Signa Vitae最新文献

{"title":"Comparison of octreotide and proton pump inhibitor in the prevention of acute pancreatitis after endoscopic retrograde cholangiopancreatography for different diseases","authors":"","doi":"10.22514/sv.2023.090","DOIUrl":"https://doi.org/10.22514/sv.2023.090","url":null,"abstract":"This study compared the role of octreotide and proton pump inhibitor (PPI) in preventing acute pancreatitis after endoscopic retrograde cholangiopancreatography (ERCP). The 320 patients who received ERCP from January 2019 to June 2022 were randomly and evenly divided into octreotide, PPI, combined treatment and control groups. The incidence of post-ERCP acute pancreatitis (PEP) and hyperamylasemia was counted. The incidence of PEP and hyperamylasemia after surgery differed significantly among all groups. For incidence of PEP, it was similar in the control, octreotide and PPI groups (12.50%, 8.75% and 10.00%), all of which were higher than that of the combined treatment group (1.25%). The incidence of hyperamylasemia was similar between the octreotide and PPI groups (12.50% and 13.75%), both decreased compared with the control group (32.50%), and further lowered in the combined treatment group (8.75%), and all differences were statistically significant (p < 0.05). For patients with choledocholithiasis, the incidence of hyperamylasemia in the combined treatment group was lower than that in the other three groups (8.33%, 31.25%, 21.43% and 16.67%) after intervention, while there were no significant differences in the incidence of PEP and hyperamylasemia in patients with cholangiocarcinoma, pancreatic head carcinoma and other lesions. In conclusion, preoperative application of octreotide or PPI alone has a slight effect on preventing PEP and hyperamylasemia after ERCP, and their combination is dramatically effective in preventing PEP.","PeriodicalId":49522,"journal":{"name":"Signa Vitae","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135358150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of an artificial-intelligent chest radiographs reporting system in an emergency department","authors":"","doi":"10.22514/sv.2023.108","DOIUrl":"https://doi.org/10.22514/sv.2023.108","url":null,"abstract":"Though chest radiography is a first-line diagnostic tool in the emergency department (ED), interpretation has a high error rate. We aimed to evaluate the usability and acceptability of deep learning-based computer-aided detection for chest radiography (DeepCADCR) in an ED environment. We conducted a single-institution survey of emergency physicians (EPs) who had used DeepCADCR (Lunit INSIGHT Chest Xray (CXR), version 3.1.4.1) as part of their ED workflow for at least three months. We developed 22 questions that assessed the subscales of effectiveness, efficiency, safety, satisfaction, and reliability. A seven-point Likert agreement scale was used to rate the responses. A total of 23 EPs who completed the survey was enrolled in the study. When averaged by subscale, satisfaction scores were highest (mean 4.71, standard deviation (SD) 1.43), and safety scores were lowest (mean 4.3, SD 0.72). When scores were converted to acceptability, the total average acceptance of DeepCADCR was 86.0%, with higher scores in ED residents than ED specialists for all subscales. Use of DeepCADCR in the ED workflow was well accepted by EPs.","PeriodicalId":49522,"journal":{"name":"Signa Vitae","volume":"47 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135508776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differences in the determination of manner of death for death certificates by physicians in South Korea: questionnaire survey","authors":"","doi":"10.22514/sv.2023.079","DOIUrl":"https://doi.org/10.22514/sv.2023.079","url":null,"abstract":"In South Korea, the manner and cause of death are determined by physicians. The present study aimed to investigate the differences in decisions made by physicians when completing death certificates and the factors that lead to these differences in South Korea. Questionnaires were used to survey 210 physicians who routinely complete death certificates, and demographic data along with information on their decisions regarding the manner and cause of death as well as natural and unnatural contributory causes were ascertained for eight representative cases. The study sample comprised 149 (71.0%) and 61 (29.0%) male and female physicians, respectively, and the mean age in this sample was 36.93 ± 4.51 years. We found that 64.7%, 61.4%, 7.6%, 4.3%, 4.3%, 65.7%, 84.3%and 53.3% of the physicians considered cases 1, 2, 3, 4, 5, 6, 7 and 8 as unnatural deaths, respectively, while 27.6%, 32.0%, 91.9%, 95%, 8.5%, 26.6%, 6.7% and 38.1%considered them to be natural deaths, respectively. In Case 5, 81.7% considered death to be due to an indeterminate cause. We found that differences may exist in how physicians select the manner of death when completing a death certificate and that this decision is influenced by several factors.","PeriodicalId":49522,"journal":{"name":"Signa Vitae","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136218163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical application of C-reactive protein, leukocyte and immunoglobulin in the diagnosis and treatment of infantile pneumonia at acute stage","authors":"","doi":"10.22514/10.22514/sv.2023.089","DOIUrl":"https://doi.org/10.22514/10.22514/sv.2023.089","url":null,"abstract":"This study aims to explore the clinical significance of C-reactive protein, leukocyte and immunoglobulin in the diagnosis and treatment of infantile pneumonia at acute stage. From January to December 2018, a total of 124 children with pneumonia and healthy children admitted to our hospital were selected as study objects. Among them, 62 children diagnosed with bacterial pneumonia were categorized as the study group, and 62 healthy children who came for physical examination were classified as the control group. The levels of C-reactive protein (CRP), white blood cell (WBC) and immunoglobulin (IgA, IgM and IgG) were observed and compared in the two groups. In this study, higher levels of CRP, IgM, IgG and WBC, along with lower level of IgA were observed in the study group as compared with that in the control group. In the study group, the levels of CRP, IgM, IgG and WBC were lower, but the IgA level was higher in children with mild pneumonia than those with severe pneumonia. After treatment, the levels of CRP, IgM, IgG and WBC were decreased but IgA level was increased after treatment compared with before treatment. In particular, the levels of CRP, WBC, IgA, IgM and IgG in the study group after treatment were restored to comparable levels compared with the control group. Therefore, C-reactive protein, leukocyte and immunoglobulin can be used to determine the diagnosis, condition and outcome of children with pneumonia in the acute stage. This study can provide guidance for clinical diagnosis and treatment of infantile pneumonia based","PeriodicalId":49522,"journal":{"name":"Signa Vitae","volume":"320 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135357794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Melatonin as adjuvant treatment in COVID-19 patients. A meta-analysis of randomized and propensity matched studies","authors":"","doi":"10.22514/sv.2023.076","DOIUrl":"https://doi.org/10.22514/sv.2023.076","url":null,"abstract":"Melatonin is a neurohormone well-known as sleep disorder treatment. A few clinical trials have recently pointed out the biological plausibility of utilising melatonin in the treatment of coronavirus disease 2019 (COVID-19, SARS-CoV-2) patients. Melatonin wide range of activities include anti-inflammatory, antiviral and antioxidant effects. Our meta-analysis aimed to investigate the effect of melatonin on mortality in COVID-19 patients with different disease severity. We searched PubMed, EMBASE, Web of Science with no language restrictions updated on February 2023 for randomized and propensity matched studies, comparing melatonin plus standard COVID-19 therapy vs. standard COVID-19 therapy alone. Patients had to be hospitalised with a confirmed diagnosis of SARS-CoV-2 infection. Primary outcome was mortality at the longest follow-up available. We included 7 randomized and 1 propensity matched studies enrolling 1155 overall patients with a mean age of 61 ± 19.5 years. We found a reduced mortality rate in the overall population (127/575 (22%) vs. 209/580 (36%) Relative Risk: 0.62 (confidence interval (CI): 0.40, 0.96), I2 = 86% p = 0.03, with the results confirmed when pooling the 5 studies which administered melatonin in non-intensive-care-unit patients (26/423 (6.1%) vs. 69/419 (16%) Relative Risk 0.30 (CI: 0.10, 0.86), I2 = 40% p = 0.02). According to recent randomized and propensity matched evidence, melatonin might be a life-saving adjuvant therapy in COVID-19 patients. This effect was mainly driven by non-intensive care unit patients.","PeriodicalId":49522,"journal":{"name":"Signa Vitae","volume":"2015 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136137600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Network pharmacology and molecular docking analyses on Scutellaria barbata indicate that JUN and RELA are potential targets to treat and prevent COVID-19 viremia","authors":"","doi":"10.22514/sv.2023.083","DOIUrl":"https://doi.org/10.22514/sv.2023.083","url":null,"abstract":"The coronavirus disease 2019 (COVID-19) pandemic has been ongoing for more than two years and is likely to continue. Scutellaria barbata (S. barbata) is a traditional Chinese herbal medicine with anti-inflammatory and anti-viral properties and has demonstrated therapeutic effects on patients with COVID-19. Our study aims to shed light on the underlying mechanism and identify possible therapeutic targets. The data on the expression of COVID-19 viremia-associated genes were retrieved from five disease-gene databases. The expression pattern of genes encoding for functional monomer components of S. barbata was retrieved from the Traditional Chinese Medicine Systems Pharmacology platform. To determine the potential mechanism, we used “Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses,” and the protein-protein interaction (PPI) network was constructed using the STRING online tool. CytoNCA, a plug-in for Cytoscape, was used for screening the hub genes. The AutoDocktools and the “PyMOL” software were used for performing molecular docking between active molecules of drugs and disease-target proteins. We identified the S. barbata target and COVID-19 viremia-associated gene sets consisting of 42 genes. GO functional enrichment analysis showed that S. barbata can act by the regulation of cytokine activity and the cytokine-mediated signaling pathway. KEGG pathway enrichment analysis showed that these genes were enriched in several pathways like T helper cell 17 differentiation, the Tumor necrosis factor, and Interleukin-17 signaling pathways. In addition, we identified 17 hub genes, including JUN, RELA, TNF, IL6, etc., using the PPI network and subnetworks. Molecular docking was performed on two highly significant genes: JUN and RELA. The former is a transcription factor, regulating activation-induced cell death, Interferon response post-COVID-19 infection, CD95 ligand promoter activity, and the expression of cytokine genes in T-cells. The five active compounds of S. barbata, including baicalein, wogonin, quercetin, luteolin, and beta-sitosterol, could enter the active pockets of COVID-19 to exert potential therapeutic effects on COVID-19 viremia. JUN and RELA could weaken T cell-mediated immune and cytokine-related inflammatory responses. They could be used as therapeutic targets and could aid in reducing COVID-19 viremia.","PeriodicalId":49522,"journal":{"name":"Signa Vitae","volume":"61 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135358170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of non-invasive sequential ventilation treatment based on the use of an invasive ventilator on the arterial blood gas and inflammatory stress reaction in patients with severe pneumonia with respiratory failure","authors":"","doi":"10.22514/sv.2023.105","DOIUrl":"https://doi.org/10.22514/sv.2023.105","url":null,"abstract":"To investigate the impact of non-invasive sequential ventilation treatment based on the use of an invasive ventilator on the arterial blood gas and inflammatory stress reaction in patients with severe pneumonia with respiratory failure. Ninety patients with severe pneumonia and respiratory failure were equally separated into two groups via a random number table: a conventional treatment group (subjected to invasive mechanical ventilation) and a study group (subjected to invasive mechanical ventilation and non-invasive sequential ventilation treatment). We compared the two groups with respect to several key parameters before and after treatment, including mechanical ventilation time, invasive ventilation time, intensive care unit (ICU) stay, hospital stay, blood gas analysis indicators and the levels of inflammatory factors in the serum. We also compared the two groups with regards to complications. Mechanical ventilation time, invasive ventilation time, ICU stay and hospital stay in the study group were significantly shorter than that in the conventional treatment group (p < 0.05). Arterial Oxygen Saturation (SaO2), Partial Pressure of Oxygen (PaO2) and pH in the study group after intervention were significantly higher than those in the conventional treatment group after intervention (p < 0.05). Following intervention, white blood cell (WBC), serum c-reactive protein (CRP) and serum interleukin-6 (IL-6) were significantly lower than those in the conventional treatment group (p < 0.05). The total incidence of complications in the study group was markedly lower than in the conventional treatment group. Non-invasive sequential ventilation therapy based on an invasive ventilator had a significant treatment impact on patients with severe pneumonia and respiratory failure. This treatment effectively reduced the average treatment time, improved blood gas analysis indicators and reduced inflammatory stress, thus reducing the incidence of complications.","PeriodicalId":49522,"journal":{"name":"Signa Vitae","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135559616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subglottic hemangioma—prevalence, clinical presentation and treatment","authors":"","doi":"10.22514/sv.2023.095","DOIUrl":"https://doi.org/10.22514/sv.2023.095","url":null,"abstract":"This retrospective study aimed to investigate the clinical features and treatment of pediatric subglottic hemangioma (SH), identify risk factors for treatment-induced adverse effects, and identify a strategy for timely therapy discontinuation in children diagnosed with SH at the national pediatric center. Medical records of patients presented with stridor from 2010 to 2020 were retrieved and assessed, the diagnosis of SH was established via flexible bronchoscopy, and the patients were treated using propranolol with a subsequent gradual dose increase to 3 mg/kg body weight daily. A two-week oral steroids trial was added for those with circumferential lesions. Early indicators of a good therapeutic response included decreased stridor and primary lesion size on follow-up bronchoscopy performed one week after propranolol commencement. Duration of therapy, tailored individually based on bronchoscopy findings, and at least twelve months of treatment were the two main criteria for deciding therapy termination. Outpatient visits were arranged at least every three months. Our results showed that SH was the third most frequent cause of stridor (15/137 patients), and biphasic stridor was uniformly present as a typical symptom. Both clinical improvement and bronchoscopy findings confirmed the efficacy of the treatment. The mean therapy duration was 17 months. The only significant adverse event observed was hypoglycemic seizures in one infant. Contributory factors were all prematurity, high propranolol dose (3 mg/kg) and poor oral intake. Collectively, defining a safe and timely protocol for therapy cessation and avoidance of risk factors for adverse effects is the mainstay of SH treatment.","PeriodicalId":49522,"journal":{"name":"Signa Vitae","volume":"50 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135595182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anakinra for patients with COVID-19: an updated systematic review and meta-analysis","authors":"","doi":"10.22514/sv.2023.025","DOIUrl":"https://doi.org/10.22514/sv.2023.025","url":null,"abstract":"Severe COVID-19 patients can develop a maladaptive immune response with hyper-production of cytokines and chemokines which lead to alveolar damage, endothelial activation, coagulopathy and thromboembolic events. We performed a meta-analysis which included any study performed on COVID-19 patients with respiratory hypoxemic failure who received anakinra versus any comparator. Primary endpoint was mortality. Secondary endpoints were intubation rate, superinfection and thromboembolic events. Subgroups analyses included patients in general ward, with hyperinflammation and/or baseline ratio of arterial oxygen partial pressure (PaO2) to fractional inspired oxygen (FiO2) >200. Twenty-four studies were included. Mortality in anakinra patients was significantly lower than mortality of controls (19% vs. 28%; p < 0.0001). Anakinra patients had significantly lower risk of intubation (16% vs. 33%; p < 0.001). Mortality reduction was confirmed in general ward settings, in patients with hyperinflammation and with PaO2/FiO2 >200, but not when selecting randomized studies only. A trend towards increased mortality in more severe patients was observed.","PeriodicalId":49522,"journal":{"name":"Signa Vitae","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135635916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case of pediatric out-of-hospital cardiac arrest due to fulminant myocarditis requiring extracorporeal cardiopulmonary resuscitation","authors":"","doi":"10.22514/sv.2023.075","DOIUrl":"https://doi.org/10.22514/sv.2023.075","url":null,"abstract":"A 7-year-old girl presented with a 2-day history of fever and chest pain that led her to collapse, prompting her father to call the emergency medical services (EMS). Both an EMS ambulance and a physician-staffed ambulance were dispatched to the scene. Upon arrival, the EMS crew discovered that the patient was in cardiac arrest, with ventricular fibrillation (VF) as the initial heart rhythm. Due to the patient’s refractory VF, the physician requested the receiving hospital to prepare for extracorporeal cardiopulmonary resuscitation (ECPR), which was successfully initiated 105 minutes after the patient’s collapse. The patient was admitted to the intensive care unit, where her cardiac function gradually improved. On the eighth day, she was successfully weaned off extracorporeal membrane oxygenation and discharged from the hospital on the thirty-third day without any neurological complications. The presumed cause of the cardiac arrest was fulminant myocarditis, based on the patient’s clinical history and findings from cardiac magnetic resonance imaging. Overall, early mechanical cardiopulmonary support is crucial for patients with fulminant myocarditis. However, cases resulting in out-of-hospital cardiac arrest generally have poor outcomes, even with ECPR. This particular case demonstrated that optimal resuscitation, spanning from the prehospital phase to the intensive care unit, utilizing ECPR, played a vital role in achieving a favorable neurological outcome.","PeriodicalId":49522,"journal":{"name":"Signa Vitae","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135949781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}