Acta medica academica最新文献

Objective: We aimed to investigate the causes and factors predictive of in-hospital death among patients with systemic lupus erythematosus (SLE) admitted to a tertiary care hospital in Thailand.

Materials and methods: We retrospectively reviewed the records of patients with SLE admitted between 2017 and 2021. We collected data related to age, sex, body mass index, comorbidities, disease duration, medication usage, clinical symptoms, vital signs, laboratory results, evidence of infection, presence of systemic inflammatory response syndrome, quick sepsis-related organ assessment scores, and SLE disease activity on the date of admission. The length of hospitalization, treatment administered, and subsequent clinical outcomes (including in-hospital complications and death) were also recorded.

Results: Among 267 enrolled patients, the overall in-hospital mortality rate was 25.5%, and infection was the most common cause of death (75.0%). Multivariate analysis revealed that prior hospitalization within 3 months (odds ratio [OR]: 2.311; 95% confidence interval [CI]: 1.002-5.369; P=0.049), initial infection on admission (OR: 2.764; 95% CI: 1.006-7.594; P=0.048), use of vasopressor drugs (OR: 2.940; 95% CI: 1.071-8.069; P=0.036), and mechanical ventilation (OR: 5.658; 95% CI: 2.046-15.647; P=0.001) were independent risk factors for in-hospital mortality.

Conclusion: Infection was the major cause of mortality in patients with SLE. Prior hospitalization within 3 months, initial infection on admission, vasopressor use, and mechanical ventilation during admission are independent risk factors for in-hospital mortality in patients with SLE.

Objective: The aim of this study is to present a relatively rare case of the coexistence of an incomplete superficial palmar arch and a Berrettini anastomosis, identified in a cadaveric specimen, and further discuss the potential clinical implications of such anatomical variations.

Case report: The variation was found in the left hand of a formalin-fixed male cadaver of Greek origin, that was dissected under an operating microscope (×4, ×10 magnification) in our Anatomy Department. In the specimen, we found an incomplete superficial palmar arch, formed only by the superficial branch of the ulnar artery, and a Type 1 Berrettini Anastomosis, originating from the ulnar nerve and joining a branch of the median nerve.

Conclusion: To avoid iatrogenic damage and permanent loss of sensation, hand surgeons and microsurgeons should be aware of the presence of a BA, and the potential coexistence of this variation with vascular abnormalities in the hand that may complicate surgical procedures.

Objective: To determine the most appropriate delay to start a webinar.

Methods: This cross-sectional study was conducted on weekly general staff scientific webinars held by the Institute of Human Virology (IHV), University of Maryland School of Medicine, Baltimore, USA. 35 observations were made at arbitrary chosen times of three consecutive IHV webinars. After standardizing the number of participants, a 4th-degree polynomial fit was applied to the data. A cost function was defined as the sum of the time wasted for those who attended the webinar early and the lost for those who attend with delay. The cost function was minimized to compute the most appropriate delay to start the webinar.

Results: The model could explain almost 95% of the observed variance in the number of participants. Normally, half of the participants attended the meeting at the webinar set starting time. The cost was a minimum if the webinar was delayed for about 3 minutes.

Conclusion: It seems that the most appropriate time for starting the IHV general staff meetings is around 3 minutes after the webinar set starting time.

Objective: The current report describes two rare cadaveric findings of a left sided brachiocephalic trunk (BCT) in relation to the trachea, and its high-riding course above the suprasternal notch (SN).

Cases description: In two elderly body donors dissected after death, a left-sided BCT was identified with a high-riding course (0.5 and 0.8 cm above the SN). The BCT originated from the aortic arch, in common with the left common carotid artery, more distally than the typical left-side location and crossed in front of the trachea. In the 1st case, the ascending and descending aortae, and the left subclavian artery had aneurysmal dilatation. In both cases, the trachea was displaced to the right side and had a stenosis due to the chronic compression.

Conclusion: A high-riding BCT is of paramount clinical importance, as it may complicate tracheotomy, thyroid surgery and mediastinoscopy, leading to fatal complications. BCT injury leads to a massive bleeding during neck dissection (level VI), when the vessel crosses the anterior tracheal wall.

Objective: Patients diagnosed with hematologic malignancies are at increased risk for severe SARS-CoV-2 infection. We evaluated the serological IgG response following two doses of the SARS-CoV-2 vaccine in patients with hematologic malignancies.

Methods: Patients treated at UT Southwestern Medical Center with a diagnosis of a myeloid or lymphoid neoplasm were included. SARS-CoV-2 vaccination response was defined as a positive quantifiable spike IgG antibody titer.

Results: Sixty patients were included in the study and 60% were diagnosed with a myeloid neoplasm. The majority (85%) of the patients with a myeloid malignancy and 50% of the patients with a lymphoid malignancy mounted a serological response after receiving two doses of the vaccine.

Conclusion: Vaccination should be offered irrespective of ongoing treatment or active disease. Findings require validation in a larger cohort of patients.

In the current molecular review, we describe the mechanisms of TP53/MDM2 deregulation and their impact on the colon adenocarcinoma molecular substrate and phenotype. Among the genes that are critically altered in carcinogenesis, the TP53 tumor suppressor gene is of major importance. The TP53 gene (gene locus: 17p13.1) regulates the cell cycle by controlling the G1/S and G2/M checkpoints securing the normal sequence of cell cycle phases. Furthermore, it is involved in apoptosis programmed cell death. The gene is mutated or epigenetically altered in all epithelial malignancies, including colon adenocarcinoma. Additionally, Mouse Double Minute 2 Homolog (MDM2), a proto-oncogene (12q14.3), acts as a major negative regulator for p53 expression in the p53-MDM2 auto-regulatory pathway. MDM2 binds directly to p53 and represses its transcriptional activity, promoting p53 degradation. CONCLUSION: In colon adenocarcinoma, MDM2 oncogene overexpression directly influences p53 oncoprotein expression levels.

Objective: The aim of this study was to investigate students' knowledge, attitudes and hesitancy regarding COVID-19 vaccination.

Methods: A cross-sectional questionnaire-based survey was conducted among a total of 1282 medical students and 509 non-medical students at four public universities in Bosnia and Herzegovina: Tuzla, Sarajevo, Banja Luka, and Mostar.

Results: A significantly higher rate of vaccination was observed in the group of medical students as well as a higher level of knowledge about vaccination in general and vaccines against the COVID-19 disease. Students who received the COVID-19 vaccine had a higher level of knowledge about vaccination in general and COVID-19 vaccines in particular compared to the non-vaccinated students in the medical and non-medical groups, respectively. Furthermore, vaccinated students, regardless of the course they are taking, showed generally stronger positive attitudes compared to non-vaccinated students, regarding the safety and effectiveness of the COVID-19 vaccine. Both groups of students believe that the rapid development of the vaccine is contributing to refusal or hesitancy to receive a vaccine against COVID-19. Social media/networks were the main sources of information about the COVID-19 vaccine. We did not find any contribution of social media to the reduced level of COVID-19 vaccine coverage.

Conclusion: Education of students about the benefits of the COVID-19 vaccine will lead to its better acceptance as well as the development of more positive attitudes towards vaccination in general, especially having in mind that students are the future population of parents, who will make decisions about vaccinating their children.

The aim of the present paper is to contribute to the understanding of the history of the anatomical study of the facial artery. The facial artery plays a fundamental role in the study of the anatomy of the face, and in maxillofacial and vascular surgery. The debate on the understating of this vessel is essential in the educational process, with special focus on the historical development of topographical and descriptive ideas about it. The comparison between the study of facial artery in the work of Thomas Turner (1793-1873) and modern anatomical concepts serves as an excellent educational paradigm. The documentary research method was used this short historical survey. CONCLUSION: Thomas Turner laid the scientific foundation for the accurate anatomical study of the facial artery.

The aim of the article is to present, primarily to the medical world and also the general public, the personality and work of Maša Živanović (1890-1960), a pioneer in the health care of children and mothers in Bosnia and Herzegovina (BH), a health educator and one of the leaders of the Yugoslav Women's Rights Movement in the period between the two world wars. She was born in Croatia (then part of the Austro-Hungarian Empire) as Maria Skopszyński, in a family of Polish-Czech origin. After studying at the Temporary Women's Lyceum in Zagreb and passing the matriculation exam at the boy's High School (1909), she obtained the title of Doctor of Medicine in Vienna (1916). Her activity in the Women's Rights Movement has so far generally attracted more attention from researchers than her medical work. However, this work was very important because the general and health education of women, expectant mothers and mothers, after the two World Wars was very poor in BH, and the rates of child morbidity and mortality were high. Maša Živanović spent almost her entire working life in Sarajevo. For 30 years, she was the head of the Dispensary for Mothers and the Children, later the Institute for Maternal and Child Health Care, into which the previous institution grew in 1931. She was among the first followers of the new concept of "comprehensive paediatrics", which included social care for children, disease prevention and treatment of the sick. She successfully connected the medical mission with the mission of a women's rights activist, also trying to act as a health educator through articles published in the Women's Movement magazine (Ženski pokret). For a time, she was the president of the Society for the Education of Woman and Protection of her Rights, i.e. the Women's Movement, and a delegate at conferences of international feminist organizations. CONCLUSION: Maša Živanović was a physician, a pioneer in the health care of children and mothers in BH, a long-time director of the Institute for Health Care of Mothers and Children in Sarajevo, and one of the leaders of the Yugoslav Women's Rights Movement.