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Associations between Dental Anxiety Levels, Self-Reported Oral Health, Previous Unpleasant Dental Experiences, and Behavioural Reactions in Dental Settings: An Adult E-Survey 牙科焦虑水平、自述口腔健康状况、以往不愉快的牙科经历与在牙科环境中的行为反应之间的关系:成人电子调查
Medicina Pub Date : 2024-08-12 DOI: 10.3390/medicina60081303
Ruzica Peric, Antonija Tadin
{"title":"Associations between Dental Anxiety Levels, Self-Reported Oral Health, Previous Unpleasant Dental Experiences, and Behavioural Reactions in Dental Settings: An Adult E-Survey","authors":"Ruzica Peric, Antonija Tadin","doi":"10.3390/medicina60081303","DOIUrl":"https://doi.org/10.3390/medicina60081303","url":null,"abstract":"Background and Objectives: The aim of this study was to investigate the prevalence of dental anxiety, its association with self-reported oral health, and sociodemographic factors in adults that are critical for improving oral health and well-being. Materials and Methods: An online survey was conducted via social media, with 1551 adults (76.5% women, 23.5% men) participating nationwide. Data collected included demographic data, Modified Dental Anxiety Scale (MDAS) scores, and associations between dental anxiety, negative experiences, and self-reported oral health. The analysis included psychophysiological, behavioural, and emotional responses and avoidance of dental visits, using descriptive and generalised linear regression models. Results: This study found that the mean score of the MDAS was 9.70 ± 5.11 out of 25, 19.1% of the participants reported no dental anxiety, and 7.8% suffered from dental phobia. Gender, age, and socioeconomic status had no significant effect on the prevalence of anxiety. Although more than half of the participants reported negative dental experiences, particularly in childhood, anxiety levels were unaffected. However, those who rated their oral health as excellent or very good had lower anxiety scores (p = 0.008, p = 0.024). Among the dental procedures, oral surgery (58.7%) and prosthetic (restorative) dental treatments (15.2%) caused the most anxiety. Avoidance behaviour correlated with increased anxiety (p ≤ 0.001), as did postponing dental visits until severe pain occurred (p = 0.011). Conclusions: These results emphasise the significant prevalence of dental anxiety in adults, particularly for surgical procedures and drilling, posing challenges in patient management. Tailored strategies are essential to reduce anxiety, improve patient well-being, and optimise dental service delivery and treatment efficacy.","PeriodicalId":18512,"journal":{"name":"Medicina","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141945198","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
Current Status and Future Directions of Bone Trauma Surgery 骨创伤外科的现状和未来发展方向
Medicina Pub Date : 2024-08-11 DOI: 10.3390/medicina60081297
Ivo Dumic-Cule
{"title":"Current Status and Future Directions of Bone Trauma Surgery","authors":"Ivo Dumic-Cule","doi":"10.3390/medicina60081297","DOIUrl":"https://doi.org/10.3390/medicina60081297","url":null,"abstract":"The ever-evolving field of bone trauma surgery and bone regeneration is characterized by continuous transformation due to advancements in medical technology, enhancements in surgical techniques, and a deeper understanding of biological interactions underlying the processes of bone healing and regeneration [...]","PeriodicalId":18512,"journal":{"name":"Medicina","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141945199","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
Lung Ultrasound Efficacy in Monitoring Post-SARS-CoV-2 Pneumonia and Inflammatory Biomarkers in Pediatric Patients 肺部超声在监测儿科患者 SARS-CoV-2 后肺炎和炎症生物标志物方面的功效
Medicina Pub Date : 2024-08-11 DOI: 10.3390/medicina60081296
Ramona Chelcea, Mihaela Dediu, Diana Dabica, Sorina Maria Denisa Laitin, Ioana Mihaiela Ciuca
{"title":"Lung Ultrasound Efficacy in Monitoring Post-SARS-CoV-2 Pneumonia and Inflammatory Biomarkers in Pediatric Patients","authors":"Ramona Chelcea, Mihaela Dediu, Diana Dabica, Sorina Maria Denisa Laitin, Ioana Mihaiela Ciuca","doi":"10.3390/medicina60081296","DOIUrl":"https://doi.org/10.3390/medicina60081296","url":null,"abstract":"Background and Objectives: Recognizing the crucial gaps in our understanding of pediatric pneumonia post-SARS-CoV-2 infection, this study aimed to assess the relationship between Pediatric Pneumonia Ultrasound Scores (PedPne) and inflammatory biomarkers. The primary objective of this study is to evaluate the predictive value of PedPne in comparison with inflammatory biomarkers (IL-6 and dNLR) for the development of pneumonia in pediatric patients following SARS-CoV-2 infection. Materials and Methods: This longitudinal observational study collected data from pediatric patients diagnosed with pneumonia after an acute SARS-CoV2 infection. The study focused on analyzing changes in PedPne scores and inflammatory markers such as IL-6 and dNLR from initial admission to follow-up at 7 days. Statistical analysis involved calculating the sensitivity, specificity, and Area Under the Curve (AUC) for each biomarker, alongside regression analysis to determine their hazard ratios for predicting pneumonia development. Results: The analysis identified significant cutoff values for dNLR at 1.88 (sensitivity 77.0%, specificity 85.7%, AUC 0.802, p < 0.001), IL-6 at 6.1 pg/mL (sensitivity 70.3%, specificity 92.9%, AUC 0.869, p < 0.001), and PedPne score at 3.3 (sensitivity 75.7%, specificity 78.6%, AUC 0.794, p < 0.001). Conversely, NLR showed lower diagnostic performance (AUC 0.485, p = 0.327). Regression analysis further highlighted the strong predictive power of these markers, with IL-6 showing a fourfold increase in pneumonia risk (HR = 4.25, CI: 2.07–9.53, p < 0.001), dNLR indicating more than a twofold increase (HR = 2.53, CI: 1.19–6.97, p = 0.006), and PedPne score associated with more than a doubling of the risk (HR = 2.60, CI: 1.33–5.18, p < 0.001). Conclusions: The study conclusively demonstrated that both PedPne ultrasound scores and specific inflammatory biomarkers such as dNLR and IL-6 are significant predictors of pneumonia development in pediatric patients post-COVID-19 infection. These findings advocate for the integration of these biomarkers in routine clinical assessments to enhance the diagnostic accuracy and management of pneumonia in children following SARS-CoV-2 infection.","PeriodicalId":18512,"journal":{"name":"Medicina","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141969324","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
Predicting Unfavorable Pregnancy Outcomes in Polycystic Ovary Syndrome (PCOS) Patients Using Machine Learning Algorithms 利用机器学习算法预测多囊卵巢综合征 (PCOS) 患者的不利妊娠结局
Medicina Pub Date : 2024-08-11 DOI: 10.3390/medicina60081298
Raluca Mogos, Liliana Gheorghe, Alexandru Carauleanu, Ingrid-Andrada Vasilache, Iulian-Valentin Munteanu, Simona Mogos, Iustina Solomon-Condriuc, Luiza-Maria Baean, Demetra Socolov, Ana-Maria Adam, Cristina Preda
{"title":"Predicting Unfavorable Pregnancy Outcomes in Polycystic Ovary Syndrome (PCOS) Patients Using Machine Learning Algorithms","authors":"Raluca Mogos, Liliana Gheorghe, Alexandru Carauleanu, Ingrid-Andrada Vasilache, Iulian-Valentin Munteanu, Simona Mogos, Iustina Solomon-Condriuc, Luiza-Maria Baean, Demetra Socolov, Ana-Maria Adam, Cristina Preda","doi":"10.3390/medicina60081298","DOIUrl":"https://doi.org/10.3390/medicina60081298","url":null,"abstract":"Background and Objectives: Polycystic ovary syndrome (PCOS) is a complex disorder that can negatively impact the obstetrical outcomes. The aim of this study was to determine the predictive performance of four machine learning (ML)-based algorithms for the prediction of adverse pregnancy outcomes in pregnant patients diagnosed with PCOS. Materials and Methods: A total of 174 patients equally divided into 2 groups depending on the PCOS diagnosis were included in this prospective study. We used the Mantel–Haenszel test to evaluate the risk of adverse pregnancy outcomes for the PCOS patients and reported the results as a crude and adjusted odds ratio (OR) with a 95% confidence interval (CI). A generalized linear model was used to identify the predictors of adverse pregnancy outcomes in PCOS patients, quantifying their impact as risk ratios (RR) with 95% CIs. Significant predictors were included in four machine learning-based algorithms and a sensitivity analysis was employed to quantify their performance. Results: Our crude estimates suggested that PCOS patients had a higher risk of developing gestational diabetes and had a higher chance of giving birth prematurely or through cesarean section in comparison to patients without PCOS. When adjusting for confounders, only the odds of delivery via cesarean section remained significantly higher for PCOS patients. Obesity was outlined as a significant predictor for gestational diabetes and fetal macrosomia, while a personal history of diabetes demonstrated a significant impact on the occurrence of all evaluated outcomes. Random forest (RF) performed the best when used to predict the occurrence of gestational diabetes (area under the curve, AUC value: 0.782), fetal macrosomia (AUC value: 0.897), and preterm birth (AUC value: 0.901) in PCOS patients. Conclusions: Complex ML algorithms could be used to predict adverse obstetrical outcomes in PCOS patients, but larger datasets should be analyzed for their validation.","PeriodicalId":18512,"journal":{"name":"Medicina","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141969299","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
Impact of the Type of Anticoagulation Therapy on Long-Term Clinical Outcomes in Patients with Coronary Bifurcation Lesion and Atrial Fibrillation—Insights from the Bulgarian Bifurcation Registry 抗凝疗法类型对冠状动脉分叉病变和心房颤动患者长期临床疗效的影响--来自保加利亚分叉注册中心的启示
Medicina Pub Date : 2024-08-10 DOI: 10.3390/medicina60081294
Niya Mileva, Dobrin Vassilev, Panayot Panayotov, Pavel Nikolov, Georgi Dimitrov, Kiril Karamfiloff, Gianluca Rigatelli, Robert J. Gil
{"title":"Impact of the Type of Anticoagulation Therapy on Long-Term Clinical Outcomes in Patients with Coronary Bifurcation Lesion and Atrial Fibrillation—Insights from the Bulgarian Bifurcation Registry","authors":"Niya Mileva, Dobrin Vassilev, Panayot Panayotov, Pavel Nikolov, Georgi Dimitrov, Kiril Karamfiloff, Gianluca Rigatelli, Robert J. Gil","doi":"10.3390/medicina60081294","DOIUrl":"https://doi.org/10.3390/medicina60081294","url":null,"abstract":"Background and Objectives: Patients with atrial fibrillation and coronary artery disease represent a group with a greater risk of mortality. To evaluate patients with atrial fibrillation (AF) and a significant coronary bifurcation lesion and compare the clinical outcomes between the patients on anticoagulant treatment with Vitamin K antagonist (VKA) and those on direct anticoagulant (DOAC). Materials and Methods: This is a prospective study of patients with AF and stable coronary artery disease, who had evidence of a significant coronary bifurcation lesion. A log-rank test was used to assess the difference in mortality between patients taking VKA and those on DOAC. The primary endpoint was the incidence of all-cause and cardiovascular death at mid-term. Results: A total of 226 patients with AF and a significant bifurcation lesion were included. The mean age was 70.9 ± 9.2, and 70% were males. Of the patients, 123 (54.7%) were on VKA treatment, and 103 (45.3%) were taking DOAC. For a median follow-up time of 55 (39–96) months, overall mortality was 40%, whereas CV mortality was 31%. Both all-cause (28.2% versus 50.4%, p = 0.020) and CV death (12.7% versus 24.9%, p = 0.032) were significantly lower in patients taking DOAC versus those on VKA. In patients treated with PCI, CV mortality was significantly lower in patients taking DOAC (21.4% versus 40.5%, p = 0.032). VKA therapy was an independent predictor of cardiovascular death (HR 1.88; 95% CI 1.11–3.18; p = 0.01), together with chronic kidney disease (HR 1.81; 95% CI 1.13–2.92; p = 0.01). Conclusions: Treatment with DOAC in patients with atrial fibrillation and coronary bifurcation lesion was associated with significantly lower mortality independently of the treatment approach. VKA was an independent predictor of CV mortality.","PeriodicalId":18512,"journal":{"name":"Medicina","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141969326","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
Which Position for Novice Surgeons? Effect of Supine and Prone Positions on Percutaneous Nephrolithotomy Learning Curve 哪种体位适合外科医生新手?仰卧位和俯卧位对经皮肾镜取石术学习曲线的影响
Medicina Pub Date : 2024-08-10 DOI: 10.3390/medicina60081292
Ender Cem Bulut, Uğur Aydın, Çağrı Coşkun, Serhat Çetin, Ali Ünsal, Fazlı Polat, Bora Küpeli
{"title":"Which Position for Novice Surgeons? Effect of Supine and Prone Positions on Percutaneous Nephrolithotomy Learning Curve","authors":"Ender Cem Bulut, Uğur Aydın, Çağrı Coşkun, Serhat Çetin, Ali Ünsal, Fazlı Polat, Bora Küpeli","doi":"10.3390/medicina60081292","DOIUrl":"https://doi.org/10.3390/medicina60081292","url":null,"abstract":"Background and Objectives: Percutaneous nephrolithotomy (PCNL) is a current treatment method with high success rates and low complication rates in treating large kidney stones. It can be conducted in different positions, especially supine and prone positions. PCNL in the supine position is becoming increasingly common due to its advantages, such as simultaneous retrograde intervention and better anesthesia management. This study aimed to assess how the choice of position impacts the PCNL learning curve. Materials and Methods: The results of the first 50 consecutive PCNL cases performed by two separate chief residents as primary surgeons in supine and prone positions in a reference center for stone treatment between August 2021 and January 2023 were evaluated. The two groups’ demographic and clinical data, stone-free rates, operation times, and fluoroscopy times were compared. Results: While the mean operation time was 94.6 ± 9.8 min in the supine PCNL group, it was 129.9 ± 20.3 min in the prone PCNL group (p < 0.001). Median fluoroscopy times in the supine PCNL and prone PCNL groups were 31 (10–89) seconds and 48 (23–156) seconds, respectively (p = 0.001). During the operation, the plateau was reached after the 10th case in the supine PCNL group, while it was reached after the 40th case in the prone PCNL group. Conclusions: For surgeons who are novices in performing PCNL, supine PCNL may offer both better results and a faster learning curve. Prospective and randomized studies can provide more robust conclusions on this subject.","PeriodicalId":18512,"journal":{"name":"Medicina","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141969325","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
Prospective Assessment of Serum Lipid Alterations in Chronic Hepatitis C Patients Treated with Direct Acting Antivirals: Insights Six Months Post Sustained Virological Response 对接受直接作用抗病毒药物治疗的慢性丙型肝炎患者血清脂质变化的前瞻性评估:持续病毒学应答后六个月的启示
Medicina Pub Date : 2024-08-10 DOI: 10.3390/medicina60081295
Oana Koppandi, Dana Iovănescu, Bogdan Miuțescu, Alexandru Cătălin Motofelea, Oana Maria Jigău, Andreea Iulia Papoi, Călin Burciu, Eyad Gadour, Deiana Vuletici, Eftimie Miuțescu
{"title":"Prospective Assessment of Serum Lipid Alterations in Chronic Hepatitis C Patients Treated with Direct Acting Antivirals: Insights Six Months Post Sustained Virological Response","authors":"Oana Koppandi, Dana Iovănescu, Bogdan Miuțescu, Alexandru Cătălin Motofelea, Oana Maria Jigău, Andreea Iulia Papoi, Călin Burciu, Eyad Gadour, Deiana Vuletici, Eftimie Miuțescu","doi":"10.3390/medicina60081295","DOIUrl":"https://doi.org/10.3390/medicina60081295","url":null,"abstract":"Background and Objectives: Chronic hepatitis C virus (HCV) infection is intricately linked with dysregulation of lipid metabolism. In particular, cholesterol plays a crucial role in HCV replication. Direct-acting antiviral agents (DAAs) therapy has revolutionized the hepatitis C treatment landscape, achieving high rates of sustained virological response (SVR). However, viral clearance comes with some alterations in lipid-related markers. This prospective study aimed to evaluate the impact of HCV clearance on lipid homeostasis and non-invasive liver fibrosis markers in hepatitis C patients treated with DAAs. Material and Methods: Fifty-two patients with varying degrees of fibrosis treated with DAAs therapy were evaluated at baseline and 24 weeks post-SVR. Lipid profiles and non-invasive liver fibrosis markers were assessed. Results: Our findings revealed an increase in total cholesterol, triglyceride, and LDLc (low-density lipoprotein cholesterol) levels at 24 weeks post-SVR, alongside an improvement in serum liver enzymes. Although improvements in liver stiffness were observed in non-invasive tests, there was an increase in lipid-related markers post-SVR. Conclusions: This suggests a potential increased cardiovascular risk despite improvements in liver function and fibrosis, highlighting the necessity for statin therapy in some cases and extended follow-ups for these patients. These findings underscore the importance of closely monitoring lipid profiles in chronic hepatitis C patients post-SVR, as well as the potential need for statin therapy to mitigate cardiovascular risk. Additionally, extended follow-up is essential to assess long-term outcomes and ensure the optimal management of these patients.","PeriodicalId":18512,"journal":{"name":"Medicina","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141945264","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
Cross-Sectional Study on Self-Perception of Dento-Facial Asymmetry 关于牙面不对称自我认知的横断面研究
Medicina Pub Date : 2024-08-10 DOI: 10.3390/medicina60081291
Alexandra - Nina Botezatu, Eduard Radu Cernei, Georgeta Zegan
{"title":"Cross-Sectional Study on Self-Perception of Dento-Facial Asymmetry","authors":"Alexandra - Nina Botezatu, Eduard Radu Cernei, Georgeta Zegan","doi":"10.3390/medicina60081291","DOIUrl":"https://doi.org/10.3390/medicina60081291","url":null,"abstract":"Background and Objectives: Facial symmetry is a key component of facial beauty and attractiveness. However, perfect symmetry is rare, and slight asymmetries, also known as natural asymmetries, are common and contribute to the uniqueness of each face. The perception of facial asymmetry varies among individuals and can be influenced by several factors. This study aimed to investigate the self-perception of dento-facial asymmetry among a sample of Romanian individuals, focusing on their awareness, the extent to which it bothers them, and their desire for correction. Materials and Methods: A cross-sectional analytical study was conducted with 283 participants from Romania between January and February 2024. Participants completed a questionnaire designed to assess their self-perception of facial asymmetry and socio-demographic characteristics. The questionnaire included 10 questions on self-perception of facial asymmetry and 8 questions on socio-demographic data. Statistical analysis was performed using SPSS 26.0, and the Pearson Chi-square test was used for comparative analysis. Results: The sample was predominantly female (75.3%) with an average age of 32.24 years. Most participants were from urban areas (80.6%) and had university degrees (58.7%). About 28.7% of participants observed facial asymmetry, with dental asymmetry being the most frequently reported, followed by asymmetries in the eyebrows and eyelids. The right side of the face was more commonly perceived as asymmetric. Although 24.4% of participants were bothered by their asymmetry, 39.2% expressed a desire to correct it. Conclusions: One-third of participants identified dento-facial asymmetry, with the dental level being the most reported. A significant portion of participants expressed a desire to correct their asymmetries, highlighting the importance of understanding self-perception in the context of facial aesthetics. This study underscores the subjective nature of facial asymmetry perception and the varying thresholds for what is considered bothersome or in need of correction.","PeriodicalId":18512,"journal":{"name":"Medicina","volume":"199 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141945200","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
Renal Angiomyolipoma with Tumor Thrombus in the Inferior Vena Cava and Right Atrium Accompanied by Renal Cell Carcinoma: A Case Report 肾血管脂肪瘤伴下腔静脉和右心房肿瘤血栓,同时伴有肾细胞癌:病例报告
Medicina Pub Date : 2024-08-10 DOI: 10.3390/medicina60081293
Fan Shu, Yichang Hao, Ye Yan, Min Lu, Lulin Ma, Shaohui Deng, Liyuan Ge, Shudong Zhang
{"title":"Renal Angiomyolipoma with Tumor Thrombus in the Inferior Vena Cava and Right Atrium Accompanied by Renal Cell Carcinoma: A Case Report","authors":"Fan Shu, Yichang Hao, Ye Yan, Min Lu, Lulin Ma, Shaohui Deng, Liyuan Ge, Shudong Zhang","doi":"10.3390/medicina60081293","DOIUrl":"https://doi.org/10.3390/medicina60081293","url":null,"abstract":"Background: Renal angiomyolipoma (AML) without local invasion is generally considered benign. However, it may extend to the renal sinus, even the renal vein, or the inferior vena cava (IVC). In patients with non-tuberous sclerosis complex, coexistence of renal cell carcinoma (RCC) and renal AML is uncommon. Case presentation: A 72-year-old woman was incidentally found to have a solitary right renal mass with an IVC thrombus extending into the right atrium during a routine health checkup. Robot-assisted laparoscopic radical nephrectomy and thrombectomy were successfully performed through adequate preoperative examination and preparation. Two tumor lesions were found and pathologically confirmed as renal AML and RCC, and the tumor thrombus was derived from the renal AML. During the one-year follow-up period, no signs of recurrence or metastatic disease were observed. Conclusions: Renal AML with a tumor thrombus in the IVC and right atrium accompanied by RCC may occur, although rarely. In clinical practice, if preoperative manifestations differ from those of common diseases, rare diseases must be considered to avoid missed diagnoses. In addition, adequate examination and multidisciplinary discussions before making a diagnosis are necessary. For a level 4 tumor thrombus with no infringement of the venous wall, adoption of robot-assisted minimally invasive surgery, without extracorporeal circulation technology, is feasible.","PeriodicalId":18512,"journal":{"name":"Medicina","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141945201","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 Comparison of the Effectiveness of the McCoy Laryngoscope and the C-MAC D-Blade Video Laryngoscope in Obese Patients 麦考伊喉镜和 C-MAC D 刀片视频喉镜在肥胖患者中的效果比较
Medicina Pub Date : 2024-08-09 DOI: 10.3390/medicina60081285
Jung-Min Lee, Soo-Kyung Lee, Min-ah Jang, M. Oh, Eun-Young Park
{"title":"A Comparison of the Effectiveness of the McCoy Laryngoscope and the C-MAC D-Blade Video Laryngoscope in Obese Patients","authors":"Jung-Min Lee, Soo-Kyung Lee, Min-ah Jang, M. Oh, Eun-Young Park","doi":"10.3390/medicina60081285","DOIUrl":"https://doi.org/10.3390/medicina60081285","url":null,"abstract":"Background and Objective: Obesity is associated with difficult or failed intubation attempts, making general anesthesia challenging for anesthesiologists to perform. The purpose of this study was to evaluate and compare the efficacy of a McCoy laryngoscope and a C-MAC D-blade video laryngoscope for intubation in obese patients with a body mass index (BMI) ≥ 35 kg/m2. Methods: In total, 104 patients were randomly assigned to be intubated with a McCoy (McCoy group) or C-MAC D-blade video laryngoscope (C-MAC group). The primary outcome was intubation time. The secondary outcomes were vocal cord exposure time, vocal cord passage time, proportion of successful intubation, mask ventilation scale, intubation difficulty scale (IDS), percentage of glottis opening (POGO) score, and hemodynamic variables. Results: Although the intubation time did not significantly differ, the C-MAC group showed shorter vocal cord exposure times and a higher rate of successful vocal cord exposure within 5 s. The IDS value was significantly lower in the C-MAC group than in the McCoy group. The proportion of patients who required an increase in lifting force during laryngoscopy was higher in the McCoy group than in the C-MAC group, which may explain the difference in MAP between the groups. Conclusions: Both the McCoy laryngoscope and the C-MAC D-blade video laryngoscope were useful during the intubation of obese patients. The C-MAC D-blade video laryngoscope might be more useful for obese patients in terms of hemodynamic stability.","PeriodicalId":18512,"journal":{"name":"Medicina","volume":"3 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141921272","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
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