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Differences in the clinical course, laboratory and radiological findings of COVID-19 infection between male, female and pregnant patients in demographically homogeneous groups 同质人群中男性、女性和妊娠患者COVID-19感染的临床病程、实验室和影像学表现的差异
Pub Date : 2023-01-01 DOI: 10.5455/annalsmedres.2022.08.256
Hilal zsoy, Serhat nal, S. L, Behiye Oral
Objective: This study examines for any differences in the clinical course, laboratory and radiological findings of COVID-19 infection between male, female and pregnant patients in similar age groups. Materials and Methods: This retrospective study involved a review of the data of patients treated between March 2020 and May 2021, included a total of 528 cases (193 pregnant females, 170 non-pregnant females and 165 males) aged 18–40 years with RT-PCR-confirmed COVID-19. Results: A comparison of the three demographically homogeneous groups revealed more common symptomatic infection at admission in the male patient group than in the other two patient groups (p<0.001), as well as a longer hospital stay (p<0.001) and higher incidences of moderate and severe pneumonia (p<0.001) based on radiological findings. In contrast, no significant difference was noted in the intensive care unit admission and mortality rates of the three groups. Conclusion: The results of our study reveal that females have some degree of protection against severe presentations of COVID-19 infection when compared to men. The heterogeneity of immunocompetence and immune response can help to understand the different COVID-19 responses of males and females, and can be used as a guide for disease prognosis and gender-specific treatments.
目的:本研究探讨相似年龄组的男性、女性和孕妇在COVID-19感染的临床病程、实验室和影像学表现上的差异。材料与方法:本回顾性研究回顾了2020年3月至2021年5月期间接受治疗的患者数据,共纳入528例年龄在18-40岁的rt - pcr确诊的COVID-19患者(孕妇193例,非孕妇170例,男性165例)。结果:三个人口统计学同质组的比较显示,入院时男性患者组比其他两个患者组更常见的有症状感染(p<0.001),并且根据放射检查结果,住院时间更长(p<0.001)和中重度肺炎的发生率更高(p<0.001)。相比之下,三组在重症监护病房住院率和死亡率方面没有显著差异。结论:我们的研究结果表明,与男性相比,女性对COVID-19严重感染有一定程度的保护。免疫能力和免疫反应的异质性有助于了解男性和女性对COVID-19的不同反应,并可作为疾病预后和性别特异性治疗的指导。
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引用次数: 0
The relationship between osteochondral lesion of the talus and the foot arch angles in adults: A retrospective study 成人距骨软骨病变与足弓角度关系的回顾性研究
Pub Date : 2023-01-01 DOI: 10.5455/annalsmedres.2022.10.300
M. Boz, Abdullah ahin, Mehmet ek
Objective: The current study aimed to compare the arch angles of the foot, Achilles tendinopathy, subcutaneous fat tissue thickness of the heel, and epin calcanei (EC) in patients with osteochondral lesion of the talus (OLT). Methods:The magnetic resonance images (MRI) of the ankle performed by the radiology clinic between March 2020 and October 2021 were examined.Based on the MRI findings, the patients diagnosed with OLT were included in the study group (n = 55) and those not diagnosed with OLT formed the control group (n = 118). All the patients included in the study were investigated for their demographic characteristics and presence of EC. Weight-bearing lateral X-ray images were used to measure the lateral talus-first metatarsal angle (Meary’s angle), lateral talocalcaneal angle (LTCA), and calcaneal inclination angle (also known as the calcaneal pitch). Results: The study and control groups had no significant difference in terms of gender distribution (P = 0.575). The patients in the study group had a significantly higher mean age than the control group (P < 0.001). Evaluation of the arch angles of the foot showed the patients with OLT to have higher LTCA and calcaneal pitch angles and greater subcutaneous fat thicknesses (p < 0.001, p < 0.001, and p = 0.004, respectively). In addition, the study group showed higher rates of patients with EC and Achilles tendinopathy (p = 0.076 and p = 0.019, respectively).Conclusion: Our study demonstrated that sex had no effect on OLT incidence, whereas changes in the LTCA and pitch angles elevated the risk of OLT. Furthermore, increased age was found to be associated with a higher risk of OLT formation. We also showed that Achilles tendinopathy and EC were significantly higher in patients with OLT.A considerable number of future studies are needed to establish whether this significant relationship is causal.
目的:本研究旨在比较距骨软骨病变(OLT)患者足弓角度、跟腱病变、足跟皮下脂肪组织厚度和跟骨针(EC)。方法:对2020年3月至2021年10月在放射科门诊进行的踝关节磁共振成像(MRI)进行检查。根据MRI表现,将诊断为OLT的患者纳入研究组(n = 55),未诊断为OLT的患者为对照组(n = 118)。所有纳入研究的患者都调查了他们的人口统计学特征和EC的存在。负重侧位x线图像测量距骨外侧第一跖骨角(Meary’s角)、距骨外侧跟骨角(LTCA)和跟骨倾斜角(也称为跟骨节距)。结果:研究组与对照组在性别分布上差异无统计学意义(P = 0.575)。研究组患者的平均年龄明显高于对照组(P < 0.001)。足弓角度评估显示,OLT患者LTCA和跟骨俯仰角较高,皮下脂肪厚度较大(p < 0.001, p < 0.001, p = 0.004)。此外,研究组出现EC和跟腱病变的比例更高(p = 0.076和p = 0.019)。结论:我们的研究表明,性别对OLT的发生率没有影响,而LTCA和俯仰角的变化会增加OLT的风险。此外,年龄的增加与OLT形成的风险增加有关。我们还发现跟腱病和EC在OLT患者中明显更高。未来还需要大量的研究来确定这种显著的关系是否存在因果关系。
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引用次数: 1
Effects Of Shunt Types Used In Idiopathic Normal Pressure Hydrocephalus On Patients' Clinical Outcomes 特发性常压脑积水分流器类型对患者临床预后的影响
Pub Date : 2023-01-01 DOI: 10.5455/annalsmedres.2022.11.333
M. Akyol, E. Çetin
Background: Idiopathic normal pressure hydrocephalus (iNPH) is a surgically reversible neurological disorder in adults. It is a neurological condition characterized by ventricular enlargement detected on cranial imaging as well as gait disturbance, cognitive decline and urinary incontinence, with no other reason to explain the clinical findings. Ventricular shunting, predominantly ventriculoperitoneal (VP) shunt, has been shown to be successful in relieving symptoms in patients. In this study, we aimed to investigate the effects of two VP shunts used in the iNPH patients treated in our clinic. Methods: Clinical and laboratory records of 28 patients who underwent VP shunting due to iNPH were reviewed retrospectively via the Enlyl system. A programmable shunt was inserted in 9 (32.1%) and a medium-pressure shunt was inserted in 19 (67.9%) patients. Results: There was no significant difference between the two shunt types with regard to patient age, gender, and preoperative tests (p>0.05). However, the prevalence of ataxic gait was significantly higher in the Programmable Shunt group compared to the Medium-Pressure Shunt group (p<0.05). On the other hand, no significant difference was found between the shunt types with regard to postoperative examination findings and additional neurological disorders (p>0.05 for both). Conclusion: In the present study, no significant difference was observed between the shunt types with regard to clinical outcomes and thus both types of shunts were revealed as viable options.
背景:特发性常压脑积水(iNPH)是一种手术可逆的成人神经系统疾病。它是一种神经系统疾病,其特征是颅成像检测到脑室增大,以及步态障碍,认知能力下降和尿失禁,没有其他原因可以解释临床表现。脑室分流,主要是脑室-腹膜(VP)分流,已被证明是成功的缓解症状的患者。在这项研究中,我们的目的是探讨在我们诊所治疗的iNPH患者中使用的两种VP分流器的效果。方法:通过Enlyl系统对28例因静脉内ph引起的VP分流患者的临床和实验室记录进行回顾性分析。9例(32.1%)置入可编程分流器,19例(67.9%)置入中压分流器。结果:两种分流术在患者年龄、性别、术前检查等方面差异无统计学意义(p>0.05)。然而,与中压分流器组相比,可编程分流器组的共济失调步态发生率显著高于中压分流器组(p0.05)。结论:在本研究中,两种分流器的临床结果没有明显差异,因此两种分流器都是可行的选择。
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引用次数: 0
A comparison of multivariate statistical methods to detect risk factors for Type 2 diabetes mellitus 多因素统计方法检测2型糖尿病危险因素的比较
Pub Date : 2023-01-01 DOI: 10.5455/annalsmedres.2022.09.276
ipek ek, Saim Lu, ibrahim ahin
Aim: The goal of this study is to compare the performances of Logistic Regression (LR), Artificial Neural Networks (ANN) and Decision Tree models, which are machine learning classification methods, in the diagnosis of Type 2 Diabetes Mellitus (DM) and to determine the most successful method. It is also the examination of risk factors affecting Type 2 DM using these models. Method: The study's data was collected from patients who visited the Diabetes and Thyroid polyclinic at the Inonu University Faculty of Medicine Turgut Ozal Medical Center, Department of Internal Medicine. The k-Nearest Neighbor algorithm, which is one of the missing value assignment methods, was used to eliminate the problems related to missing values. Sensitivity, accuracy, precision, specificity, AUC F1-score, and classification error were used as performance evaluation criteria. Evolutionary algorithm parameter optimization method was used to optimize the parameters of the ANN model. Missing value assignment, modeling and parameter optimization were done with Rapidminer Studio Free version 8.1. Results: Among the three methods applied in the diagnosis of Type 2 DM, the ANN gave the best classification performance. The accuracy, sensitivity, selectivity, precision, F1-score, AUC and classification error values obtained from this method are respectively; 98.94%, 100%, 97.73%, 98.04%, 99.01%, 0.978 and 1.06. For the ANN method, the importance values of the gender, long-term drug use, family history, concomitant disease, cortisone use, stress factor, high blood pressure, smoking, high cholesterol, heart disease, exercise status, carbohydrate use, alcohol consumption, vegetable use, meat use, age, weight, height, starting age, daily bread consumption, LDL, HDL, Total Cholesterol, Triglyceride, Fasting blood sugar the importance values of independent variables are respectively; 0.017, 0.009, 0.013, 0.017, 0.008, 0.016, 0.008, 0.006, 0.053, 0.024, 0.023, 0.040, 0.007, 0.020, 0.007, 0.046, 0.083, 0.049, 0.024, 0.066, 0.084, 0.083, 0.020, 0.031, 0.244. Conclusion: According to the performance criteria obtained from the three classification models used to predict Type 2 DM; it has been found that the best classification performance belongs to the ANN model. According to the ANN method, the three most important risk factors that may cause Type 2 DM were found to be fasting blood glucose, LDL, and HDL, respectively.
目的:本研究的目的是比较逻辑回归(LR)、人工神经网络(ANN)和决策树模型这三种机器学习分类方法在2型糖尿病(DM)诊断中的性能,并确定最成功的方法。这也是使用这些模型检查影响2型糖尿病的危险因素。方法:本研究的数据收集自伊诺努大学医学院Turgut Ozal医学中心内科糖尿病和甲状腺综合诊所的患者。使用缺失值分配方法之一的k近邻算法来消除缺失值相关问题。灵敏度、准确度、精密度、特异度、AUC f1评分、分类误差作为性能评价标准。采用进化算法参数优化方法对人工神经网络模型的参数进行优化。缺失值赋值、建模和参数优化都是在Rapidminer Studio免费版8.1中完成的。结果:在3种诊断2型糖尿病的方法中,人工神经网络的分类效果最好。该方法得到的准确度、灵敏度、选择性、精密度、f1评分、AUC和分类误差值分别为;98.94%、100%、97.73%、98.04%、99.01%、0.978和1.06。对于人工神经网络方法,性别、长期用药、家族史、合并症、可的松使用、应激因素、高血压、吸烟、高胆固醇、心脏病、运动状况、碳水化合物使用、酒精使用、蔬菜使用、肉类使用、年龄、体重、身高、起始年龄、每日面包消费量、LDL、HDL、总胆固醇、甘油三酯、空腹血糖的重要值分别为;0.017、0.009、0.013、0.017、0.008、0.016、0.008、0.006、0.053、0.024、0.023、0.040、0.007、0.020、0.007、0.046、0.083、0.049、0.024、0.066、0.084、0.083、0.020、0.031、0.244。结论:根据三种分类模型所得的性能标准,可用于预测2型糖尿病;结果表明,人工神经网络模型的分类性能最好。根据ANN方法,发现可能导致2型糖尿病的三个最重要的危险因素分别是空腹血糖、低密度脂蛋白和高密度脂蛋白。
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引用次数: 0
The relationship between balance and flu-like symptoms: a medical condition that needs attention 平衡与流感样症状之间的关系:需要注意的医学状况
Pub Date : 2023-01-01 DOI: 10.5455/annalsmedres.2023.01.039
Serhat Kaya
Objective: In general, while upper respiratory tract viruses cause flu-like complaints, balance problems associated with these viruses are often overlooked. It has been a long time since the first appearance of Covid-19, but unfortunately, there is still no fully effective treatment for this disease. Along with balance manifestations, especially several vestibular symptoms such as dizziness, vertigo, and tinnitus are described as common clinical manifestations in COVID-19. In our study, we investigated the effects of Covid-19 on the balance system with routine balance tests and we tried to localize a possible disorder in the balance system. Materials and Methods: Volunteers were divided into two groups. The number of volunteers in each group was thirty. The first group consisted of SARS-CoV-2-positive patients and the second group consisted of healthy people. Spontaneous nystagmus determination, Romberg test, Fukuda stepping test (FST), head thrust test (HTT), head shake test (HST), finger-nose test, and tandem walking test were applied. Results: The lateral fall in the Romberg test, rotation in the FST, and nystagmus in the HST are significant in Group 1 (p<0.001), (p<0.001), (p<0.03). The relationship between the fall side in the Romberg test and the direction of rotation in the FST were found to be significant in Group 1 (p<0.001). Similarly, the relationship between the direction of rotation in the FST and the nys-tagmus direction in the HST, and the direction of the saccadic correction in the HTT were found to be sig-nificant (p<0.026), (p<0.010). Conclusion: In SARS-CoV-2 positive patients, the balance system, especially the peripheric vestibular system, may be affected even if the patients do not have obvious complaints about balance. Routine balance tests that can be performed quickly in the outpatient clinic can be used effectively for the evaluation of balance.
目的:一般来说,虽然上呼吸道病毒引起流感样症状,但与这些病毒相关的平衡问题往往被忽视。自Covid-19首次出现以来已经很长时间了,但不幸的是,这种疾病仍然没有完全有效的治疗方法。除了平衡表现外,前庭症状如头晕、眩晕、耳鸣等被认为是新冠肺炎的常见临床表现。在我们的研究中,我们通过常规平衡测试来研究Covid-19对平衡系统的影响,并试图定位平衡系统中可能存在的障碍。材料与方法:将志愿者分为两组。每组志愿者人数为30人。第一组由sars - cov -2阳性患者组成,第二组由健康人组成。自发性眼球震颤测定、Romberg试验、Fukuda步进试验(FST)、头推力试验(HTT)、头摇试验(HST)、指鼻试验和串联行走试验。结果:Romberg试验的侧落、FST的旋转、HST的眼球震颤在1组中有显著性差异(p<0.001)、(p<0.001)、(p<0.03)。Romberg试验中跌倒侧与FST旋转方向之间的关系在第1组中具有显著性(p<0.001)。同样,FST的旋转方向与HST的眼球-tagmus方向之间的关系,以及HTT的跳眼校正方向之间的关系也很显著(p<0.026), (p<0.010)。结论:在SARS-CoV-2阳性患者中,即使患者没有明显的平衡症状,也可能影响平衡系统,特别是外周前庭系统。可在门诊快速进行的常规平衡测试可有效地用于平衡评估。
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引用次数: 0
Changes in Motor and Sensory Parameters in Patients with Lumbar Disc Herniation 腰椎间盘突出症患者运动和感觉参数的变化
Pub Date : 2023-01-01 DOI: 10.5455/annalsmedres.2023.03.067
Bar Zorbozan, M. Yener, Belgin Bama
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引用次数: 0
Analyzing And Detecting Risk Factors For The Diagnosis Of Angina Pectoris With Machine Learning 应用机器学习分析和检测心绞痛诊断的危险因素
Pub Date : 2023-01-01 DOI: 10.5455/annalsmedres.2023.02.043
O. Ozhan, ipek ek, Zeynep Al
Aim: To classify angina pectoris (AP) in women by applying the Bagged CART approach, which is one of the machine learning (ML) methods, to the open-access AP dataset. Another aim is to reveal the risk factors associated with AP in women through modeling. Materials and Methods: In the current study, modeling was done with the Bagged CART technique utilizing an open-access data set containing the factors associated with AP. Model results were assessed with accuracy (ACC), sensitivity (Sen), balanced accuracy (BACC), positive predictive value (PPV), specificity (Spe), negative predictive value (NPV), and F1-score performance criteria. In addition, a 5-fold cross-validation approach was applied in the modeling phase. Finally, variable importance was derived with modeling. Results: ACC, BACC, Sen, Spe, PPV, NPV, and F1-score from Bagged CART modeling were 98.5%, 98.5%, 99.0%, 98.0%, 98.0%, 99.0%, and 98.5%, respectively. Depending on the variable importance values calculated for the input variables investigated in the current study, age, family history of myocardial infarction: yes, the average number of cigarettes smoked per day smoking status: current, family history of angina: yes, hypertensive condition: moderate, smoking status: ex, hypertensive condition: mild, family history of stroke: yes, whether the woman has diabetes: yes were obtained as the most important variables associated with AP. Conclusion: With the ML model used, the AP dataset was classified successfully, and the associated risk factors were revealed. ML models can be used as clinical decision support systems for early diagnosis and treatment.
目的:将机器学习(ML)方法之一Bagged CART方法应用于开放获取的心绞痛数据集,对女性心绞痛(AP)进行分类。另一个目的是通过建模揭示与女性AP相关的风险因素。材料和方法:在目前的研究中,使用Bagged CART技术利用包含与AP相关因素的开放获取数据集进行建模。模型结果通过准确性(ACC)、敏感性(Sen)、平衡准确性(BACC)、阳性预测值(PPV)、特异性(Spe)、阴性预测值(NPV)和f1评分性能标准进行评估。此外,在建模阶段采用了5倍交叉验证方法。最后,通过建模推导出变量重要性。结果:Bagged CART模型的ACC、BACC、Sen、Spe、PPV、NPV和f1评分分别为98.5%、98.5%、99.0%、98.0%、98.0%、99.0%和98.5%。根据当前研究中所调查的输入变量计算的变量重要性值,年龄、心肌梗死家族史:yes、每天平均吸烟数、吸烟状况:当前、心绞痛家族史:yes、高血压状况:中度、吸烟状况:ex、高血压状况:轻度、卒中家族史:yes、女性是否患有糖尿病:yes作为与ap相关的最重要变量。使用ML模型,AP数据集被成功分类,并揭示了相关的风险因素。ML模型可以作为早期诊断和治疗的临床决策支持系统。
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引用次数: 0
Bibliometric analysis of primary central nervous system lymphoma 原发性中枢神经系统淋巴瘤文献计量学分析
Pub Date : 2023-01-01 DOI: 10.5455/annalsmedres.2023.08.171
Serkan GUVEN, Sevil ALKAN
Aim: Primary central nervous system lymphoma (PCNSL) is an important topic in hematology due to its rare, aggressive course, difficult diagnosis and special treatment requirements. This bibliometric analysis study aimed to examine PCNSL -related publications published since the last 2000 and to identify potential points of future research. Material and methods: Web of Science Core Collection documents published between 2000 and 2022 were analyzed using selected keywords. The obtained data were visualized with bibliometric tools. Publishing countries, organizations, journals, authors, references, and keywords were all examined comprehensively. Results: 1,160 articles on PCNSL published since 2000 were retrieved. These publications tend to focus on research in oncology (n=456, 39.310%), clinical neurology (n=354, 30.517%), and hematology (n=173, 14.914%). Search criteria revealed that 6,458 authors from 65 different countries and 1,570 organizations worldwide contributed to PCNSL articles. Conclusion: Studying research on PCNSL is crucial to improve our knowledge of this disease and to create new treatment strategies. It is very important to keep in mind that the characteristics and trends in PCNSL research may change over time as new findings and developments in the field are discovered.
目的:原发性中枢神经系统淋巴瘤(Primary central nervous system lymphoma, PCNSL)因其罕见、病程严重、诊断困难、治疗要求特殊而成为血液学研究的重要课题。本文献计量分析研究旨在检查自2000年以来出版的PCNSL相关出版物,并确定未来研究的潜在点。材料与方法:选取关键词对2000 - 2022年间发表的Web of Science Core Collection文献进行分析。用文献计量学工具对所得数据进行可视化处理。出版国家、组织、期刊、作者、参考文献和关键词都被全面审查。结果:检索到2000年以来发表的PCNSL论文1160篇。这些出版物往往集中在肿瘤学(n= 456,39.310%)、临床神经病学(n= 354,30.517%)和血液学(n=173, 14.914%)方面的研究。搜索结果显示,来自65个不同国家和1570个组织的6458位作者为PCNSL贡献了文章。结论:研究PCNSL对提高我们对该病的认识和制定新的治疗策略至关重要。重要的是要记住,随着新发现和新发展的发现,PCNSL研究的特点和趋势可能会随着时间的推移而改变。
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引用次数: 0
Comparison of metastatic versus non-metastatic breast cancer at the time of diagnosis and risk factors for primary metastatic breast cancer 原发性转移性乳腺癌诊断时转移性与非转移性乳腺癌的比较及危险因素
Pub Date : 2023-01-01 DOI: 10.5455/annalsmedres.2023.08.184
Mesut YUR
Objective: The most common type of cancer in women is breast cancer. Despite an increase in the rate of early detection, distant organ metastasis is still seen at the time of diagnosis. The purpose of this study was to identify the predictive risk factors for breast cancer patients with distant organ metastases and to compare them to those without distant organ metastases. Materials and Methods: The study included data from patients who applied to our clinic for follow-up or treatment between January 2020 and July 2020. After meeting the exclusion criteria, the remaining 115 patients were included in the study. Study participants were divided into two groups: metastatic (group I) and non-metastatic (group II). Logistic regression analysis is used to assess the predictive risk factors. Results: There is a significant difference between groups in terms of the breast side, T-stage, N-stage, CA 15-3, and albumin levels (p< 0.05). In univariate analyses, T-stage, CA 15-3, estimates glomerular filtration rate (eGFR), alkaline phosphatase, and albumin levels were statistically found to be significant (p<0.05). In multivariate analysis, CA 15-3 (OR: 1.017; 95% CI: 1.005-1.030, p = 0.006), eGFR (OR: 0.944; 95% CI: 0.894-0.996, p = 0.034), and albumin (OR: 0.087; 95% CI: 0.011-0.676, p = 0.020) were found to be predictive risk factors for metastatic breast cancer. Conclusion: High T-stage, N positivity, high CA15-3 levels, and low albumin levels were observed in the metastatic breast cancer group. CA 15-3, eGFR, and albumin levels were found to be predictive factors for metastatic breast cancer at the initial diagnosis. New studies are needed to validate these findings.
目的:女性中最常见的癌症类型是乳腺癌。尽管早期发现率有所增加,但在诊断时仍然可以看到远处器官转移。本研究的目的是确定乳腺癌远处器官转移患者的预测危险因素,并将其与未发生远处器官转移的患者进行比较。材料和方法:本研究纳入了2020年1月至2020年7月期间到我们诊所申请随访或治疗的患者的数据。符合排除标准后,其余115例患者纳入研究。研究参与者分为两组:转移性(I组)和非转移性(II组)。采用Logistic回归分析来评估预测的危险因素。结果:两组患者在乳腺侧、t期、n期、ca15 -3、白蛋白水平(p<0.05)。在单变量分析中,t期,CA 15-3,估计肾小球滤过率(eGFR),碱性磷酸酶和白蛋白水平具有统计学意义(p<0.05)。在多变量分析中,CA 15-3 (OR: 1.017;95% CI: 1.005-1.030, p = 0.006), eGFR (OR: 0.944;95% CI: 0.894-0.996, p = 0.034),白蛋白(OR: 0.087;95% CI: 0.011-0.676, p = 0.020)为转移性乳腺癌的预测危险因素。结论:转移性乳腺癌组t分期高,N阳性,CA15-3水平高,白蛋白水平低。CA 15-3、eGFR和白蛋白水平在最初诊断时被发现是转移性乳腺癌的预测因素。需要新的研究来验证这些发现。
{"title":"Comparison of metastatic versus non-metastatic breast cancer at the time of diagnosis and risk factors for primary metastatic breast cancer","authors":"Mesut YUR","doi":"10.5455/annalsmedres.2023.08.184","DOIUrl":"https://doi.org/10.5455/annalsmedres.2023.08.184","url":null,"abstract":"Objective: The most common type of cancer in women is breast cancer. Despite an increase in the rate of early detection, distant organ metastasis is still seen at the time of diagnosis. The purpose of this study was to identify the predictive risk factors for breast cancer patients with distant organ metastases and to compare them to those without distant organ metastases. Materials and Methods: The study included data from patients who applied to our clinic for follow-up or treatment between January 2020 and July 2020. After meeting the exclusion criteria, the remaining 115 patients were included in the study. Study participants were divided into two groups: metastatic (group I) and non-metastatic (group II). Logistic regression analysis is used to assess the predictive risk factors. Results: There is a significant difference between groups in terms of the breast side, T-stage, N-stage, CA 15-3, and albumin levels (p< 0.05). In univariate analyses, T-stage, CA 15-3, estimates glomerular filtration rate (eGFR), alkaline phosphatase, and albumin levels were statistically found to be significant (p<0.05). In multivariate analysis, CA 15-3 (OR: 1.017; 95% CI: 1.005-1.030, p = 0.006), eGFR (OR: 0.944; 95% CI: 0.894-0.996, p = 0.034), and albumin (OR: 0.087; 95% CI: 0.011-0.676, p = 0.020) were found to be predictive risk factors for metastatic breast cancer. Conclusion: High T-stage, N positivity, high CA15-3 levels, and low albumin levels were observed in the metastatic breast cancer group. CA 15-3, eGFR, and albumin levels were found to be predictive factors for metastatic breast cancer at the initial diagnosis. New studies are needed to validate these findings.","PeriodicalId":8248,"journal":{"name":"Annals of Medical Research","volume":"48 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135802054","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: 0
Botulinum toxin-A injection improves motor recovery in patients with stroke a型肉毒毒素注射可改善脑卒中患者的运动恢复
Pub Date : 2023-01-01 DOI: 10.5455/annalsmedres.2023.05.124
Arzu c, Selin Alp, lknur Akta, P nar, Feyza zkan
Aim: Spasticity that occurs after a stroke may contribute to disability. Botulinum toxin type-A (BTX-A) injections are commonly used to manage spasticity. This study sought to determine the effectiveness of BTX-A injections on spasticity and motor recovery in patients with stroke. Materials and Methods: Twenty-five patients with stroke scheduled for BTX-A injection for spasticity were included in the study. The patients were analyzed in two groups: upper limb and lower limb group. A single dose of BTX-A was applied to the patients. Before, 2, and 12 weeks after BTX-A injections, motor function was assessed using Brunnstrom recovery stages, and spasticity was evaluated according to Modified Ashworth Scale (MAS). The lower limb group additionally underwent the Functional Ambulation Classification (FAC) and 10-meter walking test. Results: Mean age of patients was 54.96 ± 12.84 years. Eighteen patients were enrolled in the upper limb group and 23 in the lower limb group. Clinical evaluation of the upper limb group two weeks after injections demonstrated a significant decrease in shoulder adductor muscle MAS, elbow, wrist, and finger flexor muscles MAS, and a significant improvement in Brunnstrom recovery stages for the upper limb and hand (p<0.05). At week 12, spasticity decreased only for the shoulder adductor muscles. In the lower limb group, clinical evaluation at week 2 showed a decrease in the knee extensor and toe flexor muscles MAS. Assessment of the patients at week 12 found a significant improvement in Brunnstrom recovery stage for the lower limbs (p<0.05). There was no statistically significant recovery in the FAC and 10-meter walking test (p>0.05). Conclusion: This study supports that BTX-A injections are effective for improving spasticity and motor function in patients with stroke.
目的:中风后出现的痉挛可能会导致残疾。a型肉毒毒素(BTX-A)注射通常用于治疗痉挛。本研究旨在确定BTX-A注射对脑卒中患者痉挛和运动恢复的有效性。材料与方法:选取25例脑卒中患者进行BTX-A注射治疗痉挛。将患者分为上肢组和下肢组进行分析。患者接受单剂量BTX-A治疗。注射BTX-A前、2周和12周,采用Brunnstrom恢复分期法评估运动功能,并根据改良Ashworth量表(MAS)评估痉挛性。下肢组在此基础上进行功能行走分类(FAC)和10米行走测试。结果:患者平均年龄54.96±12.84岁。上肢组18例,下肢组23例。上肢组注射后两周的临床评估显示肩部内收肌MAS、肘部、腕部和手指屈肌MAS显著降低,上肢和手部的Brunnstrom恢复阶段显著改善(p < 0.05)。第12周时,只有肩部内收肌痉挛减少。在下肢组,第2周的临床评估显示膝关节伸肌和脚趾屈肌MAS减少。在第12周对患者进行评估时,发现下肢的Brunnstrom恢复期有显著改善(p < 0.05)。FAC和10米步行测试的恢复无统计学意义(p>0.05)。结论:BTX-A注射液可有效改善脑卒中患者的痉挛和运动功能。
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Annals of Medical Research
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