无统计学意义（P = .46）。研究组（9±1.23）和对照组（8±1.56）治疗前的平均睡眠评分无明显差异。研究组（8 ± 1.45）和对照组（7 ± 1.23）治疗后的平均睡眠评分无明显差异（p = .43）。

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引用次数: 0

Mycobacterium abscessus infection associated with mesotherapy injections 与中胚层疗法注射有关的脓肿分枝杆菌感染

Q4 Medicine

Medicina Clinica Practica

Pub Date : 2024-06-21 DOI: 10.1016/j.mcpsp.2024.100452

Julio C. Salas-Alanís , Gerardo Rivera-Silva , Mauricio Salas-Garza , David I. Orozco-Pasadas , Raymundo Garza-Martínez , María G. Moreno-Treviño

引用次数: 0

Keratoderma palmoplantaris varians 掌跖变异性角化病

Q4 Medicine

Medicina Clinica Practica

Pub Date : 2024-06-21 DOI: 10.1016/j.mcpsp.2024.100453

Gerardo Rivera-Silva , Luis F.P. Blanco-Ortega , María G. Moreno-Treviño , Julio C. Salas-Alanís , Ma. Guadalupe Treviño-Alanís , José G. Silva-Hernández

引用次数: 0

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