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

{"title":"Family Stress and The Risk of Cardiovascular Diseases in Working-Age Population 25-64 Years (WHO program MONICA-Psychosocial)","authors":"E. Gromova, D. Panov, I. Gagulin, A. Gafarova","doi":"10.33140/mcr.06.04.05","DOIUrl":"https://doi.org/10.33140/mcr.06.04.05","url":null,"abstract":"Purpose: To determine the influence of family stress on the risk of cardiovascular diseases (myocardial infarction and stroke) in an open population aged 25–64 years in Russia / Siberia. Methods: Within the framework of the III screening of WHO’s MONICA-psychosocial program, a random representative sample of the population of both sexes of 25-64 years of Novosibirsk in 1994 (men n = 657, mean age 44,3 ± 0,4y, response 82.1%; women: n = 689, mean age 45,4 ± 0,4y, response 72.5%) was examined. The screening included: socio-demographic data, the definition of the family stress. New-onset cases of MI and stroke in women - 15 and 35 cases and in men - 30 and 22 cases, respectively detected in the cohort over follow-up period in frame of budgetary theme № AAAA-A17-117112850280-2. Results: In the open population aged of 25-64 years the prevalence of high family stress was higher in men (31.5%) than women (20.9%). The risk of myocardial infarction in men and women experiencing stressful situations in the family was 5.9 and 5.58-fold higher, respectively over 16-year period. The most significant risk factors for the development of myocardial infarction were divorce (HR = 3.9) and widowhood (HR = 6.3). The risk of developing a stroke was 3.45-fold higher in men and 3.52-fold higher in women with family stress. The risk of developing stroke was higher among those with high school and elementary education levels, both in men (HR = 3.9 and HR = 6.3) and women (HR = 2.87 and HR = 3.33). Conclusion: Stress in the family is more common in men within the working-age population. Family stress increases the risk of developing both myocardial infarction and stroke among men and women.","PeriodicalId":9304,"journal":{"name":"British Medical Journal (Clinical research ed.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85425824","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 synergistic impact of climate change and COVID-19 on gut health in Africa","authors":"Reda Elwakil, Medhat Elsahhar, Y. Fouad, P. Ocama, Masolwa Ng’wanassai","doi":"10.33140/mcr.06.027","DOIUrl":"https://doi.org/10.33140/mcr.06.027","url":null,"abstract":"Background: Agriculture represents the cornerstone of Africa’s economy and accounts for the majority of livelihoods across the continent. Therefore, African countries economy is highly exposed for climate change impacts. Countries with low-middle income are highly affected by extreme weather and climate events and are often overrepresented in the number of individuals displaced by these events. On the other hand, the poorest continent, Africa with the most vulnerable populations to infectious diseases, is predicted to be significantly affected by the ongoing COVID-19 outbreak. Currently there are no studies in the literature addressing the synergistic impact of climate change and COVID-19 on gut health in Africa. The African Middle East Association of Gastroenterology (AMAGE) and the Clinical Research Committee of the World Gastroenterology Organization (WGO) had established a joint research group called Climate change in Africa Group (CCAG) to study this point. Aim of the Work: The aim of the current review is to study the synergetic impact of both climate change and COVID-19 pandemic on gut health in Africa. Conclusion: Climate change events lead to planned and unplanned migrations with emerging new zoonotic disease due to increased exposure of humans to animals. Drastic overwhelming global events carry the risk of water scarcity, food insecurity and population gathering in camps which may increase the prevalence of water-born , food-born and vector-borne diseases. The low-middle income countries are highly affected by extreme weather and climate events and are often over represented in the number of individuals displaced by these events. Africa with the most vulnerable populations to infectious diseases is predicted to be significantly affected by the ongoing COVID-19 pandemic.","PeriodicalId":9304,"journal":{"name":"British Medical Journal (Clinical research ed.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87359976","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":"Hashimoto encephalopathy induced by coronavirus","authors":"M. Guerra, G. Alvaro, Roa-Gomez Gabriella, M. Nicu, Khaja Misbahuddini","doi":"10.33140/mcr.06.029","DOIUrl":"https://doi.org/10.33140/mcr.06.029","url":null,"abstract":"Background: Multiple factors can induce thyroid disease. The mechanism is not precise; a possible mimicry effect in the thyroid tissue could be the cause. Encephalopathy could be one manifestation of this thyroid disorder, but its mechanism is not well understood. There is a lack of data showing coronavirus as a possible cause of Hashimoto encephalopathy. Case Report: A 34-year-old obese Hispanic female was brought to our emergency department due to acute “Behavioral changes”. Her family noted her anxiety with repetitive head movement.; the patient presented with psychotic behavior, reporting family members were killed (The same that brought her), having auditory hallucinations; the family could not precisely predict the duration of this behavior. Her history includes asthma (never intubated, not on steroids), morbid obesity, galactorrhea, and extensive HTN and DM. She denied chest pain, palpitations, nausea, vomit, fever, malaise, recent flu-like symptoms. No abnormality in the physical examination was noted except for repetitive head movement; due to her acute mental status changes and lactic acidosis, she was admitted under critical care service. During her admission, the TSH/T3/ T4: 47.10/34/0.15, Antimicrosomal Ab and Coronavirus PCR were positive (Table1); CXR: No acute pathology, CT Head: Unremarkable, ultrasound neck showed Enlarged heterogeneous thyroid gland, which limits evaluation of underlying parenchyma; no measurable demonstrated solid, cystic or complex nodule (Figure 1). MRI head showed no pituitary adenoma. The patient was started on levothyroxine initially IV then transitioned to 200 mcg PO, and received ceftriaxone, dexamethasone, enoxaparin (As prophylaxis) for C19; after thyroid replacement was initiated; the patient started improving mental status drastically, she was transferred to the medical floor, later improved to baseline, and then was discharged. As an outpatient, the repeated thyroid panel showed normal values, and mental status was status as her baseline previous to her admission. Conclusion: Our case report describes a case of Hashimoto encephalopathy induced by SARS-CoV2 virus. Besides reports relating this thyroiditis with viral other viral entities, there is no data about this thyroid disorder in the 2020 pandemic.","PeriodicalId":9304,"journal":{"name":"British Medical Journal (Clinical research ed.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88991929","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":"Perceived stress and burden of caregiving among nurses in the United Arab Emirates during the COVID-19 pandemic","authors":"R. Ilesanmi, V. Hanson, E. Dabou, Carol Avil Mathias","doi":"10.33140/mcr.06.028","DOIUrl":"https://doi.org/10.33140/mcr.06.028","url":null,"abstract":"Objective: To examine the perceived stress and burden of caregiving during the COVID-19 pandemic among nurses in the United Arab Emirates. Method: A descriptive survey was conducted in two selected hospitals in the UAE. A non-probability voluntary sample (n=64) of nurses working in the Intensive Care Unit (n=41) and isolation wards (n=24) was taken. Each respondent completed an online validated Perceived Stress Scale (PSS) Cronbach’s alpha=0.754; and Professional Care Team Burden Scale (Short version) Cronbach’s alpha =0.785. Range of scores on PSS was 0-40, categorized as, Low: 0-13, Moderate: 14-26 and High: 27-40, while the PCTB score was categorized into Low: 0-13, Moderate: 14-26 and High: 27-40. Pearson (r) correlation was used to determine the relationship between perceived stress and burden of care at 5% level of significance. Results: Respondents’ mean age was 38.81 ± 7.23. In all, 61 nurses (95.3%) engaged in 12-hours duty, 59.4% were confident of fighting the virus and 57 (89.1%) signed up to work in these units, despite the fear of infecting their families (78.1%). Perceived stress scale showed that 50 (78.1%) experienced moderate level of stress with only 3.1% reporting high level of stress (x̄=18.3.47 ± 5.3), while 40 (62.5%) reported low burden of care (11.98 ± 3.78). There was positive correlation between mean PSS score and the PCTB (r=0.451, p=0.000). Conclusion: Reported moderate perceived stress may suggest vulnerability to stress-related illness. Routine screening and more support from their employers to mitigate the adverse effects on their health is recommended.","PeriodicalId":9304,"journal":{"name":"British Medical Journal (Clinical research ed.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87125733","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":"Why, Now, Just Before the Vaccine Arrives, are Experts Worried?","authors":"","doi":"10.33140/mcr.05.11.06","DOIUrl":"https://doi.org/10.33140/mcr.05.11.06","url":null,"abstract":"Vaccines based on mRNA have been known for years to be the most effective for influenza [1]. The technology allows the use of CRISPR and quick and efficient adaptation to situations of different strains of the virus that bring about the different diseases [2].","PeriodicalId":9304,"journal":{"name":"British Medical Journal (Clinical research ed.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87127126","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 Clinical Supervision of COVID-19 Infection: The Italian Experience of Home Care Unit in Lombardy Region","authors":"","doi":"10.33140/mcr.06.019","DOIUrl":"https://doi.org/10.33140/mcr.06.019","url":null,"abstract":"From March to June 2020 the Home Care Unit of Paxme Group evaluated and monitored 245 subjects COVID-19 positive or clinical suspected living in Lombardy Region. There were 101 males, 144 females, with mean age 59.1 years. The females had lower mean age than males (57.4 vs 61.9). In 67 cases (27%) the subjects were discharged from hospitals, the other 178 cases (73%) stay at home with no clinical history of hospitalization. The COVID-19 positive group had 35 males (52%) and 32 females (48%), in the clinical suspected 67 males (38%) and 111 females (62%). There were 2 deaths (1%) and 11 hospitalizations (5%). The 11 hospitalized subjects had a higher mean age (72 years), a higher presence of clinical suspected (72%) and a higher presence of females (72%). The 2 deaths were only in clinical suspected with mean age 87 ys. Older subjects (>65 years) had a higher presence of hospitalization and death. Our study suggests that the age and gender are important in the clinical evolution of COVID-19 infection. The Home Care supervision was an adequate answer to the public health needs, but for the future home healthcare should increase.","PeriodicalId":9304,"journal":{"name":"British Medical Journal (Clinical research ed.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83605775","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 COVID -19 Pandemic Lock Down on Posture in Physiotherapy Students: A CrossSectional Study","authors":"","doi":"10.33140/mcr.05.018","DOIUrl":"https://doi.org/10.33140/mcr.05.018","url":null,"abstract":"Highlights The current lifestyle, with its increased use of modern technologies, has determined modifications in people’s behavior, making individuals more and more sedentary and with inappropriate body habits. Posture is one of the most important factors affecting the physical and mental status of an individual. Purpose of this study was to analyze the effects of COVID-19 pandemic lockdown on relative changes in postural habits, patterns and associated problems among Physiotherapy students, correlating it with the increased technology use and a reduction in levels of physical activity. It was a cross-sectional online survey conducted during COVID-19 lockdown period (June to July 2020). Participants were 223 college students (mean age 20.65 ± 2.86) years recruited from undergraduate (I–IV year), internship, and postgraduate programs under Maharashtra University of Health Sciences. This was a qualitative study in which perspectives of students were obtained through a self-reported questionnaire. The results of this study revealed that the majority of the students have inefficient posture patterns and inadequate postural habits. Dominant inappropriate postural patterns were those of established low back pain, followed by neck pain, upper back pain, and shoulder pain (these being most prominent). This was majorly seen in participants who assumed awkward postures, owing to postural habits, increased use of digital devices, inappropriate ergonomics and also emotional stress. However, a significant number have also attempted to correct the same. The levels of physical activity before and during lockdown was either ‘considerably’ or ‘minimally reduced’ with the majority engaging in only light to moderate physical activity. The acquisition of adequate body behaviors and postural habits must be shaped during early adult age, minimizing postural disorders in later adult life and their consequences. Thus, early detection of postural changes and musculoskeletal risks is essential for the application of a preventive and educational protocol.","PeriodicalId":9304,"journal":{"name":"British Medical Journal (Clinical research ed.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90738466","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 Social Media on Orthopaedic Residency Application Process during the COVID-19 Pandemic","authors":"","doi":"10.33140/mcr.06.020","DOIUrl":"https://doi.org/10.33140/mcr.06.020","url":null,"abstract":"Background: With the COVID-19 pandemic, the medical community saw many changes to practices and policies including medical education and the residency application process. Traditionally medical students in their fourth year of their training are allotted time for away rotations at an institution of their choosing. As a result of COVID-19, many medical schools were forced to eliminate away rotations from their curriculum due to concerns about student safety. This led to the advent of social media outlets designed for the specific purpose of providing medical students with information about residency programs in an effort to recruit interested candidates. With virtual meetings, online communications, and social media platforms all becoming a cornerstone in management of day-to-day hospital functioning this seemed the most appropriate way of adapting to the pandemic while still finding a way to communicate with medical students interested in orthopaedic surgery (9). We hypothesize that the advent of social media accounts during the COVID-19 pandemic would play a role in the orthopaedic residency application process. Question/Purpose: Our question was to determine the role of social media on the orthopaedic surgery residency application process during the COVID-19 era. Patients/Methods: An electronic survey consisting of 12 multiple-choice questions was created to query medical students applying to the field of orthopaedics about the role of social media on their application process. The survey link was emailed to all orthopaedic residency applicants available through the ERAS system. Conclusion: Based on our results it appears applicants may be using social media accounts as a tool to get onto a residency program’s “radar” rather than to obtain meaningful information about a program. Medical students do however find zoom meetings and open houses to be meaningful and provide valuable insight for their application process.","PeriodicalId":9304,"journal":{"name":"British Medical Journal (Clinical research ed.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77885721","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":"Change Point Modeling of COVID-19 Transmission in Bangladesh","authors":"","doi":"10.33140/mcr.05.017","DOIUrl":"https://doi.org/10.33140/mcr.05.017","url":null,"abstract":"Background: COVID-19 pandemic is recognized as a significant threat to human health in 2020 in Bangladesh. Without emergence of effective medicine and vaccine it is very difficult to control the transmission of the COVID-19. Thus, identifying and monitoring the trajectory in the COVID-19 pandemic continuously is very important to assess the action taken to contain this pandemic and to have a further decision. Methods and Material: In this context, this study tries to find out the trend of daily reported confirmed cases of COVID-19 in Bangladesh. The 174 days’ daily data have been taken from the website of worldometer Bangladesh from 10 March to 30 August, 2020 for the analysis. To analyze the trends and to identify significant changes in trends joinpoint regression analysis has been used. Results: The number of cases increased by the rate of 4.98 percent per day in Bangladesh, however, from 11th June to 30th August i.e. for 81 days, the growth rate is found negative means we observed a decline in the COVID-19 cases per day with the rate of -0.6 percent. Conclusions: Evidence suggests that there is an impact of lockdown that slow down the spread of COVID-19 daily cases in Bangladesh.","PeriodicalId":9304,"journal":{"name":"British Medical Journal (Clinical research ed.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87288173","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":"Burnout Syndrome in the Health Human Resource as a consequence of COVID-19","authors":"","doi":"10.33140/mcr.06.016","DOIUrl":"https://doi.org/10.33140/mcr.06.016","url":null,"abstract":"Society is undergoing abrupt changes, the latest pandemic (COVID-19) has hit society in such a way that it is important to consider its effects. The medical world is facing a new virus; hospitals are becoming more crowded every day. The case of Mexico is one of many that exemplify the health emergency. The effect of the new coronavirus COVID-19 is such that it directly affects health promoters. Health workers are forced to intervene, and in order to mitigate or control the spread of the virus, they must be exposed to longer working hours. The objective is to elucidate how the excess work of the Health Human Resource directly caused by the new coronavirus COVID 19 can cause Burnout Syndrome in health promoters.","PeriodicalId":9304,"journal":{"name":"British Medical Journal (Clinical research ed.)","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78197686","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}