mucosa

粘膜
  • 文章类型: Journal Article
    原发性非皮肤黑色素瘤是一种罕见的黑色素瘤,主要发生在粘膜表面。头颈部区域是这些黑色素瘤最常见的部位。本文所述的以下病例包括被诊断患有原发性非皮肤黑素瘤的患者。位置包括腮腺(一例),颌下腺(一例),鼻腔和鼻旁窦(3例)。在这些患者中,1例发生淋巴结转移,1例发生远处转移.治疗包括内镜手术(1例),内镜辅助放疗1例,开放手术(一例),姑息性化疗(1例)。一名患者拒绝接受治疗。治疗后,1例患者局部复发.在一例中发现了局部和远处复发。本报告旨在描述临床特征,治疗方案,头颈部原发性非皮肤黑素瘤的预后。
    Primary non-cutaneous melanoma is a rare type of melanoma that occurs mostly on mucosal surfaces. The head and neck region is the most common site for these melanomas. The following cases described herein include patients diagnosed with primary non-cutaneous melanomas. The locations included the parotid gland (one case), the submandibular gland (one case), and the nasal cavity and paranasal sinuses (three cases). Among these patients, one patient developed lymph node metastasis and one patient had distant metastasis. Treatment included endoscopic surgery (one case), endoscopic surgery with adjuvant radiotherapy (one case), open surgery (one case), and palliative chemotherapy (one case). One patient refused to receive treatment. After treatment, one patient had local recurrence. A local and distant recurrence was noted in one case. This report aims to describe clinical features, treatment options, and prognosis of primary non-cutaneous melanomas of the head and neck.
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  • 文章类型: Journal Article
    慢性肾脏病被归类为文明疾病,并在愈来愈多的患者中被诊断。血液透析患者常同时存在高血压和糖尿病。本研究的目的是确定有关多次血液透析的成年患者的口腔状况的出版物,这些患者还被诊断为高血压和/或糖尿病,2012年至2022年发表的文章,旨在建立高血压和糖尿病对血液透析患者口腔状况影响的证据。搜索了Scopus和WebofScience数据库。审查中包括八篇文章。总的来说,3篇文章讨论了血液透析患者的口腔卫生,4讨论牙周状况,3.商量了粘膜状况和唾液参数,3讨论了念珠菌感染的问题。结论如下:讨论血液透析患者的口腔状况的出版物仍然有限;参与的文章已经证明,共存疾病可以影响血液透析患者的口腔状况并导致牙周病。较低的卫生状况,唾液参数和使念珠菌感染的风险更高。
    Chronic kidney disease is classified as a civilization disease and is being diagnosed in an increasing number of patients. Hypertension and diabetes mellitus often coexist in hemodialyzed patients. The aim of the present study was to identify publications on the oral cavity status of multimorbid hemodialyzed adult patients additionally diagnosed with hypertension and/or diabetes mellitus, published between 2012 and 2022 to establish evidence of the impact of hypertension and diabetes mellitus on the oral status of hemodialyzed patients. Scopus and Web of Science databases were searched. Eight articles were included in the review. In total, 3 articles discussed oral hygiene in hemodialyzed patients, 4 discussed periodontal status, 3 discussed mucosa condition and saliva parameters, and 3 discussed the problem of Candidiasis infections. The conclusions were as follows: there is still a limited number of publications discussing the oral status of hemodialyzed patients diagnosed with hypertension; involved articles have proven that coexisting diseases can influence the oral cavity status of hemodialyzed patients and cause periodontal disorders, lower hygiene status, saliva parameters and make the risk of Candida infections higher.
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  • 文章类型: Journal Article
    未经证实:Janus激酶抑制剂(JAKi)是通过抑制细胞膜上的各种细胞因子受体来抑制Janus激酶-信号转导和转录激活因子(JAK-STAT)途径的抗炎药物。JAK和STAT蛋白的突变和多态性可导致免疫系统平衡失调,并最终导致自身免疫性疾病。
    UNASSIGNED:记录和总结JAKi在各种自身免疫性疾病如斑秃(AA)中的总体疗效和安全性,寻常型银屑病(PV),银屑病关节炎(PsA),特应性皮炎(AD),白癜风,化脓性汗腺炎(HS),扁平苔藓(LP),和坏疽性脓皮病(PG)。
    未经评估:对PubMed和GoogleScholar关于荟萃分析的文章进行了全面审查,系统评价,临床试验和案例研究评估自身免疫性疾病的治疗,如AA,PV,PsA,AD,白癜风,LP,HS,和PG与JAKI。重复数据和动物实验或体外/离体研究被排除。
    UNASSIGNED:所有综述的文章都报道了托法替尼和鲁索替尼在治疗上述具有自身免疫易感性的疾病中的有益作用。
    UNASSIGNED:托法替尼和鲁索替尼在治疗几种自身免疫性疾病方面显示出潜在的疗效。根据审查的研究记录,两种药物均具有可接受的安全性;然而,建议医生在每种特定情况下使用此类治疗的风险和收益。
    UNASSIGNED: Janus kinase inhibitors (JAKi) are anti-inflammatory medications suppressing Janus kinase-signal transducer and activator of transcription (JAK-STAT) pathway by inhibiting various cytokines receptors on the membrane of cells. Mutations and polymorphisms on JAK and STAT proteins can cause dysregulation in the balance of immune system, and ultimately result in autoimmune disorders.
    UNASSIGNED: To record and summarize the overall efficacy and safety of JAKi in various autoimmune conditions such as alopecia areata (AA), psoriasis vulgaris (PV), psoriatic arthritis (PsA), atopic dermatitis (AD), vitiligo, hidradenitis suppurative (HS), lichen planus (LP), and pyoderma gangrenosum (PG).
    UNASSIGNED: A thorough review of articles was performed across PubMed and Google Scholar on meta-analyses, systematic reviews, clinical trials and case studies evaluating the treatment of autoimmune disorders such as AA, PV, PsA, AD, vitiligo, LP, HS, and PG with JAKi. Duplicated data and animal experiments or in vitro/ex vivo studies were excluded.
    UNASSIGNED: All the reviewed articles reported beneficial effects of tofacitinib and ruxolitinib application in the treatment of disorders mentioned above with the autoimmune predisposition.
    UNASSIGNED: Tofacitinib and ruxolitinib showed potential efficacy in treating several autoimmune disorders. Based on records in the reviewed studies, both medications had acceptable safety profiles; however, physicians are recommended to outweigh the risks and benefits of such treatments for each specific condition.
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  • 文章类型: Meta-Analysis
    目的:报告已发表的植入物支持的单冠(SC)与牙齿支持的SC相比的患者报告的美学结果指标(PROMs)的摘要。
    方法:Cochrane,Medline(PubMed),和EMBASE数据库搜索由3名审阅者对患者报告的牙齿和植入物支持的SC的美学结果的报告进行.具有至少12个月的平均随访期和至少10名患者的临床研究,和英语,法语,或包括德国报告。要比较子组,对于聚合级别的数据,使用随机效应元回归。
    结果:确定了两千15个标题(初始搜索),并独立筛选了53篇全文文章,以包括在数据提取中。包括22项研究和29个研究队列。患者对种植体和牙冠的美学满意1051名患者评估的1270个种植体支持的SCs的PROM数据的平均视觉模拟评分(VAS)值为89.6%(80.0%-94.1%)。患者的平均VAS值(n=201),谁评估了486个牙齿支持的SCs的美学结局,占94.4%(92.3%-96.0%)。患者对美学感知的VAS评分在不同牙冠材料或所用植入物类型之间没有任何差异。当牙冠由牙齿支撑时,患者对专注于SC的美学的感知有更高的趋势,然而,与植入物支持的牙冠相比,无统计学差异(p=0.067).
    结论:患者对干细胞美学的感知不受支持类型的影响,表冠材料,植入物,以及种植体和牙齿支撑的SC都存在临时牙冠。
    结论:尽管患者的期望正在增加,但患者对种植体和牙齿支撑牙冠的美学结果感到满意。
    To report a summary of published patient-reported esthetic outcome measures (PROMs) of implant-supported single crowns (SCs) compared with those of tooth-supported SCs.
    Cochrane, Medline (PubMed), and EMBASE database search was performed by three reviewers on reports with patient-reported esthetic outcomes of tooth- and implant-supported SCs. Clinical studies with at least 12 months of mean follow-up period and a minimum of 10 patients, and English, French, or German reports were included. To compare the subgroups, for aggregate-level data, random-effects meta-regression was used.
    Two thousand fifteen titles were identified (initial search) and screened independently concluding 53 full-text articles to include in data extraction. Twenty-two studies with 29 study cohorts were included. Patients were satisfied with the esthetics of implant- and tooth- supported crowns Mean visual analogue scale (VAS) value from the PROMs data of 1270 implant-supported SCs evaluated by 1051 patients was 89.6% (80.0%-94.1%). The mean VAS value of patients (n = 201), who evaluated the esthetic outcome of 486 tooth-supported SCs was 94.4% (92.3%-96.0%). VAS scores of patients regarding their perception of esthetics did not show any difference among different crown materials or type of implant used. The patients\' perception of esthetics focusing on SC had a tendency to be higher when the crowns were supported by teeth, however, no statistical difference was found when compared with implant-supported crowns (p = 0.067).
    Patient perception of esthetics in SCs was not affected by the type of support, crown material, implant, and presence of provisional crown for both implant- and tooth-supported SCs.
    Despite that patient\'s expectations are increasing overall Patients are satisfied with with esthetic outcome of implant- and tooth-supported crowns.
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  • 文章类型: Journal Article
    用谷胱甘肽治疗深色皮肤由于其脱色素特性和低毒性而变得流行。谷胱甘肽已被局部使用,口服和肠胃外管理深色皮肤。尽管一些临床试验持续时间较短,样本量较小,但尚无明确的皮肤色素沉着管理指南。我们检查了已发表的科学和患者数据,为临床医生通过口腔途径使用谷胱甘肽管理色素沉着过度提供指导。当通过口服途径施用时,检查谷胱甘肽生物利用度的各个方面。谷胱甘肽从胃肠道的吸收较差。一些试验倾向于给予高口服剂量以达到治疗效果。对于通过口服途径用谷胱甘肽治疗色素沉着过度仍有普遍共识。检查了支持从口腔粘膜吸收大量谷胱甘肽的临床和实验证据。后者优于口服途径,因为与口服摄入相比,谷胱甘肽直接进入体循环导致高得多的吸收率。因此获得的高血液水平具有治疗价值。综述了使用羟丙基纤维素(HPC)膜通过口腔途径治疗谷胱甘肽色素沉着过度的方法,以从已发表的数据中制定临床指导。未来的随机化,双盲,安慰剂对照试验应研究使用口服可分散HPC膜用谷胱甘肽治疗色素沉着过度,长期随访和更大的样本量。本文有望为临床医生使用谷胱甘肽进行色素沉着过度管理提供广泛的指导。直到更大的结果,持续时间更长的试验变得可用。
    Treatment of dark skin with glutathione has become popular due to its depigmenting properties and low toxicity. Glutathione has been used topically, orally and parenterally in the management of dark skin. There are no clear published guidelines for management of skin pigmentation despite some clinical trials of shorter duration and small sample sizes. We examined published scientific and patient data to generate guidance for the clinician for managing hyperpigmentation using glutathione by orobuccal route. Various aspects of glutathione bioavailability were examined when administered by oral routes. Absorption of glutathione from the gastrointestinal tract is poor. Some trials have favored administering high oral doses to achieve therapeutic effect. General consensus remains against treatment of hyperpigmentation with glutathione by the oral route. Clinical and experimental evidence supporting significant glutathione absorption from orobuccal mucosa was examined. The latter is superior to the oral route since glutathione passes directly into systemic circulation resulting in a much higher rate of absorption compared to that achieved by oral intake. High blood levels thus achieved have therapeutic value. Treatment of hyperpigmentation with glutathione by the orobuccal route using hydroxypropyl cellulose (HPC) film was reviewed to formulate clinical guidance from published data. A future randomized, double-blind, placebo-controlled trial should study treatment of hyperpigmentation with glutathione using oral dispersible HPC film, with longer-term follow-up and larger sample size. This paper will hopefully offer broad guidance for the clinician on use of glutathione for hyperpigmentation management, until outcomes of larger, longer duration trials become available.
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  • 文章类型: Journal Article
    背景:随着欧洲法规的变化,Co-Cr牙科合金的毒理学风险实际上是一个敏感的主题,即法规(EU)2017/745和CLP法规(EC)1972/2008的附件六。目标:这篇综述的目的是对钴铬(Co-Cr)牙科合金的细胞相容性进行严格的分析。考虑到各种参数,如细胞毒性,IV型超敏反应,致敏,和刺激,我们调查了Co-Cr在人类牙科应用中的毒性证据。数据来源:在三个电子数据库中执行了特定的搜索策略,即Medline,Embase,和WebofScience,在搜索中使用关于出版日期(1995-2022年)的主要限制。研究选择:在总共836篇文章中,仅选择21项研究,并根据PRISMA方法学进行分析.结果:其中,区分了10个使用人样品的体外研究和11个对人患者的体内研究。大多数体外研究证实,与Ni合金相比,Co-Cr合金具有良好的细胞相容性。关于体内研究,似乎Co-Cr很少会引起敏化,刺激,和过敏反应。反应主要发生在对Co或Cr过敏的人群中。然而,钛基材料表现出更好的结果。结论:这项研究提出了Co-Cr牙科合金的新技术,因此对于进行其他研究非常有用。相关性:这篇综述将帮助从业者进行日常临床选择。
    Background: The toxicological risk of Co-Cr dental alloys is actually a sensitive subject with the European regulatory changes, namely regulation (EU) 2017/745 and annex VI to the CLP regulation (EC) 1972/2008. Objectives: The objective of this review is to conduct a rigorous analysis of the cytocompatibility of cobalt-chromium (Co-Cr) dental alloys. Considering various parameters such as cytotoxicity, type IV hypersensitivity reaction, sensitization, and irritation, we investigated evidence of toxicity of Co-Cr in human dental applications. Data sources: Specific search strategies were performed in three electronic databases, namely Medline, Embase, and Web of Science, using a main restriction in the search regarding the publication date (1995-2022). Study selection: Out of a total of 836 articles, only 21 studies were selected and analyzed according to PRISMA methodology. Results: Among them, 10 in vitro studies using human samples and 11 in vivo studies on human patients were distinguished. Most of the in vitro studies confirmed that Co-Cr alloys have a good cytocompatibility compared to Ni alloys. Regarding the in vivo studies, it appeared that Co-Cr could rarely cause sensitization, irritation, and allergic reactions. Reactions were mainly observed for people allergic to Co or Cr. Nevertheless, titanium-based materials showed better results. Conclusions: This study proposes a new state of the art on Co-Cr dental alloys and will thus be very useful for carrying out additional studies. Relevance: This review will help practitioners in their daily clinical choice.
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  • 文章类型: Journal Article
    Covid-19感染中皮肤粘膜表现的患病率和严重程度通常高于Covid疫苗中的报道。因此,有必要比较Covid-19感染和疫苗接种的皮肤粘膜反应,以增强我们对此类反应的了解,并指导我们评估感染或疫苗接种的风险。在PubMed上进行了彻底的文献检索,谷歌学者,和EBSCO(LISTA),下载了2069篇文章。筛选后,11项研究仍有待最终审查。文献综述显示,与新冠肺炎感染相比,疫苗接种后粘膜皮肤不良反应的患病率和严重程度并不常见。疫苗后不良反应主要发生在第一剂量给药后,此类反应可通过抗组胺药和皮质类固醇治疗。这项比较分析突出了由于新冠肺炎感染和新冠肺炎疫苗接种引起的皮肤粘膜反应的频率和潜在严重程度。它还证实,与Covid疫苗接种相比,Covid-19感染中更可能发生潜在的关键(严重)皮肤粘膜反应。此外,疫苗后反应主要发生在第一剂之后,据报道没有危及生命,自我管理,潜在危重事件发生率较低。还得出结论,在以下剂量下,皮肤粘膜反应的发生率降低。因此,鉴于Covid-19疫苗接种后此类反应的发生率较低,与Covid-19感染相比,疫苗发生皮肤粘膜反应的风险更低。Further,由于研究数量有限,我们建议大规模试验评估此类反应,比较健康个体和自身免疫性皮肤病患者的不同类型的Covid-19疫苗。
    The prevalence and severity of mucocutaneous manifestations in Covid-19 infection are generally higher than those reported in Covid vaccines. Therefore, comparing the mucocutaneous reactions of the Covid-19 infection and vaccination is necessary to enhance our knowledge about such reactions and guide us to evaluate the risk of infection or vaccination. A thorough literature search was conducted on PubMed, Google Scholar, and EBSCO (LISTA), and 2069 articles were downloaded. After screening, 11 studies remained for the final review. The literature review revealed that the prevalence and severity of postvaccine mucocutaneous adverse reactions have been less common compared to Covid-19 infection. Postvaccine adverse reactions primarily occurred after the first dose administration and such reactions were manageable with antihistamines and corticosteroids administration. This comparative analysis highlights the frequency and potential severity of mucocutaneous reactions due to Covid-19 infection and Covid-19 vaccination. It also affirmed that potentially critical (serious) mucocutaneous reactions are more likely to occur in Covid-19 infection compared to Covid vaccination. Moreover, postvaccine reactions predominantly happened after the first dose and were reported to be non-life-threatening, self-manageable and with a lower incidence of potentially critical events. It was also concluded that the incidence of mucocutaneous reactions decreased in the following doses. Hence, given the low rate of such reactions following Covid-19 vaccination, vaccines have a lower risk of mucocutaneous reactions occurrence than Covid-19 infection. Further, due to the limited number of studies, we recommend that large-scale trials evaluate such reactions comparing various types of Covid-19 vaccines in healthy individuals and those with autoimmune skin disorders.
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  • 文章类型: Case Reports
    硬化性微囊腺癌是一种罕见且最近表征的癌症,其影响头颈部的粘膜表面而无附件累及。组织学上,皮肤的微囊性附件癌与之相似。确实如此,然而,包含独特的特征,值得我们注意潜在的诊断错误。因此,我们介绍了一名48岁男性患有硬化性舌微囊腺癌,以及对相关文献的全面讨论和简要回顾。
    Sclerosing microcystic adenocarcinoma is a rare and recently characterized cancer that affects the mucosal surfaces of the head and neck without adnexal involvement. Histologically, microcystic adnexal carcinoma of the skin resembles it. It does, however, contain unique characteristics that merit our attention for potential diagnostic errors. Therefore, we present a 48-year-old male with sclerosing microcystic adenocarcinoma of the tongue, along with a full discussion and a brief review of pertinent literature.
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  • 文章类型: Journal Article
    Stevens-Johnson综合征(SJS)和中毒性表皮坏死松解症(TEN)是罕见且严重的皮肤和粘膜反应,与高死亡率相关。尽管严重,SJS/TEN的循证治疗方案仍然缺乏.
    在本系统综述和荟萃分析中,使用以下术语搜索PubMed数据库:20年(1999-2019年)的[Stevens-Johnson综合征]OR[中毒性表皮坏死溶解症]和[治疗]OR[治疗]德语和英语.包括所有报告SJS/TEN治疗的临床研究,分析了治疗的流行病学和诊断方面。对所有符合纳入标准的比较临床研究进行荟萃分析。
    共有88项研究符合纳入标准,报告2647例患者的结果。治疗是支持性或使用全身性皮质类固醇,静脉注射免疫球蛋白,血浆置换,环孢菌素,沙利度胺或环磷酰胺治疗。荟萃分析包括16项(18%)研究,报告976例(37%)患者的结局。与其他形式的治疗相比,在所有分析中,系统性糖皮质激素对SJS/TEN患者均显示出生存益处。环孢菌素治疗也显示出有希望的结果,尽管在一小部分患者中使用。静脉注射免疫球蛋白对死亡率没有有益作用。
    糖皮质激素和环孢素可能被初步推荐为SJS/TEN最有前途的免疫调节疗法,但这些结果应在未来的前瞻性对照试验中进行研究.
    UNASSIGNED: Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare and severe skin and mucosal reactions that are associated with high mortality. Despite the severity, an evidence-based treatment protocol for SJS/TEN is still lacking.
    UNASSIGNED: In this systematic review and meta-analysis, the PubMed database was searched using the following terms: [Stevens-Johnson syndrome] OR [toxic epidermal necrolysis] AND [therapy] OR [treatment] over a 20-year period (1999-2019) in the German and English language. All clinical studies reporting on the treatment of SJS/TEN were included, and epidemiological and diagnostic aspects of treatment were analysed. A meta-analysis was conducted on all comparative clinical studies that met the inclusion criteria.
    UNASSIGNED: A total of 88 studies met the inclusion criteria, reporting outcomes in 2647 patients. Treatment was either supportive or used systemic corticosteroid, intravenous immunoglobulin, plasmapheresis, cyclosporine, thalidomide or cyclophosphamide therapy. The meta-analysis included 16 (18%) studies, reporting outcomes in 976 (37%) patients. Systemic glucocorticoids showed a survival benefit for SJS/TEN patients in all analyses compared with other forms of treatment. Cyclosporine treatment also showed promising results, despite being used in a small cohort of patients. No beneficial effects on mortality could be demonstrated for intravenous immunoglobulins.
    UNASSIGNED: Glucocorticoids and cyclosporine may be tentatively recommended as the most promising immunomodulatory therapies for SJS/TEN, but these results should be investigated in future prospective controlled trials.
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  • 文章类型: Journal Article
    粘蛋白是一类糖基化蛋白,是粘液的主要成分,在人体保护性粘膜屏障的调节中起着动态作用。溃疡性结肠炎(UC)是一种炎症性肠病(IBD),其特征是大肠内层持续发炎。在本系统综述中,我们分析了目前可用的数据,以确定UC患者结肠粘膜粘蛋白活性是否存在改变.进行了数据库搜索,以确定1990年至2020年之间发表的评估粘蛋白在UC患者队列中的作用的研究。切除活检标本进行分析,纳入对照组进行比较.最初确定了5497篇文章,并系统地选择了这14项研究进行分析,通过引文链接确定了另外2篇文章。因此,对16项研究进行了严格审查。这些研究中的13项评估了MUC2在UC中的作用,大多数文章表明MUC2结构或合成的改变对结肠粘膜有影响。尽管关于MUC2表达的结果相互矛盾。这篇综述强调了进一步研究的重要性,以增强我们对UC粘蛋白调节的理解,并总结了可能为未来研究提供信息的数据。
    Mucins are a family of glycosylated proteins which are the primary constituents of mucus and play a dynamic role in the regulation of the protective mucosal barriers throughout the human body. Ulcerative colitis (UC) is an Inflammatory Bowel Disease (IBD) characterised by continuous inflammation of the inner layer of the large intestine, and in this systematic review we analyse currently available data to determine whether alterations exist in mucin activity in the colonic mucosa of UC patients. Database searches were conducted to identify studies published between 1990 and 2020 that assess the role of mucins in cohorts of UC patients, where biopsy specimens were resected for analysis and control groups were included for comparison. 5497 articles were initially identified and of these 14 studies were systematically selected for analysis, a further 2 articles were identified through citation chaining. Therefore, 16 studies were critically reviewed. 13 of these studies assessed the role of MUC2 in UC and the majority of articles indicated that alterations in MUC2 structure or synthesis had an impact on the colonic mucosa, although conflicting results were presented regarding MUC2 expression. This review highlights the importance of further research to enhance our understanding of mucin regulation in UC and summarises data that may inform future studies.
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