Internal medicine: open access最新文献

{"title":"Magnesium and Health","authors":"M. Barbagallo, L. Dominguez","doi":"10.35248/2165-8048.19.9.e105","DOIUrl":"https://doi.org/10.35248/2165-8048.19.9.e105","url":null,"abstract":"Magnesium (Mg) is the second most abundant cation after potassium in the intracellular compartment and has a critical role in modulating a large variety of cellular activities and metabolic pathways. Mg is cofactor in over 300 enzymatic reactions including all reactions that involve ATP utilization and transfer [1,2]. Over the past decades, the clinical relevance of Mg and its impact on health has been documented. In the human body, around 24 grams (1 mole) of Mg are present. Less than 1% of total Mg is in the serum; normal serum Mg concentrations range between 0.75-0.95 mmol/L (1.7-2.5 mg/dL or 1.5-1.9 meq/L). In healthy adults, daily Mg requirement is around 300-400 mg (5 to 6 mg/kg/day) but it is higher in several physiological conditions (i.e. pregnancy, aging, exercise, etc.) and diseases (type-2 diabetes, infections, etc.). Severe Mg deficit may be associated with neuromuscular symptoms, such as weakness, tremor, muscle fasciculation, dysphagia, positive Chvostek’s sign (facial twitching as a reaction to the tapping of the facial nerve), and positive Trousseau’s sign (spasm of muscles of the hand and forearm following the application of a pressure cuff). Neurologic disturbances may involve the sympathetic and parasympathetic nervous systems, causing orthostatic hypotension or borderline hypertension. Mild to moderate Mg deficits are generally asymptomatic and clinical signs are usually absent and/or nonspecific. Subjective symptomatology may include anxiety, hyperemotionality, and fatigue, depressive symptoms to major depression, headache, insomnia, light-headedness, and dizziness. Peripheral signs such as myalgias, paresthesias, and cramps may be present. Non-specific functional complains may include chest pain, sine materia dyspnea, precordialgia, palpitations, extrasystoles, etc. Hyperemotionality, tremor, asthenia, sleep disorders, amnesic and cognitive disturbances are particularly important in older adults, and may be often overlooked or confused with age-related symptoms [3].","PeriodicalId":92650,"journal":{"name":"Internal medicine: open access","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81271048","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":"Autologous Peripheral Blood Mononuclear Cells can Lead to Pancreatic Beta Cell Regeneration","authors":"M. Younis","doi":"10.35248/2165-8048.19.9.305","DOIUrl":"https://doi.org/10.35248/2165-8048.19.9.305","url":null,"abstract":"Introduction: Type-1 diabetes (T1D) is a disease that leads to pancreatic beta cells death, resulting in complete insulin loss. \u0000 \u0000T1D occurs as a result of autoimmunity which takes insulin producing β cells as a target and is considered as a metabolic disorder causing hyperglycemia resulting from a serious loss of endogenous insulin roduction. Using cadaveric islets as a replacement therapy was done to reverse diabetes. Many various progenitor cell types have been found in the peripheral blood mononuclear cell (PBMC) fraction denoting hose PBMCs may have the ability to differentiate into many mature functional cell types in certain microenvironments. It is settled that circulating peripheral blood mononuclear cells (PBMC) contain germinal cell population which can share in the regeneration of tissues in different organs. \u0000 \u0000Materials and Methods: 2 groups of type I diabetes patients had been monitored in a private clinic, number 40 each group, with 35 females and 45 males. It lied between 8-25 years old with 4-7 years of diabetes onset. \u0000 \u0000The first group was on insulin therapy and they received peripheral blood mononuclear cells concentrate directly in the dorsal pancreatic artery. The second group was only on insulin injection. \u0000 \u0000Results: The results show a significant increase in c peptide levels after direct injection of peripheral blood mononuclear cells in the dorsal pancreatic artery with p-value less than 0.0001. \u0000 \u0000Conclusion: The peripheral blood mononuclear cells can induce beta cell regeneration and increase beta cell mass which is detected by an increase in c peptide levels.","PeriodicalId":92650,"journal":{"name":"Internal medicine: open access","volume":"14 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79709320","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":"Recurrent Spontaneous Jejunal Hematomas Resulting in Bowel Obstruction","authors":"G. Pollock, A. Chakraborty, C. Parr","doi":"10.35248/2165-8048.19.9.306","DOIUrl":"https://doi.org/10.35248/2165-8048.19.9.306","url":null,"abstract":"Spontaneous intramural small bowel hematomas are rare complications of anticoagulation therapy. We present a case of a 71-year-old male presenting to hospital twice with supratherapeutic international normalized ratio (INR) and bowel obstruction, resulting in the diagnosis of recurrent intramural small bowel hematoma. This case illustrates the importance of stringent INR monitoring in those anticoagulated with warfarin and also demonstrates the importance of remaining clinically suspicious for this complication in patients who present with abdominal pain or intestinal obstruction symptoms in the setting of a supratherapeutic INR.","PeriodicalId":92650,"journal":{"name":"Internal medicine: open access","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78027130","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":"Does Rheumatoid Arthritis Affects the Nitrergic Density and Somatic Area of the nNOS-Immunoreactive (IR) Myenteric Neurons, as well as the Morphometric Areas of CGRP and VIP-IR Varicosities of the Ileum of Arthritic Rats?","authors":"Ahmed S. Ashour, K. Virginia","doi":"10.35248/2165-8048.19.9.311","DOIUrl":"https://doi.org/10.35248/2165-8048.19.9.311","url":null,"abstract":"Few studies regarding arthritic diseases have been performed to verify the presence of the neurodegeneration. Given the increased oxidative stress and extra-articular effects of the rheumatoid arthritis, the gastrointestinal studies should be further investigated aiming a better understanding of the systemic effects the disease on enteric nervous system. To determine whether the rheumatoid arthritis affects the nitrergic density and somatic area of the nNOSimmunoreactive (IR) myenteric neurons, as well as the morphometric areas of CGRP and VIP-IR varicosities of the ileum of arthritic rats. Twenty 58-day-old male Holtzmann rats were distributed in two groups: control and arthritic. The arthritic group received a single injection of the Freund’s Complete Adjuvant in order to induce arthritis model. The whole-mount preparations of ileum were processed for immunohistochemistry to VIP, CGRP and nNOS. Quantification was used for the nitrergic neurons and morphometric analyses were performed for the three markers. The arthritic disease induced a reduction 6% in ileal area compared to control group. No significant differences were observed in nitrergic density comparing both groups. However, arthritic group yielded a reduction of the nitrergic neuronal somatic area and VIP-IR varicosity areas. However, an increase of varicosity CGRP-IR areas was also observed. Despite arthritis resulted in no alterations in the number of nitrergic neurons, the retraction of ileal area and reduction of nitrergic somatic and VIP-IR varicosity areas may suggest a negative impact the disease on the ENS.","PeriodicalId":92650,"journal":{"name":"Internal medicine: open access","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81626236","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":"Carnitine Deficiency in a Patient with Shapiro Syndrome","authors":"P. Yager, Maria Alkhasova, D. Rudy","doi":"10.35248/2165-8048.19.9.312","DOIUrl":"https://doi.org/10.35248/2165-8048.19.9.312","url":null,"abstract":"Spontaneous hyperhidrosis with hypothermia and agenesis of the corpus callosum is known as Classical Shapiro Syndrome (CSS) and was first reported by Shapiro and Plum in 1967. We report a well-documented case of a 39-yearold woman with SS diagnosed at the age of 5-years-old who was diagnosed with Carnitine deficiency at 30-years-old. This is the first reported case of SS with Carnitine deficiency, which was treated with levocarnitine. Our patient also carries with her several comorbid diagnoses which have been reported in other cases of SS. These include primary amenorrhea (untreated), primary hypothyroidism (treated with levothyroxine and liothyronine), seizure disorder (treated with lamotrigine, levetiracetam, and eslicarbazepine acetates), and hypothermia-induced cytopenia (resolved with the addition of liothyronine). Additionally, this case offers unique insights gained from longitudinal care.","PeriodicalId":92650,"journal":{"name":"Internal medicine: open access","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86615466","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":"Explosive Granulomatosis with Polyangiitis Mimicking Infective Endocarditis","authors":"L. Shue, Maggie L Chow, Br., O. Cohen, David Peng","doi":"10.35248/2165-8048.19.9.302","DOIUrl":"https://doi.org/10.35248/2165-8048.19.9.302","url":null,"abstract":"Background: Granulomatosis with polyangiitis (GPA) is a rare systemic disease that causes necrotizing granulomatous inflammation of small- and medium-sized blood vessels. Infective endocarditis (IE), which is a disease due to infection of the innermost surface of the heart, is pathophysiologically distinct from GPA and yet these two entities can manifest in strikingly similar ways. Case presentation: We report a case of a 46-year-old male whose presentation and history were strikingly suggestive of IE but was ultimately diagnosed with GPA. Originally, he presented with fever, oral ulcers, and purpuric lesions on the extremities. The patient had a history of illicit drug use and had recently undergone a dental procedure one week prior to presentation, which were classic risk factors for IE. His fever and respiratory difficulty were unresponsive to antibiotic therapy. His respiratory and renal status declined explosively during his hospitalization, requiring intubation and intensive level care. His clinical progression, negative blood cultures, and a positive c-ANCA screen prompted a workup that was more consistent with GPA. Administration of anti-inflammatory medications and plasmapheresis eventually lead to the resolution of his symptoms. Because of his precipitous pulmonary decline, his outcome would have been poor if the correct diagnosis of GPA were to have been overlooked. Conclusions: ANCA-associated vasculitis and infective endocarditis can demonstrate similar clinical findings, including in the skin. Overlap in serologic markers and other organ involvement can lead to difficulty in distinguishing these two diseases, which require contrasting treatment methods. We highlight and compare the similarities and differences between GPA and IE in discussion of this interesting case to emphasize the importance of being clinically vigilant in differentiating these two separate disease processes.","PeriodicalId":92650,"journal":{"name":"Internal medicine: open access","volume":"77 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84755919","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":"MRI Assessment of Associations between Brown Adipose Tissue and Cachexia in Murine Pancreatic Ductal Adenocarcinoma.","authors":"Yaqi Zhang,&nbsp;Su Hu,&nbsp;Junjie Shangguan,&nbsp;Liang Pan,&nbsp;Xin Zhou,&nbsp;Vahid Yaghmai,&nbsp;Yuri Velichko,&nbsp;Chunhong Hu,&nbsp;Jia Yang,&nbsp;Zhuoli Zhang","doi":"10.4172/2165-8048.1000301","DOIUrl":"https://doi.org/10.4172/2165-8048.1000301","url":null,"abstract":"<p><strong>Objective: </strong>As the major thermogenic tissue in body, the brown adipose tissue (BAT) was recently identified as an important factor to induce the rapid weight loss and malnutrition in malignancy. Current methods for detecting and quantifying brown adipose tissue (BAT) are in limited use. The aim of this study was to evaluate the changes of BAT tissue and its function in the development of pancreatic ductal adenocarcinoma (PDAC) by using magnetic resonance imaging (MRI).</p><p><strong>Methods: </strong>Ten-week-old female C57BL/6 mice were inoculated orthotopically with Pan02 tumor cells. R2* maps and two-point Dixon MRI were performed weekly for evaluation of BAT function and volume, respectively. The T2-weighted MRI was applied weekly for monitoring tumor growth. Meanwhile, the body weight was measured daily as another indication of malnutrition. The UCP1 levels in BAT and white adipose tissue (WAT) were assessed. The serum IL-6 was also measured as the biomarker of cancer-associated cachexia.</p><p><strong>Results: </strong>T2-weighted MRI indicated the rapid tumor growth from week 3 to week 5 after tumor cell inoculation. The water-fat separated MRI could clearly identify and quantify the BAT. The function and volume of BAT could be monitored by weekly MRI measurement in tumor-bearing mice. The total body weights of PDAC tumor-bearing mice were relatively stable, however, was significantly lower than that of control C57BL/6 mice.</p><p><strong>Conclusion: </strong>The results of this study demonstrated the feasibility of detection and quantification of BAT <i>in vivo</i> by MRI during the development of pancreatic cancer.</p>","PeriodicalId":92650,"journal":{"name":"Internal medicine: open access","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6502254/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37227822","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":"Tobacco Education: Reduced Risk for Peripheral Artery Disease","authors":"Blessings Wiyeh Fanka, S. Chaney","doi":"10.4172/2165-8048.1000303","DOIUrl":"https://doi.org/10.4172/2165-8048.1000303","url":null,"abstract":"Peripheral arterial (vascular) disease (PAD/PVD) in its association with significant mortality and morbidity rates has become a significant public health concern. One of the most influential risk factors for PAD is tobacco use, which carries a 3-4-fold increase d risk for PAD often presenting as severe disease. The diagnosis of PAD is usually made a decade earlier in smokers than nonsmokers. The amputation rates in patients with PAD who smoke is twice higher than those that have never smoked. Smoking elevates the risk for PAD several folds and approximately 90% of persons with PAD have a history of smoking. Although the precise mechanism by which chronic smoking induces vascular disease is not entirely understood, growing evidence shows that impairment of endothelial morphology and function plays a crucial role in the pathogenesis of vascular disease. Oxidants, delivered by cigarette and deposited in pulmonary vessels through the systemic vasculature, activate superoxide producing enzymes within the vascular wall via oxidative stress and might be the cause of endothelial dysfunction and dysregulation of endothelial barrier. The World Health Organization (WHO) estimates that there are currently 1.1 billion tobacco smokers’ worldwide ages 15 years and older. Recently, smoking-related death have been said to account for 4.9 million persons per year worldwide. Tobacco use is considered the most important preventable vascular risk factor for PAD in men and women. The association between smoking and PAD is even stronger than that between smoking and coronary disease. The connection between smoking and PAD was identified in 1911 when Erb reported that intermittent claudication was three times more common in smokers and six times more common in heavy smokers in comparison with nonsmokers.","PeriodicalId":92650,"journal":{"name":"Internal medicine: open access","volume":"74 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83294241","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 Role of Pain Catastrophizing and Anxiety Levels on Quality of Life in Fibromyalgia Compared with Healthy Women","authors":"K. Grinberg, Dyana Meshalhov, Daniel Adadi, Tomer Biton","doi":"10.35248/2165-8048.19.9.313","DOIUrl":"https://doi.org/10.35248/2165-8048.19.9.313","url":null,"abstract":"Patients with fibromyalgia (FM) present with chronic and diffuse musculoskeletal pain, a low pain threshold at specific anatomical points, weakness and fatigue, which eventually lead to reduced physical activity and decreased quality of life. Some studies have indicated a link between FM and personality and mental characteristics, but few have examined differences between women with FM and healthy women. The goals of this research were to investigate these differences, as well as the link between the degree of catastrophizing and coping with the disease among sick women. This comparative and correlative study examined 165 women 75 (46%) with FM and 90 (54%) healthy women. All the subjects filled out a socio-demographic questionnaire, the State and Trait Anxiety Questionnaire, and the Short Form Health Survey (SF-12). In addition, the women diagnosed with FM answered the Pain Catastrophizing Scale and the Fibromyalgia Impact Questionnaire (FIQ). We found that women with FM report high levels of anxiety and low levels of quality of life regarding their disease. It seems that their mental health is linked to their physical status. Interventions to improve mental health in this patient population may also bring enhancement in quality of life.","PeriodicalId":92650,"journal":{"name":"Internal medicine: open access","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80795375","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":"Predictors of Impaired Quality of Life and Work Disability in Patients with Systemic Diseases","authors":"Ben Hadj Ali Emna, Bouker Ahmed, Guiga Ahmed, B. Y. Wissal, Atig Amira, Bahri Fethi, G. Neirouz","doi":"10.35248/2165-8048.19.9.309","DOIUrl":"https://doi.org/10.35248/2165-8048.19.9.309","url":null,"abstract":"Background: Systemic diseases are heterogeneous diseases that represent one of the leading causes of disability with high rates of premature mortality and significant social costs. Methods: We conducted a cross-sectional study at an Internal Medicine Department between July 2017 and September 2017. We investigated patients with systemic rheumatic diseases and we evaluated the Quality of Life (QoL). The outcomes were baseline Short Form Health Survey Physical (PCS) and Mental (MCS) Component Scores. Work disability was evaluated by the Work Productivity Assessment Impairment (WPAI) questionnaire. Correlations were calculated by the test t student or ANOVA factor test and comparison with Chi2 test and multivariate regressions were then performed. Results: Two hundred thirty five patients were included, 183 females and 52 males. The average age was 48.3 years. 47% of the population had work during the study. The most frequent diseases were: Systemic lupus erythematosus in 66 patients, Behcet syndrome in 33 patients and Sjogren primary syndrome in 27 patients. Mean PCS were 52.55 ± 17.3 and MCS scores were 47.74 ± 14.8. For the predictors related to patients: the age ((PCS:r=-0.250,p=0.000), (MCS:r=-0.160,p=0.014)), the presence of comorbidities (PCS p=0.003) and the low level of education (p=0.001) were significantly correlated with impaired QoL, the presence of profession was not significantly correlated with QoL. For the predictors related to the disease; inflammatory myositis influences most the QoL. Pulmonary manifestations (PCS:p=0.021,MCS: p=0.006) were the most correlated with impaired QoL. Multivariate analysis showed effect of age, corticosteroids therapy and work disability on MCS and the effect of age and gender on PCS. Work disability was evaluated in working patients: absenteeism was at 31.16 ± 24, productivity impairment at 48.77and systemic sclerosis was the most disease predictive of absenteeism and work disability (p=0.011). Conclusion: QoL may be severely impaired in patients suffering from systemic diseases. We studied for the first time, in Tunisia, the predictors of impaired QoL for all patients followed in our department. This measure aims to further humanize medical practice, to maintain the quality of life of patients and to take into account the individuality of each patient.","PeriodicalId":92650,"journal":{"name":"Internal medicine: open access","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82363525","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}