Maedica最新文献

Objective:ST waveform analysis (STAN) was introduced to improve the interpretation of cardiotocography (CTG) resulting in reduction of unnecessary interventions and metabolic acidosis. A systematic review was conducted with the aim to evaluate the effect of STAN method compared with isolated CTG on perinatal and neonatal outcomes. Materials and methods:A search of electronic databases (PubMed, Cochrane, Scopus) was conducted to identify randomized controlled trials (RCTs) in English language. Outcomes considered operative deliveries, fetal blood sampling (FBS), metabolic acidosis, perinatal and neonatal death, neonatal seizures, neonatal encephalopathy, transfer to the neonatal intensive care unit (NICU) and Apgar score. Results:Seven RCTs were included in the present review. The first two RCTs showed that the combination of STAN and CTG was a better option than using CTG alone, because there was a documented reduction in the rate of operative deliveries due to fetal distress and metabolic acidosis. The following studies showed no statistically significant changes with the combination of methods, except from a reduction in FBS. Conclusions:The findings from the RCTs were inconclusive. Most studies did not demonstrate a superiority of the combination regarding operative deliveries and neonatal outcomes but there were many methodological differences between the trials.

Introduction: Until now, there have been few investigations on the efficacy of fosfomycin in the treatment of patients with uncomplicated urinary tract infections (UTIs). The present study is aimed to examine how fosfomycin affects females with lower UTIs. Methods:A total of 200 female patients who visited the women's clinic at Amir-Al-Momenin Hospital between 2020 and 2021 were examined in the present study. Patients were randomly divided into two groups of 100 people each, with one group receiving fosfomycin (a single 3 g dose) and the other one receiving cephalexin (a five-day regimen at 0.5 g four times daily). Then, one week and one month after treatment, the patients underwent a urine culture test. The data were collected and further analyzed in SPSS statistics software version 26. Results:According to the study findings, the mean age of females suffering from lower UTI was 25.45 ± 5.85 years. Besides, the collected data revealed that 85.5% of females diagnosed with lower UTI had E. coli. In addition, the frequency of females with Staphylococcus saprophyticus, Proteus spp and Klebsiella were 9%, 3% and 2.5%, respectively. Also, the frequency of women with UTI for E. coli, Staphylococcus saprophyticus, Proteus spp and Klebsiella were 85.5%, 9%, 3.2% and 2.5%, respectively. One month after treatment, urine culture showed positive results in 98% of patients who were treated with fosfomycin and 95% of those who received cephalexin. Conclusion:Fosfomycin can be administrated to treat uncomplicated UTIs in women with a high level of confidence, as an alternative to cephalexin.

Double J stents are commonplace tools used in modern urology, serving as a vital aid in the drainage of the upper urinary system. Along with the numerous advantages of these catheters, numerous negative consequences have also been addressed throughout time. Among the most common symptoms associated with ureteral catheters are those associated with LUTS (lower urinary tract symptoms), such as dysuria, urinary urgency, pollakiuria, the feeling of incomplete emptying of the bladder, urinary incontinence, or even urinary tract infections (UTIs). Complications associated with sexual dysfunction, including dyspareunia and pain during sex, which can lead to erectile dysfunction or loss of orgasm, are less discussed in the literature. This small review tries to focus on the most important aspects of low urinary symptoms that affect the general quality of life and those related to the quality of sexual life, which are less discussed but of particular importance in the lifestyle of any patient with such ureteral device.

Objective: Ureteroscopy (URS) is a commonly used procedure for the management of ureteral stones. While elective URS has been extensively studied, the literature on emergency URS remains limited. The aim of the present study is to evaluate the efficacy and safeness of URS performed in emergency settings and to determine the ideal candidates for this type of intervention. Methods:Patients who underwent URS for ureteral stones in a single healthcare unit, "Saint John" Emergency Clinical Hospital, Bucharest, Romania, were included in a retrospective investigation between April 2022 and March 2023. The study group was divided into two subgroups: group A (138 patients who underwent semirigid URS in an emergency setting) which was subdivided into group A1 (95 patients with stone on the distal ureter) and group A2 (43 patients with stone on the proximal ureter), and group B (151 patients who underwent a double J stent insertion). The success rate defined as stone fragmentation and resolution of renal obstruction, along with intraoperative and postoperative complications were assessed. A URS procedure was considered unsuccessful if either the instrument could not be passed to access the stone or it was deemed unsafe to perform the URS. In such cases, patients were managed by inserting a ureteric stent and scheduled for a subsequent procedure. Results:It could be observed that most complications occurred in emergency ureteroscopy on distal ureter (95 cases) and the most severe ones on proximal ureter (two cases - Clavien 4). Double J stenting provided a reduced number of complications (51 cases). It should be mentioned that patients with emergency semirigid ureteroscopy had more complications than those with double J stent for every group of BMI, while most of the complications were observed in the groups with the highest BMI. The success of the URS procedure was determined based on complete stone fragmentation and extraction, and it was of 91.3% for cases with emergency ureteroscopy. Conclusion:Patients who underwent URS for ureteral stones at a single facility, "Saint John" Emergency Clinical Hospital, Bucharest, Romania, were included in a retrospective investigation. The success rates and complication rates of emergency URS were comparable to those of elective URS, providing valuable insights for clinical decision-making.

Introduction:Myocardial bridges (MB) are congenital anomalies of hearts observed as muscle fibers covering epicardial branches of the coronary artery. The left anterior descending artery (LAD) was found to be commonly showing myocardial bridges (MBs). Clinically, MBs were claimed to cause varied symptomatology. The data on the morphology and prevalence of MBs in fetuses was limited, despite the commonly accepted congenital origin. Material and methods:Fetal hearts obtained from 37 fetuses from the donation program were used. The hearts were dissected out from the thorax by standard dissection procedure. The pericardium and epicardium were dissected. The coronary arteries were delineated, and MBs were observed and noted. The coronary artery segment having MBs, its distance from the ostium as well as the direction and length of the MBs were studied. Results:The MBs were observed in 20 out of 37 fetal hearts studied over the left anterior descending, right coronary, posterior interventricular and circumflex arteries. The mid or distal part of the coronary arteries frequently exhibited MBs. The mean length of the MB was 4.2 mm, with MBs being situated about 1.5 cm away from the coronary ostium. The oblique pattern of MB was more frequently noted. Conclusion:The morphology and prevalence of fetal MBs showed common occurrence in the LAD artery, with a predominant oblique morphological pattern.

Introduction: Cilostazol is a selective cyclic inhibitor of the 3-phosphodiesterase type (PDE3) that is recommended to be administered in cases of symptomatic peripheral vascular disease (YEI). It was discovered as a chemical compound in the 1980s, in Takao Nishi laboratory in Japan. Objective: The purpose of the present review was to evaluate the efficacy of cilostazol administration in a YEI with intermittent claudication or moderate to severe lower extremity ischemia. Materials and methods:A systematic review of the literature was carried out where articles were searched in the international database PubMed. The year 2005 was set as a time limit for the publication date of the articles. The following keywords were used: cilostazol, peripheral arterial disease, revascularization and lower limb. A total of 95 articles were found, of which only 10 were selected for the present study. Results:According to the results of the current review, the use of cilostazol increases the ability to walk, improves the quality of life, reduces the rates of re-narrowing of vessels and stents, reduces the likelihood of amputation and is co-administered with other antiplatelet and anticoagulant agents. Conclusion:Cilostazol administration should be a possible treatment option for symptomatic YEI. Further research is necessary to determine its safety after three years.

Objective: The aim of this study was to investigate the relation between cesarean section and postpartum posttraumatic stress disorder as well as the factors that contribute to the development of posttraumatic symptoms in mothers. Materials and methods: A sample of 538 women who gave birth with emergency and elective cesarean section in a University Hospital of Thessaly, Greece, have consented to participate in a two-phase prospective study. A socio-demographic questionnaire, the stressor Criterion A, the Life Events Checklist and the Posttraumatic Checklist of the fifth edition of the Diagnostic and Statistical Manual (DSM-5) were used to diagnose posttraumatic symptoms in Greek postpartum mothers. Results:Out of 538 mothers, 37.2% had an emergency cesarean section and the remaining 62.8% an elective one. Posttraumatic stress was seen in 26 (26%) of women with emergency surgery and three (3%) of those with elective surgery. The present study also found that the inclusion of a neonate to the NICU, complications during pregnancy and delivery, lack of breastfeeding and lack of support from the partner were strongly associated with the development of posttraumatic symptoms. Conclusions:The results of the current study indicate the need to take measures to reduce cesarean section rates and promote vaginal delivery. The high posttraumatic stress rates make it imperative to take additional measures for the mental health of women after cesarean section, especially in those with a traumatic birth experience.

Objective:A sizable fraction of young people with active sex lives do not utilize contraceptives and engage in high-risk sexual activity. School-based programs can prevent sexual activity, encourage birth control and reduce high-risk behavior. A survey was conducted to assess the key sources of knowledge on sexual education and document attitudes and methods of contraception used by Greek students, providing valuable information for expanding contraceptive services. Material and methods:A descriptive cross-sectional study was conducted by using an online questionnaire which was distributed to 206 digital student groups on social media platforms from May 20 to June 5, 2021. Results:The majority of participants obtained information about contraception from the Internet and used male condoms to avoid unwanted pregnancy and protect against sexually transmitted diseases (STDs). The present study found that younger ages (18-20 and 21-25) preferred to use the male condom technique in an ephemeral relationship [x² (12) =26.041, Fisher's exact test p= 0.0380.05]. Conclusions:Exploring students' attitudes toward contraceptive usage can provide valuable insights for developing effective strategies to promote safe and responsible sexual behavior among this population.

Introduction:Vitiligo is a common form of localized depigmentation and an important public health problem which affects around one percent of the global population and about two percent of the population in India. The present study aimed to document the results and side effects of non-cultured melanocyte transplant in patients with stable vitiligo without post-procedure use of NB UVB. Methods:The present study was a prospective interventional study conducted among patients with stable vitiligo who were attending the outpatient department (OPD) of dermatology of a tertiary center of Delhi. Patients with stable vitiligo aged >10 years who gave their consent for non-cultured epidermal suspension (NCES) were included in the study. Autologous skin graft of size 0.2 mm was taken from the donor site and a melanocyte cell suspension was prepared using standardized procedure, which was later transplanted to the recipient area. All patients were asked to come for follow-up at the OPD after seven days, 15 days, one month, followed by every month till six months post-transplantation, and repigmentation was assessed visually by both graph paper and photography. Data was analyzed using SPSS vs. 21. Results:In our study, the majority of patients had vitiligo vulgaris (27 subjects with 47 patches). A total number of 59 patches were transplanted, of which 38 (64.4%) achieved excellent repigmentation, 28.8% good repigmentation, 3.4% fair repigmentation and 3.39% poor repigmentation. A total of 1302.5 cm² of the depigmented area was operated by NCES and the repigmentation of 874.5 cm2 (67.14%) was achieved by six months. Conclusion:The present study found that the majority of patients (93%) with vitiligo achieved excellent or good repigmentation after NCES and the rate of complication was very low.

Background: Platelet-rich fibrin is a second-generation platelet concentrate. It is rich in platelets, cytokines, growth factors and leukocytes. Compared to platelet-rich plasma, it releases growth factors for a more extended amount of time. Methods:A literature review was conducted on the applications of platelet-rich fibrin in otolaryngology. Only articles written in English were further considered for the study; all others were excluded. Also, articles relating to oral and maxillofacial surgery were removed. Results: Twenty-five studies were deemed appropriate for inclusion in the present review. Conclusion:Based on the current data, platelet-rich fibrin appears to be a safe, healing-promoting material. It is a cost-effective, autologous material with enormous therapeutic application potential in the future. However, further clinical research is required before conclusive conclusions can be drawn about its usefulness.