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Evolutionary and Prognostic Particularities in Patients with COPD, Chronic Cor Pulmonale and COVID-19 慢性阻塞性肺病、慢性肺心病和COVID-19患者的进化和预后特点
Pub Date : 2021-09-01 DOI: 10.2478/amtsb-2021-0046
Nicoleta-Alina Popa, Adina-Marieta Sipos, M. Popescu
Abstract Chronic obstructive pulmonary disease (COPD) is a chronic disease of the respiratory airways due to the partially reversible obstruction of the airflow caused by an abnormal inflammatory response to toxic substances, most often to cigarette smoke.(1) COVID-19 is a mild to severe respiratory disease caused by a coronavirus from the genus Betacoronavirus.(2) Patients with COPD have a major risk of COVID-19 infection. Treating patients with COPD, chronic cor pulmonale and COVID-19 is a current challenge.
摘要慢性阻塞性肺病(COPD)是一种呼吸道慢性疾病,由于对有毒物质(通常是对香烟烟雾)的异常炎症反应导致气流部分可逆性阻塞。(1) 新冠肺炎是一种由Betacoronavirus属冠状病毒引起的轻度至重度呼吸道疾病。(2) 慢性阻塞性肺病患者有感染新冠肺炎的主要风险。治疗慢性阻塞性肺病、慢性肺原性心脏病和新冠肺炎患者是当前的挑战。
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引用次数: 0
Lada or Type 2 Diabetes Mellitus - A Challenging Diagnosis in Clinical Approach Lada或2型糖尿病-临床诊断的挑战
Pub Date : 2021-09-01 DOI: 10.2478/amtsb-2021-0052
Lucia Mihaela Custură, Oana Deteșan, R. Tilinca, Reka Annamaria Schmiedt, Brigitta Irén Bacso, M. Tilinca
Abstract Latent autoimmune diabetes in adults (LADA) is a frequently encountered condition in medical practice. It should be suspected in patients where the type of the diabetes mellitus is not certain. LADA consists of features from both type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM), being a condition which is often unnoticed. Considered as type 1.5 diabetes mellitus, the lack of insulin requirement at disease onset makes it initially to be included in T2DM in terms of therapeutic management. The improvement of the screening methods allows the detection of LADA at an early stage, therefore medical intervention should be effective in preserving beta-cell function and to delay the progression of the disease.
成人潜伏性自身免疫性糖尿病(LADA)是医学实践中经常遇到的疾病。在糖尿病类型不确定的患者中应加以怀疑。LADA包括1型糖尿病(T1DM)和2型糖尿病(T2DM)的特征,这是一种经常被忽视的疾病。作为1.5型糖尿病,发病时缺乏胰岛素需求使其在治疗管理上最初被纳入T2DM。筛查方法的改进使LADA能够在早期阶段被发现,因此医疗干预应有效地保持β细胞功能并延缓疾病的进展。
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引用次数: 0
Somatic Implications in Hospitalized Patients with Chronic Schizophrenia 慢性精神分裂症住院患者的躯体影响
Pub Date : 2021-09-01 DOI: 10.2478/amtsb-2021-0047
Andreea Sălcudean, Bianca-Eugenia Ősz, E. Strete, Monica Kiss, M. Pașca, C. Bodo, Maria-Melania Lica, Andreea-Georgiana Nan, Marius-Cătălin Cosma, M. Tilinca
Abstract Schizophrenic patients have a life expectancy shorter than that of the general population. The multisystemic implication of the psychotic disease is evidenced by the high prevalence of somatic comorbidities associated with the illness. Patients with schizophrenia have a higher risk to develop somatic comorbidities due to their lifestyle changes, medication intake and poor medical assistance. We conducted a retrospective descriptive study in order to determine the prevalence of certain somatic conditions associated with schizophrenia as well as the characteristics of this particular group of patients.
摘要精神分裂症患者的预期寿命比普通人群的预期寿命短。与该疾病相关的躯体合并症的高患病率证明了精神病的多系统影响。精神分裂症患者由于生活方式的改变、药物摄入和医疗救助不力,患躯体合并症的风险更高。我们进行了一项回顾性描述性研究,以确定与精神分裂症相关的某些躯体疾病的患病率以及这一特定患者群体的特征。
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引用次数: 0
Tonsillectomy in IgA Nephropathy - Clinical Case 扁桃体切除术治疗IgA肾病临床一例
Pub Date : 2021-09-01 DOI: 10.2478/amtsb-2021-0053
L. Popa, L. Popa, Cătălin-Bogdan Osalciuc
Abstract This article presents the clinical case of IgA nephropathy of a patient hospitalized in order to investigate a nephritic syndrome, apparently with acute onset, discovered in the following circumstances: recurrent macroscopic hematuria, decreased urinary volume, the first episode occurring about a month ago in the context of an acute infection of upper airways, remitted under antibiotic therapy, with reappearance every 2 weeks, also accompanied by odynophagia and decreased urinary volume.
摘要本文介绍了一名住院的IgA肾病患者的临床病例,以调查在以下情况下发现的肾病综合征,该综合征明显具有急性发作:复发性肉眼血尿、尿量减少、第一次发作发生在大约一个月前的急性上呼吸道感染,在抗生素治疗下缓解,每2周再次出现,还伴有对乙酰氨基酚过敏和尿量减少。
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引用次数: 0
Mental Health and Quality of Life of Frontline Health Care Workers After One Year of Covid-19 Pandemic 新冠肺炎疫情一年后一线医护人员的心理健康与生活质量
Pub Date : 2021-09-01 DOI: 10.2478/amtsb-2021-0040
A. Bener, D. Bhugra, A. Ventriglio
Abstract Aim: This study aimed to investigate the impact of more than one year of COVID-19 pandemic on the quality of life and mental health (in terms of depression, anxiety, stress, fear, burnout – workload) among Frontline Health Care Workers (HCWs). Subjects and methods: This is a cross-sectional survey based on 1,479 frontline HCW participants aged 20-65 years in Turkey who completed a survey including the 21-item Depression, Anxiety, Stress Scale (DASS-21), Burnout, Fear of COVID-19 Scale (FCV-19S), and WHO (World Health Organization) Quality of Life instruments during March-July 2021. Bivariate, factorial and multivariate statistical analyses were performed. Results: Statistically significant differences were found between three frontline groups of HCWs (Physicians, Nurses, Others) including: age (p<0.001), gender (p<0.001), educational level (p<0.001), income (p<0.001), number of calls per week (p<0.001). There were significantly high scores of fear of COVID-19 for all items among physicians. The findings also showed that the prevalence of depression (p=0.002), anxiety (p<0.001), and stress (p<10.005) and Pittsburgh Sleep Quality Index (p=0.011) were significantly different among the three groups of frontline HCWs. The work-related burnout was over 30% in general. The Kaiser-Meyer-Olkin Measure was 0.840 and indicated that the data of the study were suitable for a factor analysis. The factor analysis found out three factors with eigenvalue greater than one. These factors were consistent with the original scale. The multiple linear regression analysis revealed anxiety (p<0.001), stress(p<0.001), fear of COVID-19 and Burnout (p=0.008), depression (p=0.004), lack of sleeping- Pittsburgh Sleep Quality Index (p=0.014) and feeling exhausted (p=0.025) were associated with the quality of life during the COVID-19 pandemic after adjusting for the age and gender. Conclusion: The findings of this study show that fear and burnout related to COVID-19 were significantly associated with high scores of depression, anxiety, stress, and burnout after one year of pandemic among frontline-HCWs, with poor quality of life and sleep.
摘要目的:本研究旨在调查新冠肺炎大流行一年多对一线医护人员(HCW)生活质量和心理健康(抑郁、焦虑、压力、恐惧、倦怠-工作量)的影响。受试者和方法:这是一项横断面调查,基于土耳其1479名年龄在20-65岁之间的一线HCW参与者,他们在2021年3月至7月期间完成了一项调查,包括21项抑郁、焦虑、压力量表(DAS-21)、倦怠、对新冠肺炎的恐惧量表(FCV-19S)和世界卫生组织(世界卫生组织)生活质量工具。进行双变量、析因和多变量统计分析。结果:三组一线医务人员(医生、护士和其他)之间存在统计学显著差异,包括:年龄(p<0.001)、性别(p<0.01)、教育水平(p<0.05)、收入(p<001)、每周通话次数(p<0.005)。医生对新冠肺炎的恐惧评分在所有项目中均显著较高。研究结果还显示,三组一线HCW的抑郁(p=0.002)、焦虑(p<0.001)、压力(p<0.005)和匹兹堡睡眠质量指数(p=0.011)的患病率存在显著差异。工作倦怠总体上超过30%。Kaiser-Meyer-Olkin测量值为0.840,表明该研究的数据适用于因子分析。因子分析发现三个特征值大于1的因子。这些因素与原始量表一致。多元线性回归分析显示,在调整年龄和性别后,焦虑(p<0.001)、压力(p<0.01)、对新冠肺炎和精疲力竭的恐惧(p=0.008)、抑郁(p=0.001)、睡眠不足-匹兹堡睡眠质量指数(p=0.014)和感觉疲惫(p=0.025)与新冠肺炎大流行期间的生活质量相关。结论:本研究结果表明,与新冠肺炎相关的恐惧和倦怠与一线人群在大流行一年后抑郁、焦虑、压力和倦怠的高分显著相关,且生活质量和睡眠质量较差。
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引用次数: 1
Annual Report on the Evaluation of Patient Satisfaction at a Pneumophthisiology Hospital 某肺病医院患者满意度评价年度报告
Pub Date : 2021-09-01 DOI: 10.2478/amtsb-2021-0044
Violeta Frâncu
Abstract Patients realize how care was provided, but it is difficult for them to know when expectations were reasonable or when unwanted outcomes were caused by inadequate care or special circumstances. Research in the field shows that satisfaction is related to the perception of technical skills, intelligence and qualification of medical staff, but, in general, the perception of interpersonal communication skills of medical staff is more important. A number of studies have shown that patients tend to be more satisfied with the care provided if the behaviour of the service provider (doctor, nurse, etc.) “conforms” their expectations. Communication skills, empathy, the care offered, attention to personal issues influences how a patient will evaluate the care received.(1,2,3)
患者意识到护理是如何提供的,但他们很难知道什么时候期望是合理的,什么时候不希望的结果是由于护理不足或特殊情况造成的。该领域的研究表明,满意度与对医务人员的技术技能、智力和资质的感知有关,但总体而言,对医务人员人际沟通能力的感知更为重要。许多研究表明,如果服务提供者(医生、护士等)的行为“符合”他们的期望,患者往往对所提供的护理更满意。沟通技巧、同理心、所提供的护理、对个人问题的关注都会影响患者对所接受护理的评价。
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引用次数: 0
Modern Applications in Technology of Post and Core Restorations 桩核修复技术的现代应用
Pub Date : 2021-09-01 DOI: 10.2478/amtsb-2021-0056
M. Dina, M. Perieanu, R. Costea, M. Burlibașa, I. Beuran, D. Bodnar, C. Ionescu, Ș. Milicescu, N. Măru, G. Tanase, E. Marcov, Iuliana Babiuc, N. Marcov, M. Butucescu, L. Moraru
Abstract Post and core devices are elements that contribute to the complete restoration of the coronary abutment, over which the final prosthetic restoration will be created. Their role is to retain the coronary portion of the restoration and to protect the remaining coronary structures. The retention function is dictated by the major indication of the method, massive coronary destruction that does not provide conditions for coronary aggregation of the restoration. Thus, this material is approaching two unique methods of making post and core devices totally metallic and/or hybrid (metal + totally ceramic component), using both classical technology, modern technologies, but also combinations of them.
桩核装置是冠状动脉基台完全修复的重要组成部分,最终的假体修复将在此基础上完成。它们的作用是保留修复的冠状部分并保护剩余的冠状结构。保留功能是由该方法的主要指示所决定的,大量的冠状动脉破坏没有提供冠状动脉聚集恢复的条件。因此,这种材料正在接近两种独特的方法来制造完全金属和/或混合(金属+完全陶瓷组件)的桩和核心装置,既使用经典技术,现代技术,也使用它们的组合。
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引用次数: 0
Medulloblastoma in Adulthood 成人期髓母细胞瘤
Pub Date : 2021-09-01 DOI: 10.2478/amtsb-2021-0051
D. Horșia
Abstract Defined as a tumour with increased malignancy potential in childhood, medulloblastoma was first reported in the literature by Percival Bailey and Harvey Cushing in 1925. Scientific studies over the years have shown that this type of tumour represents about 20% of all intracranial tumours encountered in childhood, their percentage decreasing with advancing age. The genetic factor plays an important part in the appearance of medulloblastoma; there are certain diseases, in the patient’s history, that can be associated with this type of tumour. Here, we can specify Turcot syndrome (an autosomal recessive disease, rarely encountered) or basal cell carcinoma syndrome. This article presents the case of a young patient (41-year-old) suffering from a cerebellar tumour formation that turned out to be, after histopathological examination, a medulloblastoma. In practice we can find several types of medulloblastoma (desmoplastic or nodular, anaplastic, classical or undifferentiated). In what follows I will try to highlight a few aspects of a classic medulloblastoma.
髓母细胞瘤是一种儿童期恶性肿瘤,由Percival Bailey和Harvey Cushing于1925年首次报道。多年来的科学研究表明,这种类型的肿瘤约占儿童时期颅内肿瘤的20%,随着年龄的增长,这一比例会下降。遗传因素在成神经管细胞瘤的发生中起重要作用;在病人的病史中,有某些疾病可能与这种肿瘤有关。在这里,我们可以指定Turcot综合征(常染色体隐性遗传病,很少遇到)或基底细胞癌综合征。这篇文章提出了一个年轻的病人(41岁)患有小脑肿瘤形成,结果是,经组织病理学检查,髓母细胞瘤。在实践中,我们可以发现几种类型的髓母细胞瘤(结缔组织增生或结节状、间变性、典型或未分化)。接下来,我将着重介绍典型髓母细胞瘤的几个方面。
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引用次数: 17
Total Plasma Exchange for the Management of Thrombotic Thrombocytopenic Purpura in a 13-Year-Old Female – A Case Presentation 全血浆置换治疗13岁女性血栓性血小板减少性紫癜1例
Pub Date : 2021-09-01 DOI: 10.2478/amtsb-2021-0050
I. Codru, B. Vintilă, A. Bereanu, A. Cătană, M. Sava
Abstract Acquired thrombotic thrombocytopenic purpura (TTP) is a rare thrombotic microangiopathy, affecting preferentially young women in their fourth decade. Intensive care admission is often required due to organ dysfunction development risk and for specific critical care measures (Plasma Exchange-PEX). In this article, we will discuss our experience with PEX in the treatment of TTP. Case report: A previously healthy 13-year-old female presented with neurological impairment, and suspicion of stroke. The head computed tomography (CT) scan revealed absence of acute intracranian pathology, and biological evaluation displayed severe thrombocytopenia and haemolytic anemia. After 24 hours, the neurological symptoms were remitted and suspicion of thrombotic thrombocytopenic purpura was raised. The presence of ADAMTS-13 antibodies and Moschcowitz’s pentad confirmed the diagnosis. Discussions: The distinctiveness of this case lies in the development of the disease in a 13-year-old person, though TTP usually occurs after the age of 40. The exact cause of ADAMTS-13 low activity could not be established. The use of a high dose of steroids and of plasma exchange is considered to be the first line therapy, with the use of monoclonal antibodies in refractory cases, as it was in our case. Conclusions: The primary end points of our management was to prevent organ damage and to achieve a platelet count greater than 150 000 /µL, as well as a normal or an almost normal lactate dehydrogenase. We achieved this by using high dose corticosteroid therapy, filtration of approximately 50 liters of plasma in 14 PEX session and by administration of monoclonal antibodies.
获得性血栓性血小板减少性紫癜(TTP)是一种罕见的血栓性微血管疾病,主要影响40岁左右的年轻女性。由于器官功能障碍的发展风险和特定的重症监护措施(血浆交换- pex),通常需要重症监护住院。在本文中,我们将讨论我们使用PEX治疗TTP的经验。病例报告:一名既往健康的13岁女性,表现为神经损伤,并怀疑中风。头部计算机断层扫描(CT)显示没有急性颅内病理,生物学评估显示严重的血小板减少症和溶血性贫血。24小时后,神经症状得到缓解,并提出血栓性血小板减少性紫癜的怀疑。ADAMTS-13抗体和Moschcowitz综合征的出现证实了这一诊断。讨论:虽然TTP通常发生在40岁以后,但本病例的独特之处在于该病发生于13岁。ADAMTS-13活性低的确切原因尚未确定。使用高剂量类固醇和血浆置换被认为是一线治疗,在难治性病例中使用单克隆抗体,正如我们的病例一样。结论:我们治疗的主要目的是防止器官损伤,血小板计数大于150000 /µL,以及乳酸脱氢酶正常或接近正常。我们通过使用高剂量皮质类固醇治疗,在14个PEX疗程中过滤约50升血浆和给药单克隆抗体来实现这一目标。
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引用次数: 0
Technological Aspects Regarding the Manufacture of Screw-Retained Prosthetic Restorations Made of Ceramic Masses on Zirconia Structure (Part I) 关于在氧化锆结构上制造陶瓷块制成的螺钉固定修复体的技术方面(第一部分)
Pub Date : 2021-09-01 DOI: 10.2478/amtsb-2021-0057
R. Costea, M. Perieanu, M. Dina, M. Burlibașa, I. Beuran, D. Bodnar, C. Ionescu, Ș. Milicescu, N. Măru, G. Tanase, E. Marcov, Iuliana Babiuc, N. Marcov, M. Butucescu, L. Moraru
Abstract With the help of dental implants, an oral rehabilitation can be performed not only very complex, but also very complete of various types of edentulous spaces. After insertion of the dental implants, they can be subsequently prosthetically restored through a wide range of implant-supported prosthetic restorations. In this material, we tried to highlight some particular aspects from the point of view of the laboratory stages of dental technique, which intervene in the technological flow of making implant-supported prosthetic restorations from ceramic masses on Zirconia structure.
摘要在种植牙的帮助下,口腔康复不仅可以进行非常复杂的修复,而且可以对各种类型的无牙间隙进行非常完整的修复。在插入牙科植入物后,它们可以随后通过广泛的植入物支持的假体修复体进行修复。在这篇材料中,我们试图从牙科技术的实验室阶段的角度强调一些特定的方面,这些阶段介入了用氧化锆结构上的陶瓷块制作植入物支撑的假体修复体的技术流程。
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引用次数: 1
期刊
Acta Medica Transilvanica
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