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Chopra S, Kumar P, Kumar M. Severity of Agricultural Injuries and Its Economic Consequences in Border Belt of Gurdaspur District of Punjab, India. J Agromedicine 2024; 29:179-188. [PMID: 37953596 DOI: 10.1080/1059924x.2023.2281517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Accepted: 10/16/2023] [Indexed: 11/14/2023]
Abstract
OBJECTIVES This study collected data related to agricultural injuries, analyzed their causes, and suggested possible remedial actions. Few studies from developing countries have investigated this important topic. Such investigations are extremely important and are required to frame national policies. METHODS A well-designed structured form was developed to collect and evaluate data on agricultural incidents, their causes, the severity of injuries, and possible prevention methods. The authors followed a door-to-door survey methodology to collect data with the help of local village leaders. RESULTS Less educated and older adults in the age group 31 to 45 years were more prone to agricultural incidents (p < .05). The mean age of the victims was 35.02 years (95% CI 32.7 to 37.3); 124 (91.18%) of the victims were men; and 21 (15.4%) of the cases were fatal. Tractor rollovers caused most of the deaths. Chaff cutters were responsible for most of the incidents that required amputation. Eighteen (45%) of the chaff-cutter incidents occurred in the evening between 3:00 PM and 6:00 PM, and 12 (30%) of these incidents occurred due to fatigue. CONCLUSIONS The authors strongly recommend that rollover protective structures (ROPS) for tractors and seat belts should be made mandatory in India. Public guidelines emphasizing mandatory higher education for farmers and a model curriculum for both schools and colleges that focuses on the safety of rural populations should be developed. Special training should be provided on the safe operation of machinery and a definitive work - rest schedule should be followed to prevent fatigue and protect agricultural workers from incidents.
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Affiliation(s)
- Sumit Chopra
- Department of Mechanical Engineering, Dr B R Ambedkar National Institute of Technology, Jalandhar, India
| | - Pramod Kumar
- Department of Mechanical Engineering, Dr B R Ambedkar National Institute of Technology, Jalandhar, India
| | - Manoj Kumar
- Department of Mechanical Engineering, Dr B R Ambedkar National Institute of Technology, Jalandhar, India
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Lv X, Mou T, Hua W, Liu Y, Li X, Ma Z. Overall Description and Predictors of Disruptive Behavior Toward Nurses in the Perioperative Arena. J Perianesth Nurs 2024:S1089-9472(23)00969-3. [PMID: 38206219 DOI: 10.1016/j.jopan.2023.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 09/01/2023] [Accepted: 09/14/2023] [Indexed: 01/12/2024]
Abstract
PURPOSE To investigate the prevalence, characteristics, causes, consequences, and predictors of and responses to disruptive behavior toward nurses in the perioperative arena. DESIGN A cross-sectional design using a network questionnaire platform. METHODS Nurses in the perioperative arena were recruited online in March 2020. Data on disruptive behavior toward nurses in the past 6 months and nurses' sociodemographic and environmental factors were collected. FINDINGS Nurses (N = 496) responded validly to the survey. In total, 82.1% of participants experienced disruptive behavior. Assignment of overwhelming workloads and verbal aggression were the most common behaviors, and surgeons were the major perpetrators. Perpetrators' intrapersonal issues were the most commonly perceived causes. A positive strategy was the most common strategy adopted by participants. Further, 80.8% of participants recounted their negative experiences, and more than half of respondents (59.9%) talked with their nursing colleagues. Nearly half of respondents (45.9%) did not report disruptive behavior. Negative emotions as an immediate effect were reported by 53.1% of the participants, and the most common long-term impact was decreased passion for work. Middle age, job position, practice environment, and system help were risk factors for experiencing disruptive behavior. CONCLUSIONS The prevalence of disruptive behavior toward nurses in the perioperative arena is high, and its ramifications should not be ignored. Health care institutions should urgently implement intervention strategies to reduce disruptive behavior toward nurses.
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Affiliation(s)
- Xiaofan Lv
- Department of Operating Rooms, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
| | - Tong Mou
- Department of Operating Rooms, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China.
| | - Wei Hua
- Department of Operating Rooms, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China.
| | - Yue Liu
- Department of Anesthesiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China.
| | - Xueyun Li
- Department of Operating Rooms, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China.
| | - Zhengliang Ma
- Department of Anesthesiology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China.
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Timchenko TN, Botnaryuk MV. [The provision of balanced diet aboard of see-going ship as a measure of defense of health of crew members]. Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med 2024; 32:68-74. [PMID: 38349688 DOI: 10.32687/0869-866x-2024-32-1-68-74] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 11/02/2023] [Indexed: 02/15/2024]
Abstract
The unreasonable diet is threatening not only by development of hypodynamia but also by loosing job on board of sea vessel. Such diseases of seamen as gastric ulcer, duodenal ulcer, gastritis, pancreatitis are a basis of non-making or non-extending employment contract. The significant causes of occurrence and development of this category of occupational illness are lacking of proper diet on shipboard that considers conditions of voyages, inadequate qualification training of ship cooks, as well as insufficient funding by particular shipowners daily food allowance of crew members. The article reveals requirements of international and national normative documents regarding organization of proper diet and table service, determines daily diet of crew members of sea and river vessels. The results of survey of active sailors and cadets of higher maritime school regarding the satisfaction of organized diet are discussed. The recommendations to ensure balanced rations on board the ship are proposed.
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Affiliation(s)
- T N Timchenko
- The Federal State Budget Educational Institution of Higher Education "The Admiral F. F. Ushakov State Maritime University", 353924, Novorossiysk, Russia,
| | - M V Botnaryuk
- The Federal State Budget Educational Institution of Higher Education "The Admiral F. F. Ushakov State Maritime University", 353924, Novorossiysk, Russia
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Konfino KV. [The effect of industrial factors on health of crew members of bulk-oil fleet]. Probl Sotsialnoi Gig Zdravookhranenniiai Istor Med 2024; 32:61-67. [PMID: 38349687 DOI: 10.32687/0869-866x-2024-32-1-61-67] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 11/02/2023] [Indexed: 02/15/2024]
Abstract
The negative effect of oil vapors and oil products on health of crew of tanker fleet is a large-scale problem of shipping since safety of life and health of seamen is declared as essential value in implementation of production activity. The inert gases emitted during handling and transportation of oil products, in view of their toxicity, may result not only in acute intoxication but also in development of chronic diseases when inhaling harmful substances in moderate concentrations. The article considers main professional industrial factors that affect crew members of bulk-oil fleet, symptomatology of intoxication and initial care of crew members, application of personal cover when working with this type of cargo. The special attention is paid to chronic diseases developing against the background of negative effect of oil products on health of seamen. The recommendations of prevention and timely detection of their development are proposed.
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Affiliation(s)
- K V Konfino
- The Federal State Budget Educational Institution of Higher Education "The Admiral F. F. Ushakov State Maritime University", 353924, Novorossiysk, Russia,
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Kurdi M, Baeesa S, Okal F, Bamaga AK, Faizo E, Fathaddin AA, Alkhotani A, Karami MM, Bahakeem B. Extracranial metastasis of brain glioblastoma outside CNS: Pathogenesis revisited. Cancer Rep (Hoboken) 2023; 6:e1905. [PMID: 37814403 PMCID: PMC10728524 DOI: 10.1002/cnr2.1905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 08/16/2023] [Accepted: 09/19/2023] [Indexed: 10/11/2023] Open
Abstract
BACKGROUND The most prevalent malignant tumor of the CNS in adults is glioblastoma. Despite undergoing surgery and chemoradiotherapy, the prognosis remains unfavorable, with a median survival period ranging between 15 and 20 months. The incidence of glioblastoma metastasis outside CNS is uncommon with only 0.4%-2% reported rate, compared to other tumors that exhibit a 10% incidence rate of metastasis to the brain. On average, it takes about 11 months from the time of initial diagnosis for the tumor to spread beyond CNS. Consequently, the prognosis for metastatic glioblastoma is grim, with a 6-month survival rate following diagnosis. FINDINGS The rarity of extracranial metastasis is attributed to the blood-brain barrier and lack of a lymphatic drainage system, although rare cases of hematogenous spread and direct implantation have been reported. The possible mechanisms remain unclear and require further investigation. Risk factors have been widely described, including previous craniotomy or biopsies, ventricular shunting, young age, radiation therapy, prolonged survival time, and tumor recurrence. Due to the lack of understanding about extracranial metastasis of glioblastoma pathogenesis, no effective treatment exists to date. Aggressive chemotherapies are not recommended for metastatic glioblastoma as their side effects may worsen the patient prognosis. CONCLUSION The optimal treatment for extracranial metastasis of glioblastoma requires further investigation with a wide inclusion of patients. This review discusses the possible causes, factors, and underlying mechanisms of glioblastoma metastasis to different organs.
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Affiliation(s)
- Maher Kurdi
- Department of Pathology, Faculty of MedicineKing Abdulaziz UniversityRabighSaudi Arabia
| | - Saleh Baeesa
- Department of NeurosciencesKing Faisal Specialist Hospital and Research CenterJeddahSaudi Arabia
| | - Fahad Okal
- Department of Neuroscience, Neurosurgery Section, King Abdulaziz Medical CityNational Guard Health AffairsJeddahSaudi Arabia
| | - Ahmed K. Bamaga
- Department of Paediatric, Faculty of MedicineKing Abdulaziz University and HospitalJeddahSaudi Arabia
| | - Eyad Faizo
- Department of Surgery, Faculty of MedicineUniversity of TabukTabukSaudi Arabia
| | - Amany A. Fathaddin
- Department of Pathology, College of MedicineKing Saud UniversityRiyadhSaudi Arabia
| | - Alaa Alkhotani
- Department of Pathology, College of MedicineUmm Al‐Qura UniversityMeccaSaudi Arabia
| | - Mohammed M. Karami
- Department of Clinical Physiology, Faculty of MedicineKing Abdulaziz UniversityJeddahSaudi Arabia
| | - Basem Bahakeem
- Department of Internal MedicineUmm‐Alqura UniversityMeccaSaudi Arabia
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Posti JP, Cajanus K, Tornio A, Ruuskanen JO, Luoto TM, Rautava P, Kytö V. Causes of fatal traumatic brain injury in Finland. J Neurosurg 2023; 139:1506-1513. [PMID: 37148228 DOI: 10.3171/2023.3.jns23148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 03/27/2023] [Indexed: 05/08/2023]
Abstract
OBJECTIVE The phenotype of patients who suffer fatal traumatic brain injury (TBI) is poorly characterized. The authors examined the external causes, contributing diseases, and preinjury medication in adult patients with fatal TBI in a nationwide Finnish cohort. METHODS Deaths caused by TBIs in Finland were examined among decedents aged ≥ 16 years during 2005-2020 from the national Cause of Death Registry. Usage of prescription medications prior to TBI was studied using medication purchase data from the Social Insurance Institution of Finland. RESULTS The cohort consisted of 71,488,347 person-years, 821,259 total deaths, and 14,630 TBI-related deaths during 2005-2020, of which 67% (n = 9792) occurred in men. Women were older than men among those who suffered TBI-related death (mean age 77.2 ± 17.1 vs 64.5 ± 19.5 years, p < 0.0001). The overall crude incidence rate of fatal TBIs was 20.5/100,000 person-years (28.1/100,000 in men and 13.2/100,000 in women). TBI was the cause of death in 1.8% of all deaths in the Finnish population during the study years, but in patients aged 16-19 years, TBIs caused more than 17% of all deaths. The most common external cause of fatal TBI was a fall (70%), followed by poisoning or toxic effects (20%) and violence or self-harm (15%) overall. In men, the order of the most common causes of fatal TBI was similar to overall results (64%, 25%, and 19%, respectively), while in women, the most common cause was a fall (82%), followed by complications in healthcare (10%) and poisoning or toxic effects (9%). Cardiovascular diseases, psychiatric diseases, and infections were the most common diseases contributing to death. Blood pressure (lowering) medications were the most common type of medications used before fatal TBI. CNS medications were the second most common medication group. In the context of fatal TBI in Europe, Finland remains at the upper end of fatal TBI incidence. CONCLUSIONS TBI is a common cause of death in young adults, whereas the incidence of fatal TBI becomes increasingly higher with age in Finland. Cardiovascular diseases and psychiatric conditions were the most common diseases related to death, with opposite age trends. Healthcare facility complications were an alarmingly common cause of death in women with fatal TBI.
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Affiliation(s)
- Jussi P Posti
- 1Neurocenter, Department of Neurosurgery and Turku Brain Injury Center, Turku University Hospital and University of Turku
| | - Kristiina Cajanus
- 2Department of Clinical Pharmacology, Turku University Hospital and University of Turku
| | - Aleksi Tornio
- 2Department of Clinical Pharmacology, Turku University Hospital and University of Turku
| | - Jori O Ruuskanen
- 3Neurocenter, Department of Neurology, Turku University Hospital and University of Turku
| | - Teemu M Luoto
- 4Department of Neurosurgery, Tampere University Hospital and Tampere University, Tampere
| | - Päivi Rautava
- 5Clinical Research Center, Turku University Hospital and University of Turku
| | - Ville Kytö
- 5Clinical Research Center, Turku University Hospital and University of Turku
- 7Research Center of Applied and Preventive Cardiovascular Medicine, University of Turku, Finland
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Ahn SJ, Kim JH. Causes and trends of late diagnosis in Korean patients with hydroxychloroquine retinopathy. Front Med (Lausanne) 2023; 10:1238226. [PMID: 37809332 PMCID: PMC10551622 DOI: 10.3389/fmed.2023.1238226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 09/11/2023] [Indexed: 10/10/2023] Open
Abstract
Introduction Late diagnosis of hydroxychloroquine retinopathy remains a major concern, with the potential for irreversible visual impairment. This study aimed to investigate the causes of late diagnosis in a hospital-based cohort of Korean patients with hydroxychloroquine retinopathy and assess the trend of late diagnosis from 2015 to 2022. Methods Thirty-eight patients with a late diagnosis (severe stage at diagnosis) among 94 patients with hydroxychloroquine retinopathy were included in the analysis. The causes of late diagnosis were categorized as referral-related, patient-related, and screening-related factors. Results The most prevalent cause was no or late referral to ophthalmologists, contributing to a significant gap in timely identification. Patient-related causes included delayed monitoring visits despite scheduled appointments and early-onset disease. Screening-related causes encompassed an insufficient number of sensitive tests, leading to inadequate evidence for diagnosis, and missed or wrong diagnoses by screening physicians. The proportion of late diagnoses decreased over time, indicating improvements in overall screening and detection. The decreasing proportions of screening-related causes suggest advancements in screening practices and the use of multiple sensitive tests for screening. Discussion Efforts to further reduce late diagnoses and improve screening and diagnostic processes are necessary. Our data emphasize the importance of timely referral to ophthalmologists for early detection and management.
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Affiliation(s)
- Seong Joon Ahn
- Department of Ophthalmology, Hanyang University Hospital, Hanyang University College of Medicine, Seoul, Republic of Korea
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Woodman L, Staples L, Karin E, Solterbeck K, Burns N, Mitchell R, Nielssen O. Rates and causes of mortality among the homeless in Sydney. Australas Psychiatry 2023; 31:469-474. [PMID: 37210640 DOI: 10.1177/10398562231176734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
OBJECTIVE To report on the rate and causes of mortality, and associations with premature mortality among the homeless in inner city Sydney. METHOD Retrospective cohort study of 2,498 people who attended a psychiatric clinic conducted at the three main homeless hostels between 17 February 2008 and 19 May 2020. Cox's proportional hazards regression was used to identify factors associated with mortality. RESULTS A total of 324 of the 2498 (13.0%) clinic attenders were found to have died in the follow-up period, with a mean age at death of 50.7 years. Unnatural causes of death (119/324, 36.7%) included drug overdose (24.1%), suicide (6.8%) and other injuries (5.9%), at a younger age (44.4 years) than those who died from natural causes (54.4 years). There were 142 (43.8%) deaths from natural causes and 63 (19.4%) in which the cause of death was not determined. CONCLUSIONS The study confirms the high mortality of homeless clinic attenders in Sydney found in a study from 30 years earlier. The lower mortality among regular attenders supports the provision of accessible services to address the physical health needs of homeless people, as well as ready access to mental health and substance use services.
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Affiliation(s)
- Logan Woodman
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Macquarie Park, NSW, Australia
| | - Lauren Staples
- Associate Professor, School of Psychological Sciences, Faculty of Medicine, Health and Human Sciences Macquarie University, Clinical Data Manager, MindSpot, MQ Health, Macquarie Park, NSW, Australia
| | - Eyal Karin
- School of Psychological Sciences, Faculty of Medicine, Health and Human Sciences Macquarie University, Macquarie Park, NSW, Australia
| | - Kirra Solterbeck
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Macquarie Park, NSW, Australia
| | - Nicholas Burns
- Justice Health and Forensic Mental Health Network, Matraville, NSW, Australia
| | - Rebecca Mitchell
- Associate Professor, Australian Institute of Health Innovation, Faculty of Medicine, Human and Health Sciences, Macquarie University, Macquarie Park, NSW, Australia
| | - Olav Nielssen
- Professor of Psychiatry, Faculty of Medicine, Health and Human Sciences, Macquarie University, Matthew Talbot Hostel Clinic, Macquarie Park, NSW, Australia
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Ghani U, Farooq O, Alam S, Khan MJ, Rahim O, Rahim S. Sudden Cardiac Death in Athletes: Consensuses and Controversies. Cureus 2023; 15:e39873. [PMID: 37404395 PMCID: PMC10315103 DOI: 10.7759/cureus.39873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/02/2023] [Indexed: 07/06/2023] Open
Abstract
Exercise is widely considered beneficial for cardiovascular health. However, on rare occasions, athletes experience sudden cardiac death without any preceding symptoms. The devastating nature of these events necessitates us to understand the underlying causes. In younger athletes (age <35), the underlying causes are usually hereditary/genetic, whereas in older athletes (age >35), coronary artery disease is prevalent. Sudden cardiac death in athletes can occur regardless of the presence of any structural abnormality in the heart. Despite divergence between guidelines, the majority of cardiology societies recommend at least taking a comprehensive history and performing physical examinations for initial screening for all athletes. This article reviews the consensuses and controversies regarding the incidence, causes, and prevention of sudden cardiac death in athletes.
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Affiliation(s)
- Usman Ghani
- Cardiology, Northwest General Hospital and Research Center, Peshawar, PAK
| | - Omer Farooq
- Internal Medicine, Presence Saint Francis Hospital, Evanston, USA
| | - Sundus Alam
- Cardiology, Gloucestershire Hospitals NHS Foundation Trust, Gloucester, GBR
| | - Muhammad Junaid Khan
- Orthopaedic Surgery, Gloucestershire Hospitals NHS Foundation Trust, Gloucester, GBR
| | - Omar Rahim
- Internal Medicine, Naseer Teaching Hospital, Peshawar, PAK
| | - Sarah Rahim
- Cardiology, Rehman Medical Institute, Peshawar, PAK
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Zhang W, Yan Z. A case of complete Melkersson-Rosenthal syndrome: Possibly associated with Mycolicibacterium fortuitum from odontogenic origin. J Dermatol 2023. [PMID: 36815397 DOI: 10.1111/1346-8138.16751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 01/02/2023] [Accepted: 02/02/2023] [Indexed: 02/24/2023]
Abstract
Melkersson-Rosenthal syndrome (MRS) is a neuromucocutaneous disease of unknown pathogenesis. With this communication, we describe a case of a 26-year-old woman with complete MRS in whom Mycolicibacterium fortuitum was detected in the swelling lip biopsy by next- generation sequencing. The patient's symptoms were slightly improved after intralesional corticosteroid injection combined with broad-spectrum antibiotics, while they were significantly improved after further treatment of dental caries and removal of the residual root. This case provides insight into the possible microbial infection pathogenesis of MRS, and M. fortuitum was speculated to be related to granulomatous and neuronal disorders, most probably from odontogenic origin.
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Affiliation(s)
- Wenqing Zhang
- Department of Oral Medicine, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
| | - Zhimin Yan
- Department of Oral Medicine, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, China
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Tian M, Wang Z, Zhu Y, Tian Y, Zhang K, Li X. Incidence, Causes, and Risk Factors of Unplanned Readmissions in Elderly Patients Undergoing Hip Fracture Surgery: An Observational Study. Clin Interv Aging 2023; 18:317-326. [PMID: 36883190 PMCID: PMC9985873 DOI: 10.2147/cia.s395012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Accepted: 02/17/2023] [Indexed: 03/03/2023] Open
Abstract
Aim The purpose of this study was to examine the incidence and cause of unplanned readmission after Surgically Treated Hip Fractures in Elderly Patients and identify the associated risk factors. Methods This study retrospectively collected the data on elderly patients who underwent hip fracture surgery at two institutions from January 2020 to December 2021, and identified those who were readmitted within 12 months postoperatively. Based on the presence or not of postoperative readmission, they were divided into readmission and non-readmission groups. Demographics, surgery-related variables, and laboratory parameters were compared between groups. The specific causes for documented readmission were collected and summarized. Multivariate logistic regression analysis was performed to identify the associated risk factors. Results There were 930 patients including 76 (8.2%) patients who were readmitted within 12 months postoperatively. Overall, cardiac and respiratory complications and new-onset fractures were the first three common causes of readmission, taking an overwhelming proportion of 53.9% (41/76). Over 60% (61.8%, 47/76) of readmissions occurred within 30 days after surgery, with medical complications taking a predominance (89.4%, 42/47). New-onset fractures accounted for a proportion of 18.4% (14/76), occurring at different time points; especially, at 90-365 days, it accounted for 44.4% (8/18). Multivariate analysis revealed that age ≥80 years (OR, 1.0, 95% CI, 1.0 to 1.1; P=0.032), preoperative albumin level ≤21.5 g/L (OR, 1.1, 95% CI, 1.0 to 1.2; P=0.009), the postoperative occurrence of DVT (OR, 4.2, 95% CI, 2.5 to 7.2; P=0.001), and local anesthesia (OR, 2.1, 95% CI, 1.1 to 4.0; P=0.029) were independent risk factors for unplanned readmissions. Conclusion This study identified several risk factors for unplanned readmissions after elderly hip fractures, and provided detailed information about unplanned readmissions.
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Affiliation(s)
- Miao Tian
- Department of Orthopedic Surgery, the Third Hospital of Hebei Medical University, Shijiazhuang, People's Republic of China
| | - Zhijia Wang
- Department of Joint Surgery, Huai 'an Hospital of Huai'an City, Huai'an, People's Republic of China
| | - Yanbin Zhu
- Department of Orthopedic Surgery, the Third Hospital of Hebei Medical University, Shijiazhuang, People's Republic of China.,Hebei Orthopedic Research Institute, Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, People's Republic of China
| | - Yunxu Tian
- Department of Orthopedic Surgery, the Third Hospital of Hebei Medical University, Shijiazhuang, People's Republic of China
| | - Kexin Zhang
- Department of Orthopedic Surgery, the Third Hospital of Hebei Medical University, Shijiazhuang, People's Republic of China
| | - Xiuting Li
- Department of Orthopedic Surgery, the Third Hospital of Hebei Medical University, Shijiazhuang, People's Republic of China
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Daly T, Henry V, Bourdenx M. From Association to Intervention: The Alzheimer's Disease-Associated Processes and Targets (ADAPT) Ontology. J Alzheimers Dis 2023; 94:S87-S96. [PMID: 36683508 PMCID: PMC10473068 DOI: 10.3233/jad-221004] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/06/2022] [Indexed: 01/21/2023]
Abstract
BACKGROUND Many putative causes and risk factors have been associated with outcomes in Alzheimer's disease (AD) but all attempts at disease-modifying treatment have failed to be clinically significant. Efforts to address this "association-intervention" mismatch have tended to focus on the novel design of interventions. OBJECTIVE Here, we instead deal with the notion of association in depth. We introduce the concept of disease-associated process (DAP) as a flexible concept that can unite different areas of study of AD from genetics to epidemiology to identify disease-modifying targets. METHODS We sort DAPs using three properties: specificity for AD, frequency in patients, and pathogenic intensity for dementia before using a literature review to apply these properties in three ways. Firstly, we describe and visualize known DAPs. Secondly, we exemplify qualitative specificity analysis with the DAPs of tau protein pathology and autophagy to reveal their differential implication in AD. Finally, we use DAP properties to define the terms "risk factor," "cause," and "biomarker." RESULTS We show how DAPs fit into our collaborative disease ontology, the Alzheimer's Disease-Associated Processes and Targets (ADAPT) ontology. We argue that our theoretical system can serve as a democratic research forum, offering a more biologically adequate view of dementia than reductionist models. CONCLUSION The ADAPT ontology is a tool that could help to ground debates around priority setting using objective criteria for the identifying of targets in AD. Further efforts are needed to address issues of how biomedical research into AD is prioritized and funded.
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Affiliation(s)
- Timothy Daly
- Sorbonne Université, Science Norms Democracy UMR, Paris, France
| | - Vincent Henry
- Sorbonne Université, Brain and Spine Institute, Paris, France
| | - Mathieu Bourdenx
- University College London, UK Dementia Research Institute, London, UK
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Munakomi S, Chaulagain D. Demographical domains and clinico-radiological characteristics of study cohorts with spontaneous simultaneous multiple intracerebral hemorrhages in a tertiary neurosurgical center in Nepal: a cross-sectional study. F1000Res 2022; 11:154. [PMID: 36519009 PMCID: PMC9716112 DOI: 10.12688/f1000research.108816.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/21/2022] [Indexed: 11/29/2022] Open
Abstract
Background: Spontaneous simultaneous multiple intra-cerebral hemorrhages (SMICHs) and its occurrences in different territories of arterial disposition has been viewed as uncommon clinical occurrences, since the pathophysiological and predisposing factors as mechanisms aren't vividly defined. This research primarily aims for demographic stratification and dichotomization pertaining to risk factors, etiological classifications, anatomical distributions and outcome analysis by focusing on management strategies and pertinent stroke care. Methods: 40 patients presenting to the College of Medical Sciences, Chitwan, Nepal in the last two years were included in the study. The patients with two or more spontaneous SMICHs with affected arterial territories with similar tomographic density based profiling were chosen as samples. Regression analysis was chosen to test three hypotheses. Results: Among our study cohorts, cortical and cortical territory (60%) was the major anatomical patterns of involvement. A conservative approach was undertaken in nine patients (22.5%), whereas surgical intervention was needed in five others (12.5%). A total of 14(35%) patients leaving against medical advice and a further seven (17.5%) patients were referred for adjuvant oncologic care. Mortality was observed among five (12.5%) patients. Hypertension was seen as a significant variable in its pathogenesis. Male patients were more affected. Age groups comprising 36-45years and 56-65 years were involved in 32.5% and 30% of cases respectively. Conclusion: This study proves the need for a national stroke data bank pertaining to spontaneous SMICHs. This will help foster effective patient education during preoperative counseling; as well as formatting a management algorithm combating them.
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Affiliation(s)
- Sunil Munakomi
- Neurosurgery, College of Medical Sciences, Chitwan, Nepal,
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14
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Yoshimatsu Y, Tobino K, Ortega O, Oda H, Ota H, Kawabata T, Hiramatsu Y, Murakami Y, Clavé P. Development and implementation of an aspiration pneumonia cause investigation algorithm. Clin Respir J 2022; 17:20-28. [PMID: 36373578 PMCID: PMC9829530 DOI: 10.1111/crj.13557] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 10/28/2022] [Indexed: 11/16/2022]
Abstract
The diagnostic criteria of aspiration pneumonia have not been established, and it remains an underdiagnosed entity. Diagnosis and cause investigation is essential in improving the management of aspiration pneumonia. The Japanese Respiratory Society Guidelines for the Management of Pneumonia in Adults (JRS Guidelines) show a list of risk factors for aspiration pneumonia. We developed an algorithm to aid physicians in evaluating these possible underlying factors and guide their management with a focus on aspiration pneumonia. The algorithm was developed based on the JRS Guidelines. The algorithm suggested dysphagia screening, pneumococcal and influenza vaccination, and other preventative measures for pneumonia. The algorithm was implemented in the acute setting of a general hospital among older patients admitted with pneumonia. Their outcomes were compared with a historical control group constituting similar patients from the previous year. Forty patients with pneumonia were assessed with the algorithm group, and 44 patients were included in the control group. In the algorithm group, significantly more cases (95.0% vs. 15.9%, p < 0.01) underwent early screening for a swallowing disorder. Two patients in the algorithm group were diagnosed with a new condition causing aspiration pneumonia, as opposed to none in the control group. Drugs with a potential risk for aspiration were identified and discontinued in 27.5% of the patients in the algorithm group and 4.5% in the control group. In conclusion, an aspiration pneumonia cause investigation algorithm translating the JRS guideline approach into practice enhanced the rate of swallow screening and preventative measures for aspiration.
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Affiliation(s)
- Yuki Yoshimatsu
- Department of Respiratory MedicineIizuka HospitalFukuokaJapan,Department of PhysiologyHyogo College of MedicineNishinomiyaJapan
| | - Kazunori Tobino
- Department of Respiratory MedicineIizuka HospitalFukuokaJapan,Department of Respiratory MedicineJuntendo University Graduate School of MedicineTokyoJapan
| | - Omar Ortega
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (Ciberehd)Instituto de Salud Carlos IIIBarcelonaSpain,Gastrointestinal Motility Laboratory, Department of Surgery, Hospital de Mataró, Consorci Sanitari del MaresmeUniversitat Autònoma de BarcelonaMataróSpain
| | - Hiroyuki Oda
- Department of General MedicineIizuka HospitalFukuokaJapan
| | - Hiroaki Ota
- Department of Respiratory MedicineIizuka HospitalFukuokaJapan
| | | | - Yuri Hiramatsu
- Department of Respiratory MedicineIizuka HospitalFukuokaJapan
| | - Yosuke Murakami
- Department of Respiratory MedicineIizuka HospitalFukuokaJapan
| | - Pere Clavé
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (Ciberehd)Instituto de Salud Carlos IIIBarcelonaSpain,Gastrointestinal Motility Laboratory, Department of Surgery, Hospital de Mataró, Consorci Sanitari del MaresmeUniversitat Autònoma de BarcelonaMataróSpain
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15
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Botero-Bermúdez M, Briceño-Rodríguez L, Quiñonez-Yepes T, Taborda-Aitken JC. [Compartment syndrome: an atypical presentation as a cause of Henoch-Schönlein purpura]. Acta Ortop Mex 2022; 36:324-328. [PMID: 37402500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 07/06/2023]
Abstract
INTRODUCTION there are few case reports available that describe compartment syndrome as a complication of Henoch-Schönlein purpura. CASE REPORT we report the case of a 17-year-old patient with bilateral compartment syndrome of the foot as an atypical presentation of Henoch-Schönlein purpura. A case like this has not been reported before. CONCLUSION although the patient had an extremely rare clinical presentation, the viability and functionality of the limbs was preserved even after six months of follow-up thanks to an early diagnosis and surgical treatment.
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Affiliation(s)
- M Botero-Bermúdez
- Facultad de Medicina, Pontificia Universidad Javeriana. Bogotá, Colombia
| | | | - T Quiñonez-Yepes
- Departamento de Ortopedia y Traumatología, Hospital Universitario San Ignacio. Bogotá, Colombia
| | - J C Taborda-Aitken
- Departamento de Ortopedia y Traumatología, Hospital Universitario San Ignacio. Bogotá, Colombia
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16
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Wang Y, Rao Q, Li X. Adverse transfusion reactions and what we can do. Expert Rev Hematol 2022; 15:711-726. [PMID: 35950450 DOI: 10.1080/17474086.2022.2112564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Transfusions of blood and blood components have inherent risks and the ensuing adverse reactions. It is very important to understand the adverse reactions of blood transfusion comprehensively for ensuring the safety of any future transfusions. AREAS COVERED According to the time of onset, adverse reactions of blood transfusion are divided into immediate and delayed transfusion reactions. In acute transfusion reactions, timely identification and immediate cessation of transfusion is critical. Vigilance is required to distinguish delayed responses or reactions that present non-specific signs and symptoms. In this review, we present the progress of mechanism, clinical characteristics and management of commonly encountered transfusion reactions. EXPERT OPINION The incidence of many transfusion-related adverse events is decreasing, but threats to transfusion safety are always emerging. It is particularly important for clinicians and blood transfusion staff to recognize the causes, symptoms and treatment methods of adverse blood transfusion reactions to improve the safety. In the future, at-risk patients will be better identified and can benefit from more closely matched blood components.
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Affiliation(s)
- Yajie Wang
- Department of Blood Transfusion, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Quan Rao
- Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Xiaofei Li
- Department of Blood Transfusion, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
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17
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Abstract
statistics for genome-wide association studies (GWAS) are increasingly available for downstream analyses. Meanwhile, the popularity of causal inference methods has grown as we look to gather robust evidence for novel medical and public health interventions. This has led to the development of methods that use GWAS summary statistics for causal inference. Here, we describe these methods in order of their escalating complexity, from genetic associations to extensions of Mendelian randomization that consider thousands of phenotypes simultaneously. We also cover the assumptions and limitations of these approaches before considering the challenges faced by researchers performing causal inference using GWAS data. GWAS summary statistics constitute an important data source for causal inference research that offers a counterpoint to nongenetic methods when triangulating evidence. Continued efforts to address the challenges in using GWAS data for causal inference will allow the full impact of these approaches to be realized.
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Affiliation(s)
- Venexia M. Walker
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Jie Zheng
- MRC (Medical Research Council) Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom;
| | - Tom R. Gaunt
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - George Davey Smith
- MRC (Medical Research Council) Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom;
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18
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Puga TB, Schafer J, Agbedanu PN, Treffer K. COVID-19 Return to Sport: NFL Injury Prevalence Analysis. JMIRx Med 2022; 3:e35862. [PMID: 35511457 PMCID: PMC9048138 DOI: 10.2196/35862] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 02/17/2022] [Accepted: 03/06/2022] [Indexed: 01/23/2023]
Abstract
Background Sport injuries have been common among athletes across the globe for decades and have the potential to disrupt athletic careers, performance, and psyche. Many health professionals and organizations have undertaken injury mitigation strategies to prevent sport injuries through protective equipment, training protocols, and a host of other evidence-based practices. Many of these specialized training methods were disrupted due to protocols to mitigate the spread of COVID-19. This research examines the effects of the COVID-19 pandemic in relation to the prevalence of athletic injuries in the National Football League (NFL). Objective During the COVID-19 pandemic, NFL teams and athletes across all levels of sport were reported to have reduced training in preparation for their seasons due to protocols to mitigate the spread of COVID-19. This study compares the prevalence of injury during the 2018, 2019, and 2020 NFL seasons, with the aim to determine the potential causes of the differences in injury prevalence. Methods Official injury reports from each team were counted during the 17-week regular season of each year (2018, 2019, and 2020). The data were analyzed using an unpaired t test to compare the injury prevalence between each of the three seasons. Results The 2018 season produced a total of 1561 injuries and a mean of 48.8 injuries per team. The 2019 season produced a total of 1897 injuries and a mean of 59.3 injuries per team, while the 2020 season produced a total of 2484 injuries and a mean of 77.6 injuries per team. An unpaired t test was performed using the data to compare the mean number of injuries per team during each of the seasons. Comparison of the 2020 season against the 2019 season showed a statistically significant difference (P<.001); comparison of the 2020 season to the 2018 season found a statistically significant difference (P<.001); and comparison between the 2019 and the 2018 seasons found a statistically significant difference (P=.03). Conclusions Although the 2019 and 2018 seasons showed a statistically significant difference (P=.03), this difference is not as large when we compare the 2020 seasons versus the 2019 (P<.001) and 2018 (P<.001) seasons. The astronomical increase in injury prevalence during the 2020 season over the previous years raises the possibility that there was a reduced physiological adaptation to stress, due to the limited amount of training as a result of the closure of practice facilities in order to slow the spread of COVID-19.
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Affiliation(s)
- Troy B Puga
- College of Osteopathic Medicine Kansas City University Kansas City, MO United States
| | - Joshua Schafer
- School of Medicine University of Kansas Kansas City, KS United States
| | - Prince N Agbedanu
- Department of Health Sciences Division of Science, Technology, Engineering, and Math Friends University Wichita, KS United States
| | - Kevin Treffer
- Department of Osteopathic Manipulative Medicine College of Osteopathic Medicine Kansas City University Kansas City, MO United States
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19
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Tomaszewski T, Morales A, Lourentzou I, Caskey R, Liu B, Schwartz A, Chin J. Identifying False Human Papillomavirus (HPV) Vaccine Information and Corresponding Risk Perceptions From Twitter: Advanced Predictive Models. J Med Internet Res 2021; 23:e30451. [PMID: 34499043 PMCID: PMC8461539 DOI: 10.2196/30451] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 08/04/2021] [Indexed: 01/27/2023] Open
Abstract
Background The vaccination uptake rates of the human papillomavirus (HPV) vaccine remain low despite the fact that the effectiveness of HPV vaccines has been established for more than a decade. Vaccine hesitancy is in part due to false information about HPV vaccines on social media. Combating false HPV vaccine information is a reasonable step to addressing vaccine hesitancy. Objective Given the substantial harm of false HPV vaccine information, there is an urgent need to identify false social media messages before it goes viral. The goal of the study is to develop a systematic and generalizable approach to identifying false HPV vaccine information on social media. Methods This study used machine learning and natural language processing to develop a series of classification models and causality mining methods to identify and examine true and false HPV vaccine–related information on Twitter. Results We found that the convolutional neural network model outperformed all other models in identifying tweets containing false HPV vaccine–related information (F score=91.95). We also developed completely unsupervised causality mining models to identify HPV vaccine candidate effects for capturing risk perceptions of HPV vaccines. Furthermore, we found that false information contained mostly loss-framed messages focusing on the potential risk of vaccines covering a variety of topics using more diverse vocabulary, while true information contained both gain- and loss-framed messages focusing on the effectiveness of vaccines covering fewer topics using relatively limited vocabulary. Conclusions Our research demonstrated the feasibility and effectiveness of using predictive models to identify false HPV vaccine information and its risk perceptions on social media.
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Affiliation(s)
- Tre Tomaszewski
- School of Information Sciences, University of Illinois at Urbana-Champaign, Champaign, IL, United States
| | - Alex Morales
- Department of Computer Science, University of Illinois at Urbana-Champaign, Urbana, IL, United States
| | - Ismini Lourentzou
- Department of Computer Science, Virginia Polytechnic Institute and State University, Blacksburg, VA, United States
| | - Rachel Caskey
- College of Medicine, University of Illinois at Chicago, Chicago, IL, United States
| | - Bing Liu
- Department of Computer Science, University of Illinois at Chicago, Chicago, IL, United States
| | - Alan Schwartz
- Department of Medical Education, University of Illinois at Chicago, Chicago, IL, United States
| | - Jessie Chin
- School of Information Sciences, University of Illinois at Urbana-Champaign, Champaign, IL, United States.,Cancer Center at Illinois, University of Illinois at Urbana-Champaign, Urbana, IL, United States
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20
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Lin J, Zhang Y, Li W, Yan J, Ke Y. Flatness of the Meckel cave may cause primary trigeminal neuralgia: a radiomics-based study. J Headache Pain 2021; 22:104. [PMID: 34479476 PMCID: PMC8414677 DOI: 10.1186/s10194-021-01317-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 08/12/2021] [Indexed: 12/20/2022] Open
Abstract
Background Neurovascular contact (NVC) is the main cause of primary trigeminal neuralgia (PTN); however, cases of PTN without NVC are still observed. In this study, the Meckel cave (MC) morphology in PTN were analyzed by radiomics and compared to healthy controls (HCs) to explore the cause of PTN. Methods We studied the 3.0T MRI data of 115 patients with PTN and 46 HCs. Bilateral MC was modeled using the 3D Slicer software, and the morphological characteristics of MC were analyzed using the radiomics method. Results The right side incidence rate in the PTN group was higher than the left side incidence. By analyzing the flatness feature of MC, we observed that the affected side of the PTN was lower than that of the unaffected side, the right MC of the PTN and HC was lower than that of the left MC, the MC of the affected side of the left and right PTN without bilateral NVC was lower than that of the unaffected side. Conclusions By providing a method to analyze the morphology of the MC, we found that there is an asymmetry in the morphology of bilateral MC in the PTN and HC groups. It can be inferred that the flatness of the MC may be a cause of PTN.
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Affiliation(s)
- Jinzhi Lin
- The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, Department of Neurosurgery, Zhujiang Hospital, Southern Medical University, 510282, Guangzhou, China.,Department of Neurosurgery, Guangdong Second Provincial General Hospital, 510317, Guangzhou, China
| | - Yong Zhang
- Department of Neurosurgery, Guangdong Second Provincial General Hospital, 510317, Guangzhou, China
| | - Wuming Li
- Department of Neurosurgery, Guangdong Second Provincial General Hospital, 510317, Guangzhou, China
| | - Jianhao Yan
- Department of Neurosurgery, Guangdong Second Provincial General Hospital, 510317, Guangzhou, China
| | - Yiquan Ke
- The National Key Clinical Specialty, The Engineering Technology Research Center of Education Ministry of China, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, Department of Neurosurgery, Zhujiang Hospital, Southern Medical University, 510282, Guangzhou, China.
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21
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Wu X, Ya J, Zhou D, Ding Y, Ji X, Meng R. Nonthrombotic internal jugular venous stenosis may facilitate cerebral venous thrombosis. CNS Neurosci Ther 2021; 27:1396-1408. [PMID: 34397153 PMCID: PMC8504525 DOI: 10.1111/cns.13719] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Revised: 08/04/2021] [Accepted: 08/06/2021] [Indexed: 11/30/2022] Open
Abstract
AIMS To explore the effect of nonthrombotic internal jugular venous stenosis (IJVS) exerted on cerebral venous thrombosis (CVT). METHODS Patients with imaging confirmed CVT were enrolled into this real-world case-control study consecutively from January 2018 through April 2021, and were divided into CVT and IJVS-CVT groups, according to whether or not with non-thrombotic IJVS. Chi-square and logistic regression models were utilized for between-group comparison of thrombotic factors. RESULTS A total of 199 eligible patients entered into final analysis, including 92 cases of CVT and 107 cases of IJVS-CVT. Chi-square revealed that thrombophilic conditions were found in majority of CVT, while only minority in the IJVS-CVT group (83.7% vs. 20.6%, p < 0.001). Multivariate logistic regression indicated that most identified thrombophilia were negatively related to IJVS-CVT (all p < 0.05), including oral contraceptive use (β = -1.38), hyperhomocysteinemia (β = -1.58), hematology (β = -2.05), protein C/S deficiency (β = -2.28), connective tissue disease (β = -1.18) and infection (β = -2.77). All recruited patients underwent standard anticoagulation, 10 cases in IJVS-CVT group also received jugular angioplasty for IJVS correction. Most participants obtained alleviations during 1-year follow-up. However, both clinical and imaging outcomes in IJVS-CVT group were not as good as those in CVT group (both p < 0.05). Moreover, 8 cases with CVT and 7 cases with IJVS-CVT were rehospitalized for CVT recurrences and underwent customized treatment. CONCLUSION Nonthrombotic IJVS may be one of the risk factors of CVT. Anticoagulation might need to be suggested for IJVS patients.
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Affiliation(s)
- Xiaoqin Wu
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.,Advanced Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Department of China-America Institute of Neuroscience, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Jingyuan Ya
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.,Advanced Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Department of China-America Institute of Neuroscience, Xuanwu Hospital, Capital Medical University, Beijing, China.,Division of Clinical Neuroscience, University of Nottingham, Nottingham, UK
| | - Da Zhou
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.,Advanced Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Department of China-America Institute of Neuroscience, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Yuchuan Ding
- Department of China-America Institute of Neuroscience, Xuanwu Hospital, Capital Medical University, Beijing, China.,Department of Neurosurgery, Wayne State University School of Medicine, Detroit, MI, USA
| | - Xunming Ji
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.,Advanced Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Department of China-America Institute of Neuroscience, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Ran Meng
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.,Advanced Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China.,Department of China-America Institute of Neuroscience, Xuanwu Hospital, Capital Medical University, Beijing, China
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22
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Moosa AS, Leng NSY, Kum CL, Tan NC. A qualitative research study on the illness perception of chronic pruritus in older Asian adults based on the Common-Sense Model of self-regulation. Health Expect 2021; 24:1801-1811. [PMID: 34309980 PMCID: PMC8483190 DOI: 10.1111/hex.13320] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 05/30/2021] [Accepted: 07/11/2021] [Indexed: 12/02/2022] Open
Abstract
Background Chronic pruritus (CP), itch lasting more than 6 weeks, is common in community‐dwelling older adults. Understanding their illness perception allows the attending physician to develop a personalised care plan to mitigate CP. Aim This study explores the illness perception of CP among older Asian adults in an urban community. Design Qualitative research was conducted, framed by the Common‐Sense Model of self‐regulation (CSM). Through in‐depth interviews (IDIs), qualitative data were gathered from Asian patients with CP, and then a thematic analysis was carried out. The emergent themes were grouped according to the five domains of CSM: ‘identity’, ‘cause’, ‘time’, ‘controllability’ and ‘consequence’. Setting and Patients IDIs were conducted in a Singapore public primary care clinic before the data were saturated. Results The CSM domains illustrate the illness perception of CP. CP was identified as a ‘problem’ rather than a disease and was often described in metaphor. Patients' perception of the cause was diverse due to the lack of provision of a clear explanation by their physicians. They opined that CP continued indefinitely. Without definite time to resolution, patients adapted their help‐ and health‐seeking behaviours to control it. The consequences included therapeutic experimentation, alternative therapy, self‐isolation, avoidance behaviours, emotional disturbance and dermatological complications. Conclusion and Patient Contribution Patients provided information on their perception of CP, which aligned with the CSM. A multipronged approach is needed to deliver holistic and personalised care to patients with CP, providing clarity on its natural progression, to set their expectations on its timeline, treatment effectiveness and undertake appropriate behaviour modification to adapt to its chronicity.
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Affiliation(s)
| | | | | | - Ngiap Chuan Tan
- SingHealth Polyclinics, Singapore, Singapore.,SingHealth-Duke NUS Family Medicine Academic Clinical Programme, Singapore, Singapore
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23
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Ionescu EM, Curte AM, Olteanu AO, Preda CM, Tieranu I, Klimko A, Tieranu CG. Rare Clinical Association between Clostridioides difficile Infection and Ischemic Colitis: Case Report and Literature Review. Medicina (Kaunas) 2021; 57:705. [PMID: 34356986 PMCID: PMC8307989 DOI: 10.3390/medicina57070705] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 07/02/2021] [Accepted: 07/08/2021] [Indexed: 01/14/2023]
Abstract
Background and Objectives: Gut microbiota plays an important role in the wellbeing of the host through different interactions between microflora constituents. In certain instances, Clostridioides difficile may pullulate, causing infection with associated colitis that may vary in terms of severity from mild disease to severe colitis, with increased associated mortality due to its complications. However, there are few literature data regarding the association between Clostridioides difficile and ischemic colitis. Case report: We report the case of a 30-year-old male patient, overweight, with impending dehydration, who presented with hematochezia and colicky abdominal pain, with positive fecal tests for the detection of Clostridioides difficile infection and endoscopic appearance suggesting ischemic colitis in the sigmoid and left colon, confirmed by computed tomography and histology. The patient was treated with oral Vancomycin, with resolution of symptoms, and was reevaluated through colonoscopy eight weeks after discharge, with endoscopic mucosal normalization and histological scarring process on biopsy samples. Conclusion: We report one of the few cases in the literature of ischemic colitis associated with Clostridioides difficile infection, with resolution of clinical, endoscopic, and histologic changes after specific treatment with oral Vancomycin suggesting a possible association between the two diseases. We also review the existing literature data regarding this comorbid association.
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Affiliation(s)
- Elena Mirela Ionescu
- Department of Gastroenterology, “Elias” Emergency University Hospital, 011461 Bucharest, Romania; (A.O.O.); (C.G.T.)
- Department of Gastroenterology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (C.M.P.); (I.T.); (A.K.)
| | - Ana-Maria Curte
- Department of Pathology, “Elias” Emergency University Hospital, 011461 Bucharest, Romania;
| | - Andrei Ovidiu Olteanu
- Department of Gastroenterology, “Elias” Emergency University Hospital, 011461 Bucharest, Romania; (A.O.O.); (C.G.T.)
| | - Carmen Monica Preda
- Department of Gastroenterology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (C.M.P.); (I.T.); (A.K.)
- Department of Gastroenterology, Fundeni Clinical Institute, 022328 Bucharest, Romania
| | - Ioana Tieranu
- Department of Gastroenterology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (C.M.P.); (I.T.); (A.K.)
| | - Artsiom Klimko
- Department of Gastroenterology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (C.M.P.); (I.T.); (A.K.)
| | - Cristian George Tieranu
- Department of Gastroenterology, “Elias” Emergency University Hospital, 011461 Bucharest, Romania; (A.O.O.); (C.G.T.)
- Department of Gastroenterology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (C.M.P.); (I.T.); (A.K.)
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24
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Hawke F, McKay MJ, Baldwin JN, Chiu S, Sadler S, Oldmeadow C, Chuter V, Burns J. Correlates of night-time and exercise-associated lower limb cramps in healthy adults. Muscle Nerve 2021; 64:301-308. [PMID: 34185321 DOI: 10.1002/mus.27359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 06/15/2021] [Accepted: 06/19/2021] [Indexed: 11/09/2022]
Abstract
INTRODUCTION/AIMS We explored correlates of night-time and exercise-associated lower limb cramps in participants of the 1000 Norms Project. METHODS A volunteer community sample of healthy people aged ≥18 y underwent assessment of motor function and physical performance, and were questioned about muscle cramps in the previous 3 mo. RESULTS Of 491 (221 female) participants age 18-101 y (mean: 59.12; SD: 18.03), about 1 in 3 experienced night-time lower limb cramps, and about 1 in 4 experienced exercise-associated lower limb cramps. For night-cramps, a one unit increase in Beighton score (greater whole-body flexibility) was associated with a 31% reduced odds of cramps (odds ratio [OR] = 0.69, 95% confidence interval [CI]:0.45, 0.99) and passing all three lesser-toe strength tests was associated with 50% reduced odds of cramps (OR = 0.50, 95% CI: 0.32, 0.78). For exercise-associated cramps, participants in the fourth (lowest arch) quartile of Foot Posture Index were 2.1 times (95% CI: 1.11, 3.95) more likely to experience cramps than participants in the first (highest arch) quartile. Odds of experiencing both types of cramps versus no cramps were lower with passing all three lesser-toe strength tests (OR = 0.40, 95% CI: 0.19, 0.85) and better performance in the six-minute walk test (OR = 0.997, 95% CI: 0.996, 0.998). DISCUSSION People who experienced both exercise-associated and night-time cramps were less functional. The association between night-time cramps with less whole-body flexibility and reduced lesser-toe flexor strength should be explored to determine causation. Planovalgus (low-arched) foot type was independently associated with exercise-associated cramps. The effectiveness of foot orthoses for secondary prevention of exercise-associated cramps in people with low-arched feet should be explored.
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Affiliation(s)
- Fiona Hawke
- School of Health Sciences, College of Health, Medicine and Wellbeing, and Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Marnee J McKay
- Sydney School of Health Sciences, University of Sydney, Sydney, New South Wales, Australia
| | - Jennifer N Baldwin
- School of Health Sciences, College of Health, Medicine and Wellbeing, and Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, Callaghan, New South Wales, Australia.,Sydney School of Health Sciences, University of Sydney, Sydney, New South Wales, Australia
| | - Simon Chiu
- Hunter Medical Research Institute, New Lambton Heights, New South Wales, Australia
| | - Sean Sadler
- School of Health Sciences, College of Health, Medicine and Wellbeing, and Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, Callaghan, New South Wales, Australia
| | | | - Vivienne Chuter
- School of Health Sciences, College of Health, Medicine and Wellbeing, and Priority Research Centre for Physical Activity and Nutrition, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Joshua Burns
- Sydney School of Health Sciences, University of Sydney, Sydney, New South Wales, Australia.,The University of Sydney & The Children's Hospital at Westmead, Sydney, New South Wales, Australia
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Langga L, Oh J, López D, Blake N, McField E, Hotz J, Nava-Guerra L, Knox K, Chinnock R. Prevalence, Proportionality, and Cause of Ventilator Alarms in a Pediatric Intensive Care Setting. Respir Care 2021; 66:541-550. [PMID: 33293363 PMCID: PMC9993984 DOI: 10.4187/respcare.07200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Clinical alarms play an important role in monitoring physiological parameters, vital signs and medical device function in the hospital intensive care environment. Delays in staff response to alarms are well documented as health care providers become desensitized to increased rates of nuisance alarms. Patients can be at increased risk of harm due to alarm fatigue. Current literature suggests alarms from ventilators contribute significantly to nonactionable alarms. A greater understanding of which specific ventilator alarms are most common and the rates at which they occur is fundamental to improving alarm management. METHODS A retrospective review was performed on alarms that occurred on the Avea and Servo-i ventilators used in the pediatric ICU and pediatric cardiothoracic ICU at a major metropolitan children's hospital. High- and medium-priority alarms, as classified by the manufacturer, were studied between June 1, 2017, and November 31, 2017. Descriptive data analysis and a 2-proportion z-test were performed to identify proportionality, cause, and prevalence rates in the pediatric ICU and the cardiothoracic ICU. RESULTS Eleven distinct ventilator alarms were identified during 2,091 d of mechanical ventilation. The Inspiratory Flow Overrange alarm (42.4%) on the Servo-i, Low VTE (20.4%; expiratory tidal volume) and Circuit Integrity alarm (20.0%) on the Avea were the most prevalent causes according to ventilator type. Medium-priority alarms comprised 68.7% of all Servo-i alarms, and high-priority alarms comprised 84% of all Avea alarms. The 2-sample test of proportions was significant for differences between both areas (P < .001). The overall alarm prevalence rate was 22.5 ventilator alarms per ventilator-day per patient. CONCLUSIONS The cause and proportion of alarms varied by ventilator and care unit. High-priority alarms were most common with the Avea and medium-priority alarms for the Servo-i. The overall combined ventilator alarm prevalence rate was 22.5 alarms per ventilator-day per patient.
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Affiliation(s)
- Leo Langga
- Department of Respiratory Care, Children's Hospital Los Angeles, Los Angeles, California.
- School of Public Health, Health Policy and Leadership, Loma Linda University, Loma Linda, California
| | - Jisoo Oh
- School of Public Health, Health Policy and Leadership, Loma Linda University, Loma Linda, California
| | - David López
- Department of Cardiopulmonary Sciences, School of Allied Health Profession, Loma Linda University, Loma Linda, California
| | - Nancy Blake
- Harbor UCLA Medical Center, Torrance, California
| | - Edward McField
- Center for Community Health Policy, Loma Linda, California
| | - Justin Hotz
- Department of Respiratory Care, Children's Hospital Los Angeles, Los Angeles, California
- Anesthesia Critical Care Medicine, Children's Hospital Los Angeles, Los Angeles, California
| | - Leonardo Nava-Guerra
- Anesthesia Critical Care Medicine, Children's Hospital Los Angeles, Los Angeles, California
- Medtronic, Los Angeles, California
| | - Kelby Knox
- Anesthesia Critical Care Medicine, Children's Hospital Los Angeles, Los Angeles, California
- University of Southern California, Los Angeles, California
| | - Richard Chinnock
- School of Public Health, Health Policy and Leadership, Loma Linda University, Loma Linda, California
- Loma Linda University Children's Hospital, Loma Linda, California
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Affiliation(s)
- Archie Bleyer
- Department of Radiation Medicine, Knight Cancer Institute and Oregon Health & Science University, Portland, Oregon, USA
- McGovern Medical School, University of Texas, Houston, Texas, USA
| | - Filippo Spreafico
- Department of Medical Oncology and Hematology, Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Ronald Barr
- Departments of Medicine, Pediatrics, and Pathology, McMaster University and McMaster Children’s Hospital, Hamilton, Ontario, Canada
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Tang CL, Zhao CH, Shen HY, Liang YP, Wang ZH. [Chemical Characteristics and Causes of Groups Water in Niangziguan Spring]. Huan Jing Ke Xue 2021; 42:1416-1423. [PMID: 33742938 DOI: 10.13227/j.hjkx.202007047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Discharge in Niangziguan Spring is 7.19 m3·s-1, which is the main water supply source for Yangquan City and Pingding County. Every year, Yangquan municipal government take water from the mouth of Niangziguan Spring to supply drinking water to urban residents at a rate of approximately 1.7 m3·s-1. It is of great significance to determine the characteristics and causes of variations in spring water flow conditions for the appropriate utilization of water resources and pollution prevention. Here, sample collection and hydrochemical isotope analyses were undertaken for the Niangziguan Spring area to chemically characterize the water environment and genesis. The pH of the karst spring is 7.2-7.5 with an average of 7.36; the calcium content of the water is 112.1-135.2 mg·L-1 with a mean value of 131.4 mg·L-1; the concentration of magnesium ions is 34.8-42.3 mg·L-1 with an average of 40.8 mg·L-1; the concentration of K++Na- ions is 41.6-46.7 mg·L-1 with an average of 45.2 mg·L-1; and the sulfate ion concentration is 185.6-271.8 mg·L-1 with a mean value of 255.4 mg·L-1. The hydrochemical type of the aquifer is classified as HCO3·SO4-Ca·Mg. The spring water is characterized by high Ca2+, Mg2+, and SO42- concentrations, and low Na+, K+, and Cl- concentrations. The supply path of Chengxi Spring is shortest followed by Wulong Spring. The supply paths of the remaining five spring are much longer. The Niangziguan Spring water environment is characterized by increasing pollution from coal mine acid drainage alongside decreasing inputs from domestic sewage. Environmental isotope tracing shows that sulfate in Chengxi Spring mainly derives from precipitation and gypsum dissolution, and the concentrations of sulfate in Wulong Spring are increasing. These changes are mainly driven by the amount of coal mine acid water pollution in the area.
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Affiliation(s)
- Chun-Lei Tang
- Key Laboratory of Karst Dynamics, Guangxi Zhuang Autonomous Region, Ministry of Land and Resources, Institute of Karst Geology, Chinese Academy of Geological Sciences, Guilin 541004, China.,College of Water Conservancy Science and Engineering, Taiyuan University of Technology, Taiyuan 030024, China.,International Research Center on Karst under the Auspices of United Nations Educational, Scientific and Cultural Organization, Guilin 541004, China
| | - Chun-Hong Zhao
- Key Laboratory of Karst Dynamics, Guangxi Zhuang Autonomous Region, Ministry of Land and Resources, Institute of Karst Geology, Chinese Academy of Geological Sciences, Guilin 541004, China.,International Research Center on Karst under the Auspices of United Nations Educational, Scientific and Cultural Organization, Guilin 541004, China
| | - Hao-Yong Shen
- Key Laboratory of Karst Dynamics, Guangxi Zhuang Autonomous Region, Ministry of Land and Resources, Institute of Karst Geology, Chinese Academy of Geological Sciences, Guilin 541004, China.,International Research Center on Karst under the Auspices of United Nations Educational, Scientific and Cultural Organization, Guilin 541004, China
| | - Yong-Ping Liang
- Key Laboratory of Karst Dynamics, Guangxi Zhuang Autonomous Region, Ministry of Land and Resources, Institute of Karst Geology, Chinese Academy of Geological Sciences, Guilin 541004, China.,International Research Center on Karst under the Auspices of United Nations Educational, Scientific and Cultural Organization, Guilin 541004, China
| | - Zhi-Heng Wang
- Key Laboratory of Karst Dynamics, Guangxi Zhuang Autonomous Region, Ministry of Land and Resources, Institute of Karst Geology, Chinese Academy of Geological Sciences, Guilin 541004, China.,International Research Center on Karst under the Auspices of United Nations Educational, Scientific and Cultural Organization, Guilin 541004, China
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Meng X, Zhou W, Sun Z, Han Q, Zhang J, Zhang H, Wang W, Zhong M, Wang M, Zhang J, Hao J, Han H, Zhao X, Hu X, Zhu X, Li J, Wang T, Huang Y, Liao M, Song Y, Yan H. Prevalence and causes of bilateral visual impairment in rural areas of Tianjin, China - The Tianjin Eye Study. Acta Ophthalmol 2021; 99:e136-e143. [PMID: 32602247 DOI: 10.1111/aos.14523] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 05/27/2020] [Accepted: 05/28/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE To estimate the prevalence, causes and risk factors of bilateral visual impairment in rural areas of Tianjin, China. METHODS A large population-based, cross-sectional study. A stratified random cluster sampling method was used to investigate 12 233 participants in all age groups living in rural Tianjin. Participants completed questionnaires and received professional ophthalmology examinations. RESULTS According to World Health Organization best-corrected visual acuity (BCVA) criteria, the crude prevalence of bilateral visual impairment (BCVA < 20/63), bilateral low vision (BCVA < 20/63 to ≥20/400) and bilateral blindness (BCVA < 20/400) was 2.53%, 2.40% and 0.14% (age- and gender-standardized prevalence was 1.86%, 1.76% and 0.11%). The prevalence increased with age and was higher in women than men. The most common causes of bilateral visual impairment in the total population were cataract (48.39%), refractive error/amblyopia (17.74%), age-related macular degeneration (AMD) (10.00%), diabetic retinopathy (5.81%) and glaucoma (3.87%). For participants younger than 50 years, refractive error/amblyopia was the leading cause of low vision and blindness, while cataract was the major cause in the participants over 50. Female gender, older age and self-reported diabetes were associated with increased risks of visual impairment. CONCLUSION The age- and gender-standardized prevalence of low vision, especially in the older group (50+), was higher in this study compared with previous studies in China. Refractive error/amblyopia was the leading cause of bilateral visual impairment in younger group, while cataract was the primary cause in the older group. These findings will provide useful information for planning comprehensive eye healthcare programmes in China.
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Affiliation(s)
- Xiangda Meng
- Department of Ophthalmology Tianjin Medical University General Hospital Tianjin China
| | - Wei Zhou
- Department of Ophthalmology Tianjin Medical University General Hospital Tianjin China
| | - Zhuoyu Sun
- Department of Epidemiology and Statistics School of Public Health Tianjin Medical University Tianjin China
| | - Qi Han
- Department of Ophthalmology Tianjin Medical University General Hospital Tianjin China
| | - Jingkai Zhang
- Department of Ophthalmology Tianjin Medical University General Hospital Tianjin China
| | - Hongwen Zhang
- Department of Ophthalmology The People’s Hospital of Jizhou District Tianjin China
| | - Weijuan Wang
- Department of Ophthalmology Binhai Hospital of Tianjin Medical University General Hospital Tianjin China
| | - Min Zhong
- Department of Ophthalmology Jinghai Hospital Tianjin China
| | - Meiyan Wang
- Department of Ophthalmology Tianjin Haibin People’s Hospital Tianjin China
| | - Junlan Zhang
- Department of Ophthalmology The People’s Hospital of Wuqing District Tianjin China
| | - Jing Hao
- Department of Ophthalmology Tianjin Medical University General Hospital Tianjin China
| | - Han Han
- Department of Ophthalmology Tianjin Medical University General Hospital Tianjin China
| | - Xiao Zhao
- Department of Ophthalmology Tianjin Medical University General Hospital Tianjin China
| | - Xingxing Hu
- Department of Ophthalmology Tianjin Medical University General Hospital Tianjin China
| | - Xinlei Zhu
- Department of Ophthalmology Tianjin Medical University General Hospital Tianjin China
| | - Jianan Li
- Department of Ophthalmology Tianjin Medical University General Hospital Tianjin China
| | - Tian Wang
- Department of Ophthalmology Tianjin Medical University General Hospital Tianjin China
| | - Yunli Huang
- Department of Ophthalmology Tianjin Medical University General Hospital Tianjin China
| | - Mengyu Liao
- Department of Ophthalmology Tianjin Medical University General Hospital Tianjin China
| | - Yinting Song
- Department of Ophthalmology Tianjin Medical University General Hospital Tianjin China
| | - Hua Yan
- Department of Ophthalmology Tianjin Medical University General Hospital Tianjin China
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Ventimiglia E, Pozzi E, Capogrosso P, Boeri L, Alfano M, Cazzaniga W, Matloob R, Abbate C, Viganò P, Montorsi F, Salonia A. Extensive Assessment of Underlying Etiological Factors in Primary Infertile Men Reduces the Proportion of Men With Idiopathic Infertility. Front Endocrinol (Lausanne) 2021; 12:801125. [PMID: 35002977 PMCID: PMC8739963 DOI: 10.3389/fendo.2021.801125] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Accepted: 12/03/2021] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE Up to 40% of infertile men remain without a recognized cause (i.e., idiopathic infertility). We aimed to identify, categorize, and report the supposed causes of male infertility in a cohort of white-European men presenting for primary couple's infertility, by using a thorough and extensive baseline diagnostic work-up. MATERIAL AND METHODS Cross-sectional study of 1,174 primary infertile men who underwent a thorough diagnostic work-up including: detailed medical history, physical examination, hormonal assessment, genetic testing, semen analyses; semen and urine cultures; testis color Duplex US. Men without any identified causal factor were considered as idiopathic. Six different etiological categories were established, and their prevalence was estimated. Logistic regression models estimated the risk of missing causal identification. RESULTS A possible causal factor was identified in 928 (81%) men. Hypogonadism was the most frequent identified cause (37%), followed by varicocele (27%). Genetic abnormalities were found in 5% of patients. A causal factor was more easily identifiable for the more severe infertility cases, and azoospermic men were those less likely to be defined as idiopathic (OR and 95% CIs: 0.09; 0.04-0.20). Relative proportion of identified causes remained constant during the 10-year study period (p>0.43). CONCLUSIONS Due to a more comprehensive and extensive diagnostic work-up, at least one underlying cause of male infertility factor in 4 out of 5 infertile men can be identified. Men with a less severe phenotype remain a clinical challenge in terms of establishing a possible etiologic factor. Further studies are needed to assess which subset of infertile men deserves a more extensive work-up.
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Affiliation(s)
- Eugenio Ventimiglia
- Division of Experimental Oncology/Unit of Urology, Urological Research Institute (URI), Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS) Ospedale San Raffaele, Milan, Italy
- Department of Urology, University Vita-Salute San Raffaele, Milan, Italy
| | - Edoardo Pozzi
- Division of Experimental Oncology/Unit of Urology, Urological Research Institute (URI), Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS) Ospedale San Raffaele, Milan, Italy
- Department of Urology, Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS) Fondazione Ca’ Granda – Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Paolo Capogrosso
- Division of Experimental Oncology/Unit of Urology, Urological Research Institute (URI), Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS) Ospedale San Raffaele, Milan, Italy
- Department of Urology, University Vita-Salute San Raffaele, Milan, Italy
| | - Luca Boeri
- Division of Experimental Oncology/Unit of Urology, Urological Research Institute (URI), Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS) Ospedale San Raffaele, Milan, Italy
- Department of Urology, Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS) Fondazione Ca’ Granda – Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Massimo Alfano
- Division of Experimental Oncology/Unit of Urology, Urological Research Institute (URI), Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS) Ospedale San Raffaele, Milan, Italy
| | - Walter Cazzaniga
- Division of Experimental Oncology/Unit of Urology, Urological Research Institute (URI), Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS) Ospedale San Raffaele, Milan, Italy
- Department of Urology, University Vita-Salute San Raffaele, Milan, Italy
| | - Rayan Matloob
- Division of Experimental Oncology/Unit of Urology, Urological Research Institute (URI), Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS) Ospedale San Raffaele, Milan, Italy
| | - Costantino Abbate
- Division of Experimental Oncology/Unit of Urology, Urological Research Institute (URI), Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS) Ospedale San Raffaele, Milan, Italy
| | - Paola Viganò
- Infertility Unit, Unit of Obstetrics/Gynecology, Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS) Ospedale San Raffaele, Milan, Italy
| | - Francesco Montorsi
- Division of Experimental Oncology/Unit of Urology, Urological Research Institute (URI), Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS) Ospedale San Raffaele, Milan, Italy
- Department of Urology, University Vita-Salute San Raffaele, Milan, Italy
| | - Andrea Salonia
- Division of Experimental Oncology/Unit of Urology, Urological Research Institute (URI), Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS) Ospedale San Raffaele, Milan, Italy
- Department of Urology, University Vita-Salute San Raffaele, Milan, Italy
- *Correspondence: Andrea Salonia,
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Chung BY, Um JY, Kim JC, Kang SY, Jung MJ, Kim HO, Park CW. Anaphylaxis: Five Years' Experience in the Emergency Rooms of Five University Hospitals in Korea. ACTA ACUST UNITED AC 2020; 56:E695. [PMID: 33327374 DOI: 10.3390/medicina56120695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 12/05/2020] [Accepted: 12/10/2020] [Indexed: 11/17/2022]
Abstract
Background: Anaphylaxis is an allergic disease that requires special handling due to its potential fatality. Recent epidemiological data indicate that the incidence of anaphylaxis is rising. However, actual data on the prevalence or causes of anaphylaxis in Korea are limited. Methods: The emergency room attendees diagnosed with anaphylaxis between 2011 and 2015 in five university hospitals were included. Medical records were reviewed retrospectively. Results: During the 5 years, a total of 505 subjects were diagnosed with anaphylaxis. Respiratory presentations were more common in children than in adults, while adults presented more frequently with cardiovascular symptoms. Intraoral angioedema was more often observed in the countryside than in the city. Insect stings/bites were more common in the countryside than in the city. Drugs were much more common in adults than in children. In the countryside, the frequency of anaphylaxis was higher in summer and autumn than in spring and winter. The use of corticosteroids was less common in children than in adults, while children more frequently got treatment with inhaled beta 2 agonist. Conclusions: The principal causes of anaphylaxis in Korean patients were food, drugs, and stings/bites. The cause, clinical features and management of anaphylaxis were significantly different depending on age and region. These real-world data on anaphylaxis could be helpful to deepen that understanding of this condition for physicians and patients.
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Cheema E, McGuinness K, Hadi MA, Paudyal V, Elnaem MH, Alhifany AA, Elrggal ME, Al Hamid A. Causes, Nature and Toxicology of Fentanyl-Associated Deaths: A Systematic Review of Deaths Reported in Peer-Reviewed Literature. J Pain Res 2020; 13:3281-3294. [PMID: 33324089 PMCID: PMC7732170 DOI: 10.2147/jpr.s280462] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 11/12/2020] [Indexed: 01/30/2023] Open
Abstract
PURPOSE Fentanyl poisoning has been widely reported, yet there is a lack of systematic evaluation of the nature and toxicology of associated deaths in the published literature. This article aims to systematically review the nature, causes, routes of administration and toxicology of fentanyl-associated deaths using case studies and case series in peer-reviewed published literature. METHODS Four electronic databases including Embase, Medline (via Ovid), Scopus and Google Scholar were searched from inception until October 2019 to identify the studies reporting fentanyl related deaths. Two independent reviewers screened and selected the titles and then evaluated the full texts. Only case studies and case series were included. A structured data extraction tool was used to extract data on the number of deaths, routes of administration, concomitant drug use and toxicological data. The Joanna Briggs Institute quality assessment tool was used to evaluate the quality of included studies. Data were synthesized narratively. RESULTS Of 1251 articles identified during initial search, 8 case reports and 9 case series met the inclusion criteria. A total of 1969 deaths were reported in the included studies. Deaths were concentrated in the north American region (n = 1946) and the Nordic region (n = 22). Reported causes of death included fentanyl overdose (n = 321, 56.4%), mixed drug toxicity (n = 196, 34.5%), natural (n = 28, 4.9%), other drug toxicity (n = 10, 1.8%), fentanyl and ethanol intoxication (n = 8, 1.4%), incidental (n = 5, <1%) and aspiration (n = 1). Most common routes of use were intravenous (70.5%) and transdermal routes (23.0%). Deaths came swiftly via the intravenous route. Mean level of blood fentanyl amongst all reported deaths was 0.024 µg/mL. CONCLUSION Literature related to fentanyl-associated deaths predominantly come from North America. Deaths are comparatively lower or not reported in peer-reviewed publications from the rest of the world. Abuse through intravenous administration, mixed drug toxicities and self-treatment of breakthrough pain are mainly responsible for majority of the reported deaths.
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Affiliation(s)
- Ejaz Cheema
- School of Pharmacy, University of Birmingham, Birmingham, UK
| | | | | | - Vibhu Paudyal
- School of Pharmacy, University of Birmingham, Birmingham, UK
| | - Mohammed Hassan Elnaem
- Department of Pharmacy Practice, Faculty of Pharmacy, International Islamic University, Kuantan, Malaysia
| | - Abdullah A Alhifany
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, Makkah, Kingdom of Saudi Arabia
| | - Mahmoud E Elrggal
- Department of Clinical Pharmacy, College of Pharmacy, Umm Al-Qura University, Makkah, Kingdom of Saudi Arabia
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Abstract
BACKGROUND AND PURPOSE Readmission within 30 days of index acute ischemic stroke (AIS) after hospitalization increases the burden on patients and healthcare expense. The purpose of our study was to investigate predictors and causes of 30-day readmission after AIS and investigate hospitalization expenses, length of stay (LOS) and in-hospital mortality of 30-day readmission. METHODS This is a multicenter retrospective study. AIS were captured by International Classification of Diseases, Tenth Revision (ICD-10) diagnosis codes, patients with readmitted within 30 days after discharge were identified as readmission group. Multivariable logistic regression was used to identify independent predictors of 30-day readmissions. Hospitalization expenses, LOS and in-hospital mortality were compared for index admission and readmission. RESULTS We identified 2371 patients with AIS, 176 patients died before discharge, 504(23.0%) patients were admitted within 30 days. Older age, prior stroke, non-neurology floor during index admission, indwelling urinary catheter and diabetes were independently associated with increased risk of 30-day readmission (P<0.05). The most common causes for 30-day readmission were infection (28.8%) and recurrent stroke and TIA (22.8%). Patients with 30-day readmission have longer LOS and higher hospitalization expenses on readmission compared with the mean of these metrics on index admission (P<0.001). The in-hospital mortality after a within 30-day readmission was higher than index admission (13.1% vs 8.0%; OR 1.88, 95% CI 2.5-5.3; P<0.001). CONCLUSIONS Older age, stroke severity, prior stroke, diabetes, indwelling urinary catheter and admission to non-neurology floor during index admission were associated with 30-day readmission. 30-readmission after AIS increased hospitalization expenses, LOS and in-hospital mortality.
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Affiliation(s)
- Xiaobo Qiu
- Department of Medical Services, The Second People's Hospital of Chengdu , Chengdu, P.R. China
| | - Xie Xue
- Department of Medical Services, The Second People's Hospital of Chengdu , Chengdu, P.R. China
| | - Ronghua Xu
- Department of Neurosurgery, The Second People's Hospital of Chengdu , Chengdu, P.R.China
| | - Jian Wang
- Department of Neurology, The Second People's Hospital of Chengdu , Chengdu, P.R. China
| | - LIli Zhang
- Department of Neurology, The Second People's Hospital of Chengdu , Chengdu, P.R. China
| | - Lijuan Zhang
- Department of Neurology, The Second Affiliated Hospital of Chengdu College, Nuclear Industry 416 Hospital , Chengdu, P.R. China
| | - Wang Zhao
- Department of Neurology, Yongchuan Hospital, Chongqing Medical University , Chongqing, P.R. China
| | - Lanying He
- Department of Neurology, The Second People's Hospital of Chengdu , Chengdu, P.R. China
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Carriazo S, Vanessa Perez-Gomez M, Ortiz A. Hypertensive nephropathy: a major roadblock hindering the advance of precision nephrology. Clin Kidney J 2020; 13:504-509. [PMID: 32897275 PMCID: PMC7467619 DOI: 10.1093/ckj/sfaa162] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Indexed: 12/29/2022] Open
Abstract
In the 2017 Annual Report of the ERA-EDTA Registry, hypertension continues to be the second or third most common cause of renal replacement therapy (RRT) in Europe, tied with glomerulonephritis. There is, however, one little issue: hypertension-induced end-stage renal disease (ESRD) might not exist at all as currently understood, that is, as hypertensive nephrosclerosis. In this regard, the incidence of RRT due to hypertensive nephropathy is related to the incidence of other causes of ESRD but not to the burden of hypertension per country. The current definition of hypertensive nephropathy is non-specific, outdated and only allows a delayed diagnosis by exclusion. It is not helpful that 80% of chronic kidney disease patients develop hypertension and kidney biopsy has no findings specific for hypertensive nephropathy. There is an urgent need to redefine the concept of hypertensive nephropathy with a clear and comprehensive set of criteria that at least should indicate how other nephropathies, including familial nephropathies, should be excluded. Correct causality assessment and aetiology-based therapy is a key to the progress of nephrology and it should no longer be accepted that ‘hypertensive nephropathy’ serves to disguise a suboptimal diagnostic workup. A diagnosis of nephropathy of unknown cause would be more honest when the full range of alternative aetiological diagnoses is not explored.
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Affiliation(s)
- Sol Carriazo
- IIS-Fundación Jiménez Diaz, Department of Medicine, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain and Red de Investigación Renal, Instituto Carlos III-FEDER, Madrid, Spain
| | - Maria Vanessa Perez-Gomez
- IIS-Fundación Jiménez Diaz, Department of Medicine, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain and Red de Investigación Renal, Instituto Carlos III-FEDER, Madrid, Spain
| | - Alberto Ortiz
- IIS-Fundación Jiménez Diaz, Department of Medicine, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain and Red de Investigación Renal, Instituto Carlos III-FEDER, Madrid, Spain
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Tajiri T, Kawachi H, Yoshida H, Noguchi S, Terashita S, Ikeue T, Horikawa S, Sugita T, Niimi A. The causes of acute cough: a tertiary-care hospital study in Japan. J Asthma 2020; 58:1495-1501. [PMID: 32736491 DOI: 10.1080/02770903.2020.1804576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Cough is the most frequent presenting complaint in general practice and has an adverse effect on an individual's well-being. Understanding the causes of cough is critical for appropriate patient management. According to its duration, cough is classified as acute, subacute, and chronic. While acute respiratory infection is considered to be the major cause of acute cough, there is little evidence. METHODS We retrospectively assessed the prevalence of acute cough in all patients presenting with cough to the respiratory clinic of Japanese Red Cross Wakayama Medical Center from May 2018 to April 2019. We subsequently assessed the causes of acute cough, after stratifying patients with acute cough into two subgroups based on the chest X-ray findings. RESULTS Among 685 patients (329 males; mean age, 61.8 ± 18.6 years) who presented with cough as a chief complaint, 274 (125 males; mean age, 57.6 ± 20.9 years) reported to have acute cough; chest X-ray abnormalities were detected in 113 of these patients. The most frequent cause of acute cough among 113 patients with chest X-ray abnormalities was pneumonia (55.8%), followed by lung cancer (9.7%) and pneumonia exacerbating asthma (7.1%). Among the 161 patients with acute cough without chest X-ray abnormalities, the most frequent cause was upper respiratory tract infection (57.1%), followed by asthma (23.6%) and cough variant asthma (6.2%). CONCLUSIONS Cough is the most frequent presenting complaint in general practice. Infections are the most frequent causes of acute cough regardless of the chest X-ray findings.
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Affiliation(s)
- Tomoko Tajiri
- Department of Respiratory Medicine, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan.,Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University School of Medical Sciences, Nagoya, Japan
| | - Hiroaki Kawachi
- Department of Respiratory Medicine, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan
| | - Hiroshi Yoshida
- Department of Respiratory Medicine, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan
| | - Susumu Noguchi
- Department of Respiratory Medicine, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan
| | - Satoshi Terashita
- Department of Respiratory Medicine, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan
| | - Tatsuyoshi Ikeue
- Department of Respiratory Medicine, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan
| | - Sadao Horikawa
- Department of Respiratory Medicine, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan
| | - Takakazu Sugita
- Department of Respiratory Medicine, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan
| | - Akio Niimi
- Department of Respiratory Medicine, Allergy and Clinical Immunology, Nagoya City University School of Medical Sciences, Nagoya, Japan
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Aladwan S, Harrison JJ, Blackburn DF, Taylor J, Blydt-Hansen TD, Mansell H. A Canadian Survey on Adverse Symptoms Experienced by Solid Organ Transplant Recipients. Prog Transplant 2020; 30:254-264. [PMID: 32597328 DOI: 10.1177/1526924820933821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Adverse symptoms experienced by solid organ transplant recipients remain largely unexplored despite their purported frequency. OBJECTIVE To characterize patient perspectives on adverse symptoms, identifying the most problematic symptoms and the perceived cause and treatability, and to evaluate their impact on quality of life (QoL) and medication adherence. METHODS An electronic survey was distributed to members of the Canadian Transplant Association, to characterize perceptions on symptom experience (Modified Transplant Symptom Occurrence and Distress Scale), and QoL (Short Form-12), medication adherence (Basel Assessment of Adherence to Immunosuppressive Medications Scale), demographics, and clinical situation. RESULTS The questionnaire was distributed to 249 solid organ transplant recipients and achieved a 51% response rate (N = 127). Respondents reported a mean of 25 (standard deviation 10) adverse symptoms each. In women, the most prevalent and distressing symptoms were tiredness, lack of energy, sleep difficulties, difficulty concentrating or memory problems, diarrhea, joint pain, and depression. In men, they were tiredness, flatulence, lack of energy, sleep difficulties, and erectile problems. With the exception of flatulence, these symptoms were more often perceived to be caused by medical conditions rather than by immunosuppressants or other medications. Quality of life was similar to the general public, with mean physical and mental component scores of 47.4 (9.9) and 52.1 (8.2), respectively (relative to a US average of 50 [10]). However, QoL scores inversely correlated to the number of symptoms reported and were higher in patients who perceived all symptoms to be treatable. CONCLUSION Adverse symptoms may impact patient well-being. Perceived cause and treatability should be further explored.
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Affiliation(s)
- Shirin Aladwan
- College of Pharmacy and Nutrition, 70398University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Jennifer J Harrison
- Multi-Organ Transplant Program, Toronto General Hospital, 7989University Health Network, Toronto, Ontario, Canada.,Department of Pharmacy Services, Toronto General Hospital, 7989University Health Network, Toronto, Ontario, Canada.,Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
| | - David F Blackburn
- College of Pharmacy and Nutrition, 70398University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Jeff Taylor
- College of Pharmacy and Nutrition, 70398University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Tom D Blydt-Hansen
- Multi-Organ Transplant Program, BC Children's Hospital, Vancouver, British Columbia, Canada.,Department of Pediatrics, 8166University of British Columbia, Vancouver, British Columbia, Canada
| | - Holly Mansell
- College of Pharmacy and Nutrition, 70398University of Saskatchewan, Saskatoon, Saskatchewan, Canada.,Saskatchewan Transplant Program, Saskatoon, Saskatchewan, Canada
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Pinheiro PS, Medina H, Callahan KE, Jones PD, Brown CP, Altekruse SF, McGlynn KA, Kobetz EN. The association between etiology of hepatocellular carcinoma and race-ethnicity in Florida. Liver Int 2020; 40:1201-1210. [PMID: 32087002 PMCID: PMC8637930 DOI: 10.1111/liv.14409] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 01/09/2020] [Accepted: 02/13/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND AIM The incidence of hepatocellular carcinoma (HCC) has risen considerably in the US since 1980. The main causes include metabolic disorders (NAFLD, diabetes, obesity, metabolic syndrome), alcohol-related disease (ALD) and hepatitis C and B virus infections (HCV, HBV). Etiology-specific HCC incidence rates by detailed race-ethnicity are needed to improve HCC control and prevention efforts. METHODS All HCC cases diagnosed in Florida during 2014-2015 were linked to statewide hospital discharge data to determine etiology. Age-specific and age-adjusted rates were used to assess the intersection between etiology and detailed racial-ethnicities, including White, African American, Afro-Caribbean, Asian, Cuban, Puerto Rican and Continental Hispanic (Mexican, South and Central American). RESULTS Of 3666 HCC cases, 2594 matched with discharge data. HCV was the leading cause of HCC among men and women (50% and 43% respectively), followed by metabolic disorders (25% and 37%) and ALD (16% and 9%). Puerto Rican and African American men had the highest HCV-HCC rates, 7.9 and 6.3 per 100 000 respectively. Age-specific rates for HCV-HCC peaked among baby boomers (those born in 1945-1965). Metabolic-HCC rates were highest among populations above age 70 and among Continental Hispanics. Afro-Caribbean men had high rates of HBV-HCC, whereas Puerto Rican men had high ALD-HCC. CONCLUSIONS HCC etiology is associated with specific race/ethnicity. While HCV-related HCC rates are projected to decrease soon, HCC will continue to affect Hispanics disproportionately, based on higher rates of metabolic-HCC (and ALD-HCC) among Continental Hispanics, who demographically represent 80% of all US Hispanics. Multifaceted approaches for HCC control and prevention are needed.
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Affiliation(s)
- Paulo S. Pinheiro
- Sylvester Comprehensive Cancer Center, Department of Public Health Sciences, Division of Epidemiology & Population Health Sciences, University of Miami School of Medicine, Clinical Research Building, 1120 N.W. 14th Street, Miami, FL 33136
| | - Heidy Medina
- Department of Public Health Sciences, University of Miami School of Medicine
| | | | - Patricia D. Jones
- University of Miami School of Medicine, Department of Medicine, Division of Hepatology
| | - Clyde Perry Brown
- Florida A&M University College of Pharmacy and Pharmaceutical Sciences
| | - Sean F. Altekruse
- Surveillance Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, Maryland, United States of America
| | - Katherine A. McGlynn
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Erin N. Kobetz
- Sylvester Comprehensive Cancer Center, University of Miami School of Medicine
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Poziomkowska-Gęsicka I, Kurek M. Clinical Manifestations and Causes of Anaphylaxis. Analysis of 382 Cases from the Anaphylaxis Registry in West Pomerania Province in Poland. Int J Environ Res Public Health 2020; 17:E2787. [PMID: 32316622 PMCID: PMC7215547 DOI: 10.3390/ijerph17082787] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Revised: 04/11/2020] [Accepted: 04/15/2020] [Indexed: 12/19/2022]
Abstract
Anaphylaxis is most commonly defined as an acute, severe, potentially life-threatening systemic hypersensitivity reaction. Current expert consensus has defined anaphylaxis as a serious reaction that is rapid in onset and can be fatal, and is a severe, potentially life-threatening systemic hypersensitivity reaction that is still rarely diagnosed. For safety reasons, patients should visit an allergologist to identify potential causes of this reaction. There are no data from other health care centres in Poland presenting characteristics of anaphylactic reactions. Clinical manifestations of anaphylaxis should be analysed, because some patients (10-30%) with anaphylaxis can present without cutaneous findings. This lack of skin/mucosa involvement can lead to misdiagnosis or delayed diagnosis of anaphylaxis. Objectives-to gather epidemiological data on anaphylactic reactions, to identify clinical manifestations of anaphylaxis (organ systems involved), to present diagnostic methods useful for the identification of anaphylaxis triggers, and most importantly, to find causes of anaphylaxis. In this retrospective analysis, we used a questionnaire-based survey regarding patients visiting the Clinical Allergology Department, Pomeranian Medical University (PMU) in Szczecin, between 2006 and 2015. The registry comprised patients with grade II (Ring and Messmer classification) or higher anaphylaxis. Patients with grade I anaphylaxis (e.g., urticaria) were not included in the registry. The incidence of anaphylaxis was higher in women. Clinical manifestations included cutaneous and cardiovascular symptoms, but more than 20% of patients did not present with cutaneous symptoms, which may create difficulties for fast and correct diagnosis. Causes of anaphylaxis were identified and confirmed by means of detailed medical interview, skin tests (STs), and measurement of specific immunoglobulin E (sIgE) and tryptase levels. In the analysed group, the most common cause of anaphylaxis (allergic and nonallergic) was Hymenoptera stinging (wasp), drugs (nonsteroidal anti-inflammatory drugs, NSAIDs) and foods (peanuts, tree nuts, celery). The incidence of anaphylaxis is low, but because of its nature and potentially life-threatening consequences it requires a detailed approach. Comprehensive management of patients who have had anaphylaxis can be complex, so partnerships between allergy specialists, emergency medicine and primary care providers are necessary. Monitoring its range is very important to monitor changes in allergy development.
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Affiliation(s)
- Iwona Poziomkowska-Gęsicka
- Clinical Allergology Department, Pomeranian Medical University (PMU) in Szczecin, Powstańców Wlkp 72, 70-111 Szczecin, Poland;
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Jain R, Yadav D, Puranik N, Guleria R, Jin JO. Sarcoidosis: Causes, Diagnosis, Clinical Features, and Treatments. J Clin Med 2020; 9:E1081. [PMID: 32290254 DOI: 10.3390/jcm9041081] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 04/04/2020] [Accepted: 04/08/2020] [Indexed: 12/19/2022] Open
Abstract
Sarcoidosis is a multisystem granulomatous disease with nonspecific clinical manifestations that commonly affects the pulmonary system and other organs including the eyes, skin, liver, spleen, and lymph nodes. Sarcoidosis usually presents with persistent dry cough, eye and skin manifestations, weight loss, fatigue, night sweats, and erythema nodosum. Sarcoidosis is not influenced by sex or age, although it is more common in adults (< 50 years) of African-American or Scandinavians decent. Diagnosis can be difficult because of nonspecific symptoms and can only be verified following histopathological examination. Various factors, including infection, genetic predisposition, and environmental factors, are involved in the pathology of sarcoidosis. Exposures to insecticides, herbicides, bioaerosols, and agricultural employment are also associated with an increased risk for sarcoidosis. Due to its unknown etiology, early diagnosis and detection are difficult; however, the advent of advanced technologies, such as endobronchial ultrasound-guided biopsy, high-resolution computed tomography, magnetic resonance imaging, and 18F-fluorodeoxyglucose positron emission tomography has improved our ability to reliably diagnose this condition and accurately forecast its prognosis. This review discusses the causes and clinical features of sarcoidosis, and the improvements made in its prognosis, therapeutic management, and the recent discovery of potential biomarkers associated with the diagnostic assay used for sarcoidosis confirmation.
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McLeod K, Waller S, King D, Nestel D. Struggling urology trainee: a qualitative study into causes of underperformance. ANZ J Surg 2020; 90:991-996. [PMID: 32175672 DOI: 10.1111/ans.15825] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 02/23/2020] [Accepted: 03/01/2020] [Indexed: 12/01/2022]
Abstract
BACKGROUND Urological surgical trainees who underperform are difficult to identify, manage and require significant resources in an already stretched system relying on pro bono supervisors that often have no formal training. While there are commentaries on how to manage underperforming surgical trainees, there is a lack of data detailing the complex reasons for underperformance. It is important to understand the complexities contributing to underperformance so that improved remediation plans can be developed which can better help trainees meet expectations and succeed. METHODS In this qualitative study, individual semi-structured interviews were conducted with key persons identified as having very high levels of background knowledge and involvement with current underperforming urological surgery trainees. Transcribed interviews were thematically analysed. RESULTS Ten interviews were conducted, including nine urology consultants and one educational manager. Five themes were identified: underperformance is a small but profound issue; spiral of failure; the changing trainee; lack of insight and under supported supervisors and posts. CONCLUSION Causes of underperformance in urology trainees are complex and multifactorial. Behavioural issues were considered the most likely cause, which are also the most challenging to remedy. However, in addition to trainee factors, causative factors related to supervision and training were identified. Addressing all of these issues is paramount if effective remediation of these trainees is to occur.
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Affiliation(s)
- Kathryn McLeod
- Department of Urological Surgery, Barwon Health, University Hospital, Geelong, Victoria, Australia
| | - Susan Waller
- Monash University Department of Rural Health, Latrobe Regional Hospital, Traralgon, Victoria, Australia
| | - Dennis King
- Department of Surgery, Alfred Hospital, Melbourne, Victoria, Australia
| | - Debra Nestel
- Department of Surgery, University of Melbourne, Melbourne, Victoria, Australia
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Abstract
INCIDENCE AND CAUSE Cerebral palsy (CP) is characterized by poor motor control. The more severe the affection is, the more patients are prone to deformities. Patients with Gross Motor Function Classification System level V run an up to 90% risk for spinal deformities. These are caused by poor trunk control under load. Although trunk tone is impossible to assess it seems to be low in the majority of patients, leading to collapse under gravity. The constant malposition results in growth asymmetry which leads to fixation and deterioration of the deformity. BRACE TREATMENT Brace treatment has a poor reputation in respect to the final outcome. Conventional braces as constructed for other spinal deformities are indeed difficult for patients with CP as they cannot change position in the brace and do not tolerate pressure on the belly for reflux problems. Respecting these points improves the tolerance of braces but still the time of use is far from the necessary when the trunk is upright. Nevertheless, they can help to postpone surgery for scoliosis, but they are very inefficient for sagittal plane deformities. AIM OF TREATMENT The lack of trunk control further leads to an impairment of head control and upper extremity function. Providing stability improves these problems. Braces are superior to seating shells for both treating deformity and providing stability as they remain close to the skin and follow movements. Supports on seating shells in contrast are too far away for controlling the deformity and provide stability only if the patient doesn't move forward.
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Affiliation(s)
- Reinald Brunner
- Orthopaedic Department, Children’s Hospital, University of Basel, Switzerland,Correspondence should be sent to: Reinald Brunner, Orthopaedic Department, Children’s Hospital, University of Basel, Spitalstrasse 33, 4056 Basel, Switzerland. E-Mail:
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Markovic I, Bosnjakovic P, Milenkovic Z. Occipital Encephalocele: Cause, Incidence, Neuroimaging and Surgical Management. Curr Pediatr Rev 2020; 16:200-205. [PMID: 31656152 PMCID: PMC8193807 DOI: 10.2174/1573396315666191018161535] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 10/02/2019] [Accepted: 10/02/2019] [Indexed: 11/22/2022]
Abstract
AIMS To review and present the current knowledge of incidence, signs and symptoms, diagnosis and treatment of the occipital encephalocele. BACKGROUND Encephalocele (E) is a defect of the neural tube that refers to congenital malformations featured by skull defect and dura with extracranial spread of intracranial structures. Occipital encephalocele (OE) are the most common form of this congenital disorder and are manifested as a swelling of different sizes over the occipital bone in the midline. Proper diagnosis and treatment is highly important in the management of this congenital malformation of brain. OBJECTIVE To review and present the current knowledge of incidence, signs and symptoms, diagnosis and treatment of the occipital encephalocele. METHODS We conducted a search of case reports or case-series of patients by the use of electronic databases: Pub Med, Medline, Index Medicus, Scorpus. The key words were: encephalocele, occipital encephalocele, neural tube defect, congenital malformation. The search was updated to December 31, 2018. Papers published in English were the only source of information. RESULTS Occipital encephalocelle are more frequent in females than in males. The incidence is between 1 in 3000 to 1 in 10,000 live births; approximately 90% of them involve the midline. Magnetic resonance imaging is the method of choice in diagnosis and surgery is the best option for the treatment of OE. Overall morbidity and mortality is still high in spite of advenced surgical management, but have been significantly improved in recent years thanks to sophisticated highresolution imaging, adequate and proper surgical treatment and decent post-operative care. CONCLUSION Occipital encephalocele is the most common form of encephalocele. The diagnosis is mostly based by the use of neuroimaging techniques. Operation is the best option for treatment. Overall morbidity and mortality is still high, but have been significantly improved in recent years thanks to sophisticated high-resolution imaging, adequate and proper surgical treatment and decent post-operative care.
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Affiliation(s)
| | | | - Zoran Milenkovic
- Address correspondence to this author at the General Hospital ‘Sava Surgery’ Blvrd. Zorana Djindjica 91, Nis, Serbia; Tel: +38163463461; E-mail:
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Knobbe RB, Diallo A, Fall A, Gueye AD, Dieng A, van Immerzeel TD, Ba A, Diop A, Diop A, Niang M, Boye CS. Pathogens Causing Respiratory Tract Infections in Children Less Than 5 Years of Age in Senegal. Microbiol Insights 2019; 12:1178636119890885. [PMID: 31908474 PMCID: PMC6937528 DOI: 10.1177/1178636119890885] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 11/03/2019] [Indexed: 12/28/2022] Open
Abstract
Introduction: While acute respiratory tract infections are the main cause of paediatric mortality and morbidity worldwide, pathogen patterns shift due to factors such as hygiene, vaccinations, and antibiotic resistance. Knowledge about current cause of respiratory infections is lacking, particularly in low- and middle-income countries. The aim of this study was to identity the various respiratory pathogens causing acute respiratory tract infections in children below 5 years of age visiting a sub-urban primary care clinic in Senegal. Methods: A case-control study was performed in September and October 2018. Oropharyngeal swabs were collected from cases; infants with fever and respiratory symptoms, and controls; children involved in the vaccination programme. Viral identification was conducted by polymerase chain reaction for 21 different viruses; bacteria were identified by culture studies. Associations between microorganisms, acute respiratory infection and severity of disease were calculated by multivariate regression adjusting for confounders such as age, sex, and living area. Results: Overall, 102 cases and 96 controls were included. Microorganisms were detected in 90.1% of cases and 53.7% of controls (P < .001). Influenza virus A (including H1N1), influenza virus B, respiratory syncytial virus (RSV), and Streptococcus pneumoniae were independently associated with acute respiratory tract infections. Co-detection of two or more pathogens was present in 49.5% of cases; 31.7% of cases had a pneumonia and 90.2% was treated with antibiotics. Conclusions: This case-control study in a primary care setting in sub-Saharan Africa found influenza virus A and B, RSV, and S pneumoniae to be the main causes of acute respiratory tract infections in children below 5 years of age. We recommend evaluation of antibiotics prescription behaviour in this setting.
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Affiliation(s)
- Rebecca B Knobbe
- Laboratory of Bacteriology and Virology, Aristide Le Dantec Teaching Hospital, Dakar, Senegal.,Paediatric Infectious Disease and Immunology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Abdallah Diallo
- Paediatric Medical Care Unit, Institut de Pédiatrie Sociale de Pikine, Dakar, Senegal
| | - Amary Fall
- Medical Virology Unit, Pasteur Institute, Dakar, Senegal
| | - Aida D Gueye
- Laboratory of Bacteriology and Virology, Aristide Le Dantec Teaching Hospital, Dakar, Senegal
| | - Assane Dieng
- Laboratory of Bacteriology and Virology, Aristide Le Dantec Teaching Hospital, Dakar, Senegal
| | | | - Abou Ba
- Paediatric Unit, Albert Royer Hospital, Dakar, Senegal
| | - Amadou Diop
- Laboratory of Bacteriology and Virology, Aristide Le Dantec Teaching Hospital, Dakar, Senegal
| | - Abdoulaye Diop
- Laboratory of Bacteriology and Virology, Aristide Le Dantec Teaching Hospital, Dakar, Senegal
| | - Mbayame Niang
- Medical Virology Unit, Pasteur Institute, Dakar, Senegal
| | - Cheikh Sb Boye
- Laboratory of Bacteriology and Virology, Aristide Le Dantec Teaching Hospital, Dakar, Senegal
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Chan MK, Toribio JA, Podadera JM, Child G. Incidence, cause, outcome and possible risk factors associated with facial nerve paralysis in dogs in a Sydney population (2001-2016): a retrospective study. Aust Vet J 2019; 98:140-147. [PMID: 31867719 DOI: 10.1111/avj.12906] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 11/10/2019] [Accepted: 11/15/2019] [Indexed: 12/01/2022]
Abstract
OBJECTIVE This study aims to assess the incidence and causes of facial nerve paralysis (FNP) in dogs in the Sydney region. Its outcome and possible risk factors are investigated to prognosticate and aid design of diagnostic and treatment plans. DESIGN Retrospective case study. METHODS Client-owned dogs presented to the University Veterinary Teaching Hospital, Sydney (UVTHS), between 2001 and 2016 with FNP were included (n = 122). The incidence of each cause of FNP was investigated. A reference population of noncases seen at the UVTHS during the same time period was used to study the association between idiopathic facial nerve paralysis (IFNP) and gender, age and breed. RESULTS IFNP (29.5%) was the most common diagnosis. Male dogs (odds ratio [OR], 2.3) had increased odds of IFNP compared with female dogs. Age was a significant risk factor for both the occurrence of FNP and IFNP. There was higher occurrence of IFNP among middle-aged dogs (5-13 years) and reduced risk in juvenile dogs (less than 2 years). Cavalier King Charles Spaniels were over-represented for FNP (OR, 6.9) and IFNP (OR, 17.5). For IFNP, 6 of 16 dogs with known follow-up showed definitive resolution within 3 years of diagnosis. Concurrent vestibular signs were common in dogs with middle/inner ear abnormality and intracranial disease; and were also seen in 50% of dogs with IFNP. CONCLUSION The results of this study demonstrate statistical predilections in age, gender and breed for IFNP. Guarded prognosis for recovery should be given to dogs diagnosed with IFNP and supportive management instigated.
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Affiliation(s)
- M K Chan
- Sydney School of Veterinary Science, The University of Sydney, New South Wales, Australia
| | - J-Alml Toribio
- Sydney School of Veterinary Science, The University of Sydney, New South Wales, Australia
| | - J M Podadera
- Sydney School of Veterinary Science, The University of Sydney, New South Wales, Australia
| | - G Child
- Sydney School of Veterinary Science, The University of Sydney, New South Wales, Australia
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Matsuda Y, Maeda I, Morita T, Yamauchi T, Sakashita A, Watanabe H, Kaneishi K, Amano K, Iwase S, Ogawa A, Yoshiuchi K. Reversibility of delirium in Ill-hospitalized cancer patients: Does underlying etiology matter? Cancer Med 2019; 9:19-26. [PMID: 31696671 PMCID: PMC6943139 DOI: 10.1002/cam4.2669] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 10/17/2019] [Accepted: 10/17/2019] [Indexed: 02/03/2023] Open
Abstract
Background The objective of this study was to explore the underlying etiologies associated with the resolution and improvement of delirium in ill‐hospitalized cancer patients. Methods We conducted a secondary analysis of a multicenter, prospective, observational study to estimate the effectiveness of pharmacotherapy for delirium. Participants were cancer patients with delirium. We assessed the Delirium Rating Scale, Revised‐98 (DRS‐R98) severity scale score at baseline and three days after pharmacotherapy initiation. Delirium resolution was defined as a DRS‐R98 severity scale score ≤9, and improvement was defined as ≥50% reduction at Day 3. Results We enrolled 566 patients (491 patients had performance status of 3 or 4). The resolution and improvement rates in all patients were 22.6% and 19.3%, respectively. Univariate analysis determined that nonrespiratory infection (OR 2.18, 95% CI 1.38‐3.45) was significantly associated with greater resolution, while dehydration (0.40, 0.19‐0.87), organic damage to the central nervous system (CNS) (0.32, 0.43‐0.72), hypoxia (0.25, 0.12‐0.52), and hyponatremia (0.34, 0.12‐0.97) were significantly associated with no resolution. Potential causes associated with delirium improvement were nonrespiratory infection (1.93, 1.19‐3.13), organic damage to the CNS (0.40, 0.18‐1.90), and hypoxia (0.32, 0.16‐0.65). After multivariate analysis, dehydration (0.34, 0.15‐0.76), organic damage to the CNS (0.25, 0.10‐0.60), and hypoxia (0.29, 0.14‐0.61) were significantly associated with no resolution. Conclusions Delirium caused by nonrespiratory infection may be reversible, while delirium associated with dehydration, organic damage to the CNS, hypoxia, or hyponatremia seems to be irreversible in ill‐hospitalized cancer patients.
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Affiliation(s)
- Yoshinobu Matsuda
- Department of Psychosomatic Internal Medicine, National Hospital Organization Kinki-Chuo Chest Medical Center, Osaka, Japan
| | | | - Tatsuya Morita
- Palliative and Supportive Care Division, Seirei Mikatahara General Hospital, Shizuoka, Japan
| | | | - Akihiro Sakashita
- Department of Palliative Medicine, Kobe University Graduate School of Medicine, Hyogo, Japan
| | - Hiroaki Watanabe
- Department of Palliative Care, Komaki City Hospital, Aichi, Japan
| | - Keisuke Kaneishi
- Department of Palliative Care Unit, JCHO Tokyo Shinjuku Medical Center, Tokyo, Japan
| | - Koji Amano
- Department of Palliative Medicine, Osaka City General Hospital, Osaka, Japan
| | - Satoru Iwase
- Department of Palliative Medicine, Saitama Medical University, Saitama, Japan
| | - Asao Ogawa
- Department of Psycho-Oncology, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Chiba, Japan
| | - Kazuhiro Yoshiuchi
- Department of Stress Science and Psychosomatic Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Abstract
From 2017 to 2018, Guangzhou experienced a shortage in 3–6 types of National Immunization Program (NIP) vaccines. To evaluate the current situation and causes of the NIP vaccine shortage, we analysed the duration, intensity and causes of the shortage from data in the vaccine information system of the Guangzhou Center for Disease Control and Prevention; we also proposed countermeasures to resolve the shortage. In 2017, there were shortages of three types of NIP vaccines in Guangzhou. The most affected vaccines were inactivated poliovirus (IPV) vaccine and meningococcal group AC (MenAC) vaccine, accounting for 39.5% and 16.5% of the reported shortages, respectively. In 2018, the shortage extended to six vaccine types; the most affected were diphtheria, tetanus and pertussis (DTP) vaccine, MenAC vaccine, and Bacille Calmette Guerin (BCG) vaccine. The four main causes for the shortage were: 1) an insufficient production capacity; 2) a delay in batch issuance; 3) vaccine-related events; and 4) an extended bidding procurement cycle. Four solutions are proposed: 1) expand production output; 2) exempt creditworthy enterprises from batch inspections; 3) establish alternative enterprises and emergency use authorizations; and 4) establish public health funds and stockpile storage systems.
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Affiliation(s)
- Zhiqun Li
- Guangzhou Center For Disease Control And Prevention, Guangzhou, China
| | - Jindong Xu
- Department of Anesthesiology, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital & Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China
| | - Jianxiong Xu
- Guangzhou Center For Disease Control And Prevention, Guangzhou, China
| | - Huifeng Tan
- Guangzhou Center For Disease Control And Prevention, Guangzhou, China
| | - Chunhuan Zhang
- Guangzhou Center For Disease Control And Prevention, Guangzhou, China
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Abstract
The frequency of blunders perioperative because of anesthesia is expanding, and the precise occurrence is significantly thought little of practically due to underreporting. Root cause analysis of majority of anesthesia errors due to lack of knowledge, unfollow the patient procedures and guidelines, medications errors and lack of communication between the members of anesthesia team leading to morbidity or even mortality. The cornerstone in the operating room environment is the communication, especially the patient's data are accumulated and changed continuously during a patient's anesthesia. Continuous attempts for establishing Iideal strategies to reduce the incidence and chance of anesthesia errors. The advancement of a nonaccuse condition where mistakes are transparently revealed and talked about, and guidelines for naming the medication holders, vials, and ampoules are focused. All endeavors ought to be made in the revealing and anticipation of medical drug errors. It is time to incorporate electronic and digital concepts to encourage the evolution of anesthesia-related drug delivery system.
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Affiliation(s)
- Ayman Aly Rayan
- Department of Anesthesia and Intensive Care, Faculty of Medicine, Menoufia University, Menoufia, Egypt
| | - Sherif Essam Hemdan
- Department of Anesthesia and Intensive Care, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Ayman Mohamed Shetaia
- Department of Anesthesia and Intensive Care, Faculty of Medicine, Menoufia University, Menoufia, Egypt
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Tajiri T, Toriyama A, Sokai A, Goto K, Fukata H, Nakamura Y, Kita H. [THE CAUSES OF ACUTE COUGH: A SINGLE-CENTER STUDY IN JAPAN]. Arerugi 2019; 67:46-52. [PMID: 29459525 DOI: 10.15036/arerugi.67.46] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Cough is the most frequent presenting complaint in clinics, and is classified into the following three groups: acute, subacute and chronic. The major causes of acute cough are infectious diseases, however, few observations on acute cough have been reported. METHODS We retrospectively assessed the causes of acute cough among patients who had visited the respiratory clinic of our hospital because of acute cough from September 2014 to August 2015. RESULTS Of 374 patients (195 females, mean age 60.3 years) who visited the clinic complaining of cough, 129 patients (63 females, mean age 61.5 years) suffered from acute cough. All acute cases were stratified into two groups based on the presence (n=43) or absence (n=86) of abnormal findings on the chest X-ray. The main causes of acute cough with abnormal findings were pneumonia (46.5%), interstitial pneumonia (18.6%) and lung cancer (16.3%). The main causes of acute cough without abnormal findings were respiratory tract infection (39.5%), post infectious cough (18.6%) and bronchial asthma (17.4%). Acute cough was the primary complaint in 29.5% and 19.6% of all patients diagnosed with bronchial asthma and cough variant asthma, respectively. CONCLUSION Non-infectious diseases including asthma as well as infectious diseases could be the causes in acute cough without abnormal findings on the chest X-ray.
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Affiliation(s)
- Tomoko Tajiri
- Department of Respiratory Medicine, Takatsuki Red Cross Hospital
| | - Ayano Toriyama
- Department of Respiratory Medicine, Takatsuki Red Cross Hospital
| | - Akihiko Sokai
- Department of Respiratory Medicine, Takatsuki Red Cross Hospital
| | - Kenichi Goto
- Department of Respiratory Medicine, Takatsuki Red Cross Hospital
| | - Hiroko Fukata
- Department of Respiratory Medicine, Takatsuki Red Cross Hospital
| | | | - Hideo Kita
- Department of Respiratory Medicine, Takatsuki Red Cross Hospital
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Xu MZ, Liu JY, Fu Z. [ Causes of chronic cough in children in Chongqing, China: an analysis of 202 cases]. Zhongguo Dang Dai Er Ke Za Zhi 2019; 21:436-440. [PMID: 31104658 PMCID: PMC7389422 DOI: 10.7499/j.issn.1008-8830.2019.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Indexed: 06/09/2023]
Abstract
OBJECTIVE To investigate the constitution of causes of chronic cough in children. METHODS The clinical data of 202 children with chronic cough who were hospitalized in the Affiliated Children's Hospital of Chongqing Medical University from May 2015 to November 2017 were retrospectively analyzed. RESULTS As for the causes of chronic cough in the 202 children, 81 (40.1%) had post-infection cough (PIC), 71 (35.1%) had cough variant asthma (CVA), 43 (21.3%) had upper airway cough syndrome (UACS), 3 (1.5%) had foreign body aspiration, 1 (0.5%) had gastroesophageal reflux cough, 2 (1.0%) had Tourette syndrome, and 1 (0.5%) had congenital respiratory disorders. Of the 202 children, 119 (58.9%) had chronic cough caused by a single factor and 83 (41.1%) had chronic cough caused by multiple factors. There was a significant difference in the constitution of causes of chronic cough among the children with different ages (<1 year, ≥1 year, ≥3 years and 6-14 years) or natures of cough (wet cough and dry cough) (P<0.01). CONCLUSIONS The top three causes of chronic cough in children are PIC, CVA and UACS. There are significant differences in the main causes of chronic cough between children with different ages and between those with different natures of cough.
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Affiliation(s)
- Mao-Zhu Xu
- Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.
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Flinik-Jankowska M. [Suicide attempts of patients in the material of the Department of Psychiatry of the 10th Military Clinical Hospital in Bydgoszcz in the years 2015-2017]. Pol Merkur Lekarski 2019; 46:134-138. [PMID: 30912523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
UNLABELLED Suicides are the most serious cause of death among patients with mental disorders. AIM The aim of the work was the analysis of suicide attempts of patients staying at the Department of the 10th Military Clinical Hospital in Bydgoszcz in the years 2015-2017. MATERIALS AND METHODS The study was conducted in a group of 61 patients, 43 women and 18 men, admitted to the clinic due to a suicide attempt, in whom one of the diagnoses was made: depressive disorders, adaptive disorders, personality disorders, organic mood disorders. Biographical factors were analyzed: age, marital status, place of residence, education, professional activity, previous psychiatric treatment, stays in psychiatric hospitals, the method and causes of the suicide attempt. RESULTS Among 61 patients hospitalized in the Department of Psychiatry due to suicide attempts, the main clinical findings were personality disorders (36,1%) , depressive disorders (21,3%), organic mood disorders (18,0%) and adaptive disorders (4,9%). The most frequent metod of suicide attempt was drug poisoning (63,9%) and drug and alcohol poisoning (21,3%). CONCLUSIONS he analysis of suicide attempts of patients hospitalized in the Department of Psychiatry showed that the main diagnosis was personality disorder, and the most common suicide attempt was drug poisoning.
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Singhrao SK, Olsen I. Assessing the role of Porphyromonas gingivalis in periodontitis to determine a causative relationship with Alzheimer's disease. J Oral Microbiol 2019; 11:1563405. [PMID: 30728914 PMCID: PMC6352933 DOI: 10.1080/20002297.2018.1563405] [Citation(s) in RCA: 85] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 12/05/2018] [Accepted: 12/13/2018] [Indexed: 01/14/2023] Open
Abstract
Chronic periodontitis of 10 years' duration is reported to become a twofold risk factor for the development of Alzheimer's disease (AD). Periodontitis is modifiable, and this fits with the current action plan for preventing AD. However, until periodontitis, becomes acknowledged as a firm risk factor for AD, this risk will continue. Here, we put forward our own argument based on the current literature for in vivo infection-mediated periodontal disease models supporting the antimicrobial protection hypothesis of AD and interventional studies supporting the causal links. Oral infections with Porphyromonas gingivalis, or introduction of its lipopolysaccharide (LPS), in various mouse models has demonstrated the development of key neuropathological hallmark lesions defining AD. These are extracellular amyloid-beta plaques, phosphorylated tau, neurofibrillary tangles, widespread acute and chronic inflammation, blood-brain barrier defects together with the clinical phenotype showing impaired learning and spatial memory. Live P. gingivalis and its LPS (commercial or from 'microbullets') are powerful peripheral and intracerebral inflammatory signalling initiators, and this has direct implications on memory and lesion development. Maintaining a healthy oral microbiome and managing periodontal disease with regular surveillance and good oral hygiene throughout life is likely to reduce the unnecessary burden of AD in some individuals.
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Affiliation(s)
- Sim K Singhrao
- Dementia and Neurodegenerative Diseases Research Group, Faculty of Clinical and Biomedical Sciences, School of Dentistry, University of Central Lancashire, Preston, UK
| | - Ingar Olsen
- Department of Oral Biology, Faculty of Dentistry, University of Oslo, Oslo, Norway
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