General Medicine: Open Access最新文献

{"title":"A Call for the Definitive Diet Study to End the Diet Debate Once and for All","authors":"Fleming Rm, M. Fleming, A. McKusick, K. Ayoob, David W. Grotto, T. Chaudhuri","doi":"10.35248/2327-5146.7.322","DOIUrl":"https://doi.org/10.35248/2327-5146.7.322","url":null,"abstract":"The current level of \"discussion\" on these diets by many people reminds me of elementary school children fighting on the playground during recess. Ms. Michaels efforts to bring some intelligence to this discussion is different. Despite the constant arguments about, you cannot honestly call any of this a debate or intelligent discussion, between the low carbohydrate diets and the other types of diets proposed by the diet pundits, there is little if any new or useful information. Study after study show if you change the way a person eats, they can lose weight; big deal! These same studies use changes in blood tests to support the benefit they have for reducing heart disease. These studies exclude people whose cholesterol and other blood tests for inflammation go up, thereby making the results look better, while criticizing other studies for not agreeing with them. The major problem with this approach is that I never said that reducing your cholesterol level or your insulin resistance or your CRP level would reduce your heart disease. My \"inflammation and heart disease\" and \"angina\" Theories explain why people develop heart disease and why this heart disease causes chest pain. In 2008 while developing a method to actually measure heart disease my research showed that changes in these blood tests of inflammation didn't match actual changes in heart disease; which means that measuring cholesterol and other blood tests won't tell you if your heart disease is changing. To know what's happening to your heart, you actually have to measure it. The only quantitative method for accurately, consistently and reproducibly being able to do this is FMTVDM. If the diet pundits want to know what happens to your heart when you go on their diets, they will need to measure it with FMTVDM.","PeriodicalId":122998,"journal":{"name":"General Medicine: Open Access","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130598481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Pilot Study to Evaluate Appropriateness of Empirical Antibiotic Use in Intensive Care Unit of King Saud Medical City, Riyadh, Saudi Arabia","authors":"Basim Huwait, Basheer Abd El Rahman, M. A. Rana, H. Alam, Ramadan Oes, W. Aletreby, A. Mady, Harthy Ama","doi":"10.35248/2327-5146.7.323","DOIUrl":"https://doi.org/10.35248/2327-5146.7.323","url":null,"abstract":"Background: Antibiotics are commonly administered therapies in ICU. There has been a concern over antibiotic misuse recently. ICU is both a victim and a contributor to the ongoing antibiotic misuse problem and a cause of emerging resistance among the pathogens commonly acquired in intensive care units. Because of high mortality associated with sepsis, it is a great challenge for intensive care physicians to select appropriate antibiotic sometimes without any culture and sensitivity. Similarly the time to deescalate also remains a tough call. Selection of appropriate antibiotics empirically has always been a topic of debate among Intensive Care and Infectious Disease practitioners. \u0000 \u0000Objective: The aim of our pilot study was not only to assess the appropriateness of use of antibiotics in our ICU but to help us guide to design a bigger study and structure a stewardship program for ICU; also to assess the differences among prescription of ICU and Infectious Disease Consultants. \u0000 \u0000Method: A prospective observational study in King Saud Medical City ICU following antibiotics started and stopped from 6th November 2014 to 23rd November 2014. Study included 23 adult patients admitted with different etiologies. All 23 patients’ records were shared with two alien referees (one was infectious diseases and other was ICU consultant) from other hospital. Prescribers were blinded to the fact that data was being collected for auditing and the referees were blinded to prescribers and to each other’s. \u0000 \u0000Results: Total 46 antibiotics were used. 40 among them were started on empirically, 6 were culture based. 31 antibiotics were stopped by ICU. 28 among these 31 antibiotics were empirical. Most of included patients responded to combination or monotherapy. Piperacillin-Tazobactam was the most commonly prescribed antibiotic. No major difference was noted among the choice of intensive care or infectious disease consultant. \u0000 \u0000Conclusion: Empirical antibiotics are vital for patients admitted in ICU. We need to follow hospital's anti-biogram and stewardship programs with prompt de-escalation wherever appropriate.","PeriodicalId":122998,"journal":{"name":"General Medicine: Open Access","volume":"47 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117057008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bilateral Loss of Vision after Spinal Anaesthesia on a Dwarf Patient","authors":"M. Kassa, J. Shifa, N. Bekele, Opondo Pr","doi":"10.35248/2327-5146.7.320","DOIUrl":"https://doi.org/10.35248/2327-5146.7.320","url":null,"abstract":"Achondroplasia is the most common form of dwarfism. Achondroplasia poses multiple anaesthetic challenges ranging from securing intravenous line, monitoring and drug dose calculations and airway management among others. Spinal anaesthesia is a very common method of anaesthesia in Botswana. The only type of anaesthetic drug that is in use for spinal anaesthesia in Botswana is hyper baric bupivacaine 0.5%. \u0000 \u0000We report a case of a 33-year-old achondroplastic dwarf patient who developed bilateral visual loss for three days after he had received spinal anaesthesia for appendectomy. Postoperatively the patient was found to have increased intracranial pressure on magnetic resonance imaging scan. Subsequently decompressive ventriculo-peritoneal shunt operation was done and he gradually regained his vision. \u0000 \u0000Meticulous and detailed pre anaesthetic assessment, well planned mode of anaesthesia and post-operative care of dwarf patients is essential to minimize complications and its severity. Post-operative signs and symptoms that may indicate any neurological effect of high intracranial pressure on dwarf patients have to be promptly identified and treated urgently to reduce further damage.","PeriodicalId":122998,"journal":{"name":"General Medicine: Open Access","volume":"4 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125738310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do Late Phase Hyperbaric and Normobaric Oxygen Therapies have Effect on Liver Damage? An Experimental Sepsis Model","authors":"A. Bektaş, Meltem Ulusoy, Mehmet-Refik Mas","doi":"10.35248/2327-5146.7.324","DOIUrl":"https://doi.org/10.35248/2327-5146.7.324","url":null,"abstract":"Background: Sepsis is fatal presentation which affects many systems with possible progression to organ dysfunction and organ failure. Among these organs liver plays an important role in the prognosis of this syndrome. This study investigated the effects of hyperbaric oxygen (HBO) and normobaric oxygen (NBO) therapies on liver damage and oxidative stress in an experimental sepsis model. \u0000 \u0000Materials and Methods: Forty males Wistar rats were randomized into 4 groups as sham group (n=10), control (Sepsis+Cefepime) group (n=10), HBO (Sepsis+Cefepime+HBO) group (n=10), and NBO (Sepsis+Cefepime+NBO) group (n=10). Five days after sepsis induction, animals were sacrificed. The oxidative stress parameters, malondialdehyde (MDA) and superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) for antioxidant response were measured in liver tissue. Neutrophil migration using myeloperoxidase (MPO) activity and its contribution to liver damage was evaluated. \u0000 \u0000Results: While MDA levels in HBO group were found to be lower than those in the control group, and comparable to those in the sham group, no difference was detected in the MDA levels between the control and NBO groups. SOD levels in NBO group were detected to be significantly higher than the control group. GSH-Px enzyme activity in HBO and NBO groups was at similar levels. Even though MPO levels in HBO group appeared to be lower than the control group, the difference did not reach statistical significance. When MPO levels and histopathological examination were evaluated, it was observed that neither HBO nor NBO administration in addition to antibiotherapy provided decrease in neutrophil infiltration which has an important role in liver damage. \u0000 \u0000Conclusion: The benefit of HBO in the treatment of sepsis in addition to the use of antibiotics has also been confirmed to be successful in this study. Furthermore the data obtained from NBO applications in this study, is thought to be potentially useful for sepsis treatment.","PeriodicalId":122998,"journal":{"name":"General Medicine: Open Access","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116761782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evidence-based Practice Utilization and Associated Factors among Nurses Working in Public Hospitals of Jimma Zone Southwest Ethiopia: A Cross Sectional Study","authors":"Bikila Dereje, Endalew Hailu, M. Beharu","doi":"10.35248/2327-5146.7.321","DOIUrl":"https://doi.org/10.35248/2327-5146.7.321","url":null,"abstract":"Background: Evidence-based Practice is the application of the best scientific evidence for clinical decision making in professional patient care. Most of the time, Nursing care practice in Ethiopia is based on experience, tradition, intuition, common sense and untested theories. There is lack of information on the level of utilization of evidence based practice by nurses in Ethiopia. \u0000 \u0000Methods: An institutional based cross sectional study design was employed from March 10 to April 1, 2018. Stratified random sampling was deployed to select 270 respondents. Data was collected using a pretested, structured and self-administered questionnaire and in-depth interview guide. Data were entered using Epi-data version 3.1 and analyzed by SPSS version 20. Bivariate and multivariable logistic regressions were under taken to identify the associated factors. \u0000 \u0000Results: In total, 253 returned questionnaires which makes response rate of 93.7%. More than half 131(51.8%) of respondents used evidence-based practice. Further the study indicated that, being head nurse was 5.2 times AOR=5.227, 95%CI=(1.252, 21.819) more likely used EBP than staff nurses. Being knowledgeable about EBP was 2.1 times AOR=2.084, 95%CI=(1.118,3.886) more likely used EBP than those not knowledgeable about EBP. \u0000 \u0000Conclusion: The utilization of EBP among nurses working in public hospitals of Jimma zone was 51.8%. Nevertheless, only 16.5% of respondents often utilized EBP in their clinical practice.","PeriodicalId":122998,"journal":{"name":"General Medicine: Open Access","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124297268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}