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共192条结果
  • 1.

    【2hr】LATERAL INVERTED OSTEOCHONDRAL FRACTURE OF THE TALUS: CASE REPORTS AND REVIEW OF THE LITERATURE

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    机译 距骨的横向反转软骨骨折：病例报告和文献复习
    摘要：SUMMARY – Lateral inverted osteochondral fracture of the talus (LIFT) is a rare variant of stage IV osteochondral lesion of the talus (OLT), where the fragment is inverted in situ by 180°. The management of LIFT lesion is very challenging and early recognition crucial, given that treatment options depend on the articular cartilage condition and sufficiency of the adjacent bone of the displaced fragment. We describe two LIFT cases referred from other institutions after unsuccessful conservative treatment of OLT. They presented with pain, swelling and tenderness over the anterolateral aspect of the right ankle. We recognized the LIFT lesion on the magnetic resonance imaging scans in patient 2, while in patient 1 the orientation of the fragment was recognized upon direct visualization during operative treatment. Both patients underwent arthroscopic procedure. Due to articular cartilage damage and insufficiency of the adjacent bone of the fragment, both patients were treated with excision followed by microfracture. Treatment of the LIFT lesion should start arthroscopically to allow clear evaluation of the osteochondral fragment, assessment of the talar defect and identification, as well as treatment of associated disorders. If the articular cartilage appears intact with sufficient subchondral bone, fixation of the fragment is optimal management, otherwise excision and microfracture can be the treatment of choice.
  • 2.

    【2hr】Protective Effect of Blepharospasm on the Anterior Segment of the Eye

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    机译 睑裂痉挛对眼前节的保护作用
    摘要：SUMMARY – The aim of the study was to determine the role of blepharospasm as a protective factor for the anterior segment of the eye by comparing the degree of blepharospasm and changes of the anterior segment structures. The study included sixty female patients older than forty years with the clinical diagnosis of blepharospasm. They were divided into two groups; the first group consisted of patients with stage I and II of blepharospasm with dominant dry eye symptoms, and the second group consisted of patients with stage III and IV of blepharospasm who required interventional therapy (all patients in this study were treated with botulinum toxin type A). Staining of ocular surface with vital dyes such as fluorescein was used to determine ocular surface defects. Fluorescein stains the corneal epithelial defects, which were statistically less pronounced in the interventional group. In conclusion, comparison of the results between the two groups of patients may implicate that advanced blepharospasm has a protective effect on ocular surface.
  • 3.

    【2hr】THE PREVALENCE OF ONYCHOMYCOSIS IN THE ZAGREB AREA – THE ROLE OF SABOURAUD AGAR WITHOUT CYCLOHEXIMIDE IN DIAGNOSIS AND THERAPY

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    机译 萨格勒布地区青霉病的患病率-无环己二胺的沙伯氏琼脂在诊断和治疗中的作用
    摘要：SUMMARY – Mycological analysis is considered the gold standard in the diagnosis of very common fungal diseases of nails. The purpose of the article is to present the prevalence of onychomycosis obtained by using direct microscopic examination (DME) and cultivation on Sabouraud media without cycloheximide. The quantitative retrospective research was conducted on 2706 patients of both sexes (mostly middle-aged to elderly) with various toenail lesions, who had undergone mycological analyses in the Mycological Laboratory of our Department of Dermatovenereology in 2013 and 2014. Analysis of the results obtained revealed that there were 35.4% of positive DME results; of these, there were 39.2% of dermatophytes, 59.1% of yeasts and 1.7% of molds. The percentage of dermatophytes (Trichophyton spp.) was twice as high in men as in women. A considerable percentage (12%) of mixed isolates was also observed. Particularly worrisome was the high percentage (one-third) of suppressed and insufficiently developed dermatophytes (a possible indicator of inappropriate preparation of patients for mycological analysis). Cultivation on culture media without cycloheximide requires frequent inspections because of the fast-growing molds while not allowing sporulation for a great number of dermatophytes. However, it has certain advantages, i.e. it offers an insight into the wide range of the present fungi. As part of the biofilm, they can be potentially pathogenic in dystrophic nails under certain circumstances because, according to our results, the percentage of dermatophytes does not change substantially with aging; however, what does change is the percentage of molds, yeasts and mixed isolates.
  • 4.

    【2hr】ASSOCIATION OF CIRCADIAN RHYTHM WITH MYOCARDIAL INFARCTION

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    机译 IR肌节律与心肌梗死的关系
    摘要：SUMMARY – Cardiovascular diseases are the world’s leading cause of death. Human physiologic activities and state during illness are under the control of circadian rhythm. The aim of the study was to determine the potential association of chronotype and daytime sleepiness with susceptibility to myocardial infarction. We conducted a case-control study on 200 patients hospitalized due to myocardial infarction and 200 healthy controls. Systematic information on the past and present medical history was obtained from all participants. Chronotype was assessed using the Morningness-Eveningness Questionnaire (MEQ), and daytime sleepiness was assessed by the Epworth Sleepiness Scale (ESS). The mean age of the study population was 64±13 years, and 54.5% were male. There was no significant difference in MEQ (58.88±6.52 vs. 58.46±7.78, p=0.601) or ESS (5 (interquartile range, IQR 4-7.5) vs. 6 (IQR 3-8), p=0.912) score between patients and controls. Nevertheless, we found statistically significant differences related to risk factors for cardiovascular diseases, such as hypertension, dyslipidemia, and diabetes mellitus. However, there was no association of MEQ and ESS score with myocardial infarction in the study population.
  • 5.

    【2hr】RECOMMENDATIONS FOR PERIOPERATIVE MANAGEMENT OF PATIENTS WITH CARDIAC IMPLANTABLE ELECTRONIC DEVICES

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    机译 心脏可植入电子设备患者的围手术期管理建议
    摘要：SUMMARY – Four thousand cardiac implantable electronic devices (CIED) are implanted yearly in Croatia with constant increase. General anesthesia and surgery carry some specific risk for the patients with implanted CIEDs. Since most of the surgical procedures are performed in institutions without reprogramming devices available, or in the periods when they are unavailable, these guidelines aim to standardize the protocol for perioperative management of these patients. With this protocol, most of the procedures can be performed easily and, more importantly, safely in the majority of surgical patients.
  • 6.

    【2hr】EUROPEAN REGULATION OF MEDICAL PROFESSION IN THE REPUBLIC OF CROATIA

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    机译 欧洲克罗地亚共和国医疗专业条例
    • 作者：Marija Pederin
    • 刊名：Acta Clinica Croatica
    • 2018年第4期
    摘要：SUMMARY – Medical profession is regulated in all European Member States. By stipulating the conditions for performance of the profession, the said activity can only be practiced by members of the profession. The European Member States have coordinated the conditions of education and specialist training, thus simplifying all administrative procedures for the recognition of professional qualifications. During the pre-accession negotiations, the Republic of Croatia made the necessary changes to the study curriculum and in the specialist training programs, and listed all the professional titles acquired under the regulations that were in force at the time of the end of the program. Physicians can freely join/become members the Croatian Medical Association, which is an association, while professional chamber membership is mandatory for physicians who work directly with patients and should therefore have approval for independent work. Medical schools, professional societies of the Croatian Medical Association and the Croatian Chamber of Physicians, as well as the Ministry responsible for regulating the profession, all have a role to play in the regulation of the medical profession.
  • 7.

    【2hr】Questionnaire on the Midwives’ Knowledge about Oral Emergency Contraception

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    机译 助产士对口腔紧急避孕知识的问卷调查
    摘要：SUMMARY – The aim of the study was to assess the level of knowledge of midwives working in different clinical settings about oral emergency contraception. The study included 225 midwives; during the period from December 2015 to February 2016, they completed a 16-item web-based survey using the SurveyMonkey software available on the Croatian Midwives Chamber site. In total 277 participants started to fill out the survey and 225 participants responded to all 16 questions. Demographic, educational and professional characteristics of the participants in this survey are provided. Distribution of participant responses to questions regarding basic reproductive endocrinology, unplanned pregnancies and emergency contraception clearly revealed important gaps in the group knowledge. There was evident gap in the knowledge about emergency contraception in the study group of Croatian midwives. Having in mind the study group grounds in gynecology and obstetrics, and their public health relevance, targeted educational activities both during midwife formal education and on-job are required to improve the group knowledge about emergency contraception. National guidelines on oral emergency contraception are an at hand learning tool and the most appropriate local source of information on emergency contraception. Various initiatives should be considered for this document to become an integral part of formal midwife education and regular part of their on-job trainings.
  • 8.

    【2hr】MANAGEMENT OF BRACHIAL PLEXUS MISSILE INJURIES

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    机译 臂丛神经损伤的处理
    摘要：SUMMARY – Missile injuries are among the most devastating injuries in general traumatology. Traumatic brachial plexus injuries are the most difficult injuries in peripheral nerve surgery, and most complicated to be surgically treated. Nevertheless, missile wounding is the second most common mechanism of brachial plexus injury. The aim was to evaluate functional recovery after surgical treatment of these injuries. Our series included 68 patients with 202 nerve lesions treated with 207 surgical procedures. Decision on the treatment modality (exploration, neurolysis, graft repair, or combination) was made upon intraoperative finding. Results were analyzed in 60 (88.2%) patients with 173 (85.6%) nerve lesions followed-up for two years. Functional recovery was evaluated according to functional priorities. Satisfactory functional recovery was achieved in 90.4% of cases with neurolysis and 85.7% of cases with nerve grafting. Insufficient functional recovery was verified in ulnar and radial nerve lesions after neurolysis, and in median and radial nerve lesions when graft repair was done. We conclude that the best time for surgery is between two and four months after injury, except for the gunshot wound associated with injury to the surrounding structures, which requires immediate surgical treatment. The results of neurolysis and nerve grafting were similar.
  • 9.

    【2hr】Sexual Activity in Patients with Cardiac Diseases

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    机译 心脏病患者的性活动
    摘要：SUMMARY – In this article, we outline the latest guidelines published by the American Heart Association on sexual activity in patients with coronary artery disease, heart failure, structural heart diseases, arrhythmias, implanted pacemakers or cardioverter defibrillators, as well as on treatment options of sexual dysfunction. Sexual activities are similar to mild/moderate physical activity during a short period. Most patients are recommended to involve in sexual activity after prior comprehensive evaluation of physical condition. Those with stable cardiac symptoms and good functional capacity are at a low risk of adverse cardiovascular events, and others require treatment or stabilization before involving in sexual activity. Stress testing is useful in evaluating safety of sexual activity in patients with questionable or undetermined risk. Treatment of sexual dysfunction includes counseling of patients and their sexual partners, and drug treatment with phosphodiesterase inhibitors (sildenafil, tadalafil, vardenafil) which have been demonstrated to be safe and effective, in men, and with serotonin reuptake inhibitors (flibanserin) and local vaginal estrogen administration in women. In conclusion, in routine clinical practice, patients should be approached individually and multidisciplinarily in order to detect and eliminate the factors that interfere with normal sexual activities and disturb the quality of life.
  • 10.

    【2hr】EFFECT OF GROWTH HORMONE THERAPY IN CHILDREN WITH PRADER-WILLI SYNDROME – OUR FIRST EXPERIENCES

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    机译 普拉德-威利综合征对儿童生长激素治疗的疗效-我们的第一个经验
    摘要：SUMMARY – Prader-Willi syndrome (PWS) is the most common cause of morbid obesity in childhood. It is the consequence of the lack of expression of genes on the paternally inherited 15q11.2-q13 region. Hyperphagia, obesity, short stature, psychomotor retardation and deterioration of behavior predominate in clinical presentation. Recombinant human growth hormone (rhGH) therapy, along with restriction of caloric intake, has become the mainstay in the management of PWS patients. Anthropometric parameters (height, body mass index (BMI)), therapy effect on carbohydrate and lipid metabolism, and occurrence of side effects were monitored in four children with PWS treated with rhGH for ≥2 years at doses of up to 1 mg/m2/day. During the follow-up, the height standard deviation score (SDS) increased in comparison with baseline values, and after ≥2 years of treatment with rhGH it was within the reference range for the general children population. BMI SDS decreased after the first year of treatment, but thereafter increased again; still, the level of BMI SDS was much better in comparison with most children with PWS of the same age and gender. RhGH therapy had no negative effect on glucose and lipid metabolism, nor caused any other adverse effect. Therapy including a customized diet for PWS, along with rhGH therapy, provided a satisfactory growth rate and prevented development of morbid obesity without side effects. This treatment approach would ensure transition of a greater number of PWS patients into adult care, where the multidisciplinary approach in care should be continued.
  • 11.

    【2hr】BREAST CANCER IN YOUNG WOMEN: PATHOLOGIC AND IMMUNOHISTOCHEMICAL FEATURES

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    机译 年轻妇女的乳腺癌：病态和免疫组织化学特征
    摘要：SUMMARY – A young woman with breast cancer is considered to be a woman younger than 40. According to the literature, breast cancer in the population of young women usually is of a higher histologic grade, unfavorable hormonal status, and overall higher mortality rate when compared with breast cancer occurring in older population. We compared pathologic and immunohistochemical features of breast carcinoma in women under 40 years of age with the respective features in women over 60 years of age. The following parameters were observed in these two groups: tumor size, lymph node status, histologic grade, hormonal receptor status, Ki-67 prognostic index, Her2/neu status, and histologic type of the tumor. Early onset breast carcinoma was found to have a higher frequency of tumor grade 3 (29% vs. 17%) and estrogen receptor negativity (45% vs. 23%). In the group of young women, breast carcinoma was mostly multicentric (23% vs. 5%), triple-negative (32% vs. 10%), and was found to have higher proliferation index Ki-67 (25% vs. 10%). Our results confirmed differences between the young and older groups of patients. In the group of young women, we found predominantly unfavorable prognostic parameters of the disease.
  • 12.

    【2hr】Improvement of Sexual and Reproductive Function in Men with Spinal Cord Lesion

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    机译 改善脊髓病变男性的性和生殖功能
    摘要：SUMMARY – The aim of the review is to establish sexual and reproductive functions in men with spinal cord lesion (SCL). Many sexual and reproductive dysfunctions may be found in these patients including individual’s low self-esteem, delay of orgasm, erectile or ejaculatory disorder and abnormalities of semen, which are characterized by lower sperm motility or viability. Owing to improvements in physical medicine and rehabilitation, the focus has been shifted from keeping patients alive towards ensuring the quality of life and improvements of sexual dysfunctions and later reproduction. Erectile dysfunction can be treated by using phosphodiesterase-5 inhibitors, intracavernosal injections, vacuum devices and penile prostheses. Semen can be retrieved from anejaculatory patients by medically assisted methods utilizing penile vibratory stimulation, electroejaculation, prostate massage, or surgically. Although there is low chance for pregnancy in natural way in most of SCL patients, fatherhood is possible through the introduction of assisted medical management. By use of various medical, technical and surgical procedures for sperm retrieval combined with assisted reproductive methods, high pregnancy rates have been reported comparable to those in able-bodied subfertile patients. Nevertheless, future studies are needed to improve semen quality and methods of assisted ejaculation in patients with SCL.
  • 13.

    【2hr】THE ROLE OF E2/P RATIO IN THE ETIOLOGY OF FIBROCYSTIC BREAST DISEASE, MASTALGIA AND MASTODYNIA

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    机译 E2 / P比在纤维化性乳腺疾病，乳腺和乳腺症的病因中的作用
    摘要：SUMMARY – The aim of the study was to assess the role of the estradiol and progesterone relationship during the late luteal phase and the occurrence of fibrocystic breast disease (FBD). The concentration of estradiol/progesterone was measured in the group of women with FBD as study group (n=50) and control group of women without FBD (n=40). All women had regular ovulation cycles. Blood samples for estradiol (E2), progesterone (P) and prolactin determination were obtained in the morning at 8 am on days 21 and 24 of menstrual cycle. Significant mastalgia and mastodynia history in women with FBD was obtained with yes or no questionnaire. FBD diagnosis was confirmed with ultrasound (size and number of simple cysts). In the control group, a reduced E2/P ratio was noticed from day 21 to day 24 of the cycle (from 14.8±11.5 pg/mL to 9.1±6.1 pg/mL; p<0.05), which was not recorded in the group of women with FBD (study group). Even the slightest disturbance of the E2/P ratio may contribute to the occurrence of FBD with clinical manifestations of mastalgia and mastodynia.
  • 14.

    【2hr】LAPAROSCOPIC APPENDECTOMY DOES NOT INCREASE THE RATE OF NEGATIVE APPENDECTOMY along with a lower rate of perforated appendicitis – RESULTS IN 1899 PATIENTS at Zagreb UHC

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    机译 腹腔镜阑尾炎并没有增加阴性阑尾炎的发生率以及穿孔性阑尾炎的发生率– 1899年萨格勒布联合医院患者的结果
    摘要：SUMMARY – Laparoscopic appendectomy is the method of choice of many professional societies owing to its many advantages. The question arises whether surgeons urge more easily to laparoscopic exploration due to its less invasiveness, faster recovery and adequate exploration of the entire abdominal cavity than to observation in unequivocal cases. This retrospective analysis (2009-2016) included 1899 patients undergoing laparoscopic (lap) or gridiron intra-abdominal approach treated at Zagreb University Hospital Centre. The analysis included total negative appendectomy, negative-negative appendectomy (normal appendix and no other pathology found), and negative-positive appendectomy (normal appendix but another pathology found) in children (≤16 years) and adults. There was no statistically significant difference in the rates of negative appendectomy (children) – lap vs. open (p=0.24); negative appendectomy (adults) – lap vs. open (p=0.15); negative-negative appendectomy (children) – lap vs. open (p=0.36); negative-negative appendectomy (adults) – lap vs. open (p=0.21); negative-positive appendectomy (children) – lap vs. open (p=0.53); negative-positive appendectomy (adults) – lap vs. open (p=0.56); and laparoscopy group negative appendectomy in children vs. adults (p=0.56). There was a statistically significantly higher perforation rate with the open approach in total (p<0.0001), in children (p<0.0001) and in adults (p=0.02). There was no statistically significant difference between adults and children in the perforation rate with laparoscopic approach (p=0.24) and perforation rate with open approach (p=0.29). Results confirmed that there was no statistically significant difference in the rate of negative appendectomy in all subgroups. It is concluded that laparoscopic appendectomy should be offered as the method of choice in any patient population with suspicion of acute appendicitis.
  • 15.

    【2hr】CERVICAL RIPENING BALLOON AS A METHOD OF PREINDUCTION – ONE CENTER STUDY

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    机译 宫颈种植气球作为一种预诱导方法-一中心研究
    摘要：SUMMARY – Cervical ripening can be promoted in many ways, but mechanical methods are among the oldest. Like all other methods, this one also has its pros and cons. Disadvantages compared to pharmacological methods include some maternal discomfort upon manipulation of the cervix, a theoretical increase in the risk of maternal and neonatal infection from the introduction of a foreign body, potential disruption of a low-lying placenta, and increase in the need of oxytocin induction of labor. The aim of the study was to evaluate the effect of using cervical ripening balloon in preinduction on the mode of delivery. This was a longitudinal, cohort, intervention, non-randomized one center study. Inclusion criteria were term pregnancies with gestational diabetes, oligohydramnios, intrauterine growth restriction, gestational hypertension/preeclampsia and pregnancies after 41 weeks of pregnancy. Preinduction of labor was performed in term pregnancies at Sestre milosrdnice University Hospital Center. Results in the first 150 women having undergone labor preinduction with cervical ripening balloon were included. Two-sided p values <0.05 were considered significant. Statistical analysis was done using SPSS Version 20.0. The study included 150 women; one woman was excluded from further analyses due to conversion of fetal presentation (head to breech). Indications for labor preinduction were as follows: gestational diabetes, oligohydramnios, intrauterine growth restriction, gestational hypertension/preeclampsia and pregnancies after 41 weeks of pregnancy. Women with normal vaginal delivery (96/149) had lower rates of gestational diabetes and oligohydramnios and used epidural analgesia more frequently. Women with dystocia (32/53) had a significantly longer labor duration and higher neonatal birth weight. In multivariate analysis, multiparity, greater cervical dilatation after balloon removal and use of epidural analgesia were associated with a decreased risk of cesarean section, while the presence of gestational diabetes and oligohydramnios was associated with an increased risk of cesarean section. We found this preinduction method safe and efficient, with a potential to increase the rate of vaginal deliveries.
  • 16.

    【2hr】SOCIOECONOMIC INFLUENCE OF TOBACCO USE AND DENTAL CARIES EXPERIENCE IN DIFFERENT MALE CROATIAN POPULATIONS

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    机译 烟草使用和不同龋齿人群龋病的社会经济影响
    摘要：SUMMARY – The purpose was to evaluate dental caries experience in different male subpopulations of Croatian Army recruits and dental students, and subsequently, smoking habits related to the level of education and place of residence. Croatian army recruits (n=248; mean age 20.2) and male dental students (n=56; mean age 21.5) were evaluated according to DMFT and FST indices, divided according to age and place of residence, and interviewed about their dietary habits and smoking of tobacco. In the subpopulation of recruits, the median value of DMFT was 6 and of FST index 25. A statistically significant difference was recorded between DT and FST index (p<0.05) according to dietary role of carbohydrates reflected in caries development. The number of recruits with finished elementary school coming from a rural area who smoked (in total 57.66% of smokers) was significantly larger (p=0.0041). In dental students, the median value of DMFT was 5, with statistical significance in comparison with recruits (p=0.03). There was a difference in FST index (median 28) (p<0.0001). Students were mostly nonsmokers (71.43%) and had urban residence (p<0.0001). FST index was a more specific indicator in the socioeconomically heterogeneous sample of recruits (more subjects coming from rural areas and with a lower level of education) than in the sample of dental students (more subjects coming from urban areas).
  • 17.

    【2hr】Cardiovascular Risk Assessed by Reynolds Risk Score in Relation to Waist Circumference in Apparently Healthy Middle-Aged Population in Montenegro

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    机译 雷诺风险评分与黑山腰围相关的心血管风险评估
    摘要：SUMMARY – Reynolds Risk Score (RRS) is regarded as a good screening tool for cardiovascular disease (CVD) risk. Since CVD is the leading cause of death in Montenegro, we aimed to assess the risk of CVD as assessed by RRS and to examine its association with cardiometabolic parameters in apparently healthy middle-aged population. In addition, we aimed to test whether obesity had an independent influence on RRS. A total of 132 participants (mean age 56.2±6.73 years, 69% females) were included. Body mass index (BMI), waist circumference (WC), blood pressure (BP) and biochemical parameters (fasting glucose, insulin, lipid parameters, creatinine and high sensitivity C-reactive protein) were determined. Insulin resistance (HOMA-IR) and glomerular filtration rate (eGFR) were calculated. Compared with females, a significantly higher number of males were in the high RRS subgroup (χ2=45.9, p<0.001). Furthermore, significantly higher fasting glucose (p=0.030), insulin, HOMA-IR, triglycerides (p<0.001 all), anthropometric parameters (e.g., BMI and WC; p=0.004 and p<0.001, respectively), and creatinine, but lower eGFR and HDL-c (p<0.001 both) were recorded in the high-risk subgroup compared with low and medium risk subgroups. In all participants, in addition to LDL-c, diastolic BP and creatinine, WC was independently positively associated with RRS (β=0.194, p=0.006; β=0.286, p=0.001; β=0.267, p=0.001; and β=0.305, p=0.019, respectively), and 40% of variation in RRS could be explained with this model. In conclusion, middle-aged population with higher WC should be screened for RRS in order to estimate CVD risk.
  • 18.

    【2hr】ISCHEMIC PITUITARY APOPLEXY, HYPOPITUITARISM AND DIABETES INSIPIDUS: A TRIAD UNIQUE TO NECROTIZING HYPOPHYSITIS

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    机译 缺血性垂体中风，垂体功能低下和糖尿病性窦性肌炎的一种独特性
    摘要：SUMMARY – A rare case of necrotizing hypophysitis (NH) in a 52-year-old man presenting with pituitary apoplexy and sterile meningitis is described. This case indicates that the diagnosis of NH could be made without biopsy, based on concomitant presence of diabetes insipidus, hypopituitarism and radiologic features of ischemic pituitary apoplexy. Conservative management of pituitary apoplexy should be advised in NH. Additionally, this is the first report of a case of sterile meningitis caused by ischemic pituitary apoplexy.
  • 19.

    【2hr】THYROGLOBULIN AS A TUMOR MARKER IN DIFFERENTIATED THYROID CANCER – CLINICAL CONSIDERATIONS

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    机译 甲状腺球蛋白作为分化型甲状腺癌的肿瘤标志物-临床考虑
    摘要：SUMMARY – Initial treatment of the majority of patients with differentiated thyroid cancer (DTC) includes total thyroidectomy. Postoperative ablation therapy with radioactive iodine (I-131) is indicated in all high-risk patients, however, there is disagreement regarding its use in low- and intermediate-risk patients. Over the last few decades, thyroglobulin (Tg) has been established as the primary biochemical tumor marker for patients with DTC. Thyroglobulin can be measured during thyroid hormone therapy or after thyroid-stimulating hormone (TSH) stimulation, through thyroid hormone withdrawal or the use of human recombinant TSH. In many studies, the cut-off value for adequate Tg stimulation is a TSH value ≥30 mIU/L. However, there is an emerging body of evidence suggesting that this long-established standard should be re-evaluated, bringing this threshold into question. Recently, a risk stratification system of response to initial therapy (with four categories) has been introduced and Tg measurement is one of the main components. The relationship between the Tg/TSH ratio and the outcome of radioiodine ablation has also been studied, as well as clinical significance of serum thyroglobulin doubling-time. The postoperative serum Tg value is an important prognostic factor that is used to guide clinical management, and it is the most valuable tool in long term follow-up of patients with DTC.
  • 20.

    【2hr】Lower Extremity Injuries in Novice Runners: Incidence, Types, Time Patterns, Sociodemographic and Motivational Risk Factors in a Prospective Cohort Study

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    机译 新手跑步者的下肢损伤：前瞻性队列研究的发生率，类型，时间模式，社会人口统计学和动机危险因素
    摘要：SUMMARY – The aim was to determine types and incidence of running-related lower extremity injuries and identify sociodemographic and motivational risk factors in novice runners attending an eight-month running school. Between January 2011 and October 2014, 349 novice runners were included. Sociodemographic, anthropometric, and data on running motivation and self-perceived health and fitness were collected. Subjects were screened for lower extremity injuries at regular three-month intervals. The cohort mean age was 35.46±7.31 years, and 271 (79.5%) were female. There were 173 (49.9%) injuries recorded, less frequently among women (42.9% vs. 62.7%, p=0.016; OR 0.878, 95% CI 0.788-0.977). The mean body mass index was 23.89±3.88 kg/m2 at baseline and 22.99±3.35 kg/m2 post-school (p<0.001). Median self-perceived fitness level on a ten-point visual analog scale was 4 (interquartile range (IQR) 3-5) at baseline and 8 (IQR 7-8) post-school (p<0.001). Median self-perceived overall health was 6 (IQR 5-8) at baseline and 8 (IQR 7-9) post-school (p<0.001). The knee had a significantly higher rate of injuries compared to other anatomic regions (p<0.001). Subjects listed improvement of fitness as the most common motivation for entering the school (n=159; 45.7%). In conclusion, novice runners should include strengthening exercises for knee injury prevention into their training routine.
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