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Treatment of Chronic Kidney Diseases with Darpeboetin can Ameliorate Kidney Functions: A Possible Clinical Relevance Darpeboetin治疗慢性肾脏疾病可以改善肾功能:可能的临床相关性
Pub Date : 2023-11-10 DOI: 10.33140/mcr.08.11.03
Background: Erythropoietin (EPO) has been used clinically for the treatment of anemia as it was the first characterized hematopoietic factor. Erythropoietin is produced primarily by the kidneys (renal cortical fibroblasts) which induces proliferation and differentiation of erythroid progenitor cells. Previous studies suggested that erythropoietin may directly stimulates the regeneration of damaged tubular cells due to presence of erythropoietin receptors on renal tubular epithelial, mesangial and endothelial cells. EPO directly prevent glomerulosclerosis as a consequence of amelioration of podocyte injury. Therefore, to improve kidney function in chronic kidney disease (CKD), it is of critical importance to investigate clinically the beneficial reno-protective effects of EPO in patients with CKD. Methodology: The study was conducted at King Abdulaziz Medical City and included patients with chronic kidney diseases. Patients were under medical treatment with Darpeboetin for the first time. The administration frequency of Darpeboetin was single dose weekly. Kidney function tests including serum creatinine, serum urea, alkaline phosphatase, serum calcium, serum phosphorus, serum albumin and albuminuria were collected from the hospital electronic medical record system (BestCareR). Test values before and after treatment were compared. of the patients before starting treatment and at the end of treatment. The week before starting treatment was considered week 0 (baseline) Results: The results indicated that, treatment with a weekly single dose of Darpeboetin reduces blood urea nitrogen (BUN p=0.002) and serum uric acid level (p=0.009). The effect of treatment on serum calcium and potassium, showed a significant elevation of serum potassium (P<0.001), serum calcium (P<0.001) and adjusted calcium (P<0.001) levels parallel with significant decrease in serum phosphorus (p=0.004). Also treatment of chronic kidney disease patients significantly ameliorates serum albumin (P<0.001). Conclusion: Treatment with Darpeboetin may confirm the reno-protective potency. Darpeboetin is a promising drug to prevent or attenuate tissues kidney damage especially in chronic kidney disease
背景:促红细胞生成素(EPO)作为第一个被发现的造血因子,已被临床用于治疗贫血。促红细胞生成素主要由肾脏(肾皮质成纤维细胞)产生,诱导红细胞祖细胞的增殖和分化。以往的研究表明,促红细胞生成素可能是由于肾小管上皮细胞、系膜细胞和内皮细胞上存在促红细胞生成素受体而直接刺激受损小管细胞的再生。EPO通过改善足细胞损伤直接预防肾小球硬化。因此,为了改善慢性肾脏疾病(CKD)患者的肾功能,临床研究EPO在CKD患者中的有益肾保护作用至关重要。方法:该研究在阿卜杜勒阿齐兹国王医疗城进行,纳入了患有慢性肾脏疾病的患者。患者首次接受Darpeboetin治疗。达泊博汀给药频率为每周单次。从医院电子病历系统(BestCareR)采集肾功能检查结果,包括血清肌酐、血清尿素、碱性磷酸酶、血清钙、血清磷、血清白蛋白和蛋白尿。治疗前后各项指标比较。在开始治疗前和治疗结束时。开始治疗前一周视为第0周(基线)结果:结果表明,每周单剂量达泊博汀治疗可降低血尿素氮(BUN p=0.002)和血清尿酸水平(p=0.009)。治疗对血清钙和钾的影响显示血清钾(P<0.001)、血清钙(P<0.001)和校正钙(P<0.001)水平显著升高,血清磷显著降低(p=0.004)。此外,慢性肾病患者的治疗显著改善了血清白蛋白(P<0.001)。结论:达泊博汀治疗可证实其肾保护作用。Darpeboetin是一种有希望预防或减轻组织肾损害的药物,特别是在慢性肾脏疾病中
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引用次数: 0
Treatment Options for Patients with Inflammatory Bowel Disease During the COVID-19 Epidemic: A Review COVID-19流行期间炎症性肠病患者的治疗方案:综述
Pub Date : 2023-11-10 DOI: 10.33140/mcr.08.11.02
The Corona Virus Disease (COVID-19) outbreak is affecting life around the world. In particular, people with basic diseases are concerned about whether COVID-19 will affect their original disease,Increasing attention is whether patients with inflammatory bowel disease (IBD) are more susceptible to COVID-19.Whether the treatment plans need to be adjusted, Summary literature shows that IBD patients have comparable infection rates as those in the general population, patients with IBD using biologics are more likely to develop asymptomatic infections and have fewer symptoms than normal populations, The use of parenteral-selective biologic agents may have a protective effect in lung function, which may be associated with its mitigation of cytokine storm syndrome. So patients with IBD should not interrupt the original biological treatment regimen. However, in preparation selection, parenteral-selective biological agents are preferred.
冠状病毒病(COVID-19)的爆发正在影响世界各地的生活。特别是基础疾病患者关注的是新冠病毒是否会影响其原有疾病,炎症性肠病(IBD)患者是否更容易感染新冠病毒越来越受到关注。是否需要调整治疗方案,综述文献显示,IBD患者的感染率与普通人群相当,使用生物制剂的IBD患者更容易发生无症状感染,症状比正常人群少,使用肠外选择性生物制剂可能对肺功能有保护作用,这可能与其缓解细胞因子风暴综合征有关。因此,IBD患者不应中断原有的生物治疗方案。然而,在制剂选择上,首选非肠外选择性生物制剂。
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引用次数: 0
On the Individualized Cancer Management 论癌症个体化管理
Pub Date : 2023-11-10 DOI: 10.33140/mcr.08.11.01
Individualized cancer management is the opposite of the standardized care adapted for current clinical practice by the mainstream medicine. It is not a fancy concept but a logic and inevitable reality derived from the intrinsic characteristics of cancer and host antitumor response. The question is not whether it should be done but how it is done. Previous efforts have identified various cancer driver gene mutations in individual cancer patient, which have provided basis for treating different patients with different drugs that target various mutated kinases that drive tumor replication. This progress has made one step towards individualized cancer management with limited success in the past two decades in certain type of cancer. A much larger step awaits to be made towards true individualized management of cancer. This step is based on the individual differences in antitumor immunity in different cancer patients. Because antitumor immunity is the most impacting factor for cancer survival once the malignancy of a tumor is established, to fully recognize and utilize this force in the battle against cancer maximize patient survival to the theoretical limit. A true individualized cancer therapy is not only based on personal situation for each patient, but must also satisfy the criterion that the outcome of selected therapy is predictable for that patient, a feature that current standardized care does not have. Thus, treating each patient according to the status of his antitumor immunity should be the most critical skills a physician needs to master when facing each individual cancer patient. In the past nine years, we have been exploring individualized management of cancer through recognizing and manipulating antitumor immunity in each patient. Our combined experiences indicate a significant benefit to patient survival with reduced costs even when such effort was not perfect in the past. With time and more learning, we see this practice becoming more and more practical in a clinical setting. When this individualized approach becomes guideline for cancer management, we will see a significant leap of clinical improvement on both patient survival and cancer cure rate.
癌症个体化管理与主流医学适应当前临床实践的标准化护理相反。它不是一个花哨的概念,而是从癌症和宿主抗肿瘤反应的内在特征中衍生出来的逻辑和必然的现实。问题不在于是否应该这样做,而在于如何这样做。以往的努力已经在个体癌症患者中发现了多种癌症驱动基因突变,这为针对驱动肿瘤复制的各种突变激酶使用不同的药物治疗不同的患者提供了依据。这一进展使个体化癌症管理迈出了一步,在过去二十年中,在某些类型的癌症中取得了有限的成功。在癌症的真正个体化治疗方面,还有更大的一步等待着我们去完成。这一步是基于不同癌症患者抗肿瘤免疫的个体差异。因为一旦确定肿瘤的恶性,抗肿瘤免疫是影响肿瘤生存的最重要因素,在与癌症的斗争中充分认识和利用这种力量可以最大限度地提高患者的生存能力。真正的个体化癌症治疗不仅要基于每个患者的个人情况,还必须满足所选治疗结果对该患者是可预测的标准,这是目前标准化治疗所不具备的特征。因此,根据患者的抗肿瘤免疫状态来治疗每个患者,应该是医生面对每个癌症患者时需要掌握的最关键的技能。在过去的九年中,我们一直在探索通过识别和控制每位患者的抗肿瘤免疫来实现癌症的个体化治疗。我们的综合经验表明,即使在过去这种努力并不完美的情况下,也可以通过降低成本来显著改善患者的生存。随着时间的推移和更多的学习,我们看到这种做法在临床环境中变得越来越实用。当这种个体化方法成为癌症治疗的指导方针时,我们将看到患者生存和癌症治愈率的临床改善的重大飞跃。
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引用次数: 0
Investigating Workplace Safety Programs in a Chemical Industry in Africa 调查非洲某化学工业的工作场所安全项目
Pub Date : 2023-10-09 DOI: 10.33140/mcr.05.09.03
Safety is a critical component in any organisation. The purpose of this study was to investigate the safety culture of a chemical industry in Africa. This was a cross-sectional study conducted among 124 employees from South Africa, Ghana, Nigeria, Kenya and Zimbabwe. Data were collected using self-administered questionnaire via online programme (QuestionPro). The majority of the respondents were satisfied with the overall organisational culture, workplace condition and the support provided by management to ensure employee safety within the organisation. The respondents attested to a positive safety climate, although some felt that it would be of benefit to recognise and reward safety performance. Employee awareness of ImproChem’s safety standards and the level of compliance were also satisfactory. More focus can be directed to increasing individual hazard recognition and elimination to ensure “No harm to anyone ever”.
安全是任何组织的重要组成部分。本研究的目的是调查非洲化学工业的安全文化。这是一项对124名来自南非、加纳、尼日利亚、肯尼亚和津巴布韦的员工进行的横断面研究。数据收集采用在线程序(QuestionPro)自行填写的问卷。大多数受访者对公司的整体文化、工作环境,以及管理层为确保员工安全所提供的支援感到满意。受访者证明了积极的安全氛围,尽管有些人认为认可和奖励安全表现将是有益的。员工对ImproChem的安全标准和合规水平的认识也令人满意。可以将更多的重点放在增加对个人危害的认识和消除上,以确保“永远不伤害任何人”。
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引用次数: 0
Preventive Cancer Screening: A Strategy to Reduce U.S. Healthcare Costs 预防性癌症筛查:降低美国医疗保健费用的策略
Pub Date : 2023-10-09 DOI: 10.33140/mcr.05.09.08
The Agency for Healthcare Research and Quality (AHRQ) estimated that the direct medical costs for cancer in the United States (U.S.) in 2014 was $87.3 billion, and it is projected that the cost to the U.S. taxpayer will rise to $173 billion in 2020 [1, 2]. In addition to the financial cost, cancer is the second leading cause of death in the U.S. [3]. Increasing access to and uptake of preventive cancer screenings could significantly reduce the burden of death and the cost of treating cancer in the U.S. We conduct a literature review to summarize knowledge about preventive cancer screenings in the U.S. including the burden of disease that currently exists in the population, the benefits of receiving preventive cancer screenings, the factors that act as barriers or predictors to receiving preventive care, cost effectiveness of selected preventive services, and the exploration of ways to increase the uptake of preventive services. Increasing preventive cancer screenings in the U.S. is an effective strategy to reduce health care costs.
美国医疗保健研究与质量机构(AHRQ)估计,2014年美国癌症的直接医疗成本为873亿美元,预计到2020年美国纳税人的成本将上升至1730亿美元[1,2]。除经济成本外,癌症是美国第二大死亡原因[3]。我们进行了一项文献综述,以总结美国关于预防性癌症筛查的知识,包括目前存在于人群中的疾病负担、接受预防性癌症筛查的好处、作为接受预防性护理的障碍或预测因素。选定的预防服务的成本效益,以及探索提高预防服务使用率的方法。在美国,增加预防性癌症筛查是降低医疗成本的有效策略。
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引用次数: 0
Exploring of Breast Cancer Characteristic Features and Their Influences on Survival Rates 探讨乳腺癌的特点及其对生存率的影响
Pub Date : 2023-10-07 DOI: 10.33140/mcr.08.10.05
Breast cancer stands as the most predominant form of neoplasm and it remains the main cause of cancer-related deaths among females. Over the last four decades; a significant reduction in breast cancer mortality has been achieved due the substantial progress in the management of the disease.This retrospective study aims to evaluate the clinical and pathological features along with breast cancer molecular sub-types in city of Kirkuk-Iraq. In this study data were collected from 280 breast cancer patient who were under the care of Kirkuk oncology center from April 2020 and for nine months, patient's average age was 50.05 years and the most of the patient diagnosed with luminal A breast cancer (57%) of the cases, with the majority (56.9%) falling within the 41 to 50-year-old age range, results shows a significant correlation between menopausal status and the survival rate (p=0.002). A significant correlation (p=0.002) between tumor stage (AIII) and postmenopausal statutes has been noticed. On the same time a higher survival rate (≥5 years) has been recorded among those who diagnosed with tumor stage AIII, whereas in 85% of the cases who diagnosed with tumor stage IV showed survival rate for less than five years. Results from this study highlights the importance of considering the stage and molecular subtypes along with patient's age in the management of the disease and addressing the outcome associated with luminal A (Her2 negative) breast cancer via developing more reliable diagnoses tools and therapeutic targets among different molecular subtypes and finally enhancing women's awareness of the importance of early detection as a principle objective.
乳腺癌是最主要的肿瘤形式,它仍然是女性癌症相关死亡的主要原因。在过去的四十年中;由于在疾病管理方面取得了重大进展,乳腺癌死亡率显著降低。本回顾性研究旨在评估伊拉克基尔库克市乳腺癌的临床和病理特征及分子分型。本研究收集了基尔库克肿瘤中心自2020年4月起9个月的280例乳腺癌患者的数据,患者平均年龄为50.05岁,诊断为腔A型乳腺癌的患者最多(57%),其中大部分(56.9%)年龄在41 - 50岁之间,结果显示绝经状态与生存率有显著相关性(p=0.002)。肿瘤分期(AIII)与绝经后法规之间存在显著相关性(p=0.002)。同时,在诊断为肿瘤ii期的患者中记录了更高的生存率(≥5年),而在诊断为肿瘤IV期的患者中,85%的患者的生存率低于5年。本研究的结果强调了在疾病管理中考虑分期和分子亚型以及患者年龄的重要性,并通过开发更可靠的诊断工具和不同分子亚型的治疗靶点来解决与腔内A (Her2阴性)乳腺癌相关的结果,最终提高女性对早期发现的重要性的认识。
{"title":"Exploring of Breast Cancer Characteristic Features and Their Influences on Survival Rates","authors":"","doi":"10.33140/mcr.08.10.05","DOIUrl":"https://doi.org/10.33140/mcr.08.10.05","url":null,"abstract":"Breast cancer stands as the most predominant form of neoplasm and it remains the main cause of cancer-related deaths among females. Over the last four decades; a significant reduction in breast cancer mortality has been achieved due the substantial progress in the management of the disease.This retrospective study aims to evaluate the clinical and pathological features along with breast cancer molecular sub-types in city of Kirkuk-Iraq. In this study data were collected from 280 breast cancer patient who were under the care of Kirkuk oncology center from April 2020 and for nine months, patient's average age was 50.05 years and the most of the patient diagnosed with luminal A breast cancer (57%) of the cases, with the majority (56.9%) falling within the 41 to 50-year-old age range, results shows a significant correlation between menopausal status and the survival rate (p=0.002). A significant correlation (p=0.002) between tumor stage (AIII) and postmenopausal statutes has been noticed. On the same time a higher survival rate (≥5 years) has been recorded among those who diagnosed with tumor stage AIII, whereas in 85% of the cases who diagnosed with tumor stage IV showed survival rate for less than five years. Results from this study highlights the importance of considering the stage and molecular subtypes along with patient's age in the management of the disease and addressing the outcome associated with luminal A (Her2 negative) breast cancer via developing more reliable diagnoses tools and therapeutic targets among different molecular subtypes and finally enhancing women's awareness of the importance of early detection as a principle objective.","PeriodicalId":9304,"journal":{"name":"British Medical Journal (Clinical research ed.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135302588","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
A Rare Case of Seizures Secondary to Proton Pump Inhibitors-Induced Hypomagnesemia 质子泵抑制剂致低镁血症继发癫痫1例
Pub Date : 2023-10-07 DOI: 10.33140/mcr.08.10.09
Hypomagnesemia is a side effect in patients in treatment with proton pump inhibitors (PPI) for more than one year. It can cause arrhythmias, tetany, seizure, and it can be a life-threatening condition. We describe the case of a 78-year-old man with history of relapsing tonic clonic seizures (TCZ), remote stroke, who presented to emergency department for another episode of TCZ. At blood tests, he had severe hypomagnesemia (0.39 mmol/L). After excluding other causes for hypomagnesaemia, chronic use of PPIs was considered a plausible cause. Therefore, substitutive therapy was initiated to restore blood levels of magnesium, and PPIs were discontinued.
低镁血症是质子泵抑制剂(PPI)治疗超过一年的患者的副作用。它会导致心律失常、手足搐搦、癫痫发作,并可能危及生命。我们描述了一个78岁的男性复发强直性阵挛发作(TCZ)的历史,远端中风,谁提出了另一集的TCZ急诊科。血检显示严重低镁血症(0.39 mmol/L)。在排除低镁血症的其他原因后,慢性使用PPIs被认为是一个合理的原因。因此,替代疗法开始恢复血镁水平,PPIs停止使用。
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引用次数: 0
Evaluation the Flexural Strength of Emax Cad and E_Max Press After Thermocycling Ageing Emax Cad和E_Max压力机热循环老化后的抗弯强度评价
Pub Date : 2023-10-07 DOI: 10.33140/mcr.08.10.03
Aim: To investigate the impact of thermocycling ageing on the flexural strength of E-max cad and E-max press The objective of this research is to evaluate the impact of aging via various thermocycling protocols on the flexural strength of a feldspathic ceramic. Material and Methods: Thirty six bars of ceramic, ivoclar e max, with dimensions of 16×4×2 mm were utilized. Bars were distributed randomly into three groups (n=6) that were defined in accordance with the number of thermal cycles (TCy): G0-no TCy; G5000-5000 cycles of TCy, G10000-10 TCy. After aging, samples were subjected to a three-point bending test in a universal test machine with a speed of 1mm/min and a load of 1kgf until the catastrophic failure was reached. Results: Concerning the mechanical test, the following values of mean and standard deviation values (MPa), were obtained: G0cad (612.12± 83.16) ; G5000cad (445.44 ± 34.99); G10000cad (366.34± 41.30) and G0press (534.09±42.83) ;G5000press (428.68±17.40) and G10000press (382±38.49).Variance analysis of was conducted using the regression equation (p=0.387) and it showed that there was a significant correlation between the flexural strength and the thermal cycles number. Conclusion: One can conclude that aging in water per se through various temperature cycles numbers has an effect on the flexural strength of a feldspathic ceramic. The thermocycling of both type of lithium disilicate has negative effect on the flexural strength, Cad ceramic showed more significant decrease in flexural strength than press ceramic which was less negatively affected.
目的:研究热循环老化对E-max cad和E-max压力机抗弯强度的影响。本研究的目的是评估不同热循环老化对长石陶瓷抗弯强度的影响。材料与方法:采用尺寸为16×4×2 mm的全陶瓷棒36根。根据热循环次数(TCy)将棒随机分为三组(n=6): G0-no TCy;G5000-5000次TCy, G10000-10次TCy。老化后的试样在万能试验机上以1mm/min的速度和1kgf的载荷进行三点弯曲试验,直至达到灾难性破坏。结果:力学试验得到的均值和标准差(MPa)值为:G0cad(612.12±83.16);G5000cad(445.44±34.99);G10000cad(366.34±41.30)和G0press(534.09±42.83);G5000press(428.68±17.40)和G10000press(382±38.49)。采用回归方程进行方差分析(p=0.387),发现抗弯强度与热循环次数之间存在显著相关。结论:可以得出结论,通过不同的温度循环次数,水本身的老化对长石陶瓷的抗弯强度有影响。两种类型的二硅酸锂的热循环都对其抗弯强度有负面影响,Cad陶瓷的抗弯强度下降比压力式陶瓷明显,而压力式陶瓷的抗弯强度受负面影响较小。
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引用次数: 0
Serological Prevalence of Latent Epstein-Barr Virus Infection in Children and Adolescents 儿童和青少年潜伏性eb病毒感染的血清学患病率
Pub Date : 2023-10-07 DOI: 10.33140/mcr.08.10.01
Background: Epstein-Barr Virus (EBV), first discovered in 1946, is one of the most common viruses, which found over the world causing latent infection or different undistinguishable symptoms ranged from mild to severe. This prevalence and age distribution of this latent infection varies significantly in different populations. Aim: Serological detection of anti-EBV IgG antibodies in children and adolescents using of the sandwich enzyme-linked immunosorbent assay (ELISA), and estimating the association of seropositivity to sex of study population. Materials and Methods: A total of 182 serum samples were obtained randomly from the study population that involved children (5-12 years old) and adolescents (13-17 years old) of both sexes in Sulaymaniyah province (Iraq) during January-February (2023). Results: Sera of an overall 29.12% study individuals were showed a serological positive reactivity to EBV-IgG antibodies. Significantly (P<0.0289), latent EBV was higher in adolescents (42.86%) than those observed in children (15.39%). Concerning the association of seropositivity to sex of study population, there was a significant increase (P<0.0224) in prevalence of anti-EBV-IgG antibodies among females (42.47%) than males (20.18%). Also, females were appeared significantly (P<0.0001) at higher risk of infection (2.104) than males (0.475). Conclusion: The seroprevalence of latent EBV infection in female adolescent was higher than male children; however, additional investigations using of serological as well as molecular assays are of great importance to demonstrate the extent of infection and to define the full spectrum of EBV-associated diseases.
背景:eb病毒(Epstein-Barr Virus, EBV)于1946年首次被发现,是世界上最常见的病毒之一,可引起潜伏感染或各种难以区分的症状,从轻微到严重不等。这种潜伏性感染的流行率和年龄分布在不同的人群中差别很大。目的:利用夹心酶联免疫吸附试验(ELISA)检测儿童和青少年抗ebv IgG抗体,并估计研究人群血清阳性与性别的关系。材料与方法:于2023年1 - 2月在伊拉克苏莱曼尼亚省随机抽取儿童(5-12岁)和青少年(13-17岁)共182份血清样本。结果:29.12%的研究个体血清显示EBV-IgG抗体的血清学阳性反应。青少年潜伏性EBV阳性率(42.86%)显著高于儿童(15.39%)(P<0.0289)。在研究人群血清阳性与性别的关系方面,女性(42.47%)的ebv - igg抗体阳性率显著高于男性(20.18%)(P<0.0224)。女性感染风险(2.104)明显高于男性(0.475)(P<0.0001)。结论:青少年女性潜伏性EBV感染血清阳性率高于男性;然而,使用血清学和分子分析的额外调查对于证明感染程度和确定ebv相关疾病的全谱非常重要。
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引用次数: 0
Cardiotocography, Hypoxia, and Feto-Neonatal Neurological Damage 心脏造影,缺氧和胎儿-新生儿神经损伤
Pub Date : 2023-10-07 DOI: 10.33140/mcr.08.10.06
Complications occurring at any level of fetal oxygen supply can result in hypoxemia, which may ultimately lead to hypoxia/acidosis and neurological damage. Hypoxic-ischemic encephalopathy (HIE) is the short-term neurological dysfunction caused by intrapartum hypoxia/acidosis. This diagnosis requires the presence of several findings, including confirmation of newborn metabolic acidosis, low Apgar scores, early imaging evidence of cerebral edema, and the appearance of clinical signs of neurological dysfunction in the first 48 hours of life. Cerebral palsy (CP) comprises a heterogeneous group of nonprogressive movement and posture disorders, often accompanied by cognitive and sensory impairments, epilepsy, nutritional deficiencies, and secondary musculoskeletal lesions. Although CP is the most common long-term neurological complication associated with intrapartum hypoxia/acidosis, over 80% of cases are caused by other factors. Data on minor long-term neurological deficits are limited, but they suggest that less severe intellectual and motor impairments may result from intrapartum hypoxia/acidosis. Birth asphyxia is a broad term referring to intrapartum asphyxia severe enough to cause neurological damage in some newborns and, rarely, intrapartum or neonatal death. Cerebral palsy and long-term neurological complications such as learning difficulties and motor impairments may have causes other than birth asphyxia. Several intrapartum events can lead to asphyxia (i.e., hypoxia and metabolic acidosis), increasing the likelihood of neurological injury. The cardiotocograph (CTG) is a screening tool used to assess fetal well-being during labor and to identify the possibility of asphyxia. An abnormal CTG, sometimes severe enough to be described as a pathological trace, is commonly referred to as “fetal distress”, although many fetuses with such traces may not have hypoxia and metabolic acidosis. In current practice, these events are appropriately termed “pathological CTG trace” or “acidotic pH” rather than “fetal distress”. Accurate interpretation of the CTG is essential, and it is important to recognize a fetus displaying a pathological CTG in labor, which may imply possible hypoxia and birth asphyxia. Considering the broader clinical context when interpreting the CTG and taking timely and appropriate action based on the findings may help prevent birth asphyxia.
并发症发生在任何水平的胎儿供氧可导致低氧血症,最终可能导致缺氧/酸中毒和神经损伤。缺氧缺血性脑病(HIE)是由产时缺氧/酸中毒引起的短期神经功能障碍。这一诊断需要有几个发现,包括确认新生儿代谢性酸中毒、低Apgar评分、脑水肿的早期影像学证据,以及在出生后48小时内出现神经功能障碍的临床体征。脑瘫(CP)包括异质性的非进行性运动和姿势障碍,通常伴有认知和感觉障碍、癫痫、营养缺乏和继发性肌肉骨骼病变。虽然CP是与产时缺氧/酸中毒相关的最常见的长期神经系统并发症,但超过80%的病例是由其他因素引起的。关于轻微的长期神经功能障碍的数据有限,但它们表明,分娩时缺氧/酸中毒可能导致不太严重的智力和运动障碍。出生窒息是一个广义的术语,指分娩时窒息严重到足以引起一些新生儿神经损伤,但很少发生分娩时窒息或新生儿死亡。脑瘫和长期神经系统并发症,如学习困难和运动障碍,可能有出生窒息以外的原因。几个产时事件可导致窒息(即缺氧和代谢性酸中毒),增加神经损伤的可能性。心脏造影(CTG)是一种筛查工具,用于评估胎儿在分娩期间的健康状况,并确定窒息的可能性。异常的CTG,有时严重到足以被描述为病理痕迹,通常被称为“胎儿窘迫”,尽管许多有这种痕迹的胎儿可能没有缺氧和代谢性酸中毒。在目前的实践中,这些事件被恰当地称为“病理性CTG痕迹”或“酸中毒pH值”,而不是“胎儿窘迫”。准确地解释CTG是必要的,并且重要的是识别胎儿在分娩中显示病理性CTG,这可能意味着可能的缺氧和出生窒息。在解释CTG时考虑更广泛的临床背景,并根据发现采取及时和适当的措施可能有助于预防出生窒息。
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引用次数: 0
期刊
British Medical Journal (Clinical research ed.)
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