Journal of Clinical Medicine Research最新文献

{"title":"Study on the Instrument for Testing Radiofrequency Ablation Catheter","authors":"Lei Zhang, Wenbo Lu, Jianjun Sun, Chongchong Ai, Zechen Lin, Naishui Han, Longfei Li, Yufei Jia","doi":"10.32629/jcmr.v4i2.1234","DOIUrl":"https://doi.org/10.32629/jcmr.v4i2.1234","url":null,"abstract":"Objective — To design a detection instrument for detecting the quality of radiofrequency ablation electrode, which can quickly detect the physical properties of radiofrequency ablation electrode. Methods — The DC constant current source is introduced to measure the small resistance, test whether the thermocouple is well connected, and measure the resistance between the positive and negative wires of the thermocouple at the plug (1-core and 2-core) to determine whether the thermocouple is well connected. The resistance of the good product is about 40Ω. Detect whether the inner tube and outer tube of RF ablation are in good physical contact through resistance, and judge whether there is physical contact between the inner tube and outer tube by detecting the resistance between the positive conductor of thermocouple (2 cores) and RF connecting wire (3 cores). When in good contact, the resistance is about 0.5 Ω; Measure the short circuit between 4~8 cores of the plug and judge whether the code is correct. The measurement method of pipeline absolute tightness is adopted to detect the change of pipeline pressure. Results — The developed radiofrequency ablation electrode detector can accurately measure the resistance, circuit and pipeline tightness of radiofrequency ablation, and can meet the requirements of detection accuracy. Conclusion — The quality of the prototype is stable and can meet the needs of users.","PeriodicalId":15431,"journal":{"name":"Journal of Clinical Medicine Research","volume":"43 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86718062","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":"The Impact of Speech Therapy Combined with Audiovisual Integration Rehabilitation Training on the Intelligence and Language Recovery of Children with Global Developmental Delay","authors":"Jinghan Zhang","doi":"10.32629/jcmr.v4i2.1233","DOIUrl":"https://doi.org/10.32629/jcmr.v4i2.1233","url":null,"abstract":"Objective: To analyze the impact of speech therapy combined with audiovisual integration rehabilitation training on the intelligence and language recovery of children with global developmental delay. Methods: A total of 60 children with global developmental delay treated in our hospital from January 2021 to December 2022 were selected as the research subjects. The children were divided into two groups according to the intervention method: the control group (n=30) and the study group (n=30). The control group received speech therapy intervention, while the study group received speech therapy combined with audiovisual integration rehabilitation training. The intelligence, language, quality of life, developmental quotient changes and family satisfaction of the children in both groups were compared before and after the intervention. Results: After the intervention, the CDCC, GDS, and PedsQL scores of the children in the study group were higher than those in the control group. The developmental quotient scores of language ability, adaptability, fine motor skills, gross motor skills, and personal social behavior were also higher in the study group than in the control group. The overall satisfaction rate of the children's families was 96.67% in the study group, which was higher than the 86.67% in the control group (P<0.05). Conclusion: Speech therapy combined with audiovisual integration rehabilitation training can promote the intelligence and language recovery of children with global developmental delay, improve their quality of life, developmental quotient and family satisfaction.","PeriodicalId":15431,"journal":{"name":"Journal of Clinical Medicine Research","volume":"63 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80323084","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":"Randomized Parallel Controlled Study of Wenfeizhiluidan in the Treatment of Allergic Rhinitis with Deficiency of Lung Qi and Cold","authors":"Kepeng Wang, Xiong Zhang","doi":"10.32629/jcmr.v4i2.1242","DOIUrl":"https://doi.org/10.32629/jcmr.v4i2.1242","url":null,"abstract":"Objective — To study a randomized parallel control study of allergic rhinitis. Methods — 106 patients with lung qi deficiency and cold allergic rhinitis treated in the hospital from March 2022 to March 2023 were selected as the study objects. The patients were divided into observation group and control group according to the random parity method. 53 patients in each group took desloratadine, and the observation group took warm lung flow stop for treatment. The clinical effect, the level of inflammatory factors before and after treatment, and the immune function were compared between the two groups. Results — For the observed and control groups, 96.23% was higher than 75.47% (P<0.05). After treatment, the TNSS and RQLQ scores between the observation and control groups were lower (P<0.05). IL-33, TNF- α, and IFN- γ levels were lower in the observed and control groups (P<0.05). IgE, EOS and EOT were higher in observation and control groups (P<0.05). Conclusion — Patients with lung qi deficiency cold allergic rhinitis after taking warm lung flow Dan treatment, the clinical effect is remarkable, can effectively improve the clinical symptoms of patients, reduce their inflammatory response, improve the immune function of patients, with high clinical application value.","PeriodicalId":15431,"journal":{"name":"Journal of Clinical Medicine Research","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72969968","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":"Protein Induced by Vitamin K Absence or Antagonist-II Versus Alpha-Fetoprotein in the Diagnosis of Hepatocellular Carcinoma: A Systematic Review With Meta-Analysis.","authors":"Abdallah Kobeissy,&nbsp;Nooraldin Merza,&nbsp;Alsadiq Al-Hillan,&nbsp;Safa Boujemaa,&nbsp;Zohaib Ahmed,&nbsp;Mohamad Nawras,&nbsp;Mohammed Albaaj,&nbsp;Dushyant Singh Dahiya,&nbsp;Yaseen Alastal,&nbsp;Mona Hassan","doi":"10.14740/jocmr4951","DOIUrl":"https://doi.org/10.14740/jocmr4951","url":null,"abstract":"<p><strong>Background: </strong>Protein induced by vitamin K absence or antagonist-II (PIVKA-II) and α-fetoprotein (AFP) are promising tumor markers for the diagnosis of hepatocellular carcinoma (HCC). Yet, their diagnostic performance differs throughout HCC investigations. The aim of this meta-analysis was to assess the effectiveness of PIVKA-II and AFP in the diagnosis of HCC.</p><p><strong>Methods: </strong>A systematic literature search was performed to identify relevant studies from eight databases, which were published up to February 2023, in order to compare the diagnostic performance of PIVKA-II and AFP for HCC. Pooled sensitivity and specificity were calculated. Summary receiver operating characteristic (SROC) curve was performed to assess the diagnostic accuracy of each biomarker.</p><p><strong>Results: </strong>Fifty-three studies were identified. The pooled sensitivity (95% confidence interval (CI)) of PIVKA-II and AFP was 0.71 (0.70 - 0.72) and 0.64 (0.63 - 0.65), respectively in diagnosis of HCC, and the corresponding pooled specificity (95% CI) was 0.90 (0.89 - 0.90) and 0.87 (0.87 - 0.88), respectively. The area under the ROC curve (AUC) of PIVKA-II and AFP was 0.89 (0.88 - 0.90) and 0.78 (0.77 - 0.79), respectively. Subgroup analysis demonstrated that PIVKA-II presented higher AUC values compared to AFP in terms of ethnic group (African, European, Asian, and American patients), etiology (mixed-type HCC, hepatitis C virus (HCV)-related, and hepatitis B virus (HBV)-related) and sample size of cases (≤ 100 and > 100).</p><p><strong>Conclusion: </strong>This study reveals that PIVKA-II is a promising biomarker for identifying and tracking HCC, exhibiting greater accuracy than AFP. Our findings indicate that PIVKA-II outperforms AFP in detecting HCC across diverse racial groups and sample sizes, as well as in cases of HBV-related, HCV-related, or mixed-etiology HCC.</p>","PeriodicalId":15431,"journal":{"name":"Journal of Clinical Medicine Research","volume":"15 7","pages":"343-359"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ef/18/jocmr-15-343.PMC10416192.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9998163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Descriptive Study of Patients Treated in a Psychosomatic Internal Medicine Declared by Japanese Family Medicine Clinic.","authors":"Natsuki Kajikawa,&nbsp;Hisashi Yoshimoto,&nbsp;Shoji Yokoya","doi":"10.14740/jocmr4939","DOIUrl":"https://doi.org/10.14740/jocmr4939","url":null,"abstract":"<p><strong>Background: </strong>Psychosomatic internal medicine (PSIM) assesses psychosocial factors and provides holistic consideration. In Japan, PSIM physicians seem to be recognized as providers of mental health services, but family medicine did not so. When family physicians confront with psychological problems, high dropout rate is reported so it is needed to reveal factors related to dropouts, The purpose of this study is to describe characteristics of patients, treatment dropouts and its related factors in PSIM practice by family physician.</p><p><strong>Methods: </strong>This cross-sectional study used data from the medical records of the Kitaibaraki Center of Family Medicine located in Kitaibaraki City, Ibaraki, Japan. The study included all new patients who made an appointment and visited the PSIM in this clinic from January 2020 to December 2022.Chief complaints and diagnoses were coded based on the International Classification of Primary Care, version 2 (ICPC-2).</p><p><strong>Results: </strong>In total, 377 new patients were included in this study. The mean age was 39.9 ± 20.2 years. We found that 69.2% of patients who visited the clinic had a psychological chief complaint and 84.1% of primary diagnoses consisted of a psychological problem. One hundred sixty-five patients (43.8%) were still receiving treatment 6 months after the initial visit. Of the patients who ended treatment within 6 months after the initial visit, 84 patients (39.2%) dropped out. In multivariate analysis, the dropouts were less likely to occur patients with primary diagnosis of psychological problem (odds ratio (OR): 0.35, 95% confidence interval (CI): 0.19 - 0.67).</p><p><strong>Conclusions: </strong>Patients who visited a PSIM wanted consultation about psychological problems. Patients with a diagnosis of a psychological problem at the initial visit were less likely to drop out.</p>","PeriodicalId":15431,"journal":{"name":"Journal of Clinical Medicine Research","volume":"15 7","pages":"360-367"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/71/e4/jocmr-15-360.PMC10416189.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9998167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oral Semaglutide Induces Loss of Body Fat Mass Without Affecting Muscle Mass in Patients With Type 2 Diabetes.","authors":"Syutaro Uchiyama,&nbsp;Yukiyoshi Sada,&nbsp;Syohei Mihara,&nbsp;Yosuke Sasaki,&nbsp;Masakatsu Sone,&nbsp;Yasushi Tanaka","doi":"10.14740/jocmr4987","DOIUrl":"https://doi.org/10.14740/jocmr4987","url":null,"abstract":"<p><strong>Background: </strong>Excessive body fat may be a major cause of insulin resistance and diabetes. But body weight reduction by energy restriction may simultaneously reduce both fat and muscle. Skeletal muscle is an important organ for glucose metabolism regulation, and loss of muscle may deteriorate glucose metabolism. Therefore, it is preferable to predominantly reduce fat without significant loss of muscle with weight loss in patients with type 2 diabetes. Previously, the anti-diabetic agent glucagon-like peptide-1 receptor agonists (GLP-1RAs) liraglutide and semaglutide given by injection were reported to decrease fat with less effect on muscle in diabetic patients. Recently oral semaglutide was developed and was reported to decrease body weight, but the effect on muscle has not been fully evaluated.</p><p><strong>Methods: </strong>This was a non-interventional retrospective longitudinal study. We evaluated the effect of 24-week treatment with oral semaglutide on body fat and muscle mass in 25 Japanese patients with type 2 diabetes. Laboratory examination and body composition test by bioelectrical impedance analysis (BIA) were performed at baseline, 12 weeks, and 24 weeks, and the effects on glycemic control and body composition were assessed.</p><p><strong>Results: </strong>Hemoglobin A1c significantly decreased at 12 weeks and further ameliorated at 24 weeks (8.7±0.87% at baseline; 7.6±1.00% at 12 weeks; 7.0±0.80% at 24 weeks; mean ± standard error (SE)). While body fat significantly decreased (28.3 ± 1.52 kg at baseline; 26.8 ± 1.59 kg at 12 weeks; 25.5 ± 1.57 kg at 24 weeks; mean ± SE), whole-body lean mass was not significantly changed (48.1 ± 1.92 kg at baseline; 47.7 ± 1.93 kg at 12 weeks; 47.6 ± 1.89 kg at 24 weeks; mean ± SE). Furthermore, the appendicular skeletal muscle index (SMI) defined as appendicular skeletal muscle mass (ASM)/height squared (units; kg/m²) was also unchanged.</p><p><strong>Conclusion: </strong>The 24-week treatment with oral semaglutide ameliorated glycemic control with reduction of body fat but not muscle mass in Japanese patients with type 2 diabetes.</p>","PeriodicalId":15431,"journal":{"name":"Journal of Clinical Medicine Research","volume":"15 7","pages":"377-383"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f4/bf/jocmr-15-377.PMC10416191.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9998166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Histopathological Findings of Ectopic Pregnancy in Contraceptive-Wearing Woman.","authors":"Takuma Hayashi,&nbsp;Kenji Sano,&nbsp;Ikuo Konishi","doi":"10.14740/jocmr4924","DOIUrl":"https://doi.org/10.14740/jocmr4924","url":null,"abstract":"<p><p>In normal pregnancy, the egg is fertilized in the fallopian tube. It later moves into the uterus, where it implants into the uterine endometrium. Therefore, implantation of the fertilized egg into the endometrium is not observed in many women using contraceptives. However, if the fallopian tubes are diseased or abnormal, the fertilized egg cannot travel to the endometrium. Thus, the fertilized egg is implanted in tissues other than the uterus, resulting in an ectopic pregnancy. In most cases of ectopic pregnancy, the fertilized egg is implanted into the left or right fallopian tube or in tissues other than the fallopian tubes such as the ovary. With laparoscopic surgery, the scars are small, and the pain and physical burden are also much lesser than those with open surgery; thus, the patient can be rehabilitated immediately. Laparoscopic surgery is preferred for the termination of ectopic pregnancies because the patients recovered quickly physically after surgery and can be discharged in a short period. This paper presents our experience in treating a 37-year-old woman who had a tubal pregnancy despite using a contraceptive. Contrast-enhanced magnetic resonance imaging showed a gestational sac within the right fallopian tube. Laparoscopic surgery was performed to resect the right fallopian tube. Pathological examination suggested that the ectopic pregnancy occurred at the organogenesis stage 9 weeks after fertilization. The pathological findings revealed subpopulations of cells from the ectoderm that were separated from other cells and more specifically formed spinal and ovarian structures. The implantation of the fertilized egg into the endometrium is not observed in many women using contraceptives. However, in rare cases, ectopic pregnancy occurs in women using contraceptives; thus, caution is necessary in diagnosis and treatment. This report presents valuable surgical pathological findings from such a rare case of ectopic pregnancy to understand the differentiation into each tissue during organogenesis.</p>","PeriodicalId":15431,"journal":{"name":"Journal of Clinical Medicine Research","volume":"15 7","pages":"384-389"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f4/1e/jocmr-15-384.PMC10416193.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10370917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiologic Features of T10 Paravertebral Muscle Sarcopenia: Prognostic Factors in COVID-19.","authors":"Georgios Schinas,&nbsp;Vasiliki Dimakopoulou,&nbsp;Konstantinos Dionysopoulos,&nbsp;Georgia Fezoulidi,&nbsp;Marianna Vlychou,&nbsp;Katerina Vassiou,&nbsp;Nikolaos K Gatselis,&nbsp;Anna Samakidou,&nbsp;Georgios Giannoulis,&nbsp;Argyrios Tzouvelekis,&nbsp;Markos Marangos,&nbsp;Charalambos Gogos,&nbsp;George N Dalekos,&nbsp;Christina Kalogeropoulou,&nbsp;Karolina Akinosoglou","doi":"10.14740/jocmr4963","DOIUrl":"https://doi.org/10.14740/jocmr4963","url":null,"abstract":"<p><strong>Background: </strong>Sarcopenia, defined as a small cross-sectional area (CSA) in computed tomography (CT) measurements of skeletal muscles, serves as a disease severity marker in various clinical scenarios, including pulmonary conditions and critical illness. Another parameter of sarcopenia, the level of myosteatosis, reflected by the tissue's radiodensity, in the thoracic skeletal muscles group, has been linked to disease progression in coronavirus disease 2019 (COVID-19) patients. We hypothesize that CT-derived measurements of the skeletal muscle density (SMD) and the CSA of thoracic skeletal muscles can predict outcomes in COVID-19 pneumonia.</p><p><strong>Methods: </strong>We retrospectively reviewed the CT scans of 84 patients with COVID-19 pneumonia admitted to two of Greece's largest academic teaching hospitals between April 2020 and February 2021. CSA and SMD at the level of the T10 vertebra were measured using computational imaging methods. The patient population was stratified according to survival status and CT severity score (CT-SS). Correlations were drawn between the radiologic features of sarcopenia, CT severity subgroups, serum inflammatory markers, and adverse events, e.g., death and intubation.</p><p><strong>Results: </strong>Thoracic muscles' CSA measurements correlate with CT-SS and prominent inflammatory markers, such as white blood cell (WBC), C-reactive protein (CRP), fibrinogen, and D-dimers. Moreover, according to linear regression analysis, CSA seems to predict CT-SS variation significantly (β = -0.266, P = 0.018). CSA proved to differ significantly across survivors (P = 0.027) but not between CT severity categories and intubation subgroups. The AUC (area under the curve) of the receiver operating characteristic (ROC) curve for the predictive value of thoracic muscles' CSA in mortality is 0.774 (95% confidence interval (CI): 0.66 - 0.83, P < 0.000). The optimal cut-off value (Youden index = 0.57) for mortality prognosis, with a sensitivity of 66.7% and a specificity of 88.9%, is 15.55. Thoracic muscles' SMD analyses did not reveal any significant correlations.</p><p><strong>Conclusions: </strong>Easy to obtain and accurately calculated, radiologic features can provide a reliable alternative to laboratory methods for predicting survival in COVID-19. Thoracic muscles' CSA measurement in the level of the T10 vertebra, an acclaimed prognostic imaging assessment that relates directly to CT-SS and inflammatory markers in COVID-19 pneumonia, is a fairly specific tool for survival prognosis.</p>","PeriodicalId":15431,"journal":{"name":"Journal of Clinical Medicine Research","volume":"15 7","pages":"368-376"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/77/ec/jocmr-15-368.PMC10416190.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9998168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nutritional Interpretation of Hospital Diets for Elderly Patients With Chronic Diseases and Analysis of Factors Influencing Actual Intakes.","authors":"Yasuko Fukuda,&nbsp;Mikako Ochi,&nbsp;Ryouko Kanazawa,&nbsp;Hiromu Nakajima,&nbsp;Keisuke Fukuo,&nbsp;Masanobu Nakai","doi":"10.14740/jocmr4961","DOIUrl":"https://doi.org/10.14740/jocmr4961","url":null,"abstract":"<p><strong>Background: </strong>The provision of hospital meals is considered a therapeutic intervention, and a therapeutic diet consisting of a post-discharge meal sample is provided. For elderly patients who require long-term care, it is important to determine the significance of nutrition by taking into account hospital meals, including therapeutic meals for conditions such as diabetes. Therefore, it is important to identify the factors that influence this judgment. This study aimed to investigate the difference between the expected nutritional intake via nutritional interpretation and actual nutritional intake.</p><p><strong>Methods: </strong>The study included 51 geriatric patients (77.7 ± 9.5 years; 36 males and 15 females) who could eat meals independently. The participants completed a dietary survey to determine the perceived nutritional intake obtained from hospital meal contents. Additionally, we investigated the amount of hospital meal leftovers from the medical records and the amount of nutrients from the menus to calculate the actual nutritional intake. We calculated the amount of calories, protein concentration, and non-protein/nitrogen ratio from the perceived and actual nutritional intake values. We then calculated the cosine similarity and conducted a qualitative analysis of factorial units to examine similarities between perceived and actual intake.</p><p><strong>Results: </strong>Among factors that constituted the large cosine similarity group (gender, age, etc.), gender was found as a particularly significant factor, with a high number of female patients (P = 0.014).</p><p><strong>Conclusions: </strong>Gender was found to influence the appropriate interpretation of the significance of hospital meals. The perception of such meals as samples for post-discharge dietary practice was more significant among female patients. This demonstrated that in elderly patients, it is important to consider gender differences when providing diet and convalescence guidance.</p>","PeriodicalId":15431,"journal":{"name":"Journal of Clinical Medicine Research","volume":"15 6","pages":"321-327"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f1/c9/jocmr-15-321.PMC10332877.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9804797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Uncommon Presentation of Acute Thoracic Aortic Dissection.","authors":"MacKenzie Barton,&nbsp;Hao Wang","doi":"10.14740/jocmr4921","DOIUrl":"https://doi.org/10.14740/jocmr4921","url":null,"abstract":"<p><p>We present a case of a 40-year-old Caucasian male with past medical history of polysubstance abuse (cocaine and methamphetamine), who presented to the emergency department (ED) complaining of intermittent cough with associated chest discomfort and shortness of breath for 2 weeks. Initial vital signs demonstrated borderline tachycardia (98 beats per minute), tachypnea (37 times per minutes), and hypoxia (oxygen saturation 89% on room air), and his physical exam was grossly unremarkable. A preliminary workup including a computed tomography angiography (CTA) revealed a type A aortic dissection with both thoracic and abdominal involvement for which the patient was admitted. This patient had resection of the ascending aorta with graft placement, cardiopulmonary bypass, aortic root replacement using composite prosthesis and left and right coronary reconstruction and reimplantation and survived a complicated hospital course. This case demonstrates the classic association known to exist between recreational drug use, specifically stimulants such as cocaine and amphetamines, and acute aortic dissection (AAD). However, such a presentation of borderline subacute, painless dissection in the setting of polysubstance use raises further questions, since uncommon AAD is typically found in higher-risk populations such as those with connective tissue disorders (Marfan syndrome, Ehlers-Danlos syndrome, Loeys-Dietz syndrome), bicuspid aortic valve, chronic hypertension, or previous aortic pathology. We therefore suggest clinicians strongly consider uncommon AAD as part of their differential diagnosis in patients with known or highly suspected polysubstance abuse.</p>","PeriodicalId":15431,"journal":{"name":"Journal of Clinical Medicine Research","volume":"15 6","pages":"332-335"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f0/12/jocmr-15-332.PMC10332876.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9804803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}