Clinical Medicine & Research最新文献

{"title":"COVID-19-Related Treatment Cancellations and Oncology Patients' Psychological Health in Nigeria.","authors":"Adedayo Joseph, Abdul R Shour, Nwamaka N Lasebikan, Mutiu A Jimoh, Bolanle C Adegboyega, Emmanuella Nwachukwu, Opeyemi Awofeso, Azeezat Ajose, Abiola Ibraheem, Omolara Aminat Fatiregun, Musa Ali-Gombe, Usman M Aliyu, Abdallah Elsaid Kotkat, Olusegun Abayomi Biyi-Olutunde, Evaristus Oseiwe Oboh, Ismail H Zubairu, Mohammad Rifat Haider, Bankole Olatosi, Samuel Olaolu Adeneye, David Puthoff, Adedayo A Onitilo","doi":"10.3121/cmr.2024.1854","DOIUrl":"10.3121/cmr.2024.1854","url":null,"abstract":"<p><p><b>Objective:</b> To explore the association between COVID-19-related cancer treatment cancellations and the psychological health of cancer patients in Nigeria.<b>Methods:</b> We analyzed data collected from 15 outpatient cancer clinics, comprising 1,097 patients between April to July 2020. Study outcome was ten psychological impacts, including feeling down, stressed, and unable to access treatment due to COVID-19 (used as continuous and categorical variable (0-3,4-7,8+ events). The independent variable was treatment cancellations due to COVID-19 categorized as 0, 1, and 2+ cancellations. Confounders included religion, ethnicity, income, cancer diagnosis/type, and treatment received. Stata/SE.v.17 was used to perform all analyses. <i>P</i> values of ≤0.05 were deemed statistically significant.<b>Results:</b> Of the 1,097 cancer patients, 65.7% were female, with a mean age (SD) of 49.4 (13.8) years. Most patients (50.3%) reported four to seven psychological health events. Cancer patients who reported two/more treatment cancellations made up only 12.8% of the study sample but accounted for a greater proportion of psychological impacts (23.5%; <i>P</i><0.001). In the adjusted model, cancer patients with one treatment cancellation (Coef: 0.195, 95%CI: 0.089-0.302) and those with two/more cancellations (Coef: 0.379, 95%CI: 0.255-0.504) had a significantly higher risk of psychological health impacts than those with no treatment cancellations.<b>Conclusion:</b> More than half of our sample of primarily adult female cancer patients reported major psychological health effects due to COVID-19. Cancer patients who experienced at least one treatment cancellation had a higher risk of psychological health consequences than those who did not. The implications of our findings and how to mitigate the impact of COVID-19 on oncology service disruptions are discussed.</p>","PeriodicalId":47429,"journal":{"name":"Clinical Medicine & Research","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11374496/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142134196","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":"Extreme Reactive Thrombocytosis Caused by Obstructive Nephrolithiasis and Pyelonephritis.","authors":"Jeffrey Zhong, Clifford D Packer","doi":"10.3121/cmr.2024.1899","DOIUrl":"10.3121/cmr.2024.1899","url":null,"abstract":"<p><p>Platelet counts in reactive thrombocytosis rarely exceed 1000 × 10⁹/L. We present the case of a male patient, aged 80 years, with quiescent rheumatoid arthritis who was found to have a platelet count of 1011 × 10⁹/L on routine laboratory testing. The patient was initially asymptomatic but developed leukocytosis to 23.1 × 10⁹/L on hospital day 2. Diagnostic work-up revealed obstructive nephrolithiasis and pyelonephritis, and the thrombocytosis and leukocytosis gradually resolved with empiric antibiotic treatment and ureteral stent placement. Tests for myeloproliferative disorders, including JAK-2V617F mutation, BCR-ABL for chronic myeloid leukemia and acute lymphocytic leukemia, and myeloproliferative neoplasms (MPL/CALR), were negative. Physicians should be aware that in rare cases reactive thrombocytosis can exceed 1000 × 10⁹/L, and that markedly elevated platelet counts in the setting of urinary tract infections may be an early sign of obstructive uropathy.</p>","PeriodicalId":47429,"journal":{"name":"Clinical Medicine & Research","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11374494/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142134197","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":"Managing Alkaptonuria in Absence of Appropriate Medication: A Case Report and Review of Literature.","authors":"Ibrahim Ahmad Bhatti, Maleeha Saqib, Ibad Ur Rehman, Saman Amjed, Hashim Talib Hashim, Arsalan Ahmed Butt","doi":"10.3121/cmr.2024.1867","DOIUrl":"10.3121/cmr.2024.1867","url":null,"abstract":"<p><p>Alkaptonuria is an inborn error of metabolism inherited as an autosomal recessive disorder due to a mutation in the homogentisic acid dioxygenase gene. It occurs rarely (global prevalence of alkaptonuria is 1 in 100,000 to 250,000), and mainly affects the joints and connective tissue of the body due to deposition of homogentisic acid giving affected areas a blue-black discoloration (ochronosis).In this case report, we present a male patient, aged 47 years, with joint and scleral involvement. He had been diagnosed many years ago with the disease by gas chromatography. His symptoms kept progressively worsening since he was recently prescribed physiotherapy and vitamin C for his disease, which has not been shown to be an effective treatment. A main reason for his disease deterioration was also the lack of nitisinone availability in his home country, as well as in the subcontinent region generally. We also presen a summary of some previously reported cases and treatment regimens to compare our case and present the comparison as a learning source for future physicians.</p>","PeriodicalId":47429,"journal":{"name":"Clinical Medicine & Research","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11374495/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142134198","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":"Cardiovascular Death and Liver Disease: Mortality Trends and Disparities.","authors":"Ramzi Ibrahim, Richard Trieu, Elise Le Cam, Macklin Loveland, Kristina Terrani, Rama Mouhaffel, Hoang Nhat Pham, Mohammed Salih","doi":"10.3121/cmr.2024.1842","DOIUrl":"10.3121/cmr.2024.1842","url":null,"abstract":"","PeriodicalId":47429,"journal":{"name":"Clinical Medicine & Research","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11374492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142134193","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":"Clinicopathological Pattern of Renal Biopsies in Children with Nephrotic Syndrome.","authors":"Abhigyan Kumar, Manish Narayan, Sangeeta Kumari","doi":"10.3121/cmr.2024.1917","DOIUrl":"10.3121/cmr.2024.1917","url":null,"abstract":"<p><p><b>Background:</b> A renal biopsy is essential for the identification and management of renal disorders. Although considered an invasive operation, it is necessary for a definitive diagnosis and treatment of many renal diseases. The primary goal of this study was to assess the clinicopathological aspect of renal diseases undergoing biopsy in children receiving tertiary care.<b>Patients and Methods:</b> Children (≤18 years) hospitalized with nephrotic syndrome were the subjects of this cross-sectional study, and comprehensive assessments confirmed the need for a kidney biopsy. Included were 277 children who met the inclusion and exclusion criteria. Data on patient outcomes, biopsy indications, complications, histopathologic results, and demographic information were documented.<b>Results:</b> Of the 277 patients who underwent renal biopsy, 63.2% were male, and 36.8% were female. Average age of the patients was 15 ± 2.9 years, with age distribution ranging from 3 to 18 years. The most frequent indication for renal biopsy was atypical age of <1 and >10-years-old (91.7%), steroid-resistant (5.1%), asymptomatic hematuria (21.3%), abnormal glomerular filtration rate (16.2%), and proteinuria (14.8%). The most common histopathological findings were focal segmental glomerulosclerosis (FSGS) (36.5%), followed by minimal change disease (MCD) (13.4%), membranoproliferative glomerulonephritis (MPGN) (10.5%), membranous glomerulonephritis (MGN) (7.94%), IgA nephropathy (IGAN) (7.58%), non-proliferative glomerulonephritis (NPGN) (7.58%), diffuse proliferative glomerulonephritis (DPGN) (6.9%), crescentic GN (5.8%), and systemic lupus erythematosus (SLE) (3.97%). The high frequency of positive samples was seen in SLE, followed by DPGN, MPGN, IGAN, and MGN. In contrast, MCD, crescentic GN, and NPGN showed negativity in all differential item functioning (DIF) parameters.<b>Conclusion:</b> Renal biopsy is a safe and effective procedure in the diagnosis and treatment of in children with nephrotic syndrome. FSGS had the highest frequency in examined biopsies.</p>","PeriodicalId":47429,"journal":{"name":"Clinical Medicine & Research","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11374493/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142134194","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":"Comprehensive Statistical Approach to Investigate the Risk Factors Affecting the Occurrences of Cellulitis Episodes among Patients with Lymphedema.","authors":"Niswatul Qona'ah, Martin Lukusa","doi":"10.3121/cmr.2024.1897","DOIUrl":"10.3121/cmr.2024.1897","url":null,"abstract":"<p><p><b>Background:</b> Cellulitis is an infection of the skin and the tissues just under the skin. As any disease, cellulitis has various physiological and physical effects that deteriorate a patient's quality of life. Luckily, cellulitis can be treated when dealt with in a timely fashion. Nonetheless, some patients may experience more than one episode of cellulitis or a recurrence of cellulitis that was previously cured. In fact, the occurrences of cellulitis episodes are believed to follow a statistical distribution. The frequency distribution of cellulitis episodes is scrutinized herein. We aimed to investigate the risk factors that affect the number of cellulitis episodes and the pattern of association between cancer types and cellulitis episodes by using analytical and visual approaches.<b>Methods:</b> A statistical approach applying a two-part count regression model was used instead of the traditional one-part count model. Moreover, multiple correspondence analysis was used to support the finding of count regression models.<b>Results:</b> The results of analysis of the sample from the National Cheng Kung University hospital in Taiwan revealed the mean age of patients was 58.7 ± 14.31 years old. The two-part regression model is conceptually and numerically better than the one-part regression model when examining the risks factors that affect cellulitis episodes. Particularly, we found the significant factors based on the best model are cellulitis history ([Formula: see text]; <i>P</i> value < 0.001), clinical stage of cancer (3) ([Formula: see text]; <i>P</i> value < 0.001), no cancer ([Formula: see text]; <i>P</i> value < 0.05), cancer of female reproductive organs ([Formula: see text]; <i>P</i> value < 0.05), breast cancer ([Formula: see text]; <i>P</i> value < 0.05), and age ≥ 60 years ([Formula: see text]; <i>P</i> value < 0.05). Multiple correspondence analysis approach found cancer types (breast and female reproductive organ), age ≥ 60 years, and cellulitis history were more likely to link to excess zero cellulitis or one cellulitis episode.</p>","PeriodicalId":47429,"journal":{"name":"Clinical Medicine & Research","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11374497/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142134195","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":"Assessment of the Prophylactic Effects of Probiotics, Prebiotics, and Synbiotics Against COVID-19 Infection: A Systematic Review of Randomized Controlled Trials.","authors":"Maryam Emadzadeh, Mona Kabiri","doi":"10.3121/cmr.2024.1865","DOIUrl":"10.3121/cmr.2024.1865","url":null,"abstract":"<p><p><b>Background:</b> Although various treatments are developed against COVID-19 variants, probiotic, and synbiotic adjunct therapy with several benefits such as safety, low cost, and availability could be needed for preventing or treating COVID-19 infection.<b>Objective:</b> The present systematic review aimed to assess the prophylactic efficacy of the probiotic, prebiotic, and synbiotic administration against COVID-19.<b>Methods:</b> The protocol of this systematic review was registered at the PROSPERO (Code number: CRD42023418900). The Scopus, Cochrane Library, Web of Sciences, and PubMed databases were systematically searched to define the clinical trials published up to November 2022 in the English language. The comparison of the incidence of COVID-19 disease and levels of specific antibodies against SARS-cov2 between the intervention and placebo groups were evaluated in this systematic review.<b>Results:</b> According to the five included trials, four indicated the incidence of COVID-19, and no significant differences were observed between the probiotic and placebo groups during 1, 2, or 3 months of follow-up in the mentioned studies. Regarding the antibody assays against SARS-Cov2 including IgM, IgG, or IgA reported by three eligible trials, there were no significant differences between the intervention and control groups.<b>Conclusion:</b> It seems that the administration of single or multi-strain probiotics or synbiotics had no prophylactic effects in different populations such as high-risk staff exposed to COVID-19, elderly nursing home residents, healthy adults, and household contact with COVID-19 patients during 1-to-3-months of intervention.</p>","PeriodicalId":47429,"journal":{"name":"Clinical Medicine & Research","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11374498/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142134192","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":"Osteonecrosis of the Knee: The Unintended Consequence of Steroid Abuse.","authors":"Suhas Sondur, Govid Vj, Shakti Prasad Das","doi":"10.3121/cmr.2024.1855","DOIUrl":"10.3121/cmr.2024.1855","url":null,"abstract":"<p><p>The anti-inflammatory and immunosuppressive properties of steroids allow their use in a wide variety of rheumatological diseases, asthma, inflammatory bowel disease, cancer therapy, and severe viral infections. Though life-saving or organ-saving, long-term clinical use leads to a vast array of complications. Osteoporosis is the most common orthopedic side effect of steroid abuse, while osteonecrosis is a rare occurrence. The risk of osteonecrosis appears to be dose and duration dependent, but several patient factors also play a major role and usually affect the femoral head followed by the knee joint. The long-term effects of steroids must be explained to all patients on therapy, but this risk is missed in individuals who abuse steroids for recreational or performance-enhancing purposes. We describe a male, aged 29 years, who presented with dull aching bilateral knee pain of 2-years' duration after a long-term steroid abuse for weight and muscle mass gain. Radiological and magnetic resonance imaging studies confirmed osteonecrosis of femoral and tibial condyles and secondary degenerative arthritis of the knee joint. Prompt suspicion, early diagnosis, and intervention in osteonecrosis of knee joints, and termination of steroids may reverse the pathology and prevent progression of disease.</p>","PeriodicalId":47429,"journal":{"name":"Clinical Medicine & Research","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11149946/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140852367","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>Mycoplasmoides genitalium</i> Macrolide Resistance Detection is Needed in University Settings.","authors":"Stephen C Lavey, Brittany Cassel, Erik Munson","doi":"10.3121/cmr.2024.1871","DOIUrl":"10.3121/cmr.2024.1871","url":null,"abstract":"<p><p><b>Background:</b> <i>Mycoplasmoides genitalium</i> remains a difficult sexually-transmitted infection (STI) to manage due to its potential for antimicrobial resistance and post-infection sequelae. University students are especially vulnerable, as this demographic has the highest rate of STI in the United States. As a result, investigating prevalence rates and therapeutic outcomes in this population is essential to minimize future impact of <i>M. genitalium</i> The purpose of this study was to investigate a university student population for <i>M. genitalium</i> distribution and treatment outcome.<b>Design:</b> Retrospective chart-review of university health clinic attendees, augmented by laboratory detection of <i>M. genitalium</i> following therapeutic intervention.<b>Methods:</b> A total of 1617 student encounters at a midwestern United States university health clinic over a 28-month interval from November 2017 through February 2020 were analyzed for <i>M. genitalium</i> and <i>Chlamydia trachomatis</i> positivity rates and prevalence. Detection of these sexually-transmitted pathogens occurred by commercial RNA amplification testing. Chart review was focused on participant outcomes following initial <i>M. genitalium</i> detection and therapeutic intervention.<b>Results:</b> <i>C. trachomatis</i> positivity and prevalence rates were 7.05% and 9.00%, respectively, while analogous rates for <i>M. genitalium</i> were 7.05% and 6.51%, respectively. An average of 1.83 positive results was generated from participants infected with <i>M. genitalium</i> at any time, with an average of 1.17 positive results for <i>C. trachomatis</i> (<i>P</i> < 0.0002). For students treated with azithromycin, 30.3% generated a negative <i>M. genitalium</i> result upon follow-up, with 1g daily and 2-day 500mg dosing regimens demonstrating less efficacy than a 4-day 250mg regimen or moxifloxacin.<b>Conclusion:</b> Data indicate a need for molecular <i>M. genitalium</i> macrolide resistance determination from primary specimens in the university setting.</p>","PeriodicalId":47429,"journal":{"name":"Clinical Medicine & Research","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11149951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140872082","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":"Clinical Presentation of Blastomycosis is Associated With Infecting Species, Not Host Genotype.","authors":"Alexandra M Linz, Holly M Frost, Terrie Kitchner, Jennifer L Anderson, Jennifer Meece","doi":"10.3121/cmr.2024.1880","DOIUrl":"10.3121/cmr.2024.1880","url":null,"abstract":"<p><p><b>Objective:</b> To determine if host genetics may be a risk factor for severe blastomycosis.<b>Design:</b> A cohort of patients who had contracted blastomycosis underwent targeted SNP (single nucleotide polymorphism) genotyping. The genetics of these patients were compared to a set of age and gender-matched controls and between patients with severe versus mild to moderate blastomycosis.<b>Setting:</b> The Marshfield Clinic Health System in central and northern Wisconsin<b>Participants:</b> Patients with a diagnosis of blastomycosis prior to 2017 were contacted for enrollment in this study. A phone hotline was also set up to allow interested participants from outside the Marshfield Clinic Health System to request enrollment.<b>Methods:</b> SNP frequency was assessed for significant differences between the patient cohort and controls and between patients with severe versus mild to moderate blastomycosis. We also tested the effect of <i>Blastomyces</i> species identified in clinical isolates on disease symptoms and severity.<b>Results:</b> No significant differences were found in SNP frequency between cases and controls or between those with severe or mild to moderate blastomycosis. We did detect significant differences in symptom frequency and disease severity by <i>Blastomyces</i> species.<b>Conclusions:</b> Our study did not identify any genetic risk factors for blastomycosis. Instead, the species of <i>Blastomyces</i> causing the infection had a significant effect on disease severity.</p>","PeriodicalId":47429,"journal":{"name":"Clinical Medicine & Research","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11149952/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140866539","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}