临床医学国际期刊(英文)最新文献

{"title":"Usefulness of a Simple Protein-Energy Wasting Score for Predicting Hospitalization in Maintenance Hemodialysis Patients: A Prospective Cohort Study","authors":"Yoko Watanabe, Keiko Suzuki, Fumiko Kojima, Yoshiko Tanaka, K. Nitta","doi":"10.4236/ijcm.2021.129034","DOIUrl":"https://doi.org/10.4236/ijcm.2021.129034","url":null,"abstract":"Background: Malnutrition is a strong predictor of prognosis in maintenance hemodialysis patients (MHD). We previously proposed a new and simple protein-energy wasting (PEW) score that appears to be useful for assessing the risk of mortality in patients on MHD. Objectives: In the present study, we evaluated the reliability of this PEW score as a predictor of hospitalization in Japanese patients on MHD. Methods: In this single-center, prospective cohort study conducted in Japan, PEW score was calculated for 180 MHD patients. PEW score ranged from 0 (best: S1) to 4 (worst: S4) and was calculated based on nutritional indicators including serum albumin, body mass index, serum creatinine level, and protein intake. The outcome was the number of hospitalizations during the 2-year study period. Results: Thirty-six patients were hospitalized during the study period. Kaplan-Meier curves showed there were fewer hospitalizations in the group with a PEW score of 0/1 than in the group with a score of 3/4. Multivariate analysis revealed a hazard ratio for hospitalization of 3.109 for S3/4 versus S0, 2.777 for S3/4 versus S1, and 2.048 for S3/4 versus S2. Conclusion: The new and simple PEW score is a useful predictor of hospitalization in MHD patients and is also useful for identifying subgroups of MHD patients with a high risk of mortality.","PeriodicalId":58771,"journal":{"name":"临床医学国际期刊(英文)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49097518","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":"Correlation between Expression Differences of Epithelial-Mesenchymal Transition (EMT) in Cholangiocarcinoma Tissue","authors":"Qi Liu, Xiang Rao, H. Cai, Juncheng Guo","doi":"10.4236/ijcm.2021.128029","DOIUrl":"https://doi.org/10.4236/ijcm.2021.128029","url":null,"abstract":"Background: By studying the expression of epithelial-mesenchymal transition regulators in cholangiocarcinoma and intrahepatic duct stones, the correlation between the expression of epithelial-mesenchymal transition regulators and cholangiocarcinoma was revealed. Objective: The objective is to investigate the correlation between the expression of epithelial-mesenchymal transition (EC) regulatory factors and cholangiocarcinoma in patients with intrahepatic duct stones and cholangiocarcinoma, to investigate the relationship between clinicopathological features and prognosis, and to observe the expression of molecular markers of epithelial-mesenchymal transition (EMT) in intrahepatic duct stones and bile duct carcinoma. Methods: Twenty cases of primary cholangiocarcinoma, 20 cases of intrahepatic cholangiolithiasis complicated with cholangiocarcinoma, and 20 cases of intrahepatic cholangiolithiasis specimens were collected from the Fourth People’s Hospital and the friendly medical unit of Haikou. Immunohistochemistry was used to detect the expression differences of EMT-related molecular markers Twisit1, Twisit2, E-cadherin, N-cadherin, and Vimentin in paraffin sections of normal intrahepatic bile duct tissues and patients with intrahepatic duct stones and cholangiocarcinoma. Results: Immunohistochemical staining revealed epithelial-mesenchymal transition (EMT) in intrahepatic cholangiocarcinoma tissue, intrahepatic cholangiolithiasis with cholangiocarcinoma, intrahepatic cholangiolithiasis with normal intrahepatic cholangiolithiasis, such as Sit1, Twisit2, E-cadherin, N-cadherin, and Vimentin proteins were different. The expression of E-cadherin was decreased in cholangiocarcinoma tissue and intrahepatic cholangiolithiocarcinoma combined with cholangiocarcinoma (P 0.05). There was no difference in the expression of intrahepatic bile duct stones and EMT (P > 0.05). Conclusion: The expression of E-cadherin, the molecular marker of EMT, was down-regulated, while the expression of N-cadherin and Vimentin was up-regulated. Age, gender, depth of tumor invasion, degree of tumor differentiation and lymph node metastasis were correlated with the expression of EMT in intrahepatic cholangiocarcinoma.","PeriodicalId":58771,"journal":{"name":"临床医学国际期刊(英文)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49258017","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 Use of Standardized Reporting and Time-in-Range in the Management of Diabetes: A Consensus Report","authors":"S. Sifri, Adnan Alshaikh, B. Bin-Abbas, Eman Sheshah, Fahad Al Sabaan, Mohammed Al-Dawish, M. Al-Dubayee, Naweed Al-Zaman, Raed A. Al-Dahash, S. Alzahrani, Emad R. Issak","doi":"10.4236/ijcm.2021.128028","DOIUrl":"https://doi.org/10.4236/ijcm.2021.128028","url":null,"abstract":"Introduction: The exhaustion of healthcare resources due to the rising prevalence in Saudi Arabia mandates the search for each method that can help in better control of diabetes. Methods: The gathered task force gath-ered to develop an explicit, evidence-based consensus for the use of time-in-range targets as guidance for better glycemic control while using continuous glucose monitoring (CGM). This article has the recommenda-tions of this expert panel. Results: HbA1c and self-monitoring blood glu-cose (SMBG) are not enough to detect blood glucose (BG) fluctuations on a daily basis. The incorporation of technology like FreeStyle Libre with its applications like Libre View is now used in many institutes in Saudi Ara-bia. This system is comprehensive and has all the standardized metrics needed. However, training and support are always needed. Barriers and challenges include the awareness & experience of the technology, the time barrier, the patients’ barriers, the technical barriers, and of course, the availability barrier. All the barriers and challenges should be dealt with by designing new training programs. Conclusion: The expert panel recom-mended using CGMs technology in people with type 1 diabetes (T1DM) children and adults, type 2 diabetes (T2DM) on multiple insulin injections, gestational diabetes (GDM) who need further glycemic control, and those at high risk for hypoglycemia. In addition, we recommend using them for a short period for those who require intensive BG control or during acute illness or stress. In addition, Ambulatory Glucose Profile (AGP) could be used as an educational tool for any individuals with DM to study the im-pact of certain elements of lifestyle modifications on their immediate BG level.","PeriodicalId":58771,"journal":{"name":"临床医学国际期刊(英文)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48862677","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":"Long-Term Efficacy Analysis of Exclusive Enteral Nutrition for the Treatment of Abdominal Abscess in Crohn’s Disease","authors":"N. Ding, Qingfan Yang, Huiping Chen, Mengting Hu, Hong Yan, Xiang Gao","doi":"10.4236/ijcm.2021.128030","DOIUrl":"https://doi.org/10.4236/ijcm.2021.128030","url":null,"abstract":"Objective: The objective is to explore the long-term efficacy of total enteral nutrition in the treatment of abdominal abscess in Crohn’s disease. Methods: Patients treated with EEN in our hospital and whose abdominal abscess disappeared after 12 weeks of treatment were included, and the data of abscess recurrence and surgical treatment during follow-up were included. Results: A total of 44 consecutive cases meeting the criteria were included. The 1-year and 2-year recurrence rates were 22.5% and 39.9% respectively. Among the patients with recurrence, 10 patients chose EEN treatment again, and 5 patients received direct surgical treatment. Of the patients who chose to undergo EEN treatment again, 8 still eventually required surgery. The 1-year operative rate was 16.9%, and the 2-year operative rate was 35.6%. The median operative time was 33.3 (95% CI: 21.3, 45.4) months. Conclusions: The 2-year cumulative incidence of recurrence of abdominal abscess in CD patients whose abdominal abscess disappeared after EEN was 39.9%, and the 2-year cumulative surgical rate was 35.6%. The operative stomy rate decreased after EEN, and the primary anastomosis rate increased significantly.","PeriodicalId":58771,"journal":{"name":"临床医学国际期刊(英文)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49522625","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":"Autonomic Dysreflexia Severity between Urodynamics and Cystoscopy in Patients with Spinal Cord Injury above T6","authors":"Heyi Zhen, Tianhai Huang, Xiaoyi Yang, Qiuling Liu, Qingqing Li, Ma-ping Huang, Hui Chen","doi":"10.4236/ijcm.2021.128031","DOIUrl":"https://doi.org/10.4236/ijcm.2021.128031","url":null,"abstract":"Objective: The objective is to evaluate autonomic dysreflexia (AD) severity between urodynamics and cystoscopy in patients with spinal cord injury (SCI) above thoracic 6 (T6). Design: It is a cross-sectional survey. Subject and methods: The study was carried out in 22 patients with SCI above T6 who underwent both procedures of urodynamics and cystoscopy; all patients developed episodes of AD. The systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured and recorded at the beginning and during the various stages of the two examinations. AD was defined as a rise in SBP above 20 mm Hg. Results: There was no significant difference in SBP and DBP at baseline before urodynamics and cystoscopy. Both urodynamics and cystoscopy triggered episodes of AD. The volume of water instilled during cystoscopy was typically standard and smaller (150 mL) in comparison with urodynamics, where volume varied depending on cystometric bladder capacity (the mean bladder volume in our study was 234.86 ± 139.06 mL). The SBP was significantly different between cystoscopy and urodynamics (49.23 ± 23.07 mm Hg and 35.14 ± 15.75 mm Hg, respectively; P = 0.023). Conclusions: Although bladder distension during cystoscopy was less than that in urodynamics, the severity of AD was more pronounced during cystoscopy. It is recommended that monitoring of cardiovascular parameters during these procedures should be routinely performed.","PeriodicalId":58771,"journal":{"name":"临床医学国际期刊(英文)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46439710","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":"Effect of High-Order Aberrations and Satisfaction on Cataract Patients Implanted with Four Types of AcrySof Blue Light Filtering Intraocular Lens","authors":"Wei Wu, Shengyou Yu, Sheng-sheng Ma","doi":"10.4236/ijcm.2021.128027","DOIUrl":"https://doi.org/10.4236/ijcm.2021.128027","url":null,"abstract":"Objective: The objective is to evaluate the visual acuity, high-order aberrations and satisfaction in the cataract patients with the implantation of different types of AcrySof blue light filtering intraocular lens, which would provide the clinical guidance for the selection of individualized intraocular lens. Methods: From January 2019 to December 2020, the patients with age-related cataract in Guangzhou Red Cross Hospital were equally randomized to be divided into four groups. 20 patients (20 eyes) were implanted with AcrySof (SN60WF), which was the blue light filtering single focus group; 20 patients (20 eyes) were implanted with blue light filtering aspheric multifocal intraocular lens (AcrySof ReSTOR IOL +3.0D, SN6AD1), which was the multifocal intraocular lens group; 20 patients (20 eyes) were implanted with aspheric astigmatism correction intraocular lens (Toric SN6AT), which was the astigmatism group; 20 patients (20 eyes) were implanted with blue filtering aspheric multifocal astigmatism correction intraocular lens (AcrySof ReSTOR IOL +2.5D IQ, SV25T0), which was the ART group. Three months after the operation, the patients were followed up with slit lamp to check the visual acuity, including uncorrected distance visual acuity (UCDVA), uncorrected near visual acuity (UCNVA), best corrected distance visual acuity, (BCDVA); the questionnaire surveys on the satisfaction of different intraocular lens implantation (far and near vision, glare, halo and abnormal visual symptoms); the iTrace visual function analyzer was used to check the total high-order aberrations (spherical aberration, wisdom aberration and Clover aberration) in the 3 mm pupil diameter. Results: Three months after cataract surgery, American Simplified version of questionnaire survey showed that the scores of near removing glasses in the multifocal group and the ART group were significantly better than those in the single focus group and the astigmatism group (P P > 0.05). Three months after cataract surgery, there were statistically significant differences about UCDVA, BCDVA and UCNVA among the four groups (F = 18.189, P P P > 0.05). Conclusion: Different types of AcrySof blue light filtering intraocular lens implantation could improve the far vision and satisfaction of cataract patients, without different higher-order aberrations. Multifocal intraocular lens and ART intraocular lens could significantly improve the far vision of patients and reduce the dependence on near glasses.","PeriodicalId":58771,"journal":{"name":"临床医学国际期刊(英文)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47386833","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":"Vascular Fractality and Alimentation of Cancer","authors":"A. Szász","doi":"10.4236/ijcm.2021.127025","DOIUrl":"https://doi.org/10.4236/ijcm.2021.127025","url":null,"abstract":"Background: The basal metabolic rate has a scaling by tumor mass on the exponent of 3/4, while a simple surface-supplied volume of the mass would have a lower exponent, 2/3. The higher exponent can be explained by optimizing the overall energy distribution in the tumor, assuming that the target is four-dimensional. There are two possible ways of approximating the metabolic rate of the malignant tumor: 1) the volume blood-supply remains, but the surface and the length of the vessel network are modified; or 2) assuming that the malignant cell clusters try to maximize their metabolic rate to energize their proliferation by the longer length of the vessels. Our objective is to study how vascular fractality changes due to the greater demand for nutrients due to the proliferation of cancerous tissue. Results: It is shown that when a malignant tumor remains in expected four-dimensional volumetric conditions, it has a lower metabolic rate than the maximal metabolic potential in the actual demand of the proliferating cancer tissue. By maximizing the metabolic rate in malignant conditions, the allometric exponent will be smaller than 3/4, so the observed “dimensionality” of the metabolic rate versus mass becomes greater than four. The first growing period is exponential and keeps the “four-dimensional volume”, but the growth process turns to the sigmoidal phase in higher metabolic demand, and the tumor uses other optimizing strategies, further lowering the scaling exponent of metabolic rate. Conclusion: It is shown that a malignant cellular cluster changes its metabolic scaling exponent when maximizing its energy intake in various alimentary conditions.","PeriodicalId":58771,"journal":{"name":"临床医学国际期刊(英文)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46537086","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":"Venovenous ECMO in Severe ARDS","authors":"F. Douirek, Nada Samkaoui, M. Rhezali, M. Samkaoui","doi":"10.4236/ijcm.2021.127024","DOIUrl":"https://doi.org/10.4236/ijcm.2021.127024","url":null,"abstract":"The Veno-venous Extra Corporeal Membrane Oxygenation (ECMO) indications and usage has strikingly progressed over the last years; especially with the COVID 19 pandemic, it has become an essential tool in the care of adults and children with severe pulmonary dysfunction refractory to conventional management. In this article, we will provide a review of ECMO development, clinical indications, patients’ management, options and cannulations techniques, complications, outcomes, and the appropriate strategy of organ management while on ECMO.","PeriodicalId":58771,"journal":{"name":"临床医学国际期刊(英文)","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41757073","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 Shift of the Ischial Region during Maneuvering the Standard Wheelchair and the Electric Wheelchair in Healthy Adults","authors":"M. Uemura, Masaharu Sugimoto, Ryoko Shimizu, N. Maeshige, Y. Yoshikawa, H. Fujino","doi":"10.4236/ijcm.2021.127026","DOIUrl":"https://doi.org/10.4236/ijcm.2021.127026","url":null,"abstract":"Pressure injuries are frequent secondary complications that occur in patients with Spinal Cord Injury (SCI), and the recurrence rate of ischial pressure injury is highest in SCI patients. Most SCI patients use wheelchairs, and some studies have shown a relationship between buttock pressure and sitting posture. However, the pressure distribution during wheelchair maneuvering is unclear. We measured and compared the shift of the ischial region when maneuvering a standard wheelchair or electric wheelchair in healthy adults. The subjects drove wheelchairs on a flat ground of 10 m and the shift of ischial region was measured with a pressure distribution-measuring device. The ischial region shifted forward or backward while maneuvering both the standard wheelchair and the electric wheelchair, and the shift rate of the ischial region was not significantly different between the standard wheelchair and the electric wheelchair. The ischial region shift occurred when the forward head moved by the video while maneuvering both a standard wheelchair and an electric wheelchair. Therefore, the shift might occurred because the pelvis shifted forward in conjunction with head movement during maneuvering of both the standard wheelchair and the electric wheelchair. This result showed that it is important to reduce head and trunk movements when maneuvering a wheelchair to reduce the shear force on the buttocks and prevent pressure injuries.","PeriodicalId":58771,"journal":{"name":"临床医学国际期刊(英文)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43629306","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":"Psychological Stress and Nursing Intervention of Sick Children","authors":"Yiying Chen, Feiyan Li","doi":"10.4236/IJCM.2021.125019","DOIUrl":"https://doi.org/10.4236/IJCM.2021.125019","url":null,"abstract":"Holistic nursing is guided by modern nursing concept and framed by nursing procedures, providing high quality nursing according to patients’ psychological, physiological, social and cultural needs. To develop holistic nursing in pediatrics is to develop nursing services for the purpose of satisfying the various clinical needs and psychological nursing of children. It is of great significance to establish holistic nursing concept, provide high quality nursing service for hospitalized children, and take targeted psychological intervention to alleviate their adverse psychological stress, which can improve treatment compliance and clinical efficacy, and shorten the length of hospital stay. In this paper, scientific and effective psychological nursing stress intervention means are used to improve the psychological anti-stress level of hospitalized children, and nursing intervention means are put forward, contribute to the maintenance of children’s mental health and the development of children’s mental health work and also to provide a theoretical basis for the intervention and treatment of children with psychological stress.","PeriodicalId":58771,"journal":{"name":"临床医学国际期刊(英文)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47116702","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}