Clinical Medicine & Research最新文献

{"title":"Expanding the Abu Dhabi Bone Marrow Transplant Program (AD-BMT^®) Scope with the Collection and Cryopreservation of Cord Blood Stem Cells","authors":"Rene Antonio Rivero-Jimenez, Antonio Alfonso Bencomo-Hernandez, Yandy Marx Castillo-Aleman, Fatema Mohammed Al Kaabi, Y. Ventura-Carmenate","doi":"10.11648/j.cmr.20231202.12","DOIUrl":"https://doi.org/10.11648/j.cmr.20231202.12","url":null,"abstract":"","PeriodicalId":47429,"journal":{"name":"Clinical Medicine & Research","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87160910","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":"Analysis on the Abnormal Detection Rate of Blood Tests in 1790 Medical Radiation Workers in Nanjing","authors":"Xinghai Yan, Xiao Shan","doi":"10.11648/j.cmr.20231201.13","DOIUrl":"https://doi.org/10.11648/j.cmr.20231201.13","url":null,"abstract":"","PeriodicalId":47429,"journal":{"name":"Clinical Medicine & Research","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87103001","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":"Establishment of Standardized Diagnostic System for Brucella Spondylitis in the Elderly and Clinical Application of Precise Treatment Strategy","authors":"Yang Xinming, Zhan Zhe, Yang Chaowei, Zhang Xuyang","doi":"10.11648/j.cmr.20231202.11","DOIUrl":"https://doi.org/10.11648/j.cmr.20231202.11","url":null,"abstract":"","PeriodicalId":47429,"journal":{"name":"Clinical Medicine & Research","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77766742","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":"Ketamine in Acute Abdominal Pain in Patients with Lead Poisoning","authors":"S. Rahmani, Rana Kolahi Ahari, Hamed Shokoohsaremi, Roohie Farzaneh, Mohammad Davood Sharifi","doi":"10.11648/j.cmr.20231201.12","DOIUrl":"https://doi.org/10.11648/j.cmr.20231201.12","url":null,"abstract":": Introduction: In this study, we investigated the effect of intravenous ketamine administration on acute abdominal pain in lead poisoning patients. Methods: In this cross sectional study, we evaluated 20 patients with opium abuse with acute abdominal pain due to lead poisoning. With cardiac monitoring, 0.25 mg/kg ketamine (maximum dose was considered as 20 milligrams) was administered during 30 to 60 seconds. To control ketamine complications such as psychological irritability 0.03 mg/kg midazolam (2 milligrams was considered as maximum dose) was injected slowly during one or two minutes. Patients were observed in the ED for the next 6 hours. Pain score was assessed with VAS method, serially. Pain was measured before ketamine administration, every one hour for the next two hours and every two hours for four hours. Results: In this study 20 patients were enrolled with mean age of 37.2 ± 4.2 years (range from 30 to 44 yrs.). Repeated measurement test shows significant reduce in pain score after ketamine administration (P=0.001). Five patients report no pain 4 hours after ketamine injection, and 3 of them left the hospital with personal consent before the end of the study. From 17 remaining patients, 13 ones (76.4%) had no pain, and mean VAS score in other 4 patients was less than 2 after4 6 hours. Conclusion: our results show that low dose ketamine administration can reduce abdominal pain related to lead poisoning in opium abusers.","PeriodicalId":47429,"journal":{"name":"Clinical Medicine & Research","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73738818","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":"Nursing Students’ Knowledge, Attitudes and Death Attitude Regarding Palliative Care: A Descriptive Correlational Study","authors":"Meng-ru Cao, Wen-Xi Li, M. Wan, Lin Yang, Jun Ma","doi":"10.11648/j.cmr.20231201.11","DOIUrl":"https://doi.org/10.11648/j.cmr.20231201.11","url":null,"abstract":"","PeriodicalId":47429,"journal":{"name":"Clinical Medicine & Research","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80186681","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":"Cutaneous Manifestation in COVID-19: A Lesson Over 2 Years Into the Pandemic.","authors":"Retno Danarti,&nbsp;Nikko Vanda Limantara,&nbsp;Dionisia Lintang Unggul Rini,&nbsp;Aries Budiarso,&nbsp;Sri Awalia Febriana,&nbsp;Hardyanto Soebono","doi":"10.3121/cmr.2023.1598","DOIUrl":"https://doi.org/10.3121/cmr.2023.1598","url":null,"abstract":"<p><p>Cutaneous manifestations related to Coronavirus Disease-19 (COVID-19) have been reported over 2 years since the pandemic began. This research aimed to review articles published in English that describe cutaneous manifestations related to COVID-19/SARS-CoV-2. A data search for case reports, original studies, and review articles from the onset of the current COVID-19 pandemic to December 31, 2022, was performed using PUBMED, Cochrane Library, ResearchGate, and Google search engines. Keywords were <i>\"coronavirus\", \"novel coronavirus 2019\", \"COVID-19\", \"SARS-CoV-2\"</i>, and <i>\"2019-nCoV\"</i> in combination with <i>\"cutaneous\", \"skin\"</i> and <i>\"dermatology\"</i> The extracted data included authors, region, sex, age, number of participants with skin signs, cutaneous signs, its location, symptoms, extracutaneous/associated symptoms, suspected or confirmed status for COVID-19, timeline, and healing duration. Six authors independently reviewed the abstracts and full-texts to identify publications providing these details concerning cutaneous manifestations related to COVID-19. A total of 139 publications with full text (122 case reports, 10 case series, and 7 review articles) that reported cutaneous manifestations were identified, and reviewed from 5 continents. The most common cutaneous manifestations of COVID-19 were maculopapular, followed by chilblain-like lesion, urticarial, livedoid/necrotic, vesicular, and other/non-descript rashes/skin lesions. After 2 years into the COVID-19 pandemic, we can conclude that there is no pathognomonic cutaneous manifestation of COVID-19, since it can be also found in other viral infections.</p>","PeriodicalId":47429,"journal":{"name":"Clinical Medicine & Research","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10153677/pdf/0210036.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9405370","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":"Outcomes Associated With Early vs. Delayed Invasive Strategy in NSTEMI Complicated by High Degree AV Block: A Nationwide Analysis.","authors":"Raj Patel,&nbsp;Harsh P Patel,&nbsp;Utkarsh Kohli","doi":"10.3121/cmr.2022.1753","DOIUrl":"https://doi.org/10.3121/cmr.2022.1753","url":null,"abstract":"<p><p><b>Background:</b> High degree atrioventricular block (HDAVB) is an uncommon complication of non-ST-segment elevation myocardial infarction (NSTEMI) that frequently necessitates pacemaker implantation. This contemporary analysis compares need for pacemaker implantation based on the timing of intervention in acute NSTEMI complicated by HDAVB.<b>Methods:</b> We used 2016-2017 National Inpatient Sample database to identify admissions with NSTEMI and HDAVB. Time to coronary intervention from initial admission was used to segregate the admissions into two groups: early invasive strategy (EIS) (<24 hours) and delayed invasive strategy (DIS) (>24 hours). Multivariable linear and logistic regression analysis was performed to compare in-hospital outcomes among the two groups.<b>Results:</b> Out of 949,984 NSTEMI related admissions, coexistent HDAVB was present in 0.7% (n=6725) patients. Amongst those, 55.61% (n=3740) hospitalizations included invasive intervention (EIS=1320, DIS=2420). Patients treated with EIS were younger (69.95 years vs. 72.38 years, <i>P</i><0.05) and had concomitant cardiogenic shock. Contrarily, prevalence of chronic kidney disease, heart failure, and pulmonary hypertension was higher in DIS group. EIS was associated with lower length of stay and total hospitalization cost. In-hospital mortality and pacemaker implantation rates were not significantly different between patients in the EIS and DIS groups.<b>Conclusion:</b> HDAVB is a rare complication of NSTEMI and often associated with right coronary artery disease. The timing of revascularization does not appear to influence the rate of pacemaker placement in NSTEMI complicated by HDAVB. Further studies are needed to assess if early invasive strategy can benefit all patients with NSTEMI and HDAVB.</p>","PeriodicalId":47429,"journal":{"name":"Clinical Medicine & Research","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10153681/pdf/0210001.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9405367","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 Chest CT Quantification: Triage and Prognostic Value in Different Ages.","authors":"Alireza Almasi Nokiani,&nbsp;Razieh Shahnazari,&nbsp;Mohammad Amin Abbasi,&nbsp;Farshad Divsalar,&nbsp;Marzieh Bayazidi,&nbsp;Azadeh Sadatnaseri","doi":"10.3121/cmr.2023.1772","DOIUrl":"https://doi.org/10.3121/cmr.2023.1772","url":null,"abstract":"<p><p><b>Objective:</b> We evaluated the triage and prognostic performance of seven proposed computed tomography (CT)-severity score (CTSS) systems in two different age groups.<b>Design:</b> Retrospective study.<b>Setting:</b> COVID-19 pandemic.<b>Participants:</b> Admitted COVID-19, PCR-positive patients were included, excluding patients with heart failure and significant pre-existing pulmonary disease.<b>Methods:</b> Patients were divided into two age groups: ≥65 years and ≤64 years. Clinical data indicating disease severity at presentation and at peak disease severity were recorded. Initial CT images were scored by two radiologists according to seven CTSSs (CTSS1-CTSS7). Receiver operating characteristic (ROC) analysis for the performance of each CTSS in diagnosing severe/critical disease on admission (triage performance) and at peak disease severity (prognostic performance) was done for the whole cohort and each age group separately.<b>Results:</b> Included were 96 patients. Intraclass correlation coefficient (ICC) between the two radiologists scoring the CT scan images were good for all the CTSSs (ICC=0.764-0.837). In the whole cohort, all CTSSs showed an unsatisfactory area under the curve (AUC) in the ROC curve for triage, excluding CTSS2 (AUC=0.700), and all CTSSs showed acceptable AUCs for prognostic usage (0.759-0.781). In the older group (≥65 years; n=55), all CTSSs excluding CTSS6 showed excellent AUCs for triage (0.804-0.830), and CTSS6 was acceptable (AUC=0.796); all CTSSs showed excellent or outstanding AUCs for prognostication (0.859-0.919). In the younger group (≤64 years; n=41), all CTSSs showed unsatisfactory AUCs for triage (AUC=0.487-0.565) and prognostic usage (AUC=0.668-0.694), excluding CTSS6, showing marginally acceptable AUC for prognostic performance (0.700).<b>Conclusion:</b> Those CTSSs requiring more numerous segmentations, namely CTSS2, CTSS7, and CTSS5 showed the best ICCs; therefore, they are the best when comparison between two separate scores is needed. Irrespective of patients' age, CTSSs show minimal value in triage and acceptable prognostic value in COVID-19 patients. CTSS performance is highly variable in different age groups. It is excellent in those aged ≥65 years, but has little if any value in younger patients. Multicenter studies with larger sample size to evaluate results of this study should be conducted.</p>","PeriodicalId":47429,"journal":{"name":"Clinical Medicine & Research","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10153680/pdf/0210014.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9405369","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":"Renal Complications after Percutaneous Coronary Interventions on Concurrent Metformin Therapy: A Systematic Review with Meta-Analysis.","authors":"Xenofon M Sakellariou,&nbsp;Theofilos M Kolettis,&nbsp;Dimitrios N Nikas","doi":"10.3121/cmr.2022.1759","DOIUrl":"https://doi.org/10.3121/cmr.2022.1759","url":null,"abstract":"<p><p><b>Objective:</b> Metformin, commonly prescribed in diabetic patients, can cause lactic acidosis. Although generally rare, this side effect remains a source of concern in procedures requiring contrast media, due to the risk of contrast-induced nephropathy. Temporarily withdrawing metformin during the peri-procedural period is often practiced, but clinical decisions are difficult in emergency situations, such as acute coronary syndromes. In this systematic review with meta-analysis, we aimed to further investigate the safety of percutaneous coronary interventions in patients on concurrent metformin therapy.<b>Design, Setting and Participants:</b> We analyzed studies in patients undergoing (elective or emergency) percutaneous coronary interventions with or without concurrent metformin administration, reporting on the incidence of metformin-associated lactic acidosis and peri-procedural renal function.<b>Methods:</b> PubMed, ClinicalTrials.gov, Cochrane Library, and Scopus were systematically searched without language restrictions throughout August 2022. Randomized clinical trials and observational studies were assessed with the Revised Cochrane Collaboration Risk of Bias tool and the Newcastle-Ottawa quality scale, respectively. Data synthesis addressed the mean drop in estimated glomerular filtration rate (eGFR) and the incidence of contrast-induced nephropathy, in addition to lactic acidosis.<b>Results:</b> Nine studies were included, totaling 2235 patients (1076 continuing metformin during the peri-procedural period), mostly with eGFR above 30 mL/min/1.73m² No cases of lactic acidosis were reported. The mean post-procedural drop in eGFR was 6.81mL/min/1.73m² (95% confidence interval [CI]: 3.41 to 10.21) in the presence of metformin and 5.34 mL/min/1.73m² (95% CI: 2.98 to 7.70) in its absence. The incidence of contrast-induced nephropathy was not affected by concurrent metformin, as shown by a (between-groups) standardized mean difference of 0.0007 (95% CI: -0.1007 to 0.1022).<b>Conclusion:</b> Concurrent metformin during percutaneous coronary interventions in patients with relatively preserved renal function is safe, without added risk of lactic acidosis or contrast-induced nephropathy. Thus, emergency revascularization in the context of acute coronary syndromes should not be deferred. More data from clinical trials in patients with severe renal disease are needed.</p>","PeriodicalId":47429,"journal":{"name":"Clinical Medicine & Research","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10153679/pdf/0210026.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9405364","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":"Down-Regulation of the Mineralocorticoid Receptor (MR) and Up-Regulation of Hydroxysteroid 11-Beta Dehydrogenase Type 2 (HSD11B2) Isoenzyme in Critically Ill Patients.","authors":"Alice G Vassiliou,&nbsp;Dimitra A Vassiliadi,&nbsp;Chrysi Keskinidou,&nbsp;Edison Jahaj,&nbsp;Efi Botoula,&nbsp;Stylianos Tsagarakis,&nbsp;Anastasia Kotanidou,&nbsp;Ioanna Dimopoulou","doi":"10.3121/cmr.2023.1743","DOIUrl":"https://doi.org/10.3121/cmr.2023.1743","url":null,"abstract":"<p><p><b>Objective:</b> The mineralocorticoid receptor (MR) has two ligands, aldosterone and cortisol. Hydroxysteroid 11-beta dehydrogenase (HSD11B) isoenzymes regulate which ligand will bind to MR. In this study we aimed to evaluate the expression of the MR and the HSD11B isozymes in peripheral polymorphonuclear cells (PMNs) in critical illness for a 13-day period.<b>Design:</b> Prospective study<b>Setting:</b> One multi-disciplinary intensive care unit (ICU)<b>Participants:</b> Forty-two critically ill patients<b>Methods:</b> Messenger RNA (mRNA) expression of <i>MR, HSD11B1</i>, and <i>HSD11B2</i>, aldosterone levels, and plasma renin activity (PRA) were measured in 42 patients on ICU admission and on days 4, 8, and 13. Twenty-five age and sex-matched healthy subjects were used as controls.<b>Results:</b> Compared to healthy controls, <i>MR</i> expression in critically ill patients was lower during the entire study period. <i>HSD11B1</i> expression was also lower, while <i>HSD11B2</i> expression was higher. In patients, PRA, aldosterone, the aldosterone:renin ratio, and cortisol remained unaltered during the study period.<b>Conclusion:</b> Our results suggest that, in our cohort of critically ill patients, local endogenous cortisol availability is diminished, pointing towards glucocorticoid resistance. Aldosterone probably occupies the MR, raising the possibility that PMNs might be useful to study to gain insights into MR functionality during pathological states.</p>","PeriodicalId":47429,"journal":{"name":"Clinical Medicine & Research","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10153682/pdf/0210006.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9482327","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}