General medicine and clinical practice最新文献

{"title":"Intra-Atrial Tunneled Dialysis Catheter as Vascular Access: Ultimate Choice in a Hemodialysis Patient","authors":"M. Sobhi, I. Mami, Soumaya Mekki, Jalel Ziedi, I. Ben Mrad, M. Ben Mrad","doi":"10.31579/2639-4162/053","DOIUrl":"https://doi.org/10.31579/2639-4162/053","url":null,"abstract":"Recurrence of complications related to usual vascular access leads to exhausted vasculature. Several options were described in similar cases like tans-lumbar catheter and intra-atrial tunneled dialysis catheter. We report the case of a 22-year-old- male, with kidney failure, anuria and exhausted vasculature. Emergent kidney transplantation was not suitable to his case. We decided to combine peritoneal dialysis with once-a-week hemodialysis using a tans-lumbar tunneled catheter at first time, then an intra-atrial tunneled dialysis catheter as vascular access of last resort. Development of renal replacement therapy expose nephrologist to new challenges. Working on alternative therapy is inspiring, but rationalizing exploitation of current options meanwhile is imperative.","PeriodicalId":93288,"journal":{"name":"General medicine and clinical practice","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43580167","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":"Three-Year Experience of a Multidisciplinary Central Nervous System Clinic Model for Radiation Oncology and Neurosurgery (RADIANS) in a Community Hospital Setting.","authors":"Wencesley A. Paez, Rohi Gheewala, S. McClelland, J. Jaboin, Charles R. Thomas, B. Lucke-Wold, J. Ciporen, T. Mitin","doi":"10.31579/2639-4162/042","DOIUrl":"https://doi.org/10.31579/2639-4162/042","url":null,"abstract":"Background\u0000As academic centers partner and establish healthcare systems with community hospitals, delivery of subspecialty, multidisciplinary care in community hospital settings remains a challenge. Improving outcomes for central nervous system (CNS) disease is related to integrated care between neurosurgery (NS) and radiation oncology (RadOnc) specialties. Our multidisciplinary community hospital-based clinic, RADIANS, previously reported high patient approval of simultaneous evaluation with NS and RadOnc physicians. Three-year experience is now reported.\u0000\u0000\u0000Methods\u0000Prospectively collected clinical and demographic patient data over three years was done, and surveys administered. Descriptive statistics reported as mean and percentages for patient characteristics, diagnosis, treatment and outcomes.\u0000\u0000\u0000Results\u0000Between August 2016 and August 2019, 101 patients were evaluated. Mean age and distanced traveled was 61.2 years, and 54.9 miles, respectively. Patient Satisfaction Score was 4.79 (0-5 Scale, 5-very satisfied). Most common referral source was medical oncologists. Seventy-two patients had malignant CNS disease (brain mets 28; spine mets 27; both 6; primary brain 9; primary spine 2), 29 had benign CNS disease. Post-evaluation treatment: radiation therapy (RT) only (n=29), neurosurgery (NS) only (n=16), both RT and NS (n=22), and no RT/NS intervention (n=34). Fractionated stereotactic radiosurgery was most common RT delivered; craniotomy with tumor resection was most common NS performed. Treatment outcomes: local control=61/67 (91%); radiation necrosis or radiation-induced myelitis=2/51 (3.9%).\u0000\u0000\u0000Conclusions\u0000The RADIANS multidisciplinary community hospital-based CNS clinic model is first of its kind to be reported, continuing strong patient approval at extended follow-up. Data indicates the model serves as a regional referral center, delivering evidence-based treatment modalities for complex CNS disease in community hospital settings, yielding high rates of local control and low rates of grade 3 or 4 radiation-induced toxicity.","PeriodicalId":93288,"journal":{"name":"General medicine and clinical practice","volume":"4 1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41801011","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":"Three-Year Experience of a Multidisciplinary Central Nervous System Clinic Model for Radiation Oncology and Neurosurgery (RADIANS) in a Community Hospital Setting.","authors":"Wencesley Paez, Rohi Gheewala, Shearwood McClelland, Jerry J Jaboin, Charles R Thomas, Brandon Lucke-Wold, Jeremy N Ciporen, Timur Mitin","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>As academic centers partner and establish healthcare systems with community hospitals, delivery of subspecialty, multidisciplinary care in community hospital settings remains a challenge. Improving outcomes for central nervous system (CNS) disease is related to integrated care between neurosurgery (NS) and radiation oncology (RadOnc) specialties. Our multidisciplinary community hospital-based clinic, RADIANS, previously reported high patient approval of simultaneous evaluation with NS and RadOnc physicians. Three-year experience is now reported.</p><p><strong>Methods: </strong>Prospectively collected clinical and demographic patient data over three years was done, and surveys administered. Descriptive statistics reported as mean and percentages for patient characteristics, diagnosis, treatment and outcomes.</p><p><strong>Results: </strong>Between August 2016 and August 2019, 101 patients were evaluated. Mean age and distanced traveled was 61.2 years, and 54.9 miles, respectively. Patient Satisfaction Score was 4.79 (0-5 Scale, 5-very satisfied). Most common referral source was medical oncologists. Seventy-two patients had malignant CNS disease (brain mets 28; spine mets 27; both 6; primary brain 9; primary spine 2), 29 had benign CNS disease. Post-evaluation treatment: radiation therapy (RT) only (n=29), neurosurgery (NS) only (n=16), both RT and NS (n=22), and no RT/NS intervention (n=34). Fractionated stereotactic radiosurgery was most common RT delivered; craniotomy with tumor resection was most common NS performed. Treatment outcomes: local control=61/67 (91%); radiation necrosis or radiation-induced myelitis=2/51 (3.9%).</p><p><strong>Conclusions: </strong>The RADIANS multidisciplinary community hospital-based CNS clinic model is first of its kind to be reported, continuing strong patient approval at extended follow-up. Data indicates the model serves as a regional referral center, delivering evidence-based treatment modalities for complex CNS disease in community hospital settings, yielding high rates of local control and low rates of grade 3 or 4 radiation-induced toxicity.</p>","PeriodicalId":93288,"journal":{"name":"General medicine and clinical practice","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39243837","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":"Schistosomiasis Associated Glomerulopathy (Glomerulonephristis / Nephrotic Syndrome): A review and Update of the Literature","authors":"A. Venyo","doi":"10.31579/2639-4162/037","DOIUrl":"https://doi.org/10.31579/2639-4162/037","url":null,"abstract":"Schistosomiasis may affect a number of organs within the human body. Schistosomiasis may also be associated with glomerular disease of the kidney in the form of glomerulonephritis and nephrotic syndrome. The association between Schistosomiasis and glomerulopathy may not be well known by a number of practitioners and its pathophysiology may not be very well understood and this could be due to the underdiagnosis of the disease due to the possibility of lack of facilities within the Schistosomiasis endemic areas of the world especially within tropical Africa. Nevertheless, there are a number of patterns of renal involvement in Schistosomiasis which include (a) upper urinary tract sequelae of lower urinary tract Schistosomiasis pathology, (b) immune-related glomerulonephritis, (c) as well as oxidant-stress-mediated renal tubular glomerulonephritis. The renal involvement by Schistosomiasis does tend to be ensued by the development of Schistosomiasis-associated Glomerulopathy (Glomerulonephritis / Nephrotic Syndrome) of varying severity. Individuals affected by Schistosomiasis-associated kidney disease may develop (a) asymptomatic disease which tends to related to self-limited and asymptomatic glomerular disease (b) symptomatic disease which most commonly would tend to present with nephrotic syndrome most often in patients who develop hepato-splenic schistosomiasis with liver fibrosis associated with Schistosoma mansoni infection. Symptomatic patients tend to develop severe hypo-proteinemia, half of the patients tend to have elevated blood pressure. In the absence of nephrotic syndrome, patients who have Schistosomiasis-associated glomerulopathy may manifest with: (a) isolated non-nephrotic syndrome proteinuria (b) acute glomerulonephritis associated with haematuria and heavy proteinuria, (c) Nephrotic syndrome together with systemic manifestations of co-infection with salmonella (class II) or hepatitis C virus (Class I), (d) End stage renal disease (ESRD). Some of the patients who have Schistosomiasis of the kidney may present with Haematuria, Hypertension, Hepato-splenic Schistosomiasis. The diagnosis should be suspected with regard to the following scenarios: (a) clinical suspicion in a patient with kidney disease who is known or has been known to have Schistosoma mansoni; (b) exposure to an endemic area, (c) clinical evidence / demonstration of chronic hepatosplenic schistosomiasis, (d) if the patient has not been diagnosed as having been afflicted with schistosomiasis, then schistosomal infection should be documented, (e) majority of patients with schistosomiasis and kidney disease should have kidney biopsy. (f) The patients should be evaluated for co-infection with salmonella, hepatitis C virus, and hepatitis B virus in order to ensure adequate treatment of the disease. Schistosomiasis is the second most devastating tropical parasitic disease globally which tends to be responsible for many urological complications. Nevertheless, glomerular injury","PeriodicalId":93288,"journal":{"name":"General medicine and clinical practice","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43775531","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":"Red Blood Cell Distribution Width/Hemoglobin Ratio Correlate with Severity of Clinical Status in Residents of Long-term Geriatric and Palliative Care","authors":"Jochanan E. Naschitz, Igor Yalonetzki, G. Leibovitz, Nathalia Zaigraykin","doi":"10.31579/2639-4162/038","DOIUrl":"https://doi.org/10.31579/2639-4162/038","url":null,"abstract":"Background: The red blood cell distribution width (RDW) is a simple measure of red blood cell size heterogeneity. A high degree of anisocytosis, expressed by RDW >15%, is observed in certain anemias, but also in other disorders, where RDW >15% is associated with worse prognosis. We questioned whether the RDW/hemoglobin ratio (RDW/Hb) might closer relate to disease severity than RDW. Design: Cross sectional study Patients: 76 residents of two Department of Comprehensive Nursing Care. Method: Physicians classified the patients according to their clinical status in three groups: \"stable\", “severe-unstable”, and \"intermediate\". An outside observer extracted from the patients' files the results of RDW (elevated if >15%), hemoglobin, iron, and transferrin. The RDW (%)/Hb (g/dL) ratio and tansferrin saturation (TSAT) were computed. The associations between RDW, RDW/Hb, TSAT, and the patients' clinical status were assessed. Results: In residents of Department A, RDW >15% was found in 33% of 19 stable patients, in 58% of 10 patients with intermediate severity, and in 81% of 10 patients classified severe-unstable. The RDW/Hb ratio >1.4 was found in 24% of stable patients, in 73% with intermediate severity, and in 93% of the severe-unstable patients. In Department B, 36 out of 38 patient's were classified stable: in 61.2 % the RDW was >15% and in 38% the RDW/Hb was >1.4. Conclusions: In a heterogenic population presenting multimorbidity, the RDW and to a higher degree the RDW/Hb (p <0.00001), correlated with the patients' disease severity.","PeriodicalId":93288,"journal":{"name":"General medicine and clinical practice","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42425946","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 the Secrets of the Corona Virus: Gender Competition in Antibodies Production to Combat COVID-19","authors":"Hamzulla Khan","doi":"10.31579/2639-4162/036","DOIUrl":"https://doi.org/10.31579/2639-4162/036","url":null,"abstract":"We did a pilot study in the month of July 2020 in Qazi Hussain Ahmed Medical complex Nowshera with aim to determine the gender protective role in term of production of neutralizing Anti SARS-COV-2 antibodies. A total of 39 COVID-19 patients with recovery were selected and their antibodies cut off values were measured by electro-chemiluminescence immunoassay using Roche Cobas E411 Chemistry Analyzer for which commercial kits of Roche diagnostics were used as per the instructions of the manufacturer. It was observed that Difference in mean post infection antibodies level was statistically significant with higher cut off values in patient who had symptoms at time of being reported positive by PCR as compared to patient who were asymptomatic (p-value:0.04). We predicted using Kaplan Meir that female gender the probability of survival as 70% in with cut off values of 100, while a vertical drop up to less than 20% probability of survival was predicted in male gender. Hence female gender produces higher level of antibodies in early infections to confer immunity in COVID-19.","PeriodicalId":93288,"journal":{"name":"General medicine and clinical practice","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47957828","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":"Possible Connection between High-Voltage Power Lines & Cancer","authors":"Paul T E Cusack","doi":"10.31579/2639-4162/031","DOIUrl":"https://doi.org/10.31579/2639-4162/031","url":null,"abstract":"We have heard for years that there may be a connection between high voltage lines and cancer. Since my previous paper on Hydrogen Peroxide as a carcinogen, coupled with my equations of the mind, soul, and consciousness, I purpose a mathematical connection between Power lines and cancer. There should be safe distance to keep the magnetic field produced by the lines and the mind.","PeriodicalId":93288,"journal":{"name":"General medicine and clinical practice","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47276789","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":"Cutaneous presentation of COVID-19 Case Report","authors":"Khadiga Ahmed Ismail, Mahmoud Khalifa Marzouq, Ahmed Mahmoud Khalifa, Osama Mahmoud Khalifa","doi":"10.31579/2639-4162/041","DOIUrl":"https://doi.org/10.31579/2639-4162/041","url":null,"abstract":"COVID-19 has high transmissibility and infectivity among human. On January 30, 2020, the World Health Organization (WHO) in an effort to slow down the global spread of the virus declared the outbreak, “A global public health emergency of international concern\". The skin manifestations of the novel coronavirus COVID-19 were not recognized at the early stages of the pandemic but have received much recent attention in scientific journals. Reported manifestations range from pseudo-chilblains to a morbilliform (measles-like) exanthem, urticaria, vesicular eruptions, a dengue-like petechial rash and ovate scaling macules, and plaques mimicking pityriasis rosea.","PeriodicalId":93288,"journal":{"name":"General medicine and clinical practice","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41911091","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":"Cutaneous presentation of COVID-19 Case Report","authors":"K. Ismail","doi":"10.31579/2639-4162/034","DOIUrl":"https://doi.org/10.31579/2639-4162/034","url":null,"abstract":"COVID-19 has high transmissibility and infectivity among human. On January 30, 2020, the World Health Organization (WHO) in an effort to slow down the global spread of the virus declared the outbreak, “A global public health emergency of international concern\". The skin manifestations of the novel coronavirus COVID-19 were not recognized at the early stages of the pandemic but have received much recent attention in scientific journals. Reported manifestations range from pseudo-chilblains to a morbilliform (measles-like) exanthem, urticaria, vesicular eruptions, a dengue-like petechial rash and ovate scaling macules, and plaques mimicking pityriasis rosea.","PeriodicalId":93288,"journal":{"name":"General medicine and clinical practice","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44661927","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 Behavioral Learning Theory Public Health Promotion and Education Campaign Plan for COVID-19","authors":"Lisa Marie Portugal","doi":"10.31579/2639-4162/028","DOIUrl":"https://doi.org/10.31579/2639-4162/028","url":null,"abstract":"The article includes a COVID-19 public health promotion and education campaign plan to prompt change by applying major behavioral change principles and procedures. Best practices research to motivate, support, and sustain health behavior change includes the application of Behavioral Learning Theory when educating the public regarding COVID-19 health challenges. Topics evaluated include: (1) Behavioral Learning Theory, (2) 6-month timeline for accomplishing three COVID-19 public health communication objectives, and (3) SWOT analysis.","PeriodicalId":93288,"journal":{"name":"General medicine and clinical practice","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47167763","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}