Archives of medicine最新文献

{"title":"Systemic Lupus Erythematosus in Libyan Children: Diagnosis and Management","authors":"Khawaja Es, Zletni Ma","doi":"10.21767/1989-5216.1000276","DOIUrl":"https://doi.org/10.21767/1989-5216.1000276","url":null,"abstract":"Background: Childhood Systemic lupus erythematosus (cSLE) is a complex, chronic multisystem autoimmune inflammatory disease, 20% of SLE patients are diagnosed during childhood. The aim of this study is to evaluate disease characteristics; clinical manifestations, laboratory characteristics and treatment in patients with cSLE. Methods: We reviewed the medical files of children with diagnosis of cSLE who are following at Tripoli children hospital, rheumatology department over the last 7 years (January 2011- April 2018). The diagnosis of SLE was based on 1997 revised American college criteria (ACR) for the classification of SLE. All children fulfilled at least 4 of the ACR criteria and had been diagnosed for at least 6 months were included. The following parameters were collected: age at onset of the disease, age at diagnosis, gender, Initial diagnosis (diagnosis at referral), disease duration, diagnosis time interval (period between disease onset to diagnosis), clinical manifestations at the onset and during the evolution of the disease. Laboratory results at diagnosis, and treatment modalities received were also evaluated. Findings: Twelve children were studied, 10 Females (83.3%), two males (16.7%) with F:M ratio of 5:1, mean ages at lupus onset and diagnosis were 11.6 year, 12.5 year respectively. Diagnosis time Interval was ranged between 6 months to 8 yr. The most frequent Mucocutaneous manifestations was the Malar rash in 8 (66.7%) followed by photosensitivity in5 (41.7%), Oral ulcer in 4 (33.3%) and, Discoid rash in 1(8.3%) patient. 10 patients (83.3%) had arthritis. Hematological manifestations in 9(75%), Renal involvement was found in 6(50%), kidney biopsy was done to 5 of them, dominated by class IV (Diffuse proliferative glomerulonephritis) World health organization (WHO) nephritis stage classification. Serositis was found in 5 (41.7%), Neurological manifestations in 3 (25%), Positive anti-nuclear antibody in 11 (91.7%). positive Anti ds-DNA 12 (100%), low complement in 4 (33.3%) of patients. Conclusion: SLE in children has a wide range of presentations and a high index of suspicion should be maintained in order to make an early diagnosis. Better recognition of the age specific manifestations of this disease is required to improve its outcome.","PeriodicalId":92003,"journal":{"name":"Archives of medicine","volume":"42 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77626035","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":"Effects of Alcoholic Extract of Stem and Aerial Parts of the Alcea angulate Plant on Aorta Atherosclerotic Plaque Formation in Rabbit","authors":"Z. Fahimi, S. Soltanbeigi, K. Asadollahi, M. Kaffashi, Kaffashian Mr","doi":"10.21767/1989-5216.1000250","DOIUrl":"https://doi.org/10.21767/1989-5216.1000250","url":null,"abstract":"Background: Atherosclerosis is the main cause of mortality in heart disease patients that its dependence on cholesterol levels has been shown. The side effects of chemical drugs have created a tendency toward medicinal plants for treatment of diseases. Objective: The aim of this study is to evaluate the effect of alcoholic extract of the Alcea angulate on the formation of atherosclerotic plaque due to hypercholesterolemia in rabbit aorta. Methods: 25 male New Zealand white rabbits were divided randomly into 5 groups. Two months respectively treated with basic diet [group 1], basic diet plus 1% cholesterol [control group, group 2], 1% cholesterol with diet intervention Alcea angular at doses of 200, 400 and 800 mg/kg of body weight [groups 3, 4 and 5]. Blood lipid profile levels were measured after 60 days. At the end of the study, the animals were scarified and lipid profile and atherosclerotic plaque formation in the aorta arteries was measured. Data using SPSS ver. 16 were analyzed. Tukey HSD test was used to compare paired groups. Results: Serum levels of total cholesterol and LDL.C of the groups which treated with the Alcea angulata was significantly lower than the control group (p<0.01). Serum levels of HDL in treated groups compared to the control group significantly increased (p<0.01). Pathology studies showed the desired effects and mitigation of extract on the progression of aorta atherosclerosis in hypercholesterolemic rabbits. Conclusion: The overall result demonstrated that use of the Alcea angulate plant reduced total cholesterol and LDL in the blood and inhibited the atherosclerotic plaque formation.","PeriodicalId":92003,"journal":{"name":"Archives of medicine","volume":"157 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76607589","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":"Epidemiological, Clinical and Biological Characteristics of Cameroonian Children and Adolescents with Sickle-Cell Anemia","authors":"Chetcha Chemegni B, Bodieu Kenmegne A, Ngo Sack FF, N. E, Emelemie Megningue N, Bengondo C, Mbanya D","doi":"10.21767/1989-5216.1000255","DOIUrl":"https://doi.org/10.21767/1989-5216.1000255","url":null,"abstract":"A total of 126 patients were included in the study- 65 girls and 61 boys. The mean age of the subjects was 8 ± 4 years (ranging from three to sixteen years). The most represented age group was that from 3-4 years of age. Most of the participants were from the Central Region (46%). All of the subjects were homozygous for hemoglobin SS. Subjects with yearly frequency of three vaso-occlusive crises represented 42.9% of the sample. 57.9% of the patients had been polytransfused within the past 3 years (>2 transfusions). Up to 45.2% of the patients had been hospitalized within the past year.","PeriodicalId":92003,"journal":{"name":"Archives of medicine","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84028819","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":"Virtual Quantification is Not True Quantification: FMTVDM-TFM©℗ Provides True Quantification for SPECT and PET","authors":"Fleming Rm, Fleming Mr, A. McKusick, Chaudhuri Tk","doi":"10.21767/1989-5216.1000283","DOIUrl":"https://doi.org/10.21767/1989-5216.1000283","url":null,"abstract":"","PeriodicalId":92003,"journal":{"name":"Archives of medicine","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82502218","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":"Influence of Appendectomy Timing in the Pathological Outcome and the Morbidity of Acute Appendicitis in Children: A Retrospective Study","authors":"H. Zitouni, H. Louati, A. Nasri, S. Ammar, M. B. Dhaou, M. Jallouli, R. Mhiri","doi":"10.21767/1989-5216.1000275","DOIUrl":"https://doi.org/10.21767/1989-5216.1000275","url":null,"abstract":"Introduction: Surgery is indicated for acute appendicitis but there is controversy regarding precise timing for appendectomy. Objective: Our aim was to evaluate the impact of time delay from emergency department presentation to surgery in developing complicated appendicitis in children and associated morbidity. Methods: 540 charts of children, who underwent appendectomy, between January 2013 and December 2016 were retrospectively reviewed. Groups were divided by time of intervention. Group 1: less than 24h (n=209, 38.7%), group 2: 24h to 48h (n=293, 54.5%), and group 3: greater than 48h (n=38, 6.8%). We considered complicated appendicitis gangrenous, abscess or perforated appendix per operatively and on histopathologic examination. Statically analysis and was performed to search the predictors of complicated appendicitis and evaluate postoperative complications. Results: Among 540 children included in the study, 164 (30.4%) had complicated acute appendicitis. There was no correlation between delay to surgery and the risk of developing a complicated form of the disease for group 1 and Group 2. Beyond the 48th h (group 3), the rate of developing complicated appendicitis and post-operative complications increased significantly. Hospital stay was not affected by delayed surgery. Conclusion: A short in-hospital delay before surgery less than 48 h, for acute appendicitis in child, is not associated with an increased rate of complex appendicitis neither associated morbidity.","PeriodicalId":92003,"journal":{"name":"Archives of medicine","volume":"os-24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87208800","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":"Navigating the Pain, Psychosocial and Racial Dynamics of Hospitalized Patientswith Sickle Cell Disease","authors":"B. Mitchell","doi":"10.21767/1989-5216.1000268","DOIUrl":"https://doi.org/10.21767/1989-5216.1000268","url":null,"abstract":"Hospital readmissions are receiving more attention because of the implications on cost and quality of care. Many researchers and clinicians believe that a substantial number of readmissions are preventable as evidenced by the significant reductions achieved after the Hospital Readmission Reduction Program mandated by the Affordable Care Act. While sickle cell disease is not currently one of the diseases designated for inclusion in the Hospital Readmission Reduction Program, some of the lessons learned addressing hospital structural characteristics and processes of care can be applied to this population. Acute worsening of chronic pain is the predominant clinical presentation of patients with sickle cell disease to the hospital. Pain and the measurement of pain is subjective and there are no clearly defined objective clinical criteria or biomarkers to validate or refute the presence of acute sickle cell pain crisis. The current epidemic of nonmedical opioid use and medical opioid abuse combined with racial unrest and governmental oversight in the US worsens a wellknown atmosphere of mistrust on the part of both clinicians and patients with sickle cell disease. These dynamics force the need for a paradigm change in management of these patients.","PeriodicalId":92003,"journal":{"name":"Archives of medicine","volume":"54 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81310123","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":"Toxoplasma Gondii Encephalitis from Mycophenolate Mofetil: A Case Report and Review","authors":"JL Singer, De La Peña","doi":"10.21767/1989-5216.1000286","DOIUrl":"https://doi.org/10.21767/1989-5216.1000286","url":null,"abstract":"Mycophenolate mofetil (MMF) is often used in the treatment of autoimmune diseases such as myasthenia gravis and the prevention of organ rejection after transplantation. Toxoplasma encephalitis (TE) is typically associated with human immunodeficiency virus (HIV) infection. We present a case of an HIV sero-negative woman who developed TE after long-term MMF therapy for the treatment of myasthenia gravis. TE can occur even with low doses of MMF. A high index of suspicion is needed for patients presenting with focal neurologic deficits given poor outcomes in the majority of reported cases. Prophylaxis against TE can be considered although further study is needed.","PeriodicalId":92003,"journal":{"name":"Archives of medicine","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87914544","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":"Pyrexia of Unknown Origin- An elusive diagnosis","authors":"Sreekumar H, Gopinath M, Sasidharan S, Joseph Pp","doi":"10.21767/1989-5216.1000265","DOIUrl":"https://doi.org/10.21767/1989-5216.1000265","url":null,"abstract":"Giant cell arteritis (GCA) is a systemic inflammatory disorder that affects large vessels. Here we present the case of a 59 year old male who presented to us with complaints of fever and generalised tiredness of 6 weeks duration. He had received 2 courses of antibiotics with no respite. Investigations from outside showed elevated erythrocyte sedimentation rate (ESR) and prostate specific antigen (PSA). He was evaluated in detail as FUO. His fever persisted despite maximal dose of antipyretics, leading to high suspicion of malignancy. However, investigations were not suggestive of any malignancy. On day 3 of admission, he complained of pain on mastication. Examination revealed prominent temporal arteries, with normal pulsations without any tenderness. Fundus examination was normal. With high index of suspicion, temporal artery was biopsied and was diagnostic of giant cell arteritis. Though GCA classically presents with headache, visual changes, masticatory claudication, and symptoms of polymyalgia rheumatica, on rare occasion, GCA may present with fever as the only dominant symptom. GCA without headache is an uncommon presentation, which occurs in nearly 20% of patients.","PeriodicalId":92003,"journal":{"name":"Archives of medicine","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86102767","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":"Advance Directives in Patients Over 60 Years Old: Assessment of Perceived Value and Need For Education in the Outpatient Setting","authors":"Alshanberi A, Tallant C, Huddleston P, Imam A, Glidan A, Passmore C, van Zuilen Mh","doi":"10.21767/1989-5216.1000277","DOIUrl":"https://doi.org/10.21767/1989-5216.1000277","url":null,"abstract":"Background: Advance directives have widely been regarded as playing a pivotal role in end-of-life care for patients. This study sought to evaluate the current value and perspective on advance directives in patients greater than 60 years of age visiting outpatient clinics. Methods: A cross-sectional survey study was performed at four different departmental outpatient clinics at Texas Tech University Health Sciences Center in Amarillo, Texas for patients over the age of 60 years who presented during a three-month time frame. In addition to demographic data, the survey collected data on patients’ perspective on and completion of advance directives. Results: 314 patients completed the survey. Non-Hispanic white patients were significantly more likely than those of other racial or ethnic groups to have an advance directive in place (58.8% vs. 28.8%, p<0.001). Married and widowed patients were more likely to have advance directive than those single or separated (57.2% and 63.1% vs. 30.8% and 35.5%, p=0.002). Those with greater than 12 years of education were also more likely to have an advance directive in place than those with 12 or fewer years of education (59% vs. 48%, p=0.042). Patients who received education from their primary care provider about advance directives were more likely to have an advance directive than those who had not received any education (64.7% vs. 44.9%, p=0.01). Conclusion: Education from physicians about the value of having an advance directive is a powerful intervention that can results in a significant increase in completion of advance directives. Specific demographic groups that could benefit from education about the value of advance directives include patients of different racial or ethnic backgrounds, patients who are single or divorced, and patients with limited education. We recommend that physicians work to initiate discussions about end-of-life care with all patients over 60 years of age.","PeriodicalId":92003,"journal":{"name":"Archives of medicine","volume":"36 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85725058","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 Gonadotropin Releasing Hormone Antagonist in Women Undergoing Intrauterine Insemination","authors":"Elsemary My, Abdelnasser Bs","doi":"10.21767/1989-5216.1000263","DOIUrl":"https://doi.org/10.21767/1989-5216.1000263","url":null,"abstract":"Background: Intrauterine insemination (IUI) is considered to be a very popular treatment procedure that is used for many infertile women worldwide. The aim of this study is to evaluate whether the addition of gonadotropin releasing hormone antagonist would improve the clinical pregnancy rate in women undergoing IUI. Methods: A prospective study performed at El-Galaa Maternity Teaching Hospital where 124 women suffering from primary or secondary infertility were subjected to controlled ovarian stimulation (COS) with hMG (human menopausal gonadotropin) (74 to 150 IU/d) only (control group, n 62) or to hMG (75 to 150 IU/d) plus Cetrotide (0.25 mg/d, starting when the leading follicle was ≥ 16 mm; n 62). A single insemination was performed 36 hours after hCG was given (5,000 IU, IM) in both groups. Main Outcome Measure: Clinical pregnancy rate, premature luteinization and follicular development. Result: Clinical pregnancy rates (20% vs. 10.9%), and the number of mature follicles (2.2 ± 1.1 vs. 1.4 ± 0.96) were statistically significantly higher in the antagonist group compared with the control group. The premature luteinization rate was significantly lower in the antagonist group (0.91% vs. 4.61%). Conclusion: The addition of a GnRH antagonist to controlled ovarian stimulation and IUI was significantly associated with an increase in pregnancy rates in multifollicular cycles and a reduction in the incidence of premature luteinization.","PeriodicalId":92003,"journal":{"name":"Archives of medicine","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73352302","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}