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Breast cancer survivors and behavior: cancer care in the time of COVID-19 in Indonesia 乳腺癌症幸存者与行为:新冠肺炎期间印度尼西亚癌症护理
IF 0.3 Q4 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-08-30 DOI: 10.18051/univmed.2022.v41.277-288
W. Soewoto
The COVID-19 pandemic caused significant disruptions in cancer care, and preliminary research suggests that these disruptions are associated with increased levels of psychosocial distress among cancer survivors. Indonesia initially reported positive cases in early March 2020, followed by regular extensive occurrences across 34 provinces. The disease causes acute respiratory failure among people with specific comorbidities, including geriatric disorders, diabetes, cardiovascular and respiratory diseases, and cancer. Consequently, the patients’ conditions become more severe, possibly leading to a higher mortality rate. Individuals with cancer are at particularly elevated risk of a severe course of COVID-19 because they tend to be of older age and are at a greater risk for needing intensive care and for mortality. A reasonably good comprehension of the current COVID-19 outbreak, poor awareness of the primary disease and subsequent therapy program, and minimal understanding of the importance of continuing treatment during the pandemic are the probable factors causing the fear of contracting the COVID-19 virus that poses a significant threat of aggravating the existing breast cancer conditions in most patients. This anxiety shows a drastic impact in altering the behavioral patterns of survivors undergoing therapy. There is a very good understanding of how it is caused by the SARS-COV2 virus. Meanwhile, there is a severe lack of understanding of cancer and the therapeutic program. The patients are more afraid of contracting this virus than they are of their cancer. Patients prefer development of their cancer to contracting the SARS-COV2 virus. Therefore, massive education and supervision are needed for cancer patients to understand the COVID-19 pandemic and ensure that routine checks are appropriately managed.
新冠肺炎大流行对癌症护理造成了重大干扰,初步研究表明,这些干扰与癌症幸存者的心理社会痛苦水平增加有关。印度尼西亚最初在2020年3月初报告了阳性病例,随后在34个省定期广泛出现。该疾病会导致患有特定合并症的人急性呼吸衰竭,包括老年疾病、糖尿病、心血管和呼吸系统疾病以及癌症。因此,患者的病情变得更加严重,可能导致更高的死亡率。癌症患者患严重新冠肺炎的风险特别高,因为他们往往年龄较大,需要重症监护和死亡的风险更大。对当前新冠肺炎疫情有相当好的理解,对原发疾病和随后的治疗方案认识不足,以及对在大流行期间继续治疗的重要性的最低理解是导致人们担心感染新冠肺炎病毒的可能因素,这种病毒对大多数患者现有的癌症病情构成严重威胁。这种焦虑在改变接受治疗的幸存者的行为模式方面产生了巨大影响。人们对严重急性呼吸系统综合征冠状病毒2型是如何引起的有着非常好的了解。同时,人们对癌症和治疗方案严重缺乏了解。与癌症相比,患者更害怕感染这种病毒。与感染SARS-COV2病毒相比,患者更喜欢癌症的发展。因此,需要对癌症患者进行大规模的教育和监督,以了解新冠肺炎大流行,并确保日常检查得到适当管理。
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引用次数: 0
Pleural plaques and pleural changes among lung cancer patients exposed to asbestos 石棉暴露肺癌患者的胸膜斑块和胸膜改变
IF 0.3 Q4 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-08-22 DOI: 10.18051/univmed.2022.v41.210-218
A. Icksan, Canti Widharisastra, A. Suraya, Martina Ferstl
BackgroundIndonesia is one of the world's largest asbestos importing countries. While asbestos is the main contributor to work-related lung cancer, studies or reports regarding the CT findings of asbestos-related lung cancer have been limited in the country. The objective of this study was to compare CT findings of the size of the tumor and pleural and lung parenchymal changes between lung cancer patients exposed to asbestosis and those not exposed.MethodsThis cross-sectional study involved 96 lung cancer patients consisting of 48 subjects who had been exposed to asbestos and 48 who had not been exposed. They underwent thoracic CT scans at the Radiology Department of Persahabatan Hospital. Asbestos exposure was determined using interviews that followed a protocol similar to that of a previous study about asbestos-related lung cancer. Senior radiologists investigated the existence of pleural and parenchymal changes. An independent T- test and chi-square test to compare CT scan features between the two groups.ResultsThe mean age was 57.75 ± 8.56 years in the asbestos-exposed group and 58.56 ± 7.99 years in the unexposed group. The proportion of tumor sizes of more than five cm, pleural plaques, and subpleural dot-like or branching opacities were significantly higher among asbestos-exposed subjects compared to the non-exposed group (p = 0.044;p=0.37;p=0.041, respectively).ConclusionsAsbestos exposure is significantly related to the size of the tumor and the existence of pleural plaques and asbestosis. These findings may help further management of lung cancer patients and the policy of asbestos use in Indonesia.
背景印度尼西亚是世界上最大的石棉进口国之一。虽然石棉是与工作相关的肺癌癌症的主要诱因,但关于石棉相关的癌症的CT结果的研究或报告在该国有限。本研究的目的是比较接触石棉肺和未接触石棉肺的癌症患者的肿瘤大小、胸膜和肺实质变化的CT表现。方法对96例癌症患者进行横断面研究,其中48例接触过石棉,48例未接触过石棉。他们在Persahabatan医院放射科接受了胸部CT扫描。石棉暴露是通过访谈确定的,访谈遵循的方案类似于之前关于石棉相关的癌症的研究。资深放射科医生调查了胸膜和实质变化的存在。采用独立的T检验和卡方检验比较两组的CT扫描特征。结果石棉暴露组的平均年龄为57.75±8.56岁,未暴露组为58.56±7.99岁。与未暴露石棉组相比,暴露石棉的受试者中肿瘤大小超过5cm、胸膜斑块和胸膜下点状或分支状混浊的比例显著较高(分别为p=0.044、0.37和0.041)。这些发现可能有助于进一步管理癌症患者和印度尼西亚的石棉使用政策。
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引用次数: 0
Long-COVID neurological symptoms are associated with D-dimer levels in COVID-19 patients COVID-19患者的长期神经症状与d -二聚体水平相关
IF 0.3 Q4 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-08-13 DOI: 10.18051/univmed.2022.v41.169-175
Diah Kurnia Mirawati, P. Budianto, R. Danuaji, S. Subandi, Ira Ristinawati, Hanindia Riani Prabaningtyas
Background Coronavirus disease 2019 (COVID-19) is a disease designated as a global pandemic by the WHO that can manifest clinically as neurological disorders that can occur in the acute phase or after the acute phase (long COVID-19), such as headache, myalgia, anosmia, and cognitive impairment. These neurological disorders as symptoms of long COVID-19 are presumably caused by hypercoagulable conditions characterized by an increase in D-dimer level. This study aims to determine the correlation of long COVID-19 neurological symptoms with hypercoagulable conditions and the role of D-dimer as a biomarker of long COVID-19 neurological symptoms.MethodsThis was a cross-sectional study involving 31 patients with long COVID-19 symptoms. Admitted long COVID-19 cases with recorded D-dimer levels and definitive outcomes were included consecutively. Long COVID-19 neurological symptoms were collected. D-dimer level was measured using immunofluorescence assay and reported in fibrinogen equivalent units (ìg/mL). The correlation between D-dimer levels and neurological clinical manifestations was assessed by using ordinal regression analysis. The p-value of <0.05 was considered statistically significant.ResultsThe mean age of the subjects was 38.81 ± 11.58 years and 18 (58.06%) were female. Long COVID neurological symptoms comprised myalgia, anosmia and cephalgia, and most subjects complained of myalgia (80.65%). On multivariable analysis, long-COVID-19 neurological symptoms were significantly correlated with D-dimer [odds ratio (OR) = 1.05; p=0.020].ConclusionThe number of neurological long COVID symptoms were significantly correlated with level of D-Dimer. Ultimately, more clarity is needed on the neurological impact of COVID-19, its diagnosis, and its treatment.
背景2019冠状病毒病(新冠肺炎)是一种被世界卫生组织指定为全球大流行的疾病,临床上可表现为急性期或急性期后(长期新冠肺炎)发生的神经疾病,如头痛、肌痛、嗅觉缺失和认知障碍。这些神经系统疾病作为长期新冠肺炎的症状,可能是由高凝状态引起的,其特征是D-二聚体水平升高。本研究旨在确定长期新冠肺炎神经症状与高凝状态的相关性,以及D-二聚体作为长期新冠肺炎神经症状生物标志物的作用。方法这是一项横断面研究,涉及31名长期新冠肺炎症状患者。连续纳入记录D-二聚体水平和最终结果的长期新冠肺炎住院病例。收集长期新冠肺炎神经系统症状。使用免疫荧光测定法测量D-二聚体水平,并以纤维蛋白原当量单位(μg/mL)报告。通过顺序回归分析评估D-二聚体水平与神经系统临床表现之间的相关性。p值<0.05被认为具有统计学意义。结果受试者平均年龄38.81±11.58岁,女性18例(58.06%)。长期新冠肺炎神经系统症状包括肌痛、嗅觉缺失和头痛,大多数受试者抱怨肌痛(80.65%)。多变量分析显示,长期新冠病毒神经系统症状与D-二聚体显著相关[比值比(OR)=1.05;p=0.020]。最终,还需要进一步明确新冠肺炎对神经系统的影响、诊断和治疗。
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引用次数: 1
Reversible ethambutol-induced optic neuropathy: report of a rare case 可逆性乙胺丁醇致视神经病变1例报告
IF 0.3 Q4 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-08-13 DOI: 10.18051/univmed.2022.v41.271-276
S. Nusanti, Rasyidia Laksmita Putri, Dearaini Dearaini
BackgroundEthambutol (EMB) is one of the first-line anti-tuberculosis therapy. One of its precarious side effects is ethambutol-induced optic neuropathy (EON). The ocular manifestations of EON include painless loss of central vision and cecocentral scotomas in the visual field.Case DescriptionA 60-year old man presented with gradual and painless visual loss since 3 months prior to visit. The accompanying symptoms were frequent headache without double vision and photophobia. He had been diagnosed with pulmonary tuberculosis (TB) for 9 months and consumed EMB for 7 months before being advised to discontinue. There was neither history of systemic diseases nor family history of neuropathy. Examination showed reduced visual acuity with positive relative afferent pupillary defect (RAPD) on right eye. Humphrey test showed bilateral generalized visual loss. Ocular computed tomography (OCT) showed retinal nerve fiber layer (RNFL) thickness was within normal limit. Magnetic resonance Imaging (MRI) brain indicated unremarkable result for optic neuropathy. Based on the examinations listed above, this patient was diagnosed as EON and EMB was stopped immediately. Patient was given oral citicoline 1000mg and zinc supplementation for one month. After 1 st and 3 rd month follow up, patient’s visual function was gradually improved. The ophthalmic examinations indicated recovery of the visual function.ConclusionsThis case suggested that an early detection and intervention in patient with EON has promising result in visual outcome. EON is a reversible optic neuropathy if the ocular toxicity is monitored closely among the tuberculosis patients who are prescribed EMB regiment.
dethambutool (EMB)是一线抗结核药物之一。乙胺丁醇引起的视神经病变是其危险的副作用之一。EON的眼部表现包括无痛性中央视力丧失和视野中盲点。病例描述:60岁男性,就诊前3个月出现渐进性无痛性视力丧失。伴发头痛,无复视,畏光。他被诊断患有肺结核(TB) 9个月,服用EMB 7个月后被建议停止服用。无全身性疾病史,无神经病变家族史。检查显示视力下降,右眼相对传入瞳孔缺损(RAPD)阳性。汉弗莱测试显示双侧全身性视力丧失。眼部计算机断层扫描显示视网膜神经纤维层厚度在正常范围内。脑磁共振成像(MRI)显示视神经病变无显著结果。根据上述检查,该患者被诊断为EON,并立即停止EMB。给予胞胆碱1000mg口服,并补充锌,疗程1个月。随访1、3个月,患者视力逐渐改善。眼科检查显示视力恢复。结论该病例提示早期发现和干预对改善视力有良好效果。如果密切监测使用EMB治疗的肺结核患者的眼毒性,EON是一种可逆性视神经病变。
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引用次数: 0
Diabetes mellitus patients in Indonesia: management in a tertiary hospital compared to primary health care 印度尼西亚的糖尿病患者:三级医院的管理与初级保健的比较
IF 0.3 Q4 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-08-01 DOI: 10.18051/univmed.2022.v41.157-168
H. Permana, R. C. Koesoemadinata, N. Soetedjo, N. F. Dewi, Novi Jayanti, S. Imaculata, R. Ruslami, B. Alisjahbana, S. McAllister
Background The increasing prevalence of diabetes mellitus (DM) requires that patients have greater access to care, which is yet lacking in many low- and middle-income countries and the quality of which varies between health care facilities. We compare the characteristics, complications, and risk profile of diabetes in patients receiving care in primary and tertiary level health facilities in Bandung, Indonesia.MethodsAdult DM patients were recruited from 25 community health centres (CHCs) and the outpatient clinic at one referral hospital. Key data collected and compared to national guidelines were DM history, treatment, complications, blood pressure, height, weight, and laboratory examinations on glycated haemoglobin (HbA1c), lipid profile, and creatinine. Data analysis was by chi-square test.ResultsOf the 809 DM patients (median age 59 years, 63% female, 98% type 2 DM), 318 (39%) were from CHCs and 491 (61%) from the hospital. Overall median HbA1c was 8.3%, with no difference between CHC and hospital patients. Only 32% of patients with HbA1c ≥10% were on insulin (CHCs 5.9%, hospital 42.9%), and only 18% of those on insulin had glycaemic control. Hypertension was common (CHCs 62%, hospital 51%, p<0.001), and only 44% of CHC and 34% of hospital patients received antihypertensive therapy. Among those with macrovascular complications, only 32% (CHCs) and 26% (hospital) were receiving aspirin. The numbers reaching the treatment targets were low for those on antihypertensives and lipid-lowering medications (80/251 and 11/105, respectively).ConclusionGlycaemic control and management of complications of DM patients at both health care levels need considerable improvement.
背景糖尿病(DM)患病率的增加要求患者有更多的机会获得护理,而在许多中低收入国家却缺乏这种服务,而且不同医疗机构的服务质量也不同。我们比较了在印度尼西亚万隆的初级和三级卫生机构接受治疗的患者的糖尿病特征、并发症和风险状况。方法从25个社区卫生中心(CHCs)和一家转诊医院的门诊招募成年DM患者。收集并与国家指南进行比较的关键数据包括糖尿病病史、治疗、并发症、血压、身高、体重以及糖化血红蛋白(HbA1c)、血脂和肌酐的实验室检查。数据分析采用卡方检验。结果809例DM患者(中位年龄59岁,63%为女性,98%为2型DM)中,318例(39%)来自CHCs,491例(61%)来自医院。总的HbA1c中位数为8.3%,CHC和住院患者之间没有差异。HbA1c≥10%的患者中,只有32%服用了胰岛素(CHCs 5.9%,医院42.9%),而服用胰岛素的患者中只有18%的血糖得到了控制。高血压很常见(CHCs 62%,医院51%,p<0.001),只有44%的CHC和34%的医院患者接受了降压治疗。在那些有大血管并发症的患者中,只有32%(CHCs)和26%(医院)接受了阿司匹林治疗。服用降压药和降脂药的患者达到治疗目标的人数较低(分别为80/251和11/105)。结论糖尿病患者的血糖控制和并发症的处理在两个医疗水平上都需要相当大的改进。
{"title":"Diabetes mellitus patients in Indonesia: management in a tertiary hospital compared to primary health care","authors":"H. Permana, R. C. Koesoemadinata, N. Soetedjo, N. F. Dewi, Novi Jayanti, S. Imaculata, R. Ruslami, B. Alisjahbana, S. McAllister","doi":"10.18051/univmed.2022.v41.157-168","DOIUrl":"https://doi.org/10.18051/univmed.2022.v41.157-168","url":null,"abstract":"Background The increasing prevalence of diabetes mellitus (DM) requires that patients have greater access to care, which is yet lacking in many low- and middle-income countries and the quality of which varies between health care facilities. We compare the characteristics, complications, and risk profile of diabetes in patients receiving care in primary and tertiary level health facilities in Bandung, Indonesia.\u0000MethodsAdult DM patients were recruited from 25 community health centres (CHCs) and the outpatient clinic at one referral hospital. Key data collected and compared to national guidelines were DM history, treatment, complications, blood pressure, height, weight, and laboratory examinations on glycated haemoglobin (HbA1c), lipid profile, and creatinine. Data analysis was by chi-square test.\u0000ResultsOf the 809 DM patients (median age 59 years, 63% female, 98% type 2 DM), 318 (39%) were from CHCs and 491 (61%) from the hospital. Overall median HbA1c was 8.3%, with no difference between CHC and hospital patients. Only 32% of patients with HbA1c ≥10% were on insulin (CHCs 5.9%, hospital 42.9%), and only 18% of those on insulin had glycaemic control. Hypertension was common (CHCs 62%, hospital 51%, p<0.001), and only 44% of CHC and 34% of hospital patients received antihypertensive therapy. Among those with macrovascular complications, only 32% (CHCs) and 26% (hospital) were receiving aspirin. The numbers reaching the treatment targets were low for those on antihypertensives and lipid-lowering medications (80/251 and 11/105, respectively).\u0000ConclusionGlycaemic control and management of complications of DM patients at both health care levels need considerable improvement.","PeriodicalId":42578,"journal":{"name":"Universa Medicina","volume":" ","pages":""},"PeriodicalIF":0.3,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41868252","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: 1
Anger control is the most influential risk factor of mobile phone addiction among nursing and midwifery students of Zahedan University of Medical Sciences 在扎黑丹医学科学大学的护理和助产专业学生中,愤怒控制是手机成瘾最具影响的风险因素
IF 0.3 Q4 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-07-23 DOI: 10.18051/univmed.2022.v41.149-156
Sadegh Dehghanmehr, Fatemeh Kordsalarzehi, Najmeh Ghiamikeshtgar, Nahid Mir, Mahsima Banaei Heravan, Farhad Shafeie
BackgroundReligious attitude and anger management are two psychopathological constructs receiving little empirical scrutiny in relation to smart phone addiction, but theoretically should demonstrate significant relationships. Today one of these new media that is used by many people around the world, is the mobile phone. Students are one of the most important groups that are affected by mobile social networks. The aim of this study was to determine religious attitudes and anger management as risk factors of mobile phone addiction in nursing and midwifery students.MethodsThis study was a cross-sectional study involving 200 nursing and midwifery students. Relevant data were collected through demographic information questionnaire, anger management skills questionnaire, religious attitude questionnaire, and mobile phone addiction questionnaire. A multiple regression model was used to examine the relationship between variables.ResultsThe mean age of the research subjects was 22.04 ± 3.30 years. Anger control and religious attitude were a significant risk factors of smartphone addiction (β=-0.500; p=0.000; β= -0.069; p=0.004, respectively). The variables of anger ýcontrol and spiritual attitude can predict and explain 33.6% and 2.7% (36.3% in total) of the ýchanges in the mobile addiction score. Anger control is the most influential risk factor of mobile phone addiction among nursing and midwifery students (Beta = -0.385).ConclusionFindings indicate the importance of controlling anger and strengthening religious attitude in reducing the rate of mobile phone addiction in students. This provides guidance to the future development of smartphone addiction prevention programs for students.
背景宗教态度和愤怒管理是两种与智能手机成瘾有关的精神病理学结构,很少受到实证研究,但理论上应该证明它们之间存在显著关系。今天,世界各地许多人使用的新媒体之一是手机。学生是受移动社交网络影响最重要的群体之一。本研究的目的是确定宗教态度和愤怒管理是护理和助产专业学生手机成瘾的风险因素。方法本研究是一项横断面研究,涉及200名护理和助产专业的学生。通过人口统计信息问卷、愤怒管理技能问卷、宗教态度问卷和手机成瘾问卷收集相关数据。多元回归模型用于检验变量之间的关系。结果研究对象的平均年龄为22.04±3.30岁。愤怒控制和宗教态度是智能手机成瘾的重要危险因素(分别为β=0.500;p=0.000;β=0.069;p=0.004)。愤怒控制和精神态度变量可以预测和解释33.6%和2.7%(总计36.3%)的移动成瘾评分变化。在护理和助产专业学生中,控制愤怒是手机成瘾最具影响的危险因素(β=-0.385)。结论研究结果表明,控制愤怒和加强宗教态度对降低学生手机成瘾率具有重要意义。这为学生智能手机成瘾预防计划的未来发展提供了指导。
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引用次数: 0
The effect of purple passion fruit juice on superoxide dismutase and malondialdehyde levels in hypercholesterolemic rats 紫百香果汁对高胆固醇血症大鼠超氧化物歧化酶和丙二醛水平的影响
IF 0.3 Q4 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-06-23 DOI: 10.18051/univmed.2022.v41.139-148
Alfi Muntafiah, Johanes Hasian Siahaan, Sofyan Hardi, Dody Novrial, Hernayanti Hernayanti
BackgroundHypercholesterolemia due to a high cholesterol diet can increase free radicals resulting in oxidative stress. Superoxide dismutase (SOD) and malondialdehyde (MDA) have been used as the study markers of oxidative stress in cases of hypercholesterolemia. Purple passion fruit contains various compounds that may reduce free radicals. This study aimed to determine the effect of purple passion fruit juice on SOD and MDA levels in hypercholesterolemic rats.MethodsAn experimental analysis with post-test only control group design involving 28 male Wistar rats. They were divided into 4 groups: normal control (K1), hypercholesterolemic control (K2), purple passion fruit juice treatment at 4.2 mL/200 gBW/day (K3), and simvastatin treatment at 0.018 mg/200 gBW/day (K4). The purple passion fruit juice at 4.2 mL/200 gBW/day was administered for 14 days. SOD levels were examined by enzymatic colorimetric methods using the Ransod kit and MDA levels by the TBARS method.ResultsThe Kruskal-Wallis test showed a significant difference in SOD levels between the tested groups (p<0.05). One-way ANOVA test for MDA levels showed a significant difference (p<0.05). Post Hoc test (Mann-Whitney for SOD and LSD for MDA levels) also showed significant differences: K1 vs. K2, K2 vs. K3, K2 vs. K4, and K3 vs. K4 (p<0.05).ConclusionThis study demonstrated that purple passion fruit juice significantly increases the SOD and lowers the MDA level in hypercholesterolemic male Wistar rats. Consumption of purple passion fruit juice may help to modulate oxidative stress caused by hypercholesterolemia in rats.
背景高胆固醇饮食引起的高胆固醇血症会增加自由基,导致氧化应激。超氧化物歧化酶(SOD)和丙二醛(MDA)已被用作高胆固醇血症患者氧化应激的研究标志物。紫色百香果含有多种可以减少自由基的化合物。本研究旨在测定紫百香果汁对高胆固醇血症大鼠SOD和MDA水平的影响。方法采用单纯试验后对照组设计,对28只雄性Wistar大鼠进行实验分析。他们被分为4组:正常对照组(K1)、高胆固醇血症对照组(K2)、紫西番莲果汁4.2 mL/200 gBW/天治疗组(K3)和辛伐他汀0.018 mg/200 gBW/日治疗组(K4)。将4.2mL/200gBW/天的紫色百香果汁施用14天。用Ransod试剂盒用酶比色法检测SOD水平,用TBARS法检测MDA水平。结果Kruskal-Wallis检验显示两组SOD水平存在显著差异(p<0.05)。MDA水平的单向方差分析检验显示有显著差异(p>0.05)。Post Hoc检验(Mann-Whitney的SOD水平和LSD的MDA水平)也显示出显著差异:K1与K2、K2与K3、K2与K4和K3与K3。结论紫百香果汁能显著提高高胆固醇血症雄性Wistar大鼠SOD活性,降低MDA水平。食用紫色百香果汁可能有助于调节高胆固醇血症引起的大鼠氧化应激。
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引用次数: 1
The role of molecular pathology in the precision diagnosis and subclassification of hepatocellular carcinoma 分子病理学在肝细胞癌精确诊断和分型中的作用
IF 0.3 Q4 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-06-13 DOI: 10.18051/univmed.2022.v41.194-206
K. Effendi, Wit Thun Kwa, A. Ueno, M. Sakamoto
Hepatocellular carcinoma (HCC) remains a leading cause of cancer death worldwide despite recent advances in surveillance and therapeutic management. The outcomes for HCC patients remain poor, often as a result of late diagnosis or lack of effective treatments. Early detection and precise diagnosis are evidently crucial in improving the prognosis of HCC. However, HCC is a highly heterogeneous cancer with various clinical backgrounds and altered molecular pathways; these factors make its precise diagnosis more difficult. Approximately 25% of HCCs harbor actionable mutations, which are yet to be translated into clinical practice. In the era of precision medicine, molecular or genomic information are indispensable for HCC diagnosis and prognosis. Exploring genomic alterations has become a requirement for identifying the molecular subtypes of HCC. Recent studies have introduced molecular markers to help identify early HCC and to clarify its multistep process of carcinogenesis. The subclassification of tumors into proliferation class and nonproliferation class HCCs gives pointers to the HCC phenotype and facilitates the selection of appropriate treatments. In this review, we broadly summarize some of the latest insights into HCC subclassification from the perspective of molecular pathology. Immunohistochemistry-based subclassification allows improved characterization of HCC in daily clinical practice. Moreover, analysis of the immune microenvironment, intra-tumoral morphological heterogeneity, and imaging features gives additional information regarding the classification of HCC. Combinations of these approaches are expected to inform and advance the precision diagnosis and management of HCC.
尽管最近在监测和治疗管理方面取得了进展,肝细胞癌(HCC)仍然是全球癌症死亡的主要原因。HCC患者的预后仍然很差,通常是由于诊断较晚或缺乏有效的治疗。早期发现和准确诊断对改善HCC预后至关重要。然而,HCC是一种高度异质性的癌症,具有不同的临床背景和改变的分子途径;这些因素使得其精确诊断更加困难。大约25%的hcc含有可操作的突变,这些突变尚未转化为临床实践。在精准医疗时代,分子或基因组信息对于HCC的诊断和预后是不可或缺的。探索基因组改变已成为鉴定HCC分子亚型的必要条件。最近的研究引入了分子标记来帮助识别早期HCC并阐明其多步骤的癌变过程。将肿瘤分为增殖型和非增殖型HCC,为HCC的表型提供了指示,也便于选择合适的治疗方法。本文从分子病理学的角度综述了肝癌亚分类的最新进展。基于免疫组织化学的亚分类可以在日常临床实践中改进HCC的表征。此外,对免疫微环境、肿瘤内形态学异质性和影像学特征的分析为HCC的分类提供了额外的信息。这些方法的结合有望为HCC的精确诊断和管理提供信息和促进。
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引用次数: 0
Highest economic status increases risk of cesarean section in women of childbearing age 经济地位高的育龄妇女剖宫产的风险增加
IF 0.3 Q4 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-06-10 DOI: 10.18051/univmed.2022.v41.129-138
Haerawati Idris, R. Anggraini
BACKGROUNDCesarean section (CS) rates that are higher than the WHO recommendation may pose morbidity and mortality risks for both mother and child. In recent years, the number of CS deliveries has been increasing in developed and developing countries. The aim of the present study was to determine the rate of CS delivery and socioeconomic and demographic factors as risk factors of cesarean delivery in women of childbearing age.METHODSThis cross-sectional study used data from the 2017 Indonesian Health Demographic Survey (IDHS). The research subjects were 14,724 women of childbearing age aged 15-49 years who had given birth and met the inclusion criteria. The rate of CS was determined and the associations between independent and dependent variables were explored using logistic regression.RESULTSThe CS rate was 17.9%. Variables that had a significant relationship with cesarean delivery were geographic region, economic status, occupation, education, birth attendant, insurance ownership and antenatal care visits. The most dominant influencing variable was the highest economic status (OR 3.566; 95% CI: 2.857-4.452). Respondents with the highest economic status had a 3.5 times greater risk of having a cesarean delivery than subjects with the lowest economic status after controlling for the other variables.CONCLUSIONThis study demonstrated that the highest economic status increased the risk of CS delivery in women of childbearing age. The current epidemiological findings and evidence suggest adopting and implementing some strict guidelines in the health system to avoid unnecessary delivery by CS.
背景剖腹产(CS)率高于世界卫生组织的建议可能会给母亲和儿童带来发病率和死亡率风险。近年来,在发达国家和发展中国家,CS的交付数量一直在增加。本研究的目的是确定CS分娩率以及社会经济和人口因素作为育龄妇女剖宫产的危险因素。方法本横断面研究使用了2017年印尼健康人口调查(IDHS)的数据。研究对象为14724名15-49岁的育龄妇女,她们已经分娩并符合纳入标准。确定CS发生率,并使用逻辑回归探讨自变量和因变量之间的相关性。结果CS发生率为17.9%。与剖宫产有显著关系的变量是地理区域、经济状况、职业、教育、助产士、保险所有权和产前检查。最主要的影响变量是最高经济状况(OR 3.566;95%CI:2.857-4.452)。在控制其他变量后,经济状况最高的受访者剖宫产的风险是经济状况最低的受试者的3.5倍。结论本研究表明,最高经济地位会增加育龄妇女CS分娩的风险。目前的流行病学调查结果和证据表明,在卫生系统中采用和实施一些严格的指导方针,以避免CS不必要的分娩。
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引用次数: 0
Microbiological profile of diabetic foot infections and the detection of mecA gene in predominant Staphylococcus aureus 糖尿病足感染的微生物学特征及主要金黄色葡萄球菌mecA基因的检测
IF 0.3 Q4 MEDICINE, GENERAL & INTERNAL Pub Date : 2022-05-26 DOI: 10.18051/univmed.2022.v41.121-128
Ponmurugan Karuppiah, Suresh S. S. Raja, M. Poyil
BACKGROUNDDiabetes mellitus (DM) is a serious health problem that is rapidly expanding worldwide. Staphylococcus aureus is a pathogenic bacterium which has a number of drug resistant strains. Different variants of this pathogen have been isolated from patients with diabetic foot ulcers - in persons having uncontrolled blood sugar level - all over the world, resulting in high rates of morbidity and mortality. The objective of this study was to determine the prevalence of drug resistant Staphylococcus aureus in diabetic foot infections (DFIs). METHODS An epidemiological survey was conducted and 300 pus samples were collected from wounds, abscesses, skin and soft tissue lesions of patients having type II diabetes with foot ulcer infections at a tertiary care hospital. Further, the antibacterial susceptibility patterns of all the isolated Staphylococcus aureus were determined against methicillin, oxacillin, vancomycin and novobiocin.RESULTS Pathogenic bacterial species including coagulase positive and coagulase negative Staphylococcus aureus, Escherichia coli, Klebsiella sp., Proteus sp., Pseudomonas sp., and Citrobacter sp. were identified, among which Staphylococcus was the main genus identified. A total of 13 (4.3%) isolates of coagulase positive Staphylococcus aureus were resistant to methicillin. Using PCR, 7 (53.8%) staphylococcal isolates were detected with the mecA gene.CONCLUSIONStaphylococcus aureus is the most common cause of DFIs. This study demonstrates that about 53.8% of all methicillin resistant Staphylococcus aureus isolates have mecA genes. Such a finding is the primary step in understanding and tackling the resistance mechanism.
背景:糖尿病(DM)是一种严重的健康问题,在全球范围内迅速蔓延。金黄色葡萄球菌是一种致病细菌,有许多耐药菌株。这种病原体的不同变体已从世界各地血糖水平不受控制的糖尿病足溃疡患者中分离出来,导致高发病率和死亡率。本研究的目的是确定糖尿病足感染(dfi)中耐药金黄色葡萄球菌的患病率。方法对某三级医院2型糖尿病合并足部溃疡感染患者的伤口、脓肿、皮肤和软组织病变进行流行病学调查,收集脓液样本300份。此外,还测定了所有分离金黄色葡萄球菌对甲氧西林、氧西林、万古霉素和新生物霉素的药敏模式。结果鉴定出凝固酶阳性和凝固酶阴性的病原菌种类包括金黄色葡萄球菌、大肠杆菌、克雷伯氏菌、变形杆菌、假单胞菌和柠檬酸杆菌,其中葡萄球菌为鉴定出的主要属。13株(4.3%)凝固酶阳性金黄色葡萄球菌对甲氧西林耐药。PCR检测到7株(53.8%)葡萄球菌携带mecA基因。结论金黄色葡萄球菌是dfi最常见的病因。本研究表明,在所有耐甲氧西林金黄色葡萄球菌分离株中,约53.8%具有mecA基因。这一发现是理解和解决耐药性机制的第一步。
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引用次数: 1
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Universa Medicina
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