Medicina Clinica Practica最新文献

英文中文

Lesiones por animal ponzoñoso, raya de agua dulce: serie de casos 有毒动物伤害，淡水黄貂鱼：病例系列

Q4 Medicine

Medicina Clinica Practica

Pub Date : 2025-01-01 Epub Date: 2024-10-18 DOI: 10.1016/j.mcpsp.2024.100478

María Alejandra Ríos González , Natalia Sánchez Coronel , Dayra Constanza Rojas Duran , William Mauricio Acero Moreno , Lorena García Agudelo

Introduction

The toxin produced by the freshwater stingray has a histolytic, anaphylactic and highly painful effect.

Objective

To present a series of clinical cases of accident with a poisonous animal, the stingray, and its clinical and epidemiological characterization.

Results

32 study series, 87,50% male and 12,50% female, age range 7-74 years, mean was 40,59 years, 59,38% were from rural areas and 40,62% urban, 34,37% consulted in the first 24 hours after the event, from one day to seven days 6,25%, from seven to 15 days 15,62%, and more than 15 days 43,75%, lesion in foot 53,13%, in neck of foot 21,87%, in leg 25%, symptoms presented: pain 100%, 71,87% signs of local infection, 59,37% purulent discharge, 56,25% lesion with necrosis. Complications: 9,37% compartment syndrome, 43,75% abscess, 12,50% osteomyelitis, 59,37% coverage defect. The range of surgical procedures performed per patient was 1-7. Isolation 83,33% gram negative, 93,75% in-hospital management and 6,25% were referred due to the severity of the lesions, mortality in this study was 3,12%.

Conclusion

Fluvial stingray causes serious lesions in lower limbs that cause prolonged hospital stays, multiple surgical procedures, large coverage defects that merit the investment of high-tech materials and reconstructive plastic surgery.

导言淡水魟鱼产生的毒素具有组织溶解、过敏和剧烈疼痛作用。结果32个系列研究病例中，87.50%为男性，12.50%为女性，年龄在7-74岁之间，平均年龄为40.59岁，59.38%来自农村地区，40.62%来自城市，34.37%在事件发生后24小时内就诊，6.25%在1-7天内就诊，15.62%在7-15天内就诊，43.75%在15天以上就诊，病变部位在足部的占53.13%，在足颈部的占21.87%，在腿部的占25%，症状表现为：疼痛100%，体征71.87%：疼痛 100%，局部感染迹象 71.87%，脓性分泌物 59.37%，病变坏死 56.25%。并发症：9.37%为室间综合征，43.75%为脓肿，12.50%为骨髓炎，59.37%为覆盖缺损。每位患者的手术次数为 1-7 次。本研究中的死亡率为 3.12%。结论水流黄貂鱼会造成下肢严重病变，导致住院时间延长、多次手术、大面积覆盖缺损，值得投资高科技材料和整形外科手术。

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引用次数: 0

Evolución del paciente hospitalizado con gripe durante 2016–2020 según su estado vacunal 根据疫苗接种情况划分的 2016-2020 年流感住院病人分布情况

Q4 Medicine

Medicina Clinica Practica

Pub Date : 2025-01-01 Epub Date: 2024-10-17 DOI: 10.1016/j.mcpsp.2024.100471

Jacobo Martín Ramos , Francisco Javier Cuevas Fernández , Álvaro Torres Lana , Armando Aguirre Jaime

Introduction

Influenza vaccination is an effective measure to reduce hospital admissions and mortality. The objective of this study is to quantify the effectiveness of influenza vaccination in patients hospitalized for influenza to prevent its evolution to severity, considering other known factors that influence such severity.

Methods

Cross-sectional study of the 2016–2017 to 2019–2020 influenza epidemiological seasons with patients hospitalized at the Nuestra Señora de la Candelaria University Hospital in Tenerife diagnosed with influenza. Basic demographic and evolution variables were studied. The criteria for clinical severity used is that established by the Spanish National Epidemiology Center. Using multivariable binary logistic regression, the risk of progression to severity associated with influenza vaccination status was estimated.

Results

A total of 1,416 patients were collected. Of whom 50% were women, 56% older than 64 years, 17% with flu vaccination, 24% evolved to severity, 3% died, 72% treated with oseltamivir, 23% (CI95%: 19–27) not treated with oseltamivir were admitted to the ICU, compared to 1.5% (CI95%: 1–2) treated, 25% (CI95%: 23–28) of the non-vaccinated patients developed severity, compared to 18% (CI95%: 13–23) of the vaccinated. The odds ratio (OR) to severe evolution was 1.6 (CI95%: 1.1–2.2) for those not vaccinated.

Conclusions

Patients hospitalized for influenza who have not received influenza vaccination have a more than double the risk of a serious evolution of influenza compared to correctly vaccinated patients. The combination of oseltamivir and vaccination reduces their admission to the ICU by almost a fifth.

引言接种流感疫苗是减少入院率和死亡率的有效措施。本研究的目的是量化流感疫苗接种对因流感住院的患者防止病情恶化的效果，同时考虑到影响病情严重程度的其他已知因素。方法对2016-2017年至2019-2020年流感流行季节特内里费岛坎德拉里亚圣母大学医院住院的流感确诊患者进行横断面研究。对基本人口统计学变量和演变变量进行了研究。采用的临床严重程度标准由西班牙国家流行病学中心制定。采用多变量二元逻辑回归法，估算了与流感疫苗接种情况相关的病情恶化风险。72%的患者接受了奥司他韦治疗，23%（CI95%：19-27）未接受奥司他韦治疗的患者住进了重症监护室，而接受治疗的患者仅占1.5%（CI95%：1-2）；25%（CI95%：23-28）未接种疫苗的患者病情恶化，而接种疫苗的患者仅占18%（CI95%：13-23）。结论与正确接种疫苗的患者相比，因流感住院但未接种流感疫苗的患者发生严重流感演变的风险高出一倍多。联合使用奥司他韦和接种疫苗可将患者入住重症监护室的时间缩短近五分之一。

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引用次数: 0

Carcinoma of the ovary with metastasis to the cerebellum 伴有小脑转移的卵巢癌

Q4 Medicine

Medicina Clinica Practica

Pub Date : 2025-01-01 DOI: 10.1016/j.mcpsp.2024.100483

Irma D. Sifuentes-Najera , Juan J. Cuervo-Orozco , Ma.G. Treviño-Alanís , María G. Moreno-Treviño , Gerardo Rivera-Silva

引用次数: 0

Lóbulo de Riedel y hemangioma hepático 里德尔叶和肝血管瘤

Q4 Medicine

Medicina Clinica Practica

Pub Date : 2025-01-01 DOI: 10.1016/j.mcpsp.2024.100485

José Manuel Ramia , Cándido Alcázar , Celia Villodre , Silvia Carbonell-Morote

引用次数: 0

Bowen's disease 博文氏病

Q4 Medicine

Medicina Clinica Practica

Pub Date : 2024-11-29 DOI: 10.1016/j.mcpsp.2024.100482

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

引用次数: 0

Impact of quality of root canal fillings and coronal restorations on the prevalence of apical periodontitis in an adult Saudi subpopulation 根管填充物和冠状修复体的质量对沙特成年亚群根尖牙周炎患病率的影响

Q4 Medicine

Medicina Clinica Practica

Pub Date : 2024-11-18 DOI: 10.1016/j.mcpsp.2024.100481

Muhammad Zubair Ahmad

Objectives

This cross-sectional study aimed to evaluate the prevalence of apical periodontitis among healthy Saudi adult patients and to examine the impact of root canal filling quality and coronal restoration quality on periradicular health.

Methods

We used periapical radiographs for this study and categorized the teeth as either diseased or healthy based on the periapical index scores. Two pre-calibrated examiners independently evaluated the radiographs. Any uncertain situation was discussed with another senior examiner. Data were statistically analyzed by applying the Chi-square test or Fisher exact test at a 5% (P < .05) level of significance using IBM SPSS 29.0 software (IBM Corp, Armonk, NY).

Results

The overall prevalence of apical periodontitis in endodontically treated teeth was 29.04%. 47.79% of teeth had adequate endodontic treatments. The success rate for teeth with adequate endodontic treatment was significantly higher at 96%, compared to a 48% success rate in teeth with inadequate endodontic treatment (P < .001). Additionally, 70.1% of the teeth had adequate coronal restorations. Teeth with adequate coronal restorations showed a significantly higher success rate at 78.33% compared to the 53.7% success rate of teeth with inadequate coronal restorations (P < .001).

Conclusions

The quality of endodontic treatment determines the outcome. Therefore, improvements in root canal treatment procedures are advisable in general and specialist dental practices to enhance periradicular health. The coronal restoration is also an essential component of the overall treatment. The optimal treatment outcome can be achieved with the adequate quality of both endodontic treatment and coronal restoration.

目的这项横断面研究旨在评估健康的沙特成年患者中根尖牙周炎的患病率，并研究根管充填质量和冠状修复质量对根尖周围健康的影响。方法我们使用根尖周X光片进行研究，并根据根尖周指数评分将牙齿分为患病牙和健康牙。两名预先校准的检查员独立评估射线照片。任何不确定的情况都会与另一位资深检查员进行讨论。使用 IBM SPSS 29.0 软件（IBM Corp, Armonk, NY），在 5%（P <.05）的显著性水平下，应用卡方检验或费舍尔精确检验对数据进行统计分析。47.79%的牙齿接受了适当的牙髓治疗。与牙髓治疗不充分的牙齿的成功率 48% 相比，牙髓治疗充分的牙齿的成功率明显更高，达到 96%（P <.001）。此外，70.1% 的牙齿进行了适当的冠状修复。与冠状修复不充分的牙齿的 53.7% 成功率相比，冠状修复充分的牙齿的成功率明显更高，达到 78.33%（P <.001）。因此，全科和专科牙科诊所都应该改进根管治疗程序，以提高牙周健康水平。冠状修复也是整体治疗的重要组成部分。如果根管治疗和冠状修复的质量都足够好，就能达到最佳的治疗效果。

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引用次数: 0

Improving the quality of primary healthcare in Kosovo: Impact of targeted training of Quality Coordinators 提高科索沃初级保健质量：有针对性地培训质量协调员的影响

Q4 Medicine

Medicina Clinica Practica

Pub Date : 2024-10-24 DOI: 10.1016/j.mcpsp.2024.100479

Ardita Baraku , Gordana Pavleković

Introduction and objectives

This study focuses on enhancing the professional skills of Quality Coordinators (QCs) in primary healthcare (PHC) in Kosovo. The QCs are responsible for internal quality supervision of public PHC institutions, but their competencies for quality improvement are unknown. The objective was to enhance the professional skills of QCs through targeted training, aiming to improve healthcare quality.

Methods

The study involved determining the basic characteristics of QCs, assessing knowledge of quality standards before and after the training via a questionnaire; providing 2 training sessions; and, evaluating the impact of training on organizational adherence to healthcare quality standards. Mean, percentage, p-value, confidence interval, t-test, and rmcor were used as test statistics.

Results

There was a statistically significant increase in the QCs' knowledge of the quality standards before (x̅=11.4, SD = 2.9) and after the training (x̅=23.4, SD = 8.3), p = .011, 95% CI [3.9728, 20.0272]. Before the training, the adherence to quality standards was 83.1% (x̅=26.6, SD = 3.4), while after the training, it increased to 87.5% (x̅=28.0, SD = 3.9), and this difference was statistically significant p = .047, 95% CI [0.0303, 2.8268].

Conclusion

The study highlights the need for continuous quality-related training and appropriate tools and resources to improve and maintain quality in PHC. Further research is needed to evaluate the impact of sex and age and the possible role redefinition of QCs.

导言和目标本研究的重点是提高科索沃初级卫生保健（PHC）质量协调员（QCs）的专业技能。质量协调员负责公共初级保健机构的内部质量监督，但他们在质量改进方面的能力却不为人知。该研究包括确定质量控制员的基本特征，通过调查问卷评估培训前后对质量标准的了解程度；提供 2 次培训课程；以及评估培训对组织遵守医疗质量标准的影响。结果培训前（x̅=11.4，SD = 2.9）和培训后（x̅=23.4，SD = 8.3），质控员对质量标准的了解程度均有显著提高，P = .011，95% CI [3.9728，20.0272]。培训前，对质量标准的遵守率为 83.1%（x̅=26.6，SD = 3.4），而培训后，遵守率上升至 87.5%（x̅=28.0，SD = 3.9），这一差异具有统计学意义 p = .047，95% CI [0.0303，2.8268]。需要进一步开展研究，以评估性别和年龄的影响以及重新定义质量控制员角色的可能性。

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引用次数: 0

Inicio del síndrome de Sjögren con manifestaciones extraglandulares: reporte de caso 发病时伴有腺体外表现的斯约格伦综合征：病例报告

Q4 Medicine

Medicina Clinica Practica

Pub Date : 2024-10-18 DOI: 10.1016/j.mcpsp.2024.100477

Tania Liliana Molina-Huertas , Sara Carolina Navarro-Salgado

Introduction

Sjögren's syndrome is characterized by a broad spectrum of clinical manifestations; classically it presents with dry syndrome, However, less than 10% of these patients may present with extra glandular manifestations.

Case report

We present the case of a 36-year-old female patient with a purplish discoloration in two fingers of her hand. During anamnesis and complementary studies, she exhibited an autoimmune profile indicative of SS and cryoglobulinemic vasculitis. Additionally, a salivary gland biopsy was positive for Sjögren's syndrome.

Conclusion

The case presented represents a diagnostic challenge due to the atypical initial manifestations. Therefore, only by being aware of the different manifestations that this disease can present can one suspect it and make a timely diagnosis.

导言舍格伦综合征的临床表现范围很广，通常表现为干燥综合征，但也有不到 10%的患者会出现腺体外表现。在病史和辅助检查中，她表现出 SS 和冷球蛋白血症性血管炎的自身免疫特征。此外，唾液腺活检结果呈阳性，诊断为斯约格伦综合征。因此，只有了解这种疾病可能出现的不同表现，才能对其产生怀疑并及时做出诊断。

引用次数: 0

Lyme disease: An ultrastructural analysis 莱姆病超微结构分析

Q4 Medicine

Medicina Clinica Practica

Pub Date : 2024-10-14 DOI: 10.1016/j.mcpsp.2024.100480

María G. Moreno-Treviño, David I. Orozco-Pasadas, José F. Yañez-Mijares, Ma. G. Treviño-Alanís, Gerardo Rivera-Silva

引用次数: 0

El misterio de la orina lila 丁香尿之谜

Q4 Medicine

Medicina Clinica Practica

Pub Date : 2024-10-10 DOI: 10.1016/j.mcpsp.2024.100474

María del Pino Pérez-García , Marta Moreno Hernández , Airam Infante Guedes , Juan Francisco García-Granado

引用次数: 0

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