AIMS Medical Science最新文献

{"title":"Thyrotoxic periodic paralysis together with thyrotoxic heart disease in a Ghanaian man: case report and literature review","authors":"G. M. Amponsah, Y. Adu‐Boakye, Maureen Nyarko, H. Andoh, Kwaku Gyasi Danso, Manolo Agbenoku, I. Owusu","doi":"10.3934/medsci.2023005","DOIUrl":"https://doi.org/10.3934/medsci.2023005","url":null,"abstract":"Thyrotoxic periodic paralysis (TPP) is an uncommon symmetrical paralysis usually affecting proximal muscles, which occurs in the hyperthyroid state with associated hypokalemia. It is more prevalent in East Asian males and extremely rare in blacks. Data on TPP is scarce in Africa and no report has been made in Ghana. We report a case of a middle-aged Ghanaian man who had three episodes of paralysis in all four limbs occurring at night with the second and third episodes requiring hospital visit. He had no clinical signs of hyperthyroidism during his first hospital visit but had developed clinical and biochemical evidence of hyperthyroidism on the second visit with serum potassium levels of 1.9 mmol/l; and he was eventually diagnosed with TPP. His paralysis resolved with correction of the hypokalemia. It is important to evaluate patients presenting with paralysis comprehensively. Less common differential diagnosis such as TPP may also be considered in such patients to ensure early diagnosis and treatment which can prevent complications.","PeriodicalId":43011,"journal":{"name":"AIMS Medical Science","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78962434","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":"Chronic kidney disease report differently on change in sexual function dependent on treatment: a cohort study","authors":"J. Fryckstedt, M. Norrbäck, Charlotte Kaviani, B. Hylander","doi":"10.3934/medsci.2023013","DOIUrl":"https://doi.org/10.3934/medsci.2023013","url":null,"abstract":"Patients with Chronic Kidney Disease (CKD) report sexual dysfunction to a large extent. The objective of this study was to investigate if CKD-stage and mode of treatment correlate to self-reported experience in sexual function before and after onset of symptomatic CKD in patients without active treatment, after transplantation or on dialysis. Participants (N = 234) answered a questionnaire on frequency of sexual desire, initiative, intercourse, erection (men) /vaginal lubrication (women), and orgasm, currently and compared with before onset of symptomatic CKD. Clinical data were taken from medical charts. Within-group differences in sexual function were compared for patients without active treatment (PreT), patients with a renal transplant (Tx) and patients on dialysis treatment (D). In a subgroup analysis, five patient groups were created based on mode of treatment and CKD stage. Between-group differences in sexual function were analyzed as differences in mean composite scores and 95% CI and were estimated using ordinary least square regression with robust standard errors. In the first analysis of the study, all CKD patients reported a decrease in the frequency of sexual desire, initiative, intercourse, erection (men)/vaginal lubrication (women), and orgasm (Bonferroni p < 0.001) compared to before disease onset, irrespective of treatment mode. In the subgroup analysis, when adjusting for sex and age, dialysis patients reported a statistically significant decrease in their average score of sexual function (−2.65; 95% CI: −4.19 to −1.11; p = 0.001) compared to patients without active treatment CKD 2–3 (the reference group). The self-reported experience of CKD-patients of a deteriorating sexual function over time correlates to treatment modality and CKD stage. It is important for health-care personnel to be aware of the patients' experience of a deterioration in sexual function over time regardless of treatment modalities.","PeriodicalId":43011,"journal":{"name":"AIMS Medical Science","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88786276","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 association of dual-mobility total hip arthroplasty with dislocation compared to conventional hip arthroplasty for neck of femur fracture","authors":"Matthew C.A. Arnold, John W. Kennedy, Evan Wright, Madeleine Reece, R.M. Dominic Meek","doi":"10.3934/medsci.2023023","DOIUrl":"https://doi.org/10.3934/medsci.2023023","url":null,"abstract":"Introduction Neck of femur fractures are extremely common worldwide and have a mortality rate of 15% at 1 year. Dual-mobility cups (DMCs) have demonstrated a reduction in dislocation and revision rates for elective total hip arthroplasty (THA) but the benefits of DMC use in neck of femur fractures are less clear. The aim of this study was to compare the rate of dislocation between conventional and DMC THA following neck of femur fracture. Materials and methods Data was retrospectively collected for patients who received either DMCs or standard acetabular components for neck of femur fractures at our institution. Patients were excluded if they had less than 2 years follow-up. Dislocation and revision rates were collected for all patients in addition to radiographic analysis to assess for loosening. Results Data was collected for 39 patients with DMCs and 95 patients with conventional THA. Two patients with DMCs suffered a dislocation (5.1%) compared to 7 patients (7.3%) who underwent a conventional THA (p = 0.49). Both patients in the DMC group had additional risk factors for dislocation. One DMC patient required revision surgery for dislocation and one conventional THA patient underwent a revision for aspetic loosening. There were no cases of radiographic loosening in the DMC group. Conclusions Our study showed a trend towards lower dislocation rates in patients treated with a DMC compared to conventional THA. Although there are potential issues associated with DMC implants and cost implications, this study suggests they may be advantageous in patients at high risk for dislocation.","PeriodicalId":43011,"journal":{"name":"AIMS Medical Science","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":"135507468","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":"Healthcare workers: diminishing burnout symptoms through self-care","authors":"A. Rokach","doi":"10.3934/medsci.2023006","DOIUrl":"https://doi.org/10.3934/medsci.2023006","url":null,"abstract":"Being part of the health care system involves facing stress, loneliness and the emotional toll of assisting, listening and caring for patients who come into the office or hospital, and seek or even demand assistance. Healthcare workers, like physicians, nurses and therapists, are trained, on assisting and healing others. They are less effective in taking care of themselves. This article, which aims to heighten clinicians' awareness of the need for self-care, especially now in the post-pandemic era, addresses the demanding nature of medicine and health work, and the resistance that clinicians commonly display in the face of suggestions that they engage in self-care. The consequences of neglecting to care for oneself are delineated. The demanding nature of medicine is reviewed, along with the loneliness and isolation felt by clinicians particularly those in private practice, the professional hazards faced by those caring for others, and the ways that are available to them (should they decide to care for themselves) for the benefit of their clients, their families and, obviously, themselves.","PeriodicalId":43011,"journal":{"name":"AIMS Medical Science","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90328016","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":"Hydroxyurea and pyridostigmine repurposed for treating Covid-19 multi-systems dysfunctions","authors":"M. Foster, A. Hijazi, Raymond C. Sullivan, Rebecca Opoku","doi":"10.3934/medsci.2023010","DOIUrl":"https://doi.org/10.3934/medsci.2023010","url":null,"abstract":"Early in the COVID-19 pandemic, medical care providers at an acute illness hospital received increasing numbers of post-acute advanced COVID-19 patients from referring hospitals where they were showing no signs of improvement after receiving treatments from standard Emergency Use Authorization (EUA)-type protocols. The care providers turned to repurposing medications to treat these patients and added hydroxyurea, a medication commonly used for treating sickle cell anemia, to the hospital's COVID-19 treatment protocol and began to see notable clinical improvements. As the pandemic continued and new concerns arose concerning COVID-19 complications, those same care providers again turned to repurposing drugs. Focusing on the neuromuscular effects seen in COVID-19 patients, care providers turned to medications used to treat chronic neuromuscular conditions. Post-acute advanced Covid-19 patients initially received an abbreviated course of hydroxyurea followed by titrated doses of pyridostigmine. Positive responses were noted with cognition, diminished oxygen demands, progressive decrease in ventilator support, improved swallowing, and mobility. The authors suggest repurposed drugs could have great utility for treating COVID-19. It is recommended larger, COVID-19 clinical trials be completed to include hydroxyurea and pyridostigmine for validating the outcomes and clinical observations seen in these presented cases.","PeriodicalId":43011,"journal":{"name":"AIMS Medical Science","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75872191","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":"Evolution of the COVID-19 pandemic in Italy at the national and regional levels from February 2020 to March 2022","authors":"Rosario Megna","doi":"10.3934/medsci.2023019","DOIUrl":"https://doi.org/10.3934/medsci.2023019","url":null,"abstract":"<abstract> <p>The COVID-19 pandemic initially hit Italy at the end of February 2020. In the following two years, there were about 13 million diagnosed cases and more than 150000 deaths. For this period, we have performed a study that evaluates and compares the impacts on public health of the SARS-CoV-2 waves at the national and regional levels. Based on contagion trends, we considered four pandemic waves. For each wave, we also analyzed a restricted time interval of one month around the peak. We found an underestimation of diagnosed cases and a saturation of available intensive care unit (ICU) beds during the first wave. The second wave had a more significant impact on public health, highlighting that the system of physical distancing measures was less effective than the lockdown implemented during the first wave. Instead, during the first three peaks, the incidence of ICU bed occupancy was superimposable. In general, odds ratios of case fatality rate showed a more significant risk for males than females from the age of thirty onwards. We verified that regional responses to the health emergency were not homogeneous. In particular, in contrast with the national temporal trend, some regions showed a significant increase in the incidence of deaths. Furthermore, we found positive correlations between availability and occupancy of hospital beds from the second wave onward. In contrast, a significant correlation was verified for ICU bed occupancy and deaths only during the second peak. In light of what happened, it would be desirable to plan an increase in public health funds for new emergencies and issue a rigorous plan to face pandemics.</p> </abstract>","PeriodicalId":43011,"journal":{"name":"AIMS Medical Science","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":"135357787","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":"Neuropsychiatric sequelae of medication non-adherence in people living with HIV","authors":"D. Moreira, R. Khan, P. Sales","doi":"10.3934/medsci.2023014","DOIUrl":"https://doi.org/10.3934/medsci.2023014","url":null,"abstract":"Non-adherence to anti-retroviral therapy (cART) among people living with HIV/AIDS (PLWHA) is complex, multifactorial, and leads to increases in viral load, immunosuppression, and HIV burden related to direct CNS virulence and cART re-initiation (i.e., immune reconstitution syndrome). Among behavioral disturbances, which may become long-lasting without proper treatment, major depressive disorder, generalized anxiety disorder, schizophrenia, and bipolar spectrum disorders are frequent, as well as exacerbation of other premorbid underlying psychiatric conditions, such as post-traumatic stress disorder (PTSD) and substance use and related conditions, not to mention neurocognitive disorders that are encompassed under the umbrella term of HIV-Associated Neurocognitive Disorders (HAND). In this review, we summarized the neuropsychiatric sequelae of medication non-adherence in PLWHA by utilizing two clinical vignettes to illustrate how syndemic factors may interact and lead to unique presentations.","PeriodicalId":43011,"journal":{"name":"AIMS Medical Science","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78474107","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":"Quality evaluation of digital voice assistants for diabetes management","authors":"Joy Qi En Chia, L. Wong, K. Yap","doi":"10.3934/medsci.2023008","DOIUrl":"https://doi.org/10.3934/medsci.2023008","url":null,"abstract":"Background Digital voice assistants (DVAs) are increasingly used to search for health information. However, the quality of information provided by DVAs is not consistent across health conditions. From our knowledge, there have been no studies that evaluated the quality of DVAs in response to diabetes-related queries. The objective of this study was to evaluate the quality of DVAs in relation to queries on diabetes management. Materials and methods Seventy-four questions were posed to smartphone (Apple Siri, Google Assistant, Samsung Bixby) and non-smartphone DVAs (Amazon Alexa, Sulli the Diabetes Guru, Google Nest Mini, Microsoft Cortana), and their responses were compared to that of Internet Google Search. Questions were categorized under diagnosis, screening, management, treatment and complications of diabetes, and the impacts of COVID-19 on diabetes. The DVAs were evaluated on their technical ability, user-friendliness, reliability, comprehensiveness and accuracy of their responses. Data was analyzed using the Kruskal-Wallis and Wilcoxon rank-sum tests. Intraclass correlation coefficient was used to report inter-rater reliability. Results Google Assistant (n = 69/74, 93.2%), Siri and Nest Mini (n = 64/74, 86.5% each) had the highest proportions of successful and relevant responses, in contrast to Cortana (n = 23/74, 31.1%) and Sulli (n = 10/74, 13.5%), which had the lowest successful and relevant responses. Median total scores of the smartphone DVAs (Bixby 75.3%, Google Assistant 73.3%, Siri 72.0%) were comparable to that of Google Search (70.0%, p = 0.034), while median total scores of non-smartphone DVAs (Nest Mini 56.9%, Alexa 52.9%, Cortana 52.5% and Sulli the Diabetes Guru 48.6%) were significantly lower (p < 0.001). Non-smartphone DVAs had much lower median comprehensiveness (16.7% versus 100.0%, p < 0.001) and reliability scores (30.8% versus 61.5%, p < 0.001) compared to Google Search. Conclusions Google Assistant, Siri and Bixby were the best-performing DVAs for answering diabetes-related queries. However, the lack of successful and relevant responses by Bixby may frustrate users, especially if they have COVID-19 related queries. All DVAs scored highly for user-friendliness, but can be improved in terms of accuracy, comprehensiveness and reliability. DVA designers are encouraged to consider features related to accuracy, comprehensiveness, reliability and user-friendliness when developing their products, so as to enhance the quality of DVAs for medical purposes, such as diabetes management.","PeriodicalId":43011,"journal":{"name":"AIMS Medical Science","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84269142","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 correlation between obesity and other cardiovascular disease risk factors among adult patients attending a specialist clinic in Kumasi. Ghana","authors":"I. Owusu, Emmanuel Acheamfour-Akowuah, Lois Amoah-Kumi, Y. Wiafe, S. Opoku, E. Anto","doi":"10.3934/medsci.2023003","DOIUrl":"https://doi.org/10.3934/medsci.2023003","url":null,"abstract":"<abstract><sec> <title>Background</title> <p>Obesity is a complex and multifactorial disease marker, which has become a major threat to cardiovascular health. We sought to assess the correlation of obesity and other cardio-metabolic risk factors in patients seen at the outpatient specialist clinic in Ghana.</p> </sec><sec> <title>Methods</title> <p>A prospective cross-sectional study was conducted on 395 patients at Precise Specialist Clinic in Kumasi, Ghana. A standardized questionnaire was used to obtain demographic, anthropometric and clinical data of patients. Fisher's exact test for statistical significance at a 95% confidence interval was used to evaluate associations between categorical variables. The associations between obesity indices and cardiovascular disease risk factors were analyzed by Pearson's correlation.</p> </sec><sec> <title>Results</title> <p>Of the 395 participants, 187 were males and 208 were females. The mean (± standard deviation) age of study participants was 59.29 (± 13.93); more than half of the participants were between 50 and 69 years. The mean BMI of male participants was significantly lower than the mean BMI of female participants (28.18 kg/m² vs 31.16 kg/m², <italic>P-value</italic> < 0.0001). Gender was significantly associated with the weight categories (<italic>P</italic> = 0.0144). Obesity was seen more in females (49.0%) than in males (35.8%). The Pearson correlation analysis also showed a significant positive correlation between obesity, increasing systolic blood pressure (<italic>r</italic> = 0.1568, <italic>P-value</italic> = 0.0018) and increasing diastolic blood pressure (<italic>r</italic> = 0.2570, <italic>P-value</italic> < 0.0001).</p> </sec><sec> <title>Conclusions</title> <p>Obesity was found to be significantly associated with female gender, increasing age, increasing systolic blood pressure, and increasing diastolic blood pressure. Efforts to step-up preventive measures to reduce the increasing prevalence of obesity in Ghana are highly recommended.</p> </sec></abstract>","PeriodicalId":43011,"journal":{"name":"AIMS Medical Science","volume":null,"pages":null},"PeriodicalIF":0.7,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74844775","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":"Immunotherapy for diffuse large B-cell lymphoma: current use of immune checkpoint inhibitors therapy","authors":"Luis Miguel Juárez-Salcedo, Luis Manuel González, Samir Dalia","doi":"10.3934/medsci.2023020","DOIUrl":"https://doi.org/10.3934/medsci.2023020","url":null,"abstract":"<abstract> <p>Patients diagnosed with diffuse large B-cell lymphoma (DLBCL) have high cure rates with current treatment options including immuno-polychemotherapy. However, around 30% of cases do not respond or develop relapse disease. For this, it is necessary to search for new therapeutic options. In recent years, therapy using chimeric antigen receptor (CAR) T-cells has been a strategy for those patients with LBDCG in progression or relapse, although only 30–40% of cases achieve durable remissions. The programmed death-1 (PD-1) receptor regulates the T-cell-mediated immune response through binding to its ligands (PD-L1). Some tumor cells present high expression of PD-L1, which down-regulates T-cell activation. The beneficial antitumor activity of PD-1 and PD-L1 has been widely demonstrated in certain solid organ malignancies. However, their utility in the treatment of lymphomas is complex. To date, different clinical trials have demonstrated its usefulness as an innovative therapeutic alternative in these tumors. In this review article, we evaluate the literature on the role of the PD-1/PD-L1 pathway in DLBCL and describe future strategies involving these new anticancer agents in this lymphoid neoplasm.</p> </abstract>","PeriodicalId":43011,"journal":{"name":"AIMS Medical Science","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":"135401068","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}