Clinical Medicine & Research最新文献_第2页

Reversible Cerebral Vasoconstriction Syndrome Secondary to Escitalopram. 艾司西酞普兰继发的可逆性脑血管收缩综合征。

IF 1.2

Clinical Medicine & Research Pub Date : 2024-12-01 DOI: 10.3121/cmr.2025.1864

Matthew Postolowski, Omair Shakil, Lintu Ramachandran, Chethan Venkatasubb Rao

引用次数: 0

In-Hospital Management of Acute Trigeminal Neuralgia Pain Crises. 急性三叉神经痛疼痛危象的院内管理。

IF 1.2

Clinical Medicine & Research Pub Date : 2024-12-01 DOI: 10.3121/cmr.2024.1945

Alyssa Chow, Imran Haider, Alexandra Athanaselos, Matthew Patel

{"title":"In-Hospital Management of Acute Trigeminal Neuralgia Pain Crises.","authors":"Alyssa Chow, Imran Haider, Alexandra Athanaselos, Matthew Patel","doi":"10.3121/cmr.2024.1945","DOIUrl":"10.3121/cmr.2024.1945","url":null,"abstract":"Trigeminal neuralgia is the most common form of craniofacial neuropathic pain with an incidence of 4 to 29 per 100,000 people per year. Acute trigeminal neuralgia pain crises are characterized by increased pain frequency and severity and can impact oral intake and sleep, as well as mood. The diagnosis of acute trigeminal neuralgia is clinical and supported by magnetic resonance imaging demonstrating morphological changes in the trigeminal neurovascular bundle on the ipsilateral side of the pain. Patients often present to the hospital seeking relief from acute exacerbations, making it essential for physicians to understand the management of an acute pain crisis, which differs from the chronic management, especially as there may be limited neurology or pain specialist support after hours. The need for improved knowledge of the treatment of acute trigeminal neuralgia is evidenced by opioids being the most prescribed analgesia despite little efficacy in treating it, a lack of evidence supporting their use and concerning side-effects. This article summarizes the evidence behind pharmacological therapy with fosphenytoin, phenytoin, and lidocaine as rescue medications in acute trigeminal neuralgia through the case of a male patient, age 58 years, who experienced complete resolution of pain following administration of phenytoin.","PeriodicalId":47429,"journal":{"name":"Clinical Medicine & Research","volume":"22 4","pages":"215-221"},"PeriodicalIF":1.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11849969/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494223","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}

引用次数: 0

Prevalence of Acute Renal Failure, Para-Clinical Outcomes, and Mortality in COVID-19 Patients. COVID-19患者急性肾功能衰竭的患病率、准临床结局和死亡率

IF 1.2

Clinical Medicine & Research Pub Date : 2024-12-01 DOI: 10.3121/cmr.2024.1955

Nasrin Milani, Najmeh Majidi, Maryam Hami, Farzaneh Sharifipour, Zahra Ramatinejad, Fatemeh Rahmatinejad, Zahra Abbasi Shaye, Mona Kabiri

{"title":"Prevalence of Acute Renal Failure, Para-Clinical Outcomes, and Mortality in COVID-19 Patients.","authors":"Nasrin Milani, Najmeh Majidi, Maryam Hami, Farzaneh Sharifipour, Zahra Ramatinejad, Fatemeh Rahmatinejad, Zahra Abbasi Shaye, Mona Kabiri","doi":"10.3121/cmr.2024.1955","DOIUrl":"10.3121/cmr.2024.1955","url":null,"abstract":"Objectives: Although acute respiratory syndrome is the main manifestation of COVID-19 disease, one of the characteristics of the disease is acute kidney injury (AKI). This study aimed to assess the prevalence of kidney dysfunction and para-clinical outcomes in hospitalized COVID-19 patients and its relationship with mortality.Methods: This cross-sectional analytical study was carried out on 715 patients aged older than 16-years with a diagnosis of COVID-19 admitted to the tertiary teaching Imam Reza Hospital, Mashhad, Iran from February 2020 to February 2021. During hospitalization, these patients were evaluated for AKI based on the Kidney Disease Improving Global Outcomes classification and mortality. Demographic variables and laboratory data were extracted from the hospital information systems electronic database. The significant risk factors for the incidence of AKI were analyzed using SPSS software in the present study.Results: The mortality rate of the included patients was 18.9%, which expired during hospitalization. Mortality was higher among patients with stage 1-2 AKI (34.1%) and stage 3 AKI (44.9%) compared to patients without AKI (8.7%). Individuals in different stages of AKI were significantly older relative to the non-AKI patients; hence, aging could be considered as the predictor of AKI. Leukocytosis, lactate dehydrogenase (LDH), and blood urea nitrogen (BUN) were indicated as significant risk factors for the incidence of AKI.Conclusions: It was found that the prevalence of AKI was 37.2% in hospitalized COVID-19 patients, and there was an association between mortality and the incidence of AKI.","PeriodicalId":47429,"journal":{"name":"Clinical Medicine & Research","volume":"22 4","pages":"188-196"},"PeriodicalIF":1.2,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11849971/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494229","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}

引用次数: 0

The Relative Timing, Outcomes, and Economic Impact of Anti-Nuclear Antibody (ANA) and Extractable Nuclear Antigen (ENA) Laboratory Ordering. 抗核抗体 (ANA) 和可提取核抗原 (ENA) 实验室订购的相对时间、结果和经济影响。

IF 1.2

Clinical Medicine & Research Pub Date : 2024-09-01 DOI: 10.3121/cmr.2024.1937

Elizabeth Ethington, Ellen Melrose, Erik J Stratman

{"title":"The Relative Timing, Outcomes, and Economic Impact of Anti-Nuclear Antibody (ANA) and Extractable Nuclear Antigen (ENA) Laboratory Ordering.","authors":"Elizabeth Ethington, Ellen Melrose, Erik J Stratman","doi":"10.3121/cmr.2024.1937","DOIUrl":"10.3121/cmr.2024.1937","url":null,"abstract":"Objective: To determine the rates of simultaneous antinuclear antibodies (ANA) screening and extractable nuclear antigen (ENA) testing that do not follow recommendations.Design, Setting, and Participants: Retrospective cohort study of adult patients (≥18 years) with a HEp-2 ANA or ENA ordered in the Marshfield Clinic Health System.Main Outcome(s) and Measure(s): Counts of patients having simultaneous ANA and ENA laboratory testing or ENA testing without ANA screening. Relevant ENA positivity in ANA negative patients. Secondary measures included relative timing of ANA and ENA ordering, potential cost savings of unnecessary testing, and provider ordering characteristics including specialty and provider type.Results: Of 58,627 cohort patients, 39,155 (66.8%) were women, and the mean (SD) age at first laboratory testing was 48.7 (19.0) years. The negative ANA with positive ENA rate was 2%. Further stratification identified only 23 diagnosed autoimmune connective tissue diseases (AI-CTDs) in this 2%, with a resulting negative ANA with relevant positive ENA rate of 0.37%. Simultaneous ANA and ENA testing occurred in 8.3% of patients, and an ENA only was ordered in 24.2% of patients. The simultaneous or non-sequential ordering of ANA and ENA testing resulted in significant health care costs of $2,293,251.80 over 20,112 unique patients.Conclusions and Relevance: A significant percentage of providers do not follow recommendations to sequentially order ANA and ENA testing on patients with suspected AI-CTDs. Significant saving in health care spending without failure to diagnose AI-CTDs can be achieved if ANA testing is performed first, followed by ENA testing when suspecting AI-CTDs in patients.","PeriodicalId":47429,"journal":{"name":"Clinical Medicine & Research","volume":"22 3","pages":"123-126"},"PeriodicalIF":1.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11495665/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510314","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}

引用次数: 0

Extensive Invasive Sinusitis Secondary to Streptococcus Intermedius Infection. 继发于中间链球菌感染的广泛侵袭性鼻窦炎

IF 1.2

Clinical Medicine & Research Pub Date : 2024-09-01 DOI: 10.3121/cmr.2024.1935

McKenna Morrow, Mari Ogino, Alay Shah, John Ning

引用次数: 0

Long COVID or Post-Acute Sequelae of COVID-19 (PASC) in Children and Adolescents. 儿童和青少年长期 COVID 或 COVID-19 急性后遗症 (PASC)。

IF 1.2

Clinical Medicine & Research Pub Date : 2024-09-01 DOI: 10.3121/cmr.2024.1858

Djatnika Setiabudi, Buti Azfiani Azhali, Muhammad Akbar Tirtosudiro, Monika Hasna Ramadhan, Muhamad Rinaldhi, Heda Melinda Nataprawira

{"title":"Long COVID or Post-Acute Sequelae of COVID-19 (PASC) in Children and Adolescents.","authors":"Djatnika Setiabudi, Buti Azfiani Azhali, Muhammad Akbar Tirtosudiro, Monika Hasna Ramadhan, Muhamad Rinaldhi, Heda Melinda Nataprawira","doi":"10.3121/cmr.2024.1858","DOIUrl":"10.3121/cmr.2024.1858","url":null,"abstract":"Introduction: Few studies of children with long COVID (post-COVID-19 condition) or post-acute sequelae of SARS CoV-2 (PASC) have been reported. Those terms describe symptoms that persist for weeks or months or as new symptoms that develop after SARS-CoV-2 infection. This condition might be found to various degrees in the severity of COVID-19. This study aimed to describe long COVID in confirmed SARS-CoV-2-infected children.Design: An observational cross-sectional study.Setting: Tertiary care hospital between January and November 2021.Participants: Children, age 5-17 years, with virologically confirmed COVID?19.Methods: This study was conducted by completing an electronic form after informed consent was obtained. The subject's characteristics and parent's or guardian's phone numbers were retrieved from the pediatric COVID-19 registry. Parents were contacted to complete a structured electronic questionnaire about the long COVID symptoms noticed in their children. Descriptive statistics were displayed in percentages and median.Results: Parent contact numbers were documented in 125/135 children who fulfilled the study criteria. There were 61 parents (48.8%) who gave consent, while the rest either did not respond or refused. There were 16 children reported as deceased primarily due to chronic renal disease and leukemia. Of the 45 children enrolled, the median (IQR) age was 11 years (5.3-17.6); 51.1% were female; and 75.6% had comorbidities. Two-thirds developed long COVID symptoms, most frequently in the age 5-9 years group, and mostly fatigue (45.2%), decreased appetite (38.7%), and muscle aches (32.3%). All patients with moderate to severe and more than half asymptomatic to mild COVID-19 developed long COVID.Conclusion: Most children had long COVID symptoms similar to adults despite being otherwise asymptomatic or having mild COVID-19.","PeriodicalId":47429,"journal":{"name":"Clinical Medicine & Research","volume":"22 3","pages":"131-137"},"PeriodicalIF":1.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11495663/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510312","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}

引用次数: 0

Obstructive Shock in Acute Vena Cava Filter Thrombosis: A Rare Presentation. 急性腔静脉滤器血栓形成引起的阻塞性休克：一种罕见的表现

IF 1.2

Clinical Medicine & Research Pub Date : 2024-09-01 DOI: 10.3121/cmr.2024.1921

Kirran Bakhshi, Sashi Inkollu, Rohit Sharma

引用次数: 0

Diagnostic Accuracy of AI Algorithms in Aortic Stenosis Screening: A Systematic Review and Meta-Analysis. 主动脉瓣狭窄筛查中人工智能算法的诊断准确性：系统回顾与元分析》。

IF 1.2

Clinical Medicine & Research Pub Date : 2024-09-01 DOI: 10.3121/cmr.2024.1934

Apurva Popat, Babita Saini, Mitkumar Patel, Niran Seby, Sagar Patel, Samyuktha Harikrishnan, Hilloni Shah, Prutha Pathak, Anushka Dekhne, Udvas Sen, Sweta Yadav, Param Sharma, Shereif Rezkalla

{"title":"Diagnostic Accuracy of AI Algorithms in Aortic Stenosis Screening: A Systematic Review and Meta-Analysis.","authors":"Apurva Popat, Babita Saini, Mitkumar Patel, Niran Seby, Sagar Patel, Samyuktha Harikrishnan, Hilloni Shah, Prutha Pathak, Anushka Dekhne, Udvas Sen, Sweta Yadav, Param Sharma, Shereif Rezkalla","doi":"10.3121/cmr.2024.1934","DOIUrl":"10.3121/cmr.2024.1934","url":null,"abstract":"Background: Aortic stenosis (AS) is frequently identified at an advanced stage after clinical symptoms appear. The aim of this systematic review and meta-analysis is to evaluate the diagnostic accuracy of artificial intelligence (AI) algorithms for AS screening.Methods: We conducted a thorough search of six databases. Several evaluation parameters, such as sensitivity, specificity, diagnostic odds ratio (DOR), negative likelihood ratio (NLR), positive likelihood ratio (PLR), and area under the curve (AUC) value were employed in the diagnostic meta-analysis of AI-based algorithms for AS screening. The AI algorithms utilized diverse data sources including electrocardiograms (ECG), chest radiographs, auscultation audio files, electronic stethoscope recordings, and cardio-mechanical signals from non-invasive wearable inertial sensors.Results: Of the 295 articles identified, 10 studies met the inclusion criteria. The pooled estimates for AI-based algorithms in diagnosing AS were as follows: sensitivity 0.83 (95% CI: 0.81-0.85), specificity 0.81 (95% CI: 0.79-0.84), PLR 4.78 (95% CI: 3.12-7.32), NLR 0.20 (95% CI: 0.13-0.28), and DOR 27.11 (95% CI: 14.40-51.05). The AUC value was 0.909 (95% CI: 0.889-0.929), indicating outstanding diagnostic accuracy. Subgroup and meta-regression analyses showed that continent, type of AS, data source, and type of AI-based method constituted sources of heterogeneity. Furthermore, we demonstrated proof of publication bias for DOR values analyzed using Egger's regression test (P = 0.002) and a funnel plot.Conclusion: Deep learning approaches represent highly sensitive, feasible, and scalable strategies to identify patients with moderate or severe AS.","PeriodicalId":47429,"journal":{"name":"Clinical Medicine & Research","volume":"22 3","pages":"145-155"},"PeriodicalIF":1.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11495659/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510310","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}

引用次数: 0

Potential Application of Anti-Cyclic Citrullinated Peptide (Anti-CCP) for the Diagnosis of Periodontal Disease in Patients with Rheumatoid Arthritis with Cut-Off Determination. 抗环瓜氨酸肽（Anti-CCP）在类风湿性关节炎患者牙周病诊断中的潜在应用与临界值测定。

IF 1.2

Clinical Medicine & Research Pub Date : 2024-09-01 DOI: 10.3121/cmr.2024.1887

Ali Abdul Hussein S Al-Janabi, Emad Tahseen Al-Mussawi

{"title":"Potential Application of Anti-Cyclic Citrullinated Peptide (Anti-CCP) for the Diagnosis of Periodontal Disease in Patients with Rheumatoid Arthritis with Cut-Off Determination.","authors":"Ali Abdul Hussein S Al-Janabi, Emad Tahseen Al-Mussawi","doi":"10.3121/cmr.2024.1887","DOIUrl":"10.3121/cmr.2024.1887","url":null,"abstract":"Background: Rheumatoid arthritis (RA) and periodontal disease (PD) are both characterized by an inflammatory reaction. Anti-cyclic citrullinated peptide (anti-CCP) is a common diagnostic test for RA. Anti-CCP is proposed to be used as a serological biomarker to detect PD in patients with RA.Methods: A case-control study was designed for 94 subjects; 42 patients with RA and 52 without RA. PD and its types were investigated among these subjects. An enzyme-linked immunosorbent assay (ELISA) test was used to measure anti-CCP levels in these subjects.Results: Subjects were recategorized into four groups after PD diagnosis: group 1 for RA with PD (34.04%); group 2 for RA only (10.63%); group 3 for PD only (30.85%); and group 4 for individuals without RA and PD (24.46%). Anti-CCP may be considered an effective biomarker for predicting the development of PD in RA patients based on five current results found in group 1 compared to other groups. These included the detection of significantly higher anti-CCP levels, a high sensitivity (63.15%), low specificity (50%), higher cut-off value (58.53 U/ml), high positive predictive value (94.73%), and low negative predictive value (8.69%) of anti-CCP. Chronic periodontitis is the most common and has a significant association with elevated levels of anti-CCP.Conclusion: Measuring the anti-CCP level in RA patients may be a good indicator for PD diagnosis based on the suggested cut-off value. The sensitivity of the test is sufficiently reliable to produce true positive results. Anti-CCP may also be useful in the diagnosis of PD type, especially chronic periodontitis.","PeriodicalId":47429,"journal":{"name":"Clinical Medicine & Research","volume":"22 3","pages":"138-144"},"PeriodicalIF":1.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11495664/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510313","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}

引用次数: 0

Crafting the Future Doctor: Mentorship in the First Year of Medical School. 打造未来医生：医学院第一年的导师制。

IF 1.2

Clinical Medicine & Research Pub Date : 2024-09-01 DOI: 10.3121/cmr.2024.1911

Sarah Shidid, Haram Abdelmajid, Pakinam Mekki, Tamar Anne Smith-Norowitz

{"title":"Crafting the Future Doctor: Mentorship in the First Year of Medical School.","authors":"Sarah Shidid, Haram Abdelmajid, Pakinam Mekki, Tamar Anne Smith-Norowitz","doi":"10.3121/cmr.2024.1911","DOIUrl":"10.3121/cmr.2024.1911","url":null,"abstract":"Background: The Clinically Reimagined Apprenticeship For Physician Training (CRAFT) program is a volunteer, student-run, clinical mentorship program that started in 2015 at an academic medical center in the Mid-Atlantic region. Clinical exposure during the first year of medical school may influence a student's decision to pursue internal medicine for their residency program of choice.Methods: A retrospective chart analysis of CRAFT program volunteers was conducted. First-year medical school students at an academic medical center in the Mid-Atlantic region (first-year classes of 2020 to 2022) who participated in the CRAFT program (N=77) were followed from first year until their medical school graduation. Information regarding first year mentor's specialty and student's match list data were collected.Results: Students (51%) who participated in CRAFT matched into the same specialty of medicine as their CRAFT program mentors (P=0.765, Chi Square Test). The top specialties represented included emergency medicine, internal medicine, obstetrics/gynecology, and surgery. Of students (23%) who chose mentors in internal medicine, 50% matched into internal medicine residency programs (P<0.0001, Chi Square Test).Conclusion: Clinical mentorship programs during the first year of medical school may be important for choosing future residency programs, leading to successful career goals. Timely engagement with mentors can be crucial in influencing career choices in the field of internal medicine.","PeriodicalId":47429,"journal":{"name":"Clinical Medicine & Research","volume":"22 3","pages":"127-130"},"PeriodicalIF":1.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11495660/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510309","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}

引用次数: 0