bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of Three- and Five-Year Disease-Free Survival in Patients With Cervical Cancer With Spinal Cord Metastasis Under Treatment With External Radiotherapy + Brachytherapy
Authors: Charsouei Saeid , Mahdavi Farshad , Nasseri Ali Reza
Published: April 2024

Objectives: In developing countries, treatment of cervical cancer with metastasis to the spinal cord is generally associated with failure and reduced patient survival due to the lack of appropriate facilities. Oncologists are using a variety of methods to prolong patient survival. In the present study, we aimed to estimate the three- and five-year disease-free survival of patients with cervical cancer and spinal cord metastasis, treated with external radiotherapy + brachytherapy (i.e., internal radiotherapy. Materials and Methods: This descriptive cross-sectional study was performed over a period of ten years (2010-20) in the brachytherapy ward of Shahid Madani Hospital (Tabriz, Iran). Overall, 200 patients with cervical cancer and spinal cord metastasis who were candidates for external radiotherapy + brachytherapy were recruited by the census sampling method. The variables that were likely to affect survival were recorded and analyzed using the Koch survival test and relevant descriptive and inferential statistics in SPSS version 23 software. Results: The patients’ overall survival was 43.12 ± 1.44 months; 78 patients (39%) survived until the end of the third year, and 49 (24.5%) lived till the end of the fifth year. Also, the pathological diagnosis (P=0.013- P=0.015), disease stage (P=0.014- P=0.018), the length of the treatment area (P=0.026- P=0.044), and undergoing chemotherapy (P=0.001- P=0.002) were significantly associated with the survival of the patients who completed the treatment course. Conclusions: Chemotherapy, advanced disease, and greater length of the treatment area reduced three- and five-year survival in the patients with cervical cancer and spinal cord metastasis who underwent brachytherapy.
Effectiveness of Magnesium on Menstrual Symptoms Among Dysmenorrheal College Students: A Randomized Controlled Trial
Authors: Yaralizadeh Masoumeh , Nezamivand-Chegini Salimeh , Najar Shahnaz , Namjoyan Forough , Abedi Parvin
Published: April 2024

Objectives: The aim of this study was to compare the impact of two different doses of magnesium on severity of menstrual symptoms. Materials and Methods: In this double-blind placebo-controlled trial, 60 students with moderate or severe dysmenorrhea were randomly allocated to two intervention groups and one control group (receiving 150 mg and 300 mg magnesium stearate, or placebo from the 15th day of menstruation until the following cycle, respectively). All participants reported their menstrual symptoms according to the Symptom Severity Scale 2 cycles before and 2 cycles after the intervention. The main outcomes included menstrual symptoms such as cramps, headache, foot pain, depression, irritability, general pain, and abdominal pain. Results: According to the results, although both doses of magnesium could significantly reduce all symptoms of dysmenorrhea compared to the placebo (P<0.001), magnesium 300 mg was more effective in decreasing symptoms such as cramps, headache, back pain, foot pain, depression, irritability, and abdominal pain. Conclusions: The results showed that both doses of magnesium stearate (150 and 300 mg) can reduce severity of menstrual symptoms although the effect was greater with magnesium stearate 300 mg.
Comparative Evaluation of Septolysis Surgery and Pregnancy Outcome in Resectoscope Versus Hysteroscopic Scissor
Authors: Hafizi Leili , Pourhoseini Seyedeh Azam , Jafari Mona , Bradaran Mina , Sherafati Golrokh
Published: April 2024

Objectives: This study aimed to evaluate the short-term and long-term outcomes of adopting two types of resectoscopes and hysteroscopic scissors metroplasty methods. Methods: In this prospective, comparative, and cohort study, participants who were candidates for septum resection were recruited during 2015-2018. The uterine septum was removed using hysteroscopic scissors or a resectoscope. The second-look hysteroscopy was performed in the follicular phase after two months. In the second-look hysteroscopy, surgery outcomes were evaluated, and the residual septa or adhesions were removed in case of incidence. The study followed participants for up to five years to observe pregnancy outcomes. This involved recording the duration from hysteroscopy to pregnancy and determining if these pregnancies led to live births. Results: A total of 119 female patients with a mean age of 30.20±6.14 years were enrolled in this study, out of who 62 cases (52.1%) were in the hysteroscopic scissors group, and 57 cases (47.9%) were in the resectoscope group. The 63 (52.9%) cases had primary infertility, and the prevalence of abortion was 46 (38.7%). During the second look, hysteroscopy adhesion was diagnosed in 18 cases (15.1%), and septum residue was seen in 49 cases (67.1%). The adhesion rate in the hysteroscopic scissors group was higher than that in the resectoscope group, but it was insignificant (P=0.223). At the second follow-up stage, only 85 patients out of 119 ones were available. The successful pregnancy rate was 46 out of 85 (54.1%). The mean age of the patients in the successful pregnancy group was significantly lower than that in the unsuccessful pregnancy group (P<0.001). Conclusion: There were no differences among resectoscope and hysteroscopic scissor methods’ outcomes in term of metroplasty associated with septate uterus (SU).
Spatial Analysis of Birth Defects in Ecuador
Authors: Pozo-Palacios Juan Carlos , Zamora Giannina , Palacios Elvira
Published: April 2024

Objectives: This study aimed to assess the geographical distribution of birth defects in Ecuador. Materials and Methods: This study employed spatial analysis techniques using the records of birth defects from the Ecuadorian Public Health Ministry from January 2015 to December 2019. Morbidity rates, per 1000 newborns, were calculated by birth defect detected and the province of birth, and then the map of its distribution was depicted. The spatial distribution was assessed in each province and canton. Results: 29276 confirmed cases born between 2015 and 2019 were registered. The distribution of every disease tends to be different in every canton and birth defect type in Ecuador. The relative rates show a higher incidence in some eastern and highland cantons. Conclusions: We found a different distribution and rate of birth defects in Ecuador. The higher incidence of birth defects in some cantons should be investigated in future studies, as should environmental factors, consanguineous rates, and genetic polymorphism distribution.
Az izomrelaxáció műtét alatti monitorozási és felfüggesztési gyakorlata a hazai aneszteziológusok körében
Authors: Fedor Marianna , Fónyad Bettina , Nemes Réka , Asztalos László , Fülesdi Béla , Pongrácz Adrienn
Published: April 2024

Bevezetés: Amennyiben az anesztézia során alkalmazott
izomrelaxánsok hatása a műtét végeztével nem szűnik meg, posztoperatív
residualis neuromuscularis blokkról beszélünk, amely súlyos szövődmények forrása
lehet. A residualis blokk diagnosztizálása kvantitatív neuromuscularis monitorok
alkalmazásával lehetséges megbízhatóan. 2016-ban a magyar aneszteziológusok
körében kérdőíves felmérés készült a monitorozási és felfüggesztési szokásokról.
Célkitűzés: Célul tűztük ki annak vizsgálatát, hogy az
elmúlt hat év során alkalmazott képzési programok hatására történt-e változás a
monitorozás és felfüggesztés terén. Módszer: 10 kérdésből álló,
online kitölthető kérdőívet készítettünk a Google Forms szoftver alkalmazásával,
melyet a Magyar Aneszteziológiai és Intenzív Terápiás Társaság segítségével
juttattunk el a hazai aneszteziológusokhoz. 7 kérdés teljesen megegyezett a
2016-os kérdőív kérdéseivel, 1 kérdésnél egy plusz válaszlehetőséget adtunk meg,
és 2 új kérdést fogalmaztunk meg. A statisztikai elemzést
khi2-teszttel végeztük. Eredmények: A kérdőív 2022.
október 4-től december 31-ig volt elérhető. Összesen 132 válasz érkezett. A
felmérésben részt vevők 69%-a szerint residualis blokk az esetek csak 0–5%-ában
fordul elő. Ez az arány 2016-ban 75,6% volt (p = 0,253). A válaszadók 53,1%-a az
esetek 0–10%-ában monitorozza az izomrelaxáció fokát a korábbi 75,8%-kal
szemben, míg a rendszeresen és mindig monitorozók aránya 8%-ról 20,8%-ra
emelkedett (p = 0,0005). Csökkent azok aránya, akik csak az esetek 0–25%-ában
alkalmaznak felfüggesztést (20% vs. 31,15%), és emelkedett azok
aránya, akik rendszeresen, mindig, illetve monitorozás alapján antagonizálnak
(56,2% vs. 38,54) (p = 0,017). Az aneszteziológiai munkahelyek
82%-ában áll rendelkezésre kvantitatív monitor, de csak 23%-ában érhető az el
minden műtőben; szignifikáns változás nem történt.
Következtetés: Az aneszteziológusok továbbra is jelentős
arányban alábecsülik a residualis neuromuscularis blokk előfordulásának
gyakoriságát. A nem vagy igen ritkán monitorozók aránya csökkent, és többen
monitoroznak rendszeresen, illetve mindig. Ezzel együtt csökkent azok aránya,
akik nem vagy ritkán függesztik fel az izomrelaxánsok hatását, és szignifikánsan
megemelkedett azok aránya, akik rendszeresen, illetve mindig reverzálnak. A
kvantitatív neuromuscularis monitorok még mindig nem érhetők el mindenki
számára. Orv Hetil. 2024; 165(15): 574–583.
A gyermekkori hátfájdalom hátterében álló ritka kórkép: krónikus nem bakteriális osteomyelitis
Authors: Juszt Janka , Benedek Noémi , Mohay Gabriella , Herbert Zsuzsanna , Győri Ádám , Mosdósi Bernadett
Published: April 2024

A gerincfájdalom hátterében a gyakoribb benignus kórképek mellett malignus
elváltozások és súlyos gyulladással jellemezhető kórképek is előfordulhatnak. A
kivizsgálás során a részletes laboratóriumi vizsgálatok mellett a képalkotó
diagnosztikának kiemelkedő jelentősége van. A csontfájdalom hátterében ritkán a
krónikus nem bakteriális osteomyelitis is állhat. A szerzők egy 9 éves
leánygyermek esetét mutatják be, aki több hónapja fennálló, progrediáló háti
gerincfájdalommal jelentkezett szakvizsgálaton. A laboratóriumi vizsgálatok
során enyhén emelkedett gyulladásos aktivitáson kívül kórjelző eltérés nem volt.
A mágnesesrezonancia-vizsgálat (MRI) a thoracalis VIII. csigolyakompresszió
mellett a csigolyatestben, az alsó zárólemez mentén körülírt, hiperintenzíven
halmozó képletet írt le. A pontos etiológia tisztázására biopsziás mintavétel
történt. A szövettani vizsgálat a malignitást kizárta, krónikus gyulladásra
utaló eltérést mutatott. A beteg átmenetileg szteroidkezelésben részesült, de
relapsus jelentkezett, ezért biológiai terápia, adalimumab került bevezetésre. A
terápia hatásosnak bizonyult, mind a klinikai tünetek, mind a képalkotó
vizsgálatok alapján tartós remisszió észlelhető. A jelen esettanulmány a
gerincfájdalom hátterében álló ritka kórképre hívja fel a figyelmet. A kórkép
diagnózisában az MRI kiemelkedő fontossággal bír. A betegség kezelésében
immunszuppresszív terápia alkalmazása szükséges. Orv Hetil. 2024; 165(15):
595–600.
Környezetből származó mikrobiális nukleinsavminták vizsgálati lehetőségei
Authors: Kerekes Ivett Kriszta , Nagy Ádám , Ősz Ágnes , Zalka Péter
Published: April 2024

A kórházi fertőzések, amelyek számos pácienst érintenek világszerte, a betegbiztonság fontos komponensei közé tartoznak. Európában megközelítőleg minden tizenötödik beteg kap fertőzést a kórházban töltött idő alatt. A kórházi környezet higiéniai állapotának közel folyamatos ellenőrzése jelenleg is komoly feladat az intézmények számára, és az egyes kritikus kórokozók (például multidrogrezisztens patogén baktériumok) megjelenése azonnali beavatkozást igényel. A nosocomialis kórokozók terjedését a kórházi környezetben elsősorban a gyakran érintett felületek és a kézhigiénia befolyásolja, az egyes kórokozókat azonban gyakran már csak a fertőzés kialakulásakor sikerül azonosítani. A nukleinsav-alapú eljárások segítségével – mint például a PCR (polymerase chain reaction) és az újgenerációs szekvenálás – hatékonyabban kimutathatók a nem tenyészthető kórokozók is. Továbbá az újgenerációs szekvenálási eljárás nemcsak a környezeti mikrobiom fajösszetételéről adhat információt, hanem különböző rezisztenciagének jelenlétéről és rezisztenciamechanizmusokról is. Ez alapján elmondható, hogy a felületek, a levegőminták és a szennyvíz mikrobiomjának molekuláris módszerekkel történő vizsgálata hasznos további információt adhat a klasszikus környezetmonitorozási eljárások mellett. Ebben a dolgozatban célunk átfogó képet adni arról, hogy a fent felsorolt eljárások milyen módon alkalmazhatók a környezet mikrobiális állapotának felmérésére, és ezáltal milyen kiegészítő információkat nyújtanak a betegbiztonság növeléséhez. Orv Hetil. 2024; 165(16): 613–619.
A diabeteses cardiovascularis autonóm neuropathia klinikuma, diagnosztikája és terápiája
Authors: Kempler Péter , Körei Anna
Published: April 2024

Az autonóm neuropathia a cukorbetegség igen gyakori szövődménye, mely a diabetes
kórfejlődése során már korán kialakul, sőt már a csökkent glükóztolerancia
stádiumában is jelen lehet. A betegek életminőségére, a cardiovascularis
morbiditásra és mortalitásra gyakorolt prognosztikus jelentősége, a többi
szövődménnyel mutatott összefüggései miatt a cardiovascularis autonóm funkció
károsodása a cukorbetegség szövődményei között kiemelt jelentőségű. A
cardiovascularis autonóm neuropathia klinikai manifesztációi mint a nyugalmi
tachycardia, az orthostaticus hypotonia, a néma myocardialis ischaemia és
infarktus vagy éppen a QT-távolság megnyúlása miatt kialakuló ritmuszavarok mind
hozzájárulnak a cardiovascularis autonóm neuropathia rossz prognózisához. Ezek a
betegek gyakrabban szenvednek el hirtelen szívhalált, és a perioperatív
légzés-keringésleállás kockázata is nagyobb. A szövődmény irányában végzett
szűrővizsgálatok így alapvető jelentőségűek. A diagnosztikában a mai napig a
hagyományos cardiovascularis reflextesztek tekinthetők arany standardnak, melyek
egyszerű, noninvazív, jól reprodukálható, megfelelő szenzitivitással és
specificitással rendelkező eszközös vizsgálatok. Az egyéb vizsgálati lehetőségek
közül a szívfrekvencia-variabilitás és baroreflex-szenzitivitás a prognózis
pontosabb megítélésére, illetve elsősorban klinikai tanulmányokban végpontokként
használatosak. Az összefoglaló kitér emellett a betegek előszűrését szolgáló
kérdőíves módszerekre és a diagnosztika egyszerűsítését célzó újabb
lehetőségekkel kapcsolatos legfrissebb eredményekre. A cardiovascularis autonóm
neuropathia kezelésének sarokkövét a megfelelő glykaemiás kontroll és a
cardiovascularis kockázati tényezők kontrollja jelenti. További oki terápiás
lehetőség az alfa-liponsav alkalmazása, melynek az autonóm funkcióra gyakorolt
kedvező hatásait klinikai vizsgálat igazolta. A hagyományos értelemben vett
glykaemiás kontrollon túl újabban a glykaemiás variabilitás és egyes
antidiabetikumok idegi funkciókra gyakorolt pleiotrop hatásai kerültek előtérbe.
A testsúlycsökkentés nemcsak a diabetes, de az autonóm neuropathia tekintetében
is jótékony hatású, ugyanakkor az életmód-terápia további összetevőivel
kapcsolatban nem egyértelműek az adatok. Orv Hetil. 2024; 165(16): 602–612.
Az akut pancreatitis kezelésének aktuális kérdései a sebész szemszögéből
Authors: Szentkereszty Zsolt , Balog Klaudia , Sass Tamás , Tóth Dezső
Published: April 2024

Az akut pancreatitis sebészi kezelése az utóbbi időkben jelentősen megváltozott.
A sürgősségi műtétek indikációja és sebészi technikája alapvetően hasonló a
korábbi gyakorlathoz, azonban újabb indikációs terület jelent meg. Az
abdominalis kompartment szindróma sürgős műtéti indikációt képez, ha a
konzervatív és szemikonzervatív kezelés eredménytelen. Ilyenkor napjainkban a
dekompressziós laparotomia és a negatívnyomás-terápiával kombinált
nyitotthas-kezelés javasolt. A hagyományos sebészi necrosectomia helyett a
minimálisan invazív sebészi kezelések terjedtek el, melyek csak a betegség késői
stádiumában kialakuló, fertőzött, demarkált pancreasnecrosis esetén javasoltak.
Napjainkban a demarkált necrosis első vonalbeli kezelése az endoszkópos
endoluminalis transgastricus necrosectomia, de kiterjedt esetekben, és ha a
necroticus üreg fala túl vastag, valamint ha cholecystectomia is szükséges, a
laparoszkópos vagy nyitott transgastricus necrosectomia indokolt. A szerzők
elemzik a sebészi kezelésben beállt változásokat, kitérnek a javallatok és a
műtéti technika kérdéseire is. Orv Hetil. 2024; 165(15): 563–567.
Mobileszköz-alapú gyermekkori látásszűrés a tompalátás korai felismerésére
Authors: Csizek Zsófia , Budai Anna , Nemes Vanda Ágnes , Hegyi Péter , Szabó István , Pusztai Ágota , Piñero David P. , Jandó Gábor , Mikó-Baráth Eszter
Published: April 2024

Bevezetés: Az amblyopia vagy tompalátás binokuláris eredetű
fejlődési zavar, amelyet a legtöbbször egy szemet érintő, lencsével nem
korrigálható látásromlásként definiálnak. Magas prevalenciájával világszerte
népegészségügyi problémát jelent, így a kisgyermekkori látásszűrések fontos
célja az amblyopia megelőzése. Célkitűzés: Célunk egy
mobilapplikáció-alapú térlátásvizsgáló teszt (EuvisionTab®
sztereoteszt, ETS) értékelése, mellyel a tompalátás és rizikófaktorai
(kancsalság, törési hibák) időben kiszűrhetők. Módszer:
Vizsgálataink során nemzetközileg ismert klinikai sztereoteszteket (Lang II,
TNO, Stereo Fly, Frisby) hasonlítottunk össze az EuvisionTab sztereoteszt
különböző verzióival gyermekek körében (n = 453, átlagéletkor: 7,45 év). A
random pontokból álló EuvisionTab sztereoteszt esetén 4 különböző beállítást
alkalmaztunk, a dinamizmust, a pontsűrűséget (denzitást), illetve a vizuális
zajt változtatva. A tesztek hatékonyságát ’receiver-operating characteristic’
(ROC) módszerrel értékeltük, melynek legfontosabb mérőszáma a görbe alatti
terület (AUC). Eredmények: Az EuvisionTab sztereotesztek nagy
szenzitivitásúnak bizonyultak a klasszikus klinikai tesztekhez viszonyítva,
specificitásuk viszont több esetben elmaradt tőlük. Az amblyopia esetében a
legjobb szenzitivitást (91%) a kis denzitású, vizuális zajt tartalmazó dinamikus
teszt érte el, míg a legjobb specificitásértéket (89%) a statikus nagy denzitású
esetében kaptuk. A hagyományos klinikai tesztek közül a legjobb szenzitivitással
(88%) a TNO rendelkezett, míg a legjobb specificitással (98%) a Lang-teszt. A
ROC-analízis alapján minden alkalmazott sztereoteszt jó vagy kiválóan alkalmas
(ROC-AUC>0,80) az amblyopia szűrésére, míg a kancsalság esetén a TNO, a
Stereo Fly, valamint az EuvisionTab tesztek feleltek meg ennek a kritériumnak.
Következtetés: Az EuvisionTab sztereotesztek megfelelőnek
bizonyultak az amblyopia szűrésére, nagy szenzitivitással rendelkeznek. A
módszer további előnyei a véletlenszerű ingersorozat, a rugalmas
paraméterbeállítások, a statisztikai alapú döntéshozatal, a kényelmes
dokumentáció, valamint a könnyű és gyors kivitelezhetőség. Ezek alapján a
legmodernebb látásszűrési protokoll részévé válhat. Orv Hetil. 2024; 165(16):
620–628.
Three-dimensional concrete printing technology from a rheology perspective: a review
Authors: Yang Liuhua , Gao Yang , Chen Hui , Jiao Huazhe , Dong Mengmeng , Bier Thomas A. , Kim Mintae
Published: April 2024

The flow and deformation of cement-based materials accompanies the full cycle of three-dimensional concrete printing (3DCP) and profoundly affects the quality of printed structures. Therefore, rheology is closely related to 3DCP technology. However, since printing materials undergo complex changes (from fluid to solid) during the entire process, it is extremely difficult to obtain the rheological parameters of the material accurately, which makes it difficult to characterise the material's properties and explore the rheological laws within the technical cycle. In this regard, this article starts from the perspective of rheology, systematically reviews the performance requirements of 3DCP technology for printing materials, critically discusses the existing methods for characterisation of material printability, including various conventional and unconventional methods, and clarifies the scope of application of each method. In addition, this article introduces several buildability models based on consideration of the time dependency of the printing material and indicates the direction for the optimisation of the performance of printing materials.
Boca salada
Authors:   Universidad Cooperativa de Colombia, Jaramillo Jorge Iván
Published: April 2024

Boca salada es una novela que explora temas de desarraigo, viaje, amistad y amor en un contexto de exilio que atraviesa diversas tierras latinoamericanas como Chile, Perú, Venezuela, Colombia y Argentina. Narrada por Miranda, la historia se divide en relatos de amor, familia y memoria, que llevan al lector por caminos serenos que de repente se convierten en abismos emocionales. La obra se transforma en una geografía de memorias donde se entrelazan los recuerdos de la abuela con su boca salada, el hermano en búsqueda de cambiar el mundo, el tío que explora el amor en diferentes formas, y la búsqueda de una pasión elusiva pero poderosa. La narrativa de Jorge Iván Jaramillo es sensible y dolorosa, sumerge al lector en los pensamientos profundos de Miranda y lo enfrenta a pérdidas, muerte y desarraigo. La novela se convierte en una lección de polifonía, donde cada voz adquiere su propio espacio y perspectiva, a la vez que otorga una mirada variada sobre las geografías, ciudades, calles y amores. Boca salada es el resultado de una profunda exploración interior y purga de dolores, pero también muestra la resistencia humana y la supervivencia a través de la escritura como medio para enfrentar la vida con atención y sensibilidad.
Measuring Stress in Animals By Noninvasive Methods
Authors: Serim Balcı Ecem , Sabuncuoğlu Çoban Nilüfer
Published: April 2024

Stress is a biological response in the form of physiological, biochemical, hematological, and behavioral changes to internal or external stimuli that threaten the homeostasis of living beings. Effects that activate the defense system in living things are defined as stressors, and it is possible to talk about many different stress factors. Factors that cause stress can be divided into environmental, physical, social or emotional. Stress reactions, which begin with the effect of the stressor, vary according to the duration and severity of exposure to stress. In animal welfare, stress has many negative effects on organism. These negative effects may cause many problems and, shape future by adding problems such as stress and chain links in animals. Just as well-being is for humans, well-being is very important for animals. To determination of glucocorticoids or metabolites in the bloodstream of an organism under stress, noninvasive methods that provide reliable stress measurement without interfering with the organism have recently become increasingly popular. In this review article study, nineteen articles from various parts of the world were examined. In this review, measures of stress by non-invasive methods by looking at GlucoCorticoid Metabolites (GCM) and the latest developments in this field are discussed. In this review article study, nineteen articles from various parts of the world were examined. As a result of the articles reviewed, non-invasive methods for measuring stress may aid and improve our understanding of stress biology and animal welfare. Applying this method to many animal species and biological materials will provide accurate results and support animal welfare.
Determination of Serum Biochemical Profile and Oxidant-Antioxidant Activities in Damascus Goats at Different Ages
Authors: Tekeli Hakan , Şensoy Süleyman , Ekren Aşıcı Gamze Sevri
Published: April 2024

This study aimed to research changes in biochemical profile and oxidant-antioxidant activities of Damascus goats of different ages. The 45 non-gravid Damascus goats of different ages were included in the research. They were divided into three groups of 15 goats according to age: goat kids ( - ≤ 6-months age), young goats (2-3-year age) and old goats (5-8-year age). Biochemical parameters and oxidant-antioxidant activities were determined in serum samples using commercial kits and colorimetric methods. The lowest serum urea, blood urea nitrogen, aspartate aminotransferase, total protein, albumin, globulin and magnesium levels were observed in goat kids (P < .05). Concentrations of glucose, inorganic phosphorus, non-esterified fatty acids, albumin/globulin and alanine aminotransferase decreased with age in the goats (P < .05). Serum total oxidant capacity, total antioxidants capacity and oxidative stress index levels were increased in goat kids compared to old goats (P < .05). Furthermore the highest serum glutathione and glutathione preoxidase activities were observed in young goats (P < .05). An increase was determined in concentrations of serum β-carotene and bilirubin in old goats compared to goat kids (P < .05). In contrast, serum catalase activity, arylesterase, ceruloplasmin and uric acid values did not differ between the groups. The results obtained on the biochemical profiles and oxidant-antioxidant activities of Damascus goats will contribute to monitoring this breed's age-related health and nutritional status and establishing reference values.
Aproveitamento de água pluvial para fins não potáveis em residência: estudo de caso
Authors: Silva Everton Gabriel Medeiros da , Lordsleem Júnior Alberto Casado , Moura Micaella Raíssa Falcão de
Published: April 2024

Atualmente com população de 8 bilhões de habitantes no planeta Terra, a Organização das Nações Unidas para Educação, Ciência e Cultura estima que 2 bilhões de pessoas não possuam água potável disponível. Tal fenômeno é observado não apenas em regiões menos abastadas, mas também em grandes centros, como em Olinda, a primeira capital do Estado de Pernambuco, cujos problemas de abastecimento de água são frequentes, mesmo numa cidade Patrimônio Histórico e Cultural da Humanidade. Este trabalho busca apresentar alternativa para melhor utilização da água, promovendo o aproveitamento de água pluvial para uso em atividades que permitam o uso de recurso não-potável, favorecendo a redução do consumo de recursos hídricos potáveis. O objeto do estudo é uma residência localizada no Sítio Histórico de Olinda, onde apresenta fornecimento de água em dias alternados, de acordo com a Companhia Pernambucana de Saneamento (COMPESA). A metodologia adotada contemplou as etapas de levantamento das leituras mensais do Hidrômetro, análise das condições pluviométricas locais, área de cobertura influente, consumo efetivo de água potável e viabilidade de implantação do sistema de aproveitamento de água da chuva. Como resultado, pôde-se identificar significativo percentual econômico de água potável, observando-se ainda a viabilidade de implantação do sistema de captação, armazenamento e aproveitamento de água pluvial na residência.
The experience of nurse anaesthetists in assessing postoperative pain in orthopaedic patients
Authors: Krupić Ferid , Grbić Kemal , Bišćević Mirza , Jašarević Mahir , Čustović Svemir , S. Mukka Sebastian
Published: April 2024

Aim
To explore the experiences of anaesthesia nurses in assessing postoperative pain in patients undergoing total hip and/or knee arthroplasty.
Methods
Data were collected through four focus group interviews (FGI) using the critical incident technique (CIT). The participants were six men and 12 women, all registered nurses with further education in anaesthesia with at least five-year experience of caring for patients on a postoperative ward.
Results
 Maintaining communication with orthopaedic patients, different ways to assess pain, the assessment of unresponsive patients, using pain assessment scales and different work circumstances influencing their use, were stated as the main problems the nurses emphasize while assessing the pain of patients.
 Conclusion
Skills related to observing the behaviour and experience of pain in different individuals are needed to ensure an understanding of patients' pain, as well as the patients' ability to estimate their pain, where the intensity of the pain varies in different patients. Further studies are needed to examine the way health professionals assess pain, depending on the patients' ability to transform their pain from a subjective feeling into an objective numeric grade. The way individuals assess their pain differently and the way the resulting knowledge and experience of postoperative care may help nurses and other health-care professionals.
Correlation of demographic, histological and molecular characteristics and clinical course of the disease in patients with lung adenocarcinoma
Authors: Novaković Lacković Lora , Latinović Tadić Ljilja , Stanetić Mirko , Tanasković Nataša , Marić Slavica , Lacković Marko
Published: April 2024

Aim
 Retrospective analysis of disease clinical course with a purpose of defining potential prognostic parameters which are essential for optimal target therapy.
Methods
The study involved 29 patients with histologically confirmed lung adenocarcinoma and existing epidermal growth factor receptor (EGFR) mutations, which are treated by tyrosine kinase inhibitors (TKI).
 Results
Allegations of a larger prevalence in women and non-smokers were found. The study confirmed dominance of mutations on exon 19 and exon 21. Usefulness of the treatment with erlotinib in terms of increasing survival time was evident. Median survival of patients in the survey sample was 14.5 months. Median survival in relation to gender or smoking status did not show statistical significance.
Conclusion
Considering obtained results, we have confirmed that patients with advanced lung adenocarcinoma and present mutations of epidermal growth factor receptor, who had been treated with first generation TKI, had median survival time of over a year.
Psychological characteristics of war veterans after the war in Bosnia and Herzegovina
Authors: Selimbašić Zihnet , Kurtić Azra , Selimbašić Mirna , Brkić Maja , Hrvić Dženita
Published: April 2024

Aim
To determine psychological characteristics of war veterans after the war in Bosnia and Herzegovina (B&H).
Methods
The study included 207 war veterans with war experience in B&H. Evaluation of veterans was conducted by the Harvard Trauma Questionnaire (HTQ)-B&H version, Emotion Profile Index (EPI), Life Style Questionnaire (Life Style index-LSI). Results
Veterans who show symptoms of posttraumatic stress disorder (PTSD) had more traumatic experiences and higher level of traumatization than veterans who did not show PTSD symptoms (p=0.000). Low level of reproduction, incorporation, lack of control, self-defence and exploratory and acceptable responses (p=0.000), lack of control (p=0.025) and deprivation (p=0.013) were shown on the emotional profile by war veterans suffering from post-traumatic stress disorder. Negation, intellectualization and compensation were coping strategies for traumatic experiences and symptoms of PTSD, used by war veterans.
Conclusion
 War veterans with post-traumatic stress disorder experienced more traumatic experiences and show more severe symptoms of post-traumatic stress disorder. In the emotional profile, there was a lower level of emotional states, and coping strategies with posttraumatic stress disorder were negating, intellectualization and compensation. The treatment of post-traumatic stress disorder is becoming a conspicuous public health problem.
Scoliosis induced by costotransversectomy in minipigs model
Authors: Cervera-Irimi Javier , González-Miranda Álvaro , Riquelme-García Óscar , Burgos-Flores Jesus , Barrios-Pitarque Carlos , García-Barreno Pedro , García-Martín Azucena , Hevia-Sierra Eduardo , Rollo Giuseppe , Meccariello Luigi , Caruso Luigi , Bisaccia Michele
Published: April 2024

Aim
 To validate surgical costotransversectomy as a technique for creating a scoliosis model in minipigs and to assess whether differences in approach (posterior medial approach, posterior paramedial approach and anterior approach by video-assisted thoracoscopy) lead to differences in the production of spinal deformity. Creation of disease models in experimental animals, specifically in minipigs, is controversial, as no appropriate technique has been reported.
Methods
 Surgical costotransversectomy was performed in 11 minipigs using 3 different approaches: posterior medial approach (4 animals, group I), posterior paramedial approach (3 animals, group II) and anterior approach by videothoracoscopy (4 animals, group III). A conventional x-ray study was performed in the immediate postoperative period. Follow-up lasted for 4 months. Specimens were humanely killed according to current protocols, and a second x-ray study was performed. A deformation was measured using the Cobb angle and direct observation of the rotational component.
Results
 Data from group I revealed a scoliosis deformation of 27º-41º (mean 34.5º) with a macroscopic rotational component. No deformity (<10º) or rotational component was observed in groups II and III. Only a posterior medial costotransversectomy produced a significant deformity in minipigs and established a valid model for studying scoliosis in these animals.
Conclusion
Only a posterior medial costotransversectomy produces a significant deformity in minipigs and establish a valid model for studying scoliosis in these animals. A tensegrity model would elucidate such results and harmonize disparate conclusions. Further investigation is needed to demonstrate the reliability of tensegrity principles for spinal biomechanics.
The challenge of nonunion and malunion in distal femur surgical revision
Authors: Rollo Giuseppe , Pichierri Paolo , Grubor Predrag , Marsilio Antonio , Bisaccia Michele , Grubor Milan , Pace Valerio , Lanzetti Riccardo Maria , Giaracuni Marco , Filipponi Marco , Meccariello Luigi
Published: April 2024

Aim
 To demonstrate validity of a bio-metallic solution in bone healing combined with the quadriceps safe approach in the treatment of nonunions of distal femur while malunions were treated by metallic solution.
Methods
 We treated 57 patients with nonunion or malunion of distal femur at the Orthopaedics and Traumatology Department of a single orthopaedic trauma centre (Italy). A total of 57 patients were divided in two groups: the first (NU) group was composed of 35 patients affected; the second group (MU) was composed of 22 patients affected by malunion of distal femur. Criteria chosen to evaluate the two groups during a clinical and radiological followup were: the quality of life measured by the Short Form (12) Health Survey, the knee function and quality of life related to it measured by the Knee Injury and Osteoarthritis Outcome Score KOOS and the Knee Society Score, bone healing measured by modified Radiographic Union Score by X-rays during the follow-up and CT at one year after the surgery, the difference of the limbs length before and after the revision surgery, and postoperative complications. The evaluation endpoint was set at 12 months.
Results
There were no statistical differences between the two groups.
 Conclusion
The role of bio-metallic solution in the treatment of nonunions and malunions is to recreate the knee anatomy and functionality compatible with a satisfactory quality of life.
Caudal block with analgosedation – a superior anaesthesia technique for lower abdominal surgery in paediatric population
Authors: Šabanović Adilović Adisa , Rizvanović Nermina , Adilović Harun , Ejubović Malik , Jakić Azur , Maksić Hajrija , Simić Dušica
Published: April 2024

Aim
To compare intraoperative hemodynamic and respiratory stability and postoperative emergence delirium between two anaesthesia regimens in children (caudal block with intravenous continuous analgosedation versus general endotracheal anaesthesia) and intensity of postoperative pain and quality of postoperative analgesia.
Method
 Forty children aged 2-6 years who underwent lower abdominal surgery were randomized depending on performed anaesthesia into two groups: caudal block with analgosedation (group CB) and general endotracheal anaesthesia (group GA). Intraoperative hemodynamic and respiratory stability were evaluated measuring systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial blood pressure (MAP), heart rate (HR) and arterial oxygen saturation (SaO 2) in preinduction (t 0), at the moment of surgical incision (t 1), 10 minutes after surgical incision (t 2) and at the time of skin suturing (t 3). Postoperative emergence delirium was evaluated using Paediatric Anaesthesia Emergence Delirium score (PAED). Postoperative pain was evaluated by Children's and Infants' Postoperative Pain score (CHIPPS). Both scores were recorded every 5 minutes during first half hour postoperatively, additionally after 60 minutes postoperatively for CHIPPS score.
 Results
 SBP, DBP and MAP were lower at t 1 (p<0.0001), t 2 (p<0.05) and t 3 (p<0.001) in the group CB. HR was lower at all studied time points (p<0.005) in the group CB. SaO 2 was lower in the CB group but comparable with the GA group. PAED and CHIPPS scores were lower at 5, 10, 15, 20 and 25 minutes postoperatively (p<0.001) in the CB group. Conclusion
 Caudal block with analgosedation provides better control of intraoperative hemodynamic conditions, postoperative emergence delirium and postoperative pain than general endotracheal anaesthesia.
Peritoneal and upper genital tract tuberculosis
Authors: Wagner Alexandra , Arsenić Ruža , David Matthias , Sehouli Jalid , Vidosavljević Domagoj , Rohr Irena
Published: April 2024

Aim
 To present diagnostic and therapeutic possibilities for genital and peritoneal tuberculosis, mimicking to other pathological conditions, mainly, ovarian cancer.
Methods
Transabdominal and transvaginal ultrasound, computerized tomography, Ca125 and HE 4, ROMA-index (Risk of Ovarian Maligancy Algorithm index) and diagnostic laparoscopy were performed in order to diagnose genital tuberculosis in a female patient.
Results:
 A 23-year-old woman from Morocco presented with intermitting abdominal pain, unintentional weight loss and primary infertility. There was no positive family history for breast or ovarian cancer and no history of previous tuberculosis (TB). Elevated CA-125 level, HE 4 normal, ROMA-Index of 13.2 % suggested high risk for epithelial ovarian cancer (EOC). Ultrasound revealed free fluid, dilated fallopian tubes and a cystic mass near the right ovary. Suspecting fallopian tube or ovarian cancer, we performed exploratory laparoscopy, revealing adhesions, multiple miliary nodes and dilated fallopian tubes. Histological investigation revealed granulomatous abscessing salpingitis with suspicion of genital TB, so antituberculous therapy was administered with success.
Conclusion
 Female genital tuberculosis is very rare but important in differential diagnosis and should be kept in mind regarding suspected fallopian tube or ovarian carcinoma to prevent women from extensive surgery. An algorithm for possible differentiation between peritoneal/female genital TB and EOC may be helpful in clinical setting.
Validation of the Persian version of self-care tools for hypertension among older adults
Authors: Barati Farideh , Sadeghmoghadam Leila , Sajjadi Moosa , Nazari Shima , Bahri Narjes
Published: April 2024

Aim
 To validate two sub-scales of self-care behaviour and self-efficacy of hypertension in elderly patients in Iran using an English scale developed by Dr. Han et al.
Methods
The Persian version of two sub-scales of self-care behavior and self-efficacy was validated for 300 elderly people who suffered from hypertension. These sub-scales were translated into Persian according to the Wild et al. model. The validity of the tool was confirmed through formal, content and structural validity and reliability through calculation of internal consistency and time stability.
 Results
Cronbach's alpha was reported to 0.85 for behavior, 0.86 for self-efficacy. Pearson's correlation coefficient for behavior was 0.89, for self-efficacy 0.92. Intraclass correlation coefficient (ICC) was 0.84 for behavior and 0.88 for self-efficacy. The minimum acceptable content validity ratio (CVR) for each grade was equal to 49.0 and for the content validity index (CVI) equal to 0.79, indicating that all items obtained the grade points. In exploratory analysis, two dimensions of diet and disease management were determined for both sub-scales, which were approved according to fit indicators.
Conclusion
 The Persian version of the Self-Care Tools for hypertension showed favourable validity and reliability, and thus it can be used for measuring the level of self-care for hypertension in Iranian elderly population.
Preventive health services utilization in patients treated by family physicians
Authors: Kurspahić-Mujčić Amira , Mujčić Amra
Published: April 2024

Aim
 To explore preventive health service utilization in patients treated by family physicians and the factors associated with their use.
Methods
 This cross-sectional study was carried out in family medicine outpatient departments of the Primary Health Care Canter of Canton Sarajevo, Bosnia and Herzegovina. The study included 300 patients (150 males and 150 females). A questionnaire for the evaluation of patients' socio-demographic characteristics, health profile and use of preventive health services was used.
Results
 Females visited family physicians significantly more often than males (p=0.001). About 51.2% of males reported undergoing a prostate examination within the past 2 years, 77% of females had an examination of the breast within the past 2 years, 9.8% of males and 10.5% of females had received influenza immunization in past 12 months. A number of visits to family physicians in the last twelve months was significantly associated with having had a prostate examination (digital rectal examination and/or prostate-specific antigen testing) (B=1.413, SE=0.171; p=0.043) and an examination of the breast (clinical breast examination and/or mammography) (B=1.817, SE=0.307; p=0.041). Advancement in age was positively associated with influenza immunization (B=2.901, SE=0.026; p=0.000).
Conclusion
A visit to family physicians was an important step along the causal pathway to receiving preventive services (a prostate examination, an examination of breast). Adults aged 18-64 years were not well protected against influenza and comprehensive strategies are needed.
Genotyping test based on viral DNA, RNA or both as a management option for high-risk human papillomavirus positive women: a cross sectional study
Authors: Salimović-Bešić Irma , Tomić-Čiča Anja , Hukić Mirsada
Published: April 2024

Aim
This cross-sectional study of a group of women with abnormal cytology and high-risk human papillomavirus (hrHPV) infection compared genotyping HPV DNA and mRNA assays according to two age categories of women (S1: ≤30 and S2: >30 years).
 Methods
 The hrHPV DNA positive results of 105 cervical samples of women were pooled and those harbouring HPV-16, 18, 31, 33 and/or 45 DNA were tested for the type specific HPV oncogene E6/E7 overexpression (mRNA).
Results
 Although HPV DNA testing showed a higher proportion of women infected by any of five hrHPVs in S1 group, total agreement of hrHPV DNA and mRNA positive results was higher in S2 group of women (75.8% v. 83.9%). The most prevalent type in both age groups was HPV-16. A 100% agreement of positivity of both tests was noted for HPV-18 and 33 in S1 group, and for HPV-18 in S2 group. Increasing concordance of HPV-16 and 31 DNA and mRNA positive results with the severity of cervical cytology was observed in S1 group of women. Absolute matching (100.0%) of positivity of both diagnostic tests was recorded in S2 ASCUS group (for HPV-16, 18 and 33), in S1 HSIL (for HPV-16, 18, 31 and 33), in S1 LSIL category (for HPV-18 and 33) and in S2 HSIL group (for HPV-18).
Conclusion
The results indicate the possibility of predicting the risk of persistent infection only by HPV DNA typing test, with no need for additional RNA testing in categories of infected women showing a high (absolute) agreement of positivity of both tests.
Infectious mononucleosis (Epstein-Barr virus infection) and chronic hepatitis
Authors: Čalkić Lejla , Bajramović-Omeragić Lejla , Mujezinović Adnan
Published: April 2024

Aim
To describe a case of an eight-year-old boy with chronic Epstein-Barr virus (EBV) hepatitis with incipient cirrhosis, rarely found in practice.
Methods
 The diagnosis was based on findings of specific IgG serum antibodies and EBV positive liver biopsy. Other etiologies of hepatitis were excluded: autoimmune hepatitis, viral hepatitis A, B, or C, cytomegalovirus (CMV), herpes simplex virus (HSV), adenovirus infection, toxoplasma infection.
Results
 A mild form of infectious mononucleosis with acute hepatitis without icterus was found in the boy first time at the age of three. He got sick again in april 2018 with fever, minor loss of appetite and weakness, skin and sclera were anicteric, no enlarged neck lymph nodes. Ultrasonography of the spleen revealed a spleen diameter of 10.7 cm, while the liver was 11.8 cm. Laboratory findings, sedimentation, blood count, C reactive protein (CRP) were all normal. Ten days and a month later an increase of aminotransferase was noticed. The liver biopsy and PCR EBV DNA were performed six months of disease onset. The disease had lasted for about one more year with loss of strength and an increase of aminotransferase with maximum value of 3-4 times higher than normal one. The therapy was supportive.
Conclusion
 Chronic EBV hepatitis is very rare. In differential diagnosis of hepatitis and unclear febrile conditions, EBV infection should not be forgotten.
A new plate design to treat displaced 3-4 parts proximal humeral fractures in comparison to the most tested and used plate: clinical and radiographic study
Authors: Rollo Giuseppe , Porcellini Giuseppe , Rotini Roberto , Bisaccia Michele , Pichierri Paolo , Paladini Paolo , Guerra Enrico , De Cruto Enio , Franzese Raffaele , Grubor Predrag , Pace Valerio , Meccariello Luigi
Published: April 2024

Aim
Proximal humeral fractures are common and most complex patterns currently represent a challenge for surgeons. Difficulties in obtaining good anatomical reduction (particularly of great tuberosity) often lead to unsatisfactory results; choices often fall onto prosthesis implantation against fixation options. The aim of this study was to compare a new design of proximal humeral plate with the most used plates in the treatment of these injures by analysing outcomes and complications. Methods
 Two hundred patients with proximal 3 or 4 parts humeral fracture were enrolled (Neer 3-4). First group treated with PGR Plate composed of 98 patients. Second group treated with Philos Plate composed of 102 patients. Evaluation criteria were Non-Union Scoring System, duration of surgery, complications, objective quality of life and elbow function (Constant Shoulder Score), subjective quality of life and elbow function (Oxford Shoulder Score), post-op radiographs, centrum collum diaphyseal angle. Evaluation endpoint was 12 months.
Results
 There was no statistically significant difference between the groups with regard to the selected evaluation parameters. Achievement of good shoulder range of motion and ability to perform normal daily living activities was obtained in both groups. The PGR had a positive impact on treatment results of varuspattern of proximal humeral fractures.
Conclusions
 The PGR allowed good clinical and radiographic results in the treatment of proximal humeral fractures, comparable to those obtained with Philos. Also, PGR had the advantage to aid and keep the anatomical reduction of patterns of fracture involving the greater tuberosity.