British Medical Journal (Clinical research ed.)最新文献

{"title":"Treatment of Chronic Kidney Diseases with Darpeboetin can Ameliorate Kidney Functions: A Possible Clinical Relevance","authors":"","doi":"10.33140/mcr.08.11.03","DOIUrl":"https://doi.org/10.33140/mcr.08.11.03","url":null,"abstract":"Background: Erythropoietin (EPO) has been used clinically for the treatment of anemia as it was the first characterized hematopoietic factor. Erythropoietin is produced primarily by the kidneys (renal cortical fibroblasts) which induces proliferation and differentiation of erythroid progenitor cells. Previous studies suggested that erythropoietin may directly stimulates the regeneration of damaged tubular cells due to presence of erythropoietin receptors on renal tubular epithelial, mesangial and endothelial cells. EPO directly prevent glomerulosclerosis as a consequence of amelioration of podocyte injury. Therefore, to improve kidney function in chronic kidney disease (CKD), it is of critical importance to investigate clinically the beneficial reno-protective effects of EPO in patients with CKD. Methodology: The study was conducted at King Abdulaziz Medical City and included patients with chronic kidney diseases. Patients were under medical treatment with Darpeboetin for the first time. The administration frequency of Darpeboetin was single dose weekly. Kidney function tests including serum creatinine, serum urea, alkaline phosphatase, serum calcium, serum phosphorus, serum albumin and albuminuria were collected from the hospital electronic medical record system (BestCareR). Test values before and after treatment were compared. of the patients before starting treatment and at the end of treatment. The week before starting treatment was considered week 0 (baseline) Results: The results indicated that, treatment with a weekly single dose of Darpeboetin reduces blood urea nitrogen (BUN p=0.002) and serum uric acid level (p=0.009). The effect of treatment on serum calcium and potassium, showed a significant elevation of serum potassium (P<0.001), serum calcium (P<0.001) and adjusted calcium (P<0.001) levels parallel with significant decrease in serum phosphorus (p=0.004). Also treatment of chronic kidney disease patients significantly ameliorates serum albumin (P<0.001). Conclusion: Treatment with Darpeboetin may confirm the reno-protective potency. Darpeboetin is a promising drug to prevent or attenuate tissues kidney damage especially in chronic kidney disease","PeriodicalId":9304,"journal":{"name":"British Medical Journal (Clinical research ed.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135087367","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":"Treatment Options for Patients with Inflammatory Bowel Disease During the COVID-19 Epidemic: A Review","authors":"","doi":"10.33140/mcr.08.11.02","DOIUrl":"https://doi.org/10.33140/mcr.08.11.02","url":null,"abstract":"The Corona Virus Disease (COVID-19) outbreak is affecting life around the world. In particular, people with basic diseases are concerned about whether COVID-19 will affect their original disease,Increasing attention is whether patients with inflammatory bowel disease (IBD) are more susceptible to COVID-19.Whether the treatment plans need to be adjusted, Summary literature shows that IBD patients have comparable infection rates as those in the general population, patients with IBD using biologics are more likely to develop asymptomatic infections and have fewer symptoms than normal populations, The use of parenteral-selective biologic agents may have a protective effect in lung function, which may be associated with its mitigation of cytokine storm syndrome. So patients with IBD should not interrupt the original biological treatment regimen. However, in preparation selection, parenteral-selective biological agents are preferred.","PeriodicalId":9304,"journal":{"name":"British Medical Journal (Clinical research ed.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135087366","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":"On the Individualized Cancer Management","authors":"","doi":"10.33140/mcr.08.11.01","DOIUrl":"https://doi.org/10.33140/mcr.08.11.01","url":null,"abstract":"Individualized cancer management is the opposite of the standardized care adapted for current clinical practice by the mainstream medicine. It is not a fancy concept but a logic and inevitable reality derived from the intrinsic characteristics of cancer and host antitumor response. The question is not whether it should be done but how it is done. Previous efforts have identified various cancer driver gene mutations in individual cancer patient, which have provided basis for treating different patients with different drugs that target various mutated kinases that drive tumor replication. This progress has made one step towards individualized cancer management with limited success in the past two decades in certain type of cancer. A much larger step awaits to be made towards true individualized management of cancer. This step is based on the individual differences in antitumor immunity in different cancer patients. Because antitumor immunity is the most impacting factor for cancer survival once the malignancy of a tumor is established, to fully recognize and utilize this force in the battle against cancer maximize patient survival to the theoretical limit. A true individualized cancer therapy is not only based on personal situation for each patient, but must also satisfy the criterion that the outcome of selected therapy is predictable for that patient, a feature that current standardized care does not have. Thus, treating each patient according to the status of his antitumor immunity should be the most critical skills a physician needs to master when facing each individual cancer patient. In the past nine years, we have been exploring individualized management of cancer through recognizing and manipulating antitumor immunity in each patient. Our combined experiences indicate a significant benefit to patient survival with reduced costs even when such effort was not perfect in the past. With time and more learning, we see this practice becoming more and more practical in a clinical setting. When this individualized approach becomes guideline for cancer management, we will see a significant leap of clinical improvement on both patient survival and cancer cure rate.","PeriodicalId":9304,"journal":{"name":"British Medical Journal (Clinical research ed.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135087368","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":"Investigating Workplace Safety Programs in a Chemical Industry in Africa","authors":"","doi":"10.33140/mcr.05.09.03","DOIUrl":"https://doi.org/10.33140/mcr.05.09.03","url":null,"abstract":"Safety is a critical component in any organisation. The purpose of this study was to investigate the safety culture of a chemical industry in Africa. This was a cross-sectional study conducted among 124 employees from South Africa, Ghana, Nigeria, Kenya and Zimbabwe. Data were collected using self-administered questionnaire via online programme (QuestionPro). The majority of the respondents were satisfied with the overall organisational culture, workplace condition and the support provided by management to ensure employee safety within the organisation. The respondents attested to a positive safety climate, although some felt that it would be of benefit to recognise and reward safety performance. Employee awareness of ImproChem’s safety standards and the level of compliance were also satisfactory. More focus can be directed to increasing individual hazard recognition and elimination to ensure “No harm to anyone ever”.","PeriodicalId":9304,"journal":{"name":"British Medical Journal (Clinical research ed.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135043751","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":"Preventive Cancer Screening: A Strategy to Reduce U.S. Healthcare Costs","authors":"","doi":"10.33140/mcr.05.09.08","DOIUrl":"https://doi.org/10.33140/mcr.05.09.08","url":null,"abstract":"The Agency for Healthcare Research and Quality (AHRQ) estimated that the direct medical costs for cancer in the United States (U.S.) in 2014 was $87.3 billion, and it is projected that the cost to the U.S. taxpayer will rise to $173 billion in 2020 [1, 2]. In addition to the financial cost, cancer is the second leading cause of death in the U.S. [3]. Increasing access to and uptake of preventive cancer screenings could significantly reduce the burden of death and the cost of treating cancer in the U.S. We conduct a literature review to summarize knowledge about preventive cancer screenings in the U.S. including the burden of disease that currently exists in the population, the benefits of receiving preventive cancer screenings, the factors that act as barriers or predictors to receiving preventive care, cost effectiveness of selected preventive services, and the exploration of ways to increase the uptake of preventive services. Increasing preventive cancer screenings in the U.S. is an effective strategy to reduce health care costs.","PeriodicalId":9304,"journal":{"name":"British Medical Journal (Clinical research ed.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135043903","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":"Exploring of Breast Cancer Characteristic Features and Their Influences on Survival Rates","authors":"","doi":"10.33140/mcr.08.10.05","DOIUrl":"https://doi.org/10.33140/mcr.08.10.05","url":null,"abstract":"Breast cancer stands as the most predominant form of neoplasm and it remains the main cause of cancer-related deaths among females. Over the last four decades; a significant reduction in breast cancer mortality has been achieved due the substantial progress in the management of the disease.This retrospective study aims to evaluate the clinical and pathological features along with breast cancer molecular sub-types in city of Kirkuk-Iraq. In this study data were collected from 280 breast cancer patient who were under the care of Kirkuk oncology center from April 2020 and for nine months, patient's average age was 50.05 years and the most of the patient diagnosed with luminal A breast cancer (57%) of the cases, with the majority (56.9%) falling within the 41 to 50-year-old age range, results shows a significant correlation between menopausal status and the survival rate (p=0.002). A significant correlation (p=0.002) between tumor stage (AIII) and postmenopausal statutes has been noticed. On the same time a higher survival rate (≥5 years) has been recorded among those who diagnosed with tumor stage AIII, whereas in 85% of the cases who diagnosed with tumor stage IV showed survival rate for less than five years. Results from this study highlights the importance of considering the stage and molecular subtypes along with patient's age in the management of the disease and addressing the outcome associated with luminal A (Her2 negative) breast cancer via developing more reliable diagnoses tools and therapeutic targets among different molecular subtypes and finally enhancing women's awareness of the importance of early detection as a principle objective.","PeriodicalId":9304,"journal":{"name":"British Medical Journal (Clinical research ed.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135302588","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":"A Rare Case of Seizures Secondary to Proton Pump Inhibitors-Induced Hypomagnesemia","authors":"","doi":"10.33140/mcr.08.10.09","DOIUrl":"https://doi.org/10.33140/mcr.08.10.09","url":null,"abstract":"Hypomagnesemia is a side effect in patients in treatment with proton pump inhibitors (PPI) for more than one year. It can cause arrhythmias, tetany, seizure, and it can be a life-threatening condition. We describe the case of a 78-year-old man with history of relapsing tonic clonic seizures (TCZ), remote stroke, who presented to emergency department for another episode of TCZ. At blood tests, he had severe hypomagnesemia (0.39 mmol/L). After excluding other causes for hypomagnesaemia, chronic use of PPIs was considered a plausible cause. Therefore, substitutive therapy was initiated to restore blood levels of magnesium, and PPIs were discontinued.","PeriodicalId":9304,"journal":{"name":"British Medical Journal (Clinical research ed.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135302590","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":"Evaluation the Flexural Strength of Emax Cad and E_Max Press After Thermocycling Ageing","authors":"","doi":"10.33140/mcr.08.10.03","DOIUrl":"https://doi.org/10.33140/mcr.08.10.03","url":null,"abstract":"Aim: To investigate the impact of thermocycling ageing on the flexural strength of E-max cad and E-max press The objective of this research is to evaluate the impact of aging via various thermocycling protocols on the flexural strength of a feldspathic ceramic. Material and Methods: Thirty six bars of ceramic, ivoclar e max, with dimensions of 16×4×2 mm were utilized. Bars were distributed randomly into three groups (n=6) that were defined in accordance with the number of thermal cycles (TCy): G0-no TCy; G5000-5000 cycles of TCy, G10000-10 TCy. After aging, samples were subjected to a three-point bending test in a universal test machine with a speed of 1mm/min and a load of 1kgf until the catastrophic failure was reached. Results: Concerning the mechanical test, the following values of mean and standard deviation values (MPa), were obtained: G0cad (612.12± 83.16) ; G5000cad (445.44 ± 34.99); G10000cad (366.34± 41.30) and G0press (534.09±42.83) ;G5000press (428.68±17.40) and G10000press (382±38.49).Variance analysis of was conducted using the regression equation (p=0.387) and it showed that there was a significant correlation between the flexural strength and the thermal cycles number. Conclusion: One can conclude that aging in water per se through various temperature cycles numbers has an effect on the flexural strength of a feldspathic ceramic. The thermocycling of both type of lithium disilicate has negative effect on the flexural strength, Cad ceramic showed more significant decrease in flexural strength than press ceramic which was less negatively affected.","PeriodicalId":9304,"journal":{"name":"British Medical Journal (Clinical research ed.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135302587","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":"Serological Prevalence of Latent Epstein-Barr Virus Infection in Children and Adolescents","authors":"","doi":"10.33140/mcr.08.10.01","DOIUrl":"https://doi.org/10.33140/mcr.08.10.01","url":null,"abstract":"Background: Epstein-Barr Virus (EBV), first discovered in 1946, is one of the most common viruses, which found over the world causing latent infection or different undistinguishable symptoms ranged from mild to severe. This prevalence and age distribution of this latent infection varies significantly in different populations. Aim: Serological detection of anti-EBV IgG antibodies in children and adolescents using of the sandwich enzyme-linked immunosorbent assay (ELISA), and estimating the association of seropositivity to sex of study population. Materials and Methods: A total of 182 serum samples were obtained randomly from the study population that involved children (5-12 years old) and adolescents (13-17 years old) of both sexes in Sulaymaniyah province (Iraq) during January-February (2023). Results: Sera of an overall 29.12% study individuals were showed a serological positive reactivity to EBV-IgG antibodies. Significantly (P<0.0289), latent EBV was higher in adolescents (42.86%) than those observed in children (15.39%). Concerning the association of seropositivity to sex of study population, there was a significant increase (P<0.0224) in prevalence of anti-EBV-IgG antibodies among females (42.47%) than males (20.18%). Also, females were appeared significantly (P<0.0001) at higher risk of infection (2.104) than males (0.475). Conclusion: The seroprevalence of latent EBV infection in female adolescent was higher than male children; however, additional investigations using of serological as well as molecular assays are of great importance to demonstrate the extent of infection and to define the full spectrum of EBV-associated diseases.","PeriodicalId":9304,"journal":{"name":"British Medical Journal (Clinical research ed.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135302583","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":"Cardiotocography, Hypoxia, and Feto-Neonatal Neurological Damage","authors":"","doi":"10.33140/mcr.08.10.06","DOIUrl":"https://doi.org/10.33140/mcr.08.10.06","url":null,"abstract":"Complications occurring at any level of fetal oxygen supply can result in hypoxemia, which may ultimately lead to hypoxia/acidosis and neurological damage. Hypoxic-ischemic encephalopathy (HIE) is the short-term neurological dysfunction caused by intrapartum hypoxia/acidosis. This diagnosis requires the presence of several findings, including confirmation of newborn metabolic acidosis, low Apgar scores, early imaging evidence of cerebral edema, and the appearance of clinical signs of neurological dysfunction in the first 48 hours of life. Cerebral palsy (CP) comprises a heterogeneous group of nonprogressive movement and posture disorders, often accompanied by cognitive and sensory impairments, epilepsy, nutritional deficiencies, and secondary musculoskeletal lesions. Although CP is the most common long-term neurological complication associated with intrapartum hypoxia/acidosis, over 80% of cases are caused by other factors. Data on minor long-term neurological deficits are limited, but they suggest that less severe intellectual and motor impairments may result from intrapartum hypoxia/acidosis. Birth asphyxia is a broad term referring to intrapartum asphyxia severe enough to cause neurological damage in some newborns and, rarely, intrapartum or neonatal death. Cerebral palsy and long-term neurological complications such as learning difficulties and motor impairments may have causes other than birth asphyxia. Several intrapartum events can lead to asphyxia (i.e., hypoxia and metabolic acidosis), increasing the likelihood of neurological injury. The cardiotocograph (CTG) is a screening tool used to assess fetal well-being during labor and to identify the possibility of asphyxia. An abnormal CTG, sometimes severe enough to be described as a pathological trace, is commonly referred to as “fetal distress”, although many fetuses with such traces may not have hypoxia and metabolic acidosis. In current practice, these events are appropriately termed “pathological CTG trace” or “acidotic pH” rather than “fetal distress”. Accurate interpretation of the CTG is essential, and it is important to recognize a fetus displaying a pathological CTG in labor, which may imply possible hypoxia and birth asphyxia. Considering the broader clinical context when interpreting the CTG and taking timely and appropriate action based on the findings may help prevent birth asphyxia.","PeriodicalId":9304,"journal":{"name":"British Medical Journal (Clinical research ed.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135302582","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}