Avicenna Journal of Medicine最新文献

{"title":"Importance of the Mean Rate of Pressure Change of the Pulmonary Artery (dP/dt mean PA) in Patients with Pulmonary Arterial Hypertension.","authors":"Theodoros Sinanis,&nbsp;Alexander Schmeißer","doi":"10.1055/s-0043-1769932","DOIUrl":"https://doi.org/10.1055/s-0043-1769932","url":null,"abstract":"<p><p><b>Background</b>  Pulmonary arterial hypertension (PAH) is a rare disease of cardiopulmonary circulation characterized by elevated pressure in the pulmonary artery. The right-heart catheter is the gold standard for diagnosis, but there is interest in identifying additional prognostic indicators. The aim of this study was to examine the importance of the rate of pressure change of the pulmonary artery (dP/dt mean PA) in patients with PAH. <b>Methods</b>  We retrospectively analyzed data from 142 patients with PAH (exclusively clinical group 1) and examined the statistical correlation of dP/dt mean PA with vascular, right ventricular, and clinical parameters. Data was collected mostly from the right heart catheterization and the transthoracal echocardiography at presentation. <b>Results</b>  dP/dt mean PA showed a significant correlation with systolic pressure of the pulmonary artery ( <i>n</i> = 142, <i>R</i> ²  = 56%, <i>p</i>  < 0.001), pulmonary vascular resistance ( <i>n</i>  = 142, <i>R</i> ²  = 51%, <i>p</i>  < 0.001), the rate of pressure change in the right ventricle ( <i>n</i>  = 142, <i>R</i> ²  = 53%, <i>p</i>  < 0.001), and the right ventricular fractional area change ( <i>n</i>  = 110, <i>R</i> ²  = 51%, <i>p</i>  < 0.001). Receiver operating characteristic curve analysis showed that dP/dt mean PA had the highest prognostic value in predicting increase in the 6-minute walk test and decrease in the N-terminal-probrain natriuretic peptide after the initiation of PAH therapy, with an area under the curve of 0.73. <b>Conclusion</b>  Our findings suggest that dP/dt mean PA may be a useful prognostic indicator in the treatment of patients with PAH, and further research is warranted to validate this parameter.</p>","PeriodicalId":32889,"journal":{"name":"Avicenna Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10332940/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10173158","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":"The Feasibility of Telemedicine in the Implementation and Management of Therapeutic Hypothermia for Infants with Neonatal Hypoxic-Ischemic Encephalopathy in a Resource-Limited Country.","authors":"Adnan Hadid, Taher S Al-Shantout, Rayan S Terkawi, Baraa M Aldbes, Manal M Zahran, Fadia A Alsatouf, Hani Najjar, Mhd Hassan Mughrabieh, Nour A Alhadid, Khalid Altirkawi","doi":"10.1055/s-0042-1760434","DOIUrl":"10.1055/s-0042-1760434","url":null,"abstract":"<p><p><b>Background</b>  Telemedicine is widely used in neonatal services in developed countries, though its outcomes in low- and middle-income countries are controversial. Lack of expertise and/or facilities, however, has limited its use in developing countries and around areas of military conflicts. We aim to study the implementation and management of therapeutic hypothermia (TH) in infants with hypoxic-ischemic encephalopathy (HIE) with the help of telemedicine in a resource-limited country. <b>Methodology</b>  This is a retrospective study, evaluating patients who received TH, guided by telemedicine, through a mobile app (Telegram), an application that allows sharing and archiving of information with other beneficial features. We assessed the feasibility of utilizing telemedicine in guiding the application of TH to infants affected with HIE in the North-West of Syria between July 2020 and July 2021. Feasibility was measured by parameters related to the time gaps between initiation of consultation and treatment and clinical short-term outcomes. <b>Results</b>  Out of 5,545 newborn infants delivered during the study period, 22 patients were eligible for TH guided by telemedicine. Patients were referred for consultation at a median (interquartile range [IQR]) of 137 (35-165) minutes of life. A median (IQR) of 12 (3-18) minutes elapsed between the call for a consultation and the consultant response and a median (IQR) of 30 (0-42) minutes elapsed between seeking the consultation and the initiation of cooling therapy. Eighteen patients completed cooling for 72 hours. The patients' temperatures were within the target range (33-34°C) most of the time (84.1%). <b>Conclusion</b>  Telemedicine is a feasible method to guide the implementation TH for HIE in resource-limited areas. The short-term success rate is relatively high; however, further studies with a larger population are needed to confirm these findings.</p>","PeriodicalId":32889,"journal":{"name":"Avicenna Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10038750/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9245451","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":"A Clinical Overview of Anorexia Nervosa and Overcoming Treatment Resistance.","authors":"Hassan Nagy,&nbsp;Tanya Paul,&nbsp;Esha Jain,&nbsp;Hanyou Loh,&nbsp;Syeda Hafsa Kazmi,&nbsp;Rishbha Dua,&nbsp;Ricardo Rodriguez,&nbsp;Syed Ali Abbas Naqvi,&nbsp;Metu Chiamaka U,&nbsp;Erjola Bidika","doi":"10.1055/s-0042-1758859","DOIUrl":"https://doi.org/10.1055/s-0042-1758859","url":null,"abstract":"<p><p>Anorexia nervosa (AN) is a type of eating disorder that has been increasing in incidence and has been encountered more commonly by physicians in their daily practice. Both environmental and genetic risk factors paired along with a more susceptible neurobiology are at play in the emerging resistance to treatment in AN. Preoccupations with intense fear of weight gain, dietary restrictions, excessive exercise, and how the individual is perceived by society mixed with underlying psychopathology all further add to the issue. Many patients who fall into this cycle of obsessive and restrictive patterns refuse to get treatment. As clinicians, it is essential we recognize the early signs of both eating disorders during the initial primary care appointments. To review the literature on the etiology of AN, possible misdiagnosis leading to inappropriate management of this condition, and understand the treatment-resistant AN and its management. Additionally, it will explore possible reasons that contribute to the resistance to treatment, the underlying psychopathology of anorexics, its genetic predisposition, psychiatric comorbidities, identification of the early signs and symptoms, and timely prevention. Early recognition by a physician includes a thorough history and physical examination, pertinent laboratory, and electrolyte studies, and identifying comorbid psychiatric conditions. The treatment of AN is intricate and requires a holistic approach. Treatment includes multiple modalities such as nutritional rehabilitation and psychosocial and pharmacological therapies. An interdisciplinary team of medical professionals for managing chronic AN is recommended.</p>","PeriodicalId":32889,"journal":{"name":"Avicenna Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10038755/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9245449","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":"Emerging Health Disparities during the COVID-19 Pandemic.","authors":"Nour Mheidly,&nbsp;Nadine Y Fares,&nbsp;Mohamad Y Fares,&nbsp;Jawad Fares","doi":"10.1055/s-0042-1759842","DOIUrl":"https://doi.org/10.1055/s-0042-1759842","url":null,"abstract":"<p><p>The coronavirus disease 2019 (COVID-19) pandemic has underscored social and racial discrimination in global health, showing that health equity is still a goal to be achieved. Understanding the impact of COVID-19 on public health potential is vital to present a fair opportunity for people of different backgrounds to be as healthy as possible. As such, this communication discusses the emerging health disparities in light of the COVID-19 pandemic and analyzes their implications. Original research, effective health communication, and promotion strategies ought to be leveraged to step closer toward national and international health equity.</p>","PeriodicalId":32889,"journal":{"name":"Avicenna Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10038746/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9245456","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":"Knowledge, Attitude, Awareness, and Perceptions among Physicians toward Antibiotic Resistance in Hospitals in South Palestine.","authors":"Hussein Jabbarin,&nbsp;Inad Nawajah,&nbsp;Hatem A Hejaz","doi":"10.1055/s-0043-1764374","DOIUrl":"https://doi.org/10.1055/s-0043-1764374","url":null,"abstract":"<p><p><b>Background</b>  Antibiotic resistance is a global problem, and the World Health Organization has made this problem one of its priorities for solving. Therefore, a survey was carried out to investigate the knowledge, attitude, awareness, and perceptions of antibiotic resistance among physicians and to assess the correlation between the knowledge of antibiotic resistance and their years of experience in some Palestinian hospitals. <b>Methods</b>  This was a cross-sectional study that targeted physicians who are working in different healthcare facilities in Hebron and Bethlehem governorates. We used a questionnaire for data collection. The questionnaire consists of 42 questions to measure the knowledge, attitudes, awareness, and perceptions of antibiotic use and resistance. <b>Results</b>  The response rate was 91.33% (137 of 150 physicians completed the questionnaire). The participants' ages ranged from 25 to 56 years, and the majority were males ( <i>n</i>  = 116, 84.7%) working in governmental hospitals ( <i>n</i>  = 83, 60.6%). Of physicians, 69.3% ( <i>n</i>  = 95) perceived antibiotic resistance as a very important worldwide problem, while 54.7% ( <i>n</i>  = 75) perceived a very important problem in the country, 54.0% ( <i>n</i>  = 74) a very important problem in their hospital, and 59.1% ( <i>n</i>  = 81) a very important problem in their departments. Methicillin-resistant Staphylococcus aureus was the most known antibiotic-resistant bacteria followed by extended-spectrum beta-lactamases. Only 47 physicians (34.3%) think that antibiotics are not used appropriately in their department. Respondents' physicians showed that the development of antibiotic resistance was due to various factors that include self-medication n= (92, 67.2%), overuse of antibiotics ( <i>n</i>  = 83, 60.6%), and uncompleted treatment (n= 87, 63.5). Senior specialists/consultants were found to be more knowledgeable about antibiotic resistance. <b>Conclusion</b>  In our survey, physicians showed variable knowledge and perceptions of antibiotic resistance. Introducing educational programs is necessary to improve their understanding and perceptions of antibiotic resistance, as well as their attitude toward antibiotic use.</p>","PeriodicalId":32889,"journal":{"name":"Avicenna Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10038744/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9245455","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":"Thank You to All Our Reviewers in 2022","authors":"","doi":"10.1055/s-0043-1764391","DOIUrl":"https://doi.org/10.1055/s-0043-1764391","url":null,"abstract":"","PeriodicalId":32889,"journal":{"name":"Avicenna Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43026118","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":"Idiopathic Isolated Right Ventricular Cardiomyopathy: A Rare Case Report.","authors":"Vivek Mohanty,&nbsp;Shubham Kumar Sharma,&nbsp;Sourabh Goswami,&nbsp;Rahul Gudhage,&nbsp;Surender Deora","doi":"10.1055/s-0043-1764376","DOIUrl":"https://doi.org/10.1055/s-0043-1764376","url":null,"abstract":"<p><p>Idiopathic isolated right ventricular cardiomyopathy is an extremely rare cause of right ventricular failure. Here, we report a case of 65-year-old male presented with chief complaints of dyspnea, fatigue, and bilateral pedal edema for the last 6 months. On clinical evaluation, grade II/III pansystolic murmur was present in left parasternal area. Investigations and imaging revealed dilated right atrium and ventricle with normal pulmonary artery pressure without any etiology. Magnetic resonance imaging ruled out other common causes of right ventricular cardiomyopathy; thus, the patient was diagnosed as a case of idiopathic isolated right ventricular cardiomyopathy that is a diagnosis of exclusion.</p>","PeriodicalId":32889,"journal":{"name":"Avicenna Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10038749/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9245453","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":"Comparison of the Predictive Ability of the Blood Urea Nitrogen/Albumin, C-Reactive Protein/Albumin, and Lactate/Albumin Ratios for Short-Term Mortality in SARS-CoV-2-Infected Patients.","authors":"Serdar Özdemir,&nbsp;İbrahim Altunok","doi":"10.1055/s-0043-1761471","DOIUrl":"https://doi.org/10.1055/s-0043-1761471","url":null,"abstract":"<p><p><b>Background</b>  Hematological parameters and their ratios are the most studied biomarkers for prediction of mortality or severe illness in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. This study aims to compare the power of the blood urea nitrogen (BUN)/albumin ratio, lactate/albumin ratio, and C-reactive protein (CRP)/albumin ratio, measured at the time of admission, in predicting 30-day mortality in SARS-CoV-2-infected patients presenting to the emergency department (ED). <b>Materials and Methods</b>  This retrospectively designed, single-center, observational study was performed in the ED of a tertiary education health care center. We documented the data of patients admitted with a confirmed SARS-CoV-2 infection between September 1, 2020, and January 1, 2021. <b>Results</b>  Of the 470 patients included in the study, 232 (49.4%) were female. The all-cause 30-day mortality rate was 23.8%. The area under the curve values for the BUN/albumin ratio, lactate/albumin ratio, and CRP/albumin ratio in the prediction of 30-day mortality were 0.725, 0.641, and 0.749, respectively. Sensitivity and negative predictive value for CRP/albumin ratio (≥0.049) and specificity for BUN/albumin ratio (≥1.17) were 92.86, 94.9, and 71.23, respectively. The odds ratio values of the BUN/albumin ratio (≥1.17), CRP/albumin ratio (≥0.049), and lactate/albumin ratio (≥0.046) for 30-day mortality were determined as 4.886, 9.268, and 2.518, respectively. <b>Conclusion</b>  The BUN/albumin ratio and CRP/albumin ratio can be used to predict 30-day mortality in SARS-CoV-2-infected patients admitted to ED. Furthermore, CRP/albumin ratio had the highest sensitivity and negative predictive value, while BUN/albumin ratio had the highest specificity.</p>","PeriodicalId":32889,"journal":{"name":"Avicenna Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10038752/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10288574","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":"<i>Pneumocystis jiroveci</i> Pneumonia: A Review of Management in Human Immunodeficiency Virus (HIV) and Non-HIV Immunocompromised Patients.","authors":"Atif Ibrahim,&nbsp;Asmi Chattaraj,&nbsp;Qamar Iqbal,&nbsp;Ali Anjum,&nbsp;Mohammad Ebad Ur Rehman,&nbsp;Zobia Aijaz,&nbsp;Fazila Nasir,&nbsp;Sadia Ansar,&nbsp;Tirdad T Zangeneh,&nbsp;Ahmad Iftikhar","doi":"10.1055/s-0043-1764375","DOIUrl":"https://doi.org/10.1055/s-0043-1764375","url":null,"abstract":"<p><p><i>Pneumocystis jirovecii</i> pneumonia is an opportunistic fungal infection that was mainly associated with pneumonia in patients with advanced human immunodeficiency virus (HIV) disease. There has been a decline in <i>Pneumocystis jirovecii</i> pneumonia incidence in HIV since the introduction of antiretroviral medications. However, its incidence is increasing in non-HIV immunocompromised patients including those with solid organ transplantation, hematopoietic stem cell transplantation, solid organ tumors, autoimmune deficiencies, and primary immunodeficiency disorders. We aim to review and summarize the etiology, epidemiology, clinical presentation, diagnosis, and management of <i>Pneumocystis jirovecii</i> pneumonia in HIV, and non-HIV patients. HIV patients usually have mild-to-severe symptoms, while non-HIV patients present with a rapidly progressing disease. Induced sputum or bronchoalveolar lavage fluid can be used to make a definitive diagnosis of <i>Pneumocystis jirovecii</i> pneumonia. Trimethoprim-sulfamethoxazole is considered to be the first-line drug for treatment and has proven to be highly effective for <i>Pneumocystis jirovecii</i> pneumonia prophylaxis in both HIV and non-HIV patients. Pentamidine, atovaquone, clindamycin, and primaquine are used as second-line agents. While several diagnostic tests, treatments, and prophylactic regimes are available at our disposal, there is need for more research to prevent and manage this disease more effectively.</p>","PeriodicalId":32889,"journal":{"name":"Avicenna Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10038753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9193253","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":"COVID-19 Ramifications: A Scientific Approach to Bridge the Existing Gap between COVID Vaccines Hesitancy and Effectiveness.","authors":"Hassan Nagy,&nbsp;Maha Hameed,&nbsp;Faryal Khan,&nbsp;Edzel Lorraine Co,&nbsp;Unaiza Rauf","doi":"10.1055/s-0042-1760338","DOIUrl":"https://doi.org/10.1055/s-0042-1760338","url":null,"abstract":"<p><p>The 2019 coronavirus disease (COVID-19) has been a major dilemma all over the world since December 2019. Several types of COVID-19 vaccines were developed for public utilization to halt the widespread of the disease; however, vaccine hesitancy is one major factor that prevents a successful control of this pandemic. This study aimed to summarize the different kinds of available COVID-19 vaccines and their effectiveness, and to assess the associated factors regarding vaccine hesitancy of the general population to bridge the gap existing between the two factors. 1 3.</p>","PeriodicalId":32889,"journal":{"name":"Avicenna Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10038754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10217955","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}