Etiologic

病因学
  • 背景:随着血管介入的发展,假性动脉瘤并发症正在增加。超声引导凝血酶注射(UGTI)是目前治疗假性动脉瘤的首选方法,但是凝血酶的药理特性可能引发血管腔内的急性血栓形成。尽管发病率非常低,这种类型的原发性动脉血栓形成是UGTI的严重并发症,涉及下肢动脉多个分支的病例尤其罕见。
    方法:这里,我们报告了一例65岁的男性,他接受了UGTI,用于治疗股动脉的医源性假性动脉瘤并伴有下肢多动脉的急性血栓形成,患者最终接受了成功的血栓切除术。
    结论:我们回顾了病例并分析了可能的病因,为今后的临床工作提供参考。
    With the development of vascular intervention, pseudoaneurysm complications are increasing. Ultrasound-guided thrombin injection (UGTI) is currently the treatment of choice for pseudoaneurysm, but the pharmacological properties of thrombin may trigger acute thrombosis within the vessel lumen. Despite a very low incidence, this type of primary arterial thrombosis is a serious complication of UGTI, and cases involving multiple branches of the lower limb arteries are particularly rare.
    Here, we report a case of a 65-year-old male who underwent UGTI for the treatment of an iatrogenic pseudoaneurysm of the femoral artery complicated by acute thrombosis of multiple arteries in the lower limbs, and the patient ultimately underwent a successful thrombectomy.
    We reviewed the case and analyzed the possible etiologic causes, providing a reference for future clinical work.
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  • 文章类型: Journal Article
    简介耳鼻咽喉科急诊中最常见的疾病之一,与其他面部骨折相比,与鼻骨骨折(NBFs)有关。发病高峰出现在11至30岁的年龄组。目的本评价致力于NBFs的病因和流行病学研究。方法在本横断面研究中,对376例NBF患者进行了评估。必要的信息,如性别,年龄,教育,工作,NBF的原因,患者的临床症状已记录在清单上。结果76.9%的患者为男性,23.1%为女性;37.5%的患者为个体户,他们中的大多数来自城市地区。交通事故(26.6%)和下降(25.5%)是NBF的主要原因。NBF最常见的临床症状是压痛(96%;n=361)。鼻肿胀(90.4%;n=340),畸形(89.4%;n=336)。结论结果表明,未受过高等教育的青年男性和自雇人士的NBF发生率较高,这可能与交通事故和打架有关。此外,falls,殴打和意外打击是女性NBF的最常见原因。因此,为了降低耳鼻咽喉外伤的发生率,未来应增加有关一般生活技能的培训,并提供有关使用个人安全设备和措施的意识。
    Introduction  One of the most observed diseases in the otorhinolaryngology emergency, compared with the other facial fractures, is related to nasal bone fractures (NBFs). The peak of incidence is seen in the age group ranging from 11 to 30 years old. Objective  The present evaluation was devoted to the etiology and epidemiological study of NBFs. Methods  In the present cross-sectional study, 376 patients with NBF were evaluated. The necessary information such as gender, age, education, job, causes of NBF, and clinical symptoms of patients have been recorded on the checklist. Results  The study revealed that 76.9% of the patients were male and 23.1% were female; 37.5% of all patients were self-employed, and most of them were from urban areas. Traffic accident (26.6%) and falling (25.5%) were the main reasons for NBF. The most common clinical symptoms for NBF were tenderness (96%; n  = 361), nasal swelling (90.4%; n  = 340), and deformity (89.4%; n  = 336). Conclusion  The results showed that the incidence of NBFs in young men without higher education level and self-employed were high which can be related to the traffic accidents and fights. Also, falls, beatings and accidental hit are the most common causes of NBFs among women. Therefore, to decrease the incidence of otorhinolaryngology trauma, training about the general life skill and providing awareness about using personal safety equipment and measures should be increased at the future.
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  • 文章类型: Journal Article
    BACKGROUND: Diffuse gliomas (WHO grade II-IV) are progressive primary brain tumors with great variability in prognosis. Cognitive deficits are of important prognostic value for survival in diffuse gliomas. Until now, few studies focused on domain-specific neuropsychological assessment and rather used MMSE as a measure for cognitive functioning. Additionally, these studies did not take WHO 2016 diagnosis into account. We performed a retrospective cohort study with the aim to investigate the independent relationship between cognitive functioning and survival in treatment-naive patients undergoing awake surgery for a diffuse glioma.
    METHODS: In patients undergoing awake craniotomy between 2010 and 2017, we performed pre-operative neuropsychological assessments in five cognitive domains, with special attention for the domains executive functioning and memory. We evaluated the independent relation between these domains and survival, in a Cox proportional hazards model that included state-of-the-art integrated histomolecular (\'layered\' or WHO-2016) classification of the gliomas and other known prognostic factors.
    RESULTS: We included 197 patients. Cognitive impairments (Z-values ≦ - 2.0) were most frequent in the domains memory (18.3%) and executive functioning (25.9%). Impairments in executive functioning and memory were significantly correlated with survival, even after correcting for the possible confounders. Analyses with the domains language, psychomotor speed, and visuospatial functioning yielded no significant results. Extensive domain-specific neuropsychological assessment was more strongly correlated to survival than MMSE.
    CONCLUSIONS: Cognitive functioning is independently related to survival in diffuse glioma patients. Possible mechanisms underlying this relationship include the notion of cognitive functioning as a marker for diffuse infiltration of the tumor and the option that cognitive functioning and survival are determined by overlapping genetic pathways and biomarkers.
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  • 文章类型: Journal Article
    Pain is a multidimensional experience that can significantly impair an individual\'s quality of life. This article describes the pain classification systems, including anatomic, etiologic, intensity, duration, pathophysiological, and conditions that are not easily classified. A holistic approach is taken by addressing key components to assist with effective pain management, including the psychological and spiritual aspects of care. A case study scenario demonstrates the implementation of pain classifications in pain management. Also discussed are current controversies, potential genetic impacts, and the barriers chronic pain sufferers face, including addiction, diversion, and socioeconomic factors.
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  • 文章类型: Journal Article
    OBJECTIVE: Cleft lip and cleft palate (CLP) are the most common congenital craniofacial anomalies. They have a multifactorial etiology and result from an incomplete fusion of the facial buds. Two main mechanisms, acting alone or interacting with each other, were evidenced in this fusion defect responsible for CLP: defective tissue development and/or defective apoptosis in normal or defective tissues. The objective of this work was to study the implication and role of angiogenesis-related genes in the etiology of CL/P.
    METHODS: Our methodological approach included a systematic and thorough analysis of the genes involved in CL/P (syndromic and non-syndromic forms) including previously identified genes but also genes that could potentially be angiogenesis-related (OMIM, Pub Med).We studied the interactions of these different genes and their relationships with potential environmental factors.
    RESULTS: TGFβ, FGA, PDGFc, PDGFRa, FGF, FGFR1, FGFR2 growth factors as well as MMP and TIMP2 proteolytic enzymes are involved in the genesis of CLP (P>L). Furthermore, 18 genes involved in CLP also interact with angiogenesis-related genes.
    CONCLUSIONS: Even if the main angiogenesis-related genes involved in CLP formation are genes participating in several biological activities and their implication might not be always related to angiogenesis defects, they nevertheless remain an undeniably important research pathway. Furthermore, their interactions with environmental factors make them good candidates in the field of CLP prevention.
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  • 文章类型: Journal Article
    We report the relations between comorbidities and chronic venous disease. In this cross-sectional study, information was gathered from 1679 Serbian patients. The majority (65.0%) of patients were women. Mild forms of chronic venous disease (clinical, etiologic, anatomic and pathophysiologic [CEAP] classification; C0s-C1) were more frequent in women (11.6%), while severe forms (CEAP C4-C6) were more commonly encountered in men (42.1%). The most frequent comorbidity was emphysema/chronic obstructive pulmonary disease in both groups (74.3% in males and 70.6% in females). For females, diabetes mellitus (P < .005), arterial hypertension (P < .000), and skeletal/joint diseases (P < .042) were more commonly found in the C4 to C6 category. Both males and females, with severe form of chronic venous disease, may benefit from additional screening for comorbidities. Further studies are needed to clarify the nature of association among comorbidities and chronic venous disease.
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