Clinical medicine and diagnostics最新文献

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Radio-wave Therapy of Inferior Turbinates for Treatment of Intractable Vasomotor Rhinitis - a Clinical Study of the Subjective Long-term Outcome 下鼻甲无线电波治疗顽固性血管舒缩性鼻炎的临床研究——主观远期疗效的观察

Clinical medicine and diagnostics

Pub Date : 2012-08-31 DOI: 10.5923/J.CMD.20120201.01

E. Jaatun, C. Laurent

Objective: To evaluate the subjective outcome after treatment with bi-polar radio-wave frequency therapy of the inferior turbinates in patients with vasomotor rhinitis unresponsive to nasal steroid treatment.Material and Methods: Details of 151 patients with vasomotor rhinitis were collected from an electronic patient-record system. The main indica- tion for turbinectomy with radio-wave frequency therapy was nasal congestion. Using a questionnaire with a follow-up time between 9 and 33 months, radio-wave therapy demonstrated good subjective results with respect to nasal congestion and patient relief. No serious side effects were reported.Conclusion: Radio-wave frequency therapy is a low cost procedure suitable for out-patient clinics; the procedure is easy to perform and has a good long term effect on nasal congestion in patients with intractable vasomotor rhinitis.

目的:评价对鼻腔类固醇治疗无反应的血管舒缩性鼻炎患者下鼻甲双极射频治疗的主观疗效。材料与方法:从电子病历系统中收集151例血管舒缩性鼻炎患者的详细资料。无线电波频率治疗鼻甲切除术的主要适应症是鼻塞。通过9至33个月的随访问卷，无线电波治疗在鼻塞和患者缓解方面表现出良好的主观结果。没有严重的副作用报告。结论:射频治疗是一种低成本的治疗方法，适用于门诊;该方法操作简单，对顽固性血管舒缩性鼻炎患者鼻塞有良好的远期疗效。

引用次数: 1

Pituitary Adenoma Complicated by Multifocal Fibrosclerosis Involving Sella and Retroperitoneum 垂体腺瘤并发累及蝶鞍及腹膜后的多灶性纤维硬化

Clinical medicine and diagnostics

Pub Date : 2012-08-31 DOI: 10.5923/J.CMD.20110101.03

J. Hackney, K. Riley, M. Vaphiades, A. Bag, C. Palmer

Multifocal fibrosclerosis (MFS) is a rare syndrome characterized by the co-occurrence of two or more fi- brosing diseases thought to be of similar pathogenesis.Rarely, central nervous system manifestations of pachymeningitis or sellar/suprasellar fibrosis have been described.We report a patient with a pituitary adenoma with extensive fibrosclerotic stroma and idiopathic retroperitoneal fibrosis who initially presented with retroperitoneal fibrosis and obstructive renal failure. One day after transsphenoidal removal of the adenoma, he developed worsening vision, confirmed as hemorrhage into the residual tumor by imaging studies, and required craniotomy.The association of MFS with pituitary adenoma has not been previously reported.Such patients may be at greater risk for hemorrhagic complications due to the consistency of the tumor and its adherence to nearby normal anatomy.

多灶性纤维硬化(MFS)是一种罕见的综合征，其特点是两种或两种以上的纤维化疾病同时发生，被认为是相似的发病机制。很少有中枢神经系统表现为厚膜脑膜炎或鞍上/鞍上纤维化。我们报告一例垂体腺瘤伴广泛纤维硬化间质并特发性腹膜后纤维化的患者，其最初表现为腹膜后纤维化和阻塞性肾功能衰竭。经蝶窦切除腺瘤后1天，患者视力恶化，影像学检查证实为残留肿瘤出血，需要开颅手术。MFS与垂体腺瘤的关系此前未见报道。由于肿瘤的一致性及其与附近正常解剖结构的粘附性，这类患者发生出血性并发症的风险更大。

引用次数: 1

Central Sensitization: Clinical Implications for Chronic Head and Neck Pain 中枢致敏:慢性头颈部疼痛的临床意义

Clinical medicine and diagnostics

Pub Date : 2012-08-31 DOI: 10.5923/J.CMD.20110101.01

Arthur Roberts

Chronic clinical pain associated with CS, is a potentially progressive, devastating, multimodal disease with a significant worldwide economic and social burden. Effective intervention is dependent upon recognizing the fundamental differences in acute and chronic pain, the effects on and by the neuromatrix upon the biopsychosocial health of the in

慢性临床疼痛与慢性脊髓炎相关，是一种潜在的进行性、破坏性、多模式疾病，具有重大的全球经济和社会负担。有效的干预取决于认识到急性和慢性疼痛的根本差异，以及神经基质对患者生物心理社会健康的影响

引用次数: 6

Cardiac Syndrome X Electrocardiographic Patterns Using Signal-Averaged Orthogonal Leads and VCG Indices 使用信号平均正交导联和VCG指数的心脏综合征X心电图模式

Clinical medicine and diagnostics

Pub Date : 2012-08-31 DOI: 10.5923/J.CMD.20120203.03

M. Matveev, V. Krasteva, S. Tsonev, R. Prokopova, M. Milanova

Cardiac syndrome X (CSX) is a clinical condition, characterized by angina, positive stress test and negative coronary angiography. Myocardial ischemia is suggested to influence the ischemic changes in the electrocardiogram (ECG), observed during stress test. The aim of this study, is to obtain CSX patterns of the high-resolution vectorcardiographic (VCG) loops in the horizontal (H), frontal (F) and right sagittal (RS) planes of the Frank corrected orthogonal leads (X,Y, Z), and to assess their similarity with the reference VCG loops of normal subjects. The results suggest that CSX VCG profile in resting state could be considered as a variant of the normal profile; however, it contains some VCG changes seen in the ischemic heart disease.

心脏综合征X (CSX)是一种以心绞痛、应激试验阳性、冠状动脉造影阴性为特征的临床病症。心肌缺血可能影响应激试验中心电图(ECG)的缺血变化。本研究的目的是获得Frank校正正交导联(X,Y, Z)的水平(H)，额(F)和右矢状面(RS)平面的高分辨率矢量心动图(VCG)环路的CSX模式，并评估其与正常受试者参考VCG环路的相似性。结果表明，CSX静息状态下的VCG谱可视为正常VCG谱的变异;然而，它含有一些缺血性心脏病中常见的VCG变化。

引用次数: 0

Antibiotics Overuse in Children with Upper Respiratory Tract Infections in Saudi Arabia: Risk Factors and Potential Interventions 沙特阿拉伯上呼吸道感染儿童抗生素过度使用:危险因素和潜在干预措施

Clinical medicine and diagnostics

Pub Date : 2012-08-31 DOI: 10.5923/J.CMD.20110101.02

Arwa Alumran, C. Hurst, X. Hou, S. Arabia

Background: Antibiotics misuse is currently one of the major public health issues worldwide. This misuse lead to the development of bacterial resistance, increasing the burden of chronic diseases, rising costs of health services, and the development of side effects. Several factors may influence this pattern of overuse. Objectives:This article will re- view the pertinent factors contributing to the overuse of antibiotics worldwide, and to assess the intervention strategies to limit this overuse. Methods: studies about antibiotics use in children were reviewed from several electronic databases, such as MEDLINE and Pubmed. Results: Factors contributing to the overuse of antibiotics could include psychosocial factors, such as behaviors and attitudes (e.g. self-medication, over-the-counter medication, or patients/parents pressure), and demo- graphic factors, such as socio-economic status and education level. Several intervention strategies were reported to be ef- fective in reducing the overuse of antibiotics, such as health education, doctor-patient communication, and policies change. Multifaceted interventions were found to be the most effective in reducing the antibiotics overuse.

背景:抗生素滥用是目前世界范围内主要的公共卫生问题之一。这种滥用导致细菌产生耐药性，增加慢性病负担，增加卫生服务费用，并产生副作用。有几个因素可能影响这种过度使用的模式。目的:本文将回顾导致全球抗生素过度使用的相关因素，并评估限制抗生素过度使用的干预策略。方法:从MEDLINE、Pubmed等电子数据库中检索有关儿童抗生素使用的相关研究。结果:导致抗生素过度使用的因素可能包括社会心理因素，如行为和态度(如自我用药、非处方药或患者/家长压力)和人口统计学因素，如社会经济地位和教育水平。一些干预策略，如健康教育、医患沟通和政策改变，对减少抗生素的过度使用是有效的。多方面的干预措施对减少抗生素的过度使用最为有效。

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引用次数: 61

Value of New Modification of Tuberculosis Score in Diagnosis of Childhood Pulmonary Tuberculosis 结核评分新修订在儿童肺结核诊断中的价值

Clinical medicine and diagnostics

Pub Date : 2012-06-01 DOI: 10.1016/J.IJID.2012.05.955

H. Koura, A. Mohammed

引用次数: 1

Predictors of Poor Prognosis in Patients with Malignant Ascites: A Prospective Study 恶性腹水患者预后不良的预测因素:一项前瞻性研究

Clinical medicine and diagnostics

Pub Date : 2012-04-09 DOI: 10.5923/J.CMD.20120202.01

A. Ayantunde, S. Parsons

Malignant ascites is a manifestation of end stage events in a variety of cancers with significant morbidity and a poor prognosis.This study prospectively evaluated factors predicting poor prognosis in patients with malignant ascites. Clinico-pathologic data of patients with malignant ascites at our institution over a period of 18 months were prospectively analysed. Predictors of poor survival were evaluated and survival compared among different cancer groups. A total of 150 patients (96 females, 54 males) with median age of 63 (19-95) years were studied. The commonest cancer was ovarian. Liver metastases were significantly commoner in the gastrointestinal cancers (P=0.0001). Serial paracentesis was offered to 131, chemotherapy in 89, diuretics in 35, intraperitoneal monoclonal antibody in 6 and 7 patients had drainage at surgery. The median survival after the diagnosis of malignant ascites was 9.2 months. Ovarian cancer and female gender favour longer survival while poor performance status, low serum albumin/serum protein, liver metastases, high serum urea, creatinine and total bilirubin levels adversely affected survival. The independent prognostic factors for survival were poor performance status, cancer type, liver metastases, low serum albumin and high urea levels. The cancer type and performance status significantly influence the choice of treatment option.

恶性腹水是多种癌症终末期事件的表现，发病率高，预后差。本研究对恶性腹水患者预后不良的预测因素进行了前瞻性评价。对我院恶性腹水患者18个月的临床病理资料进行前瞻性分析。对不良生存率的预测因素进行评估，并对不同癌症组的生存率进行比较。共150例患者，其中女性96例，男性54例，中位年龄63(19-95)岁。最常见的癌症是卵巢癌。肝转移在胃肠道肿瘤中更为常见(P=0.0001)。连续穿刺131例，化疗89例，利尿剂35例，腹腔注射单克隆抗体6例，术中引流7例。诊断为恶性腹水后的中位生存期为9.2个月。卵巢癌和女性倾向于较长的生存期，而表现不佳、低血清白蛋白/血清蛋白、肝转移、高血清尿素、肌酐和总胆红素水平对生存不利。生存的独立预后因素是表现不佳、癌症类型、肝转移、低血清白蛋白和高尿素水平。肿瘤类型和表现状态对治疗方案的选择有显著影响。

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引用次数: 10

Comparison of an Immunochromatographic Rapid Strip Test, ELISA and PCR in the Diagnosis of Hepatitis C in HIV Patients in Hospital Settings in Cameroon 免疫层析快速试纸、ELISA和PCR在喀麦隆HIV患者丙型肝炎诊断中的比较

Clinical medicine and diagnostics

Pub Date : 2012-01-09 DOI: 10.5923/J.CMD.20110101.04

T. Kwenti, R. Njouom, L. Njunda, H. Kamga

Cameroon belongs to the group of countries highly endemic for hepatitis C viruses. Coinfection of hepatitis C and HIV are also common due to the shared route of transmission of both viruses. In hospital settings in Cameroon, diagnosis prior to treatment of hepatitis C is based solely on the results obtained with an immunochromatographic rapid strip test (97%). This study was aimed at determining the validity of the results that is obtained when an immunochromatographic rapid strip test is used to diagnose hepatitis C virus infection in HIV-positive patients in comparison with more sensitive and specific methods like ELISA and PCR. In a cross-sectional study in two parts, 700 participants were enrolled, 350 were HIV-positive patients and a control group of 350 individuals not infected with HIV. All participants were screened for anti-HCV antibodies using ACON HCV strip test, an assay commonly used in 57·1% of Cameroon hospitals. While using the rapid strip test, of the 350 HIV-positive patients, 25 (7·1%) were found to be positive with the rapid strip test of whom 3(12%) were positive with an ELISA and all 3(100%) positive with the ELISA were also positive with PCR. Evaluation of the rate of false positives with the rapid strip test using ELISA as the gold standard gave a rate of 6·3%. Meanwhile in the control group, after screening with the rapid strip test, 39 (11·1%) were positive of whom 6 (15·4%) were positive with the ELISA and 3 (50%) of the 6 positive with the ELISA were positive with the PCR. Evaluation of the rate of false positives with the rapid strip test in the control group using ELISA as the gold gave a rate of 9·6%. False positive results with this immunochromatographic rapid strip test for the diagnosis of hepatitis C virus infection is therefore common and therefore reinforce the need for a confirmatory test prior to treatment in hospital settings in Cameroon.

喀麦隆属于丙型肝炎病毒高度流行的国家。由于两种病毒的传播途径相同，丙型肝炎和艾滋病毒的合并感染也很常见。在喀麦隆的医院环境中，丙型肝炎治疗前的诊断完全基于免疫层析快速试纸获得的结果(97%)。本研究旨在确定免疫层析快速试纸试验用于诊断hiv阳性患者丙型肝炎病毒感染的结果与ELISA和PCR等更敏感和特异性的方法相比的有效性。在一项分为两部分的横断面研究中，700名参与者被招募，其中350人是艾滋病毒阳性患者，350人是未感染艾滋病毒的对照组。所有参与者都使用ACON HCV试条进行抗HCV抗体筛查，这是喀麦隆57.1%医院常用的一种检测方法。采用快速试纸法，350例hiv阳性患者中，25例(7.1%)快速试纸法阳性，其中ELISA法阳性3例(12%)，PCR法阳性3例(100%)。以ELISA为金标准的快速试纸法评估假阳性率为6.3%。对照组经快速试纸筛选，阳性39例(11.1%)，ELISA阳性6例(15.4%)，PCR阳性3例(50%)。以ELISA为金法评价对照组快速试纸法的假阳性率为9.6%。因此，这种用于诊断丙型肝炎病毒感染的免疫层析快速试纸的假阳性结果很常见，因此加强了在喀麦隆医院治疗前进行确证试验的必要性。

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引用次数: 11

Clinical Genomic Analysis and Diagnosis --Genomic Analysis Ex Vivo, in Vitro and in Silico. 临床基因组分析和诊断——体内、体外和硅体内的基因组分析。

Clinical medicine and diagnostics

Pub Date : 2012-01-01 DOI: 10.5923/j.cmd.20120204.04

Biaoru Li

Seven years ago, I systemically reviewed single cell techniques with genomic and proteomic analyses which was called Single-Cell Genomic Analysis. After many years of arduous work, single cell techniques with downstream genomic and proteomic analysis have been applied to clinical fields including molecular pathology, molecular genetics, forensic medicine and biomarker discovery. On top of that, dynamic cell-sorting technique combined with downstream cell culture and genomic analysis of stem cell for regeneration medicine and cancer stem cell for differentiation have also been greatly developed in clinical fields. More importantly, tissue level sampling with in silico analysis has been applied in therapeutic targeting for advanced neoplastic disease. Recent development in sorting homogeneous cells in vitro (or single cells technique), ex vivo (dynamic analysis or small number of cell culture with downstream genomic analysis) and insilico (tissue level sampling with in silico analysis) have allowed physician scientists with a choice to select one of these above techniques with genomic analysis to apply to their clinical research fields. To fully understand these modern techniques, this manual will review recently developed methods or clinical genomic analysis in vitro, in silico and ex vivo. In the review paper, I will also introduce how to utilize these techniques in different clinical fields. The manual will also address some of the challenges for clinical genomics analysis and diagnosis due to mixed cells from clinical specimens.

七年前，我系统地回顾了单细胞技术与基因组和蛋白质组学分析，称为单细胞基因组分析。经过多年的艰苦工作，具有下游基因组和蛋白质组分析的单细胞技术已应用于临床领域，包括分子病理学、分子遗传学、法医学和生物标志物发现。除此之外，动态细胞分选技术与下游细胞培养和基因组分析相结合的再生医学干细胞和癌症分化干细胞在临床领域也得到了很大发展。更重要的是，组织水平采样和计算机分析已被应用于晚期肿瘤疾病的治疗靶向。在体外（或单细胞技术）、离体（动态分析或少量细胞培养与下游基因组分析）和原位（组织水平取样与计算机分析）分选同质细胞方面的最新进展，使医生科学家可以选择上述基因组分析技术中的一种应用于其临床研究领域。为了充分理解这些现代技术，本手册将回顾最近开发的体外、计算机和离体临床基因组分析方法。在综述论文中，我还将介绍如何在不同的临床领域使用这些技术。该手册还将解决临床基因组学分析和诊断中由于临床标本中的混合细胞而带来的一些挑战。

{"title":"Clinical Genomic Analysis and Diagnosis --Genomic Analysis Ex Vivo, in Vitro and in Silico.","authors":"Biaoru Li","doi":"10.5923/j.cmd.20120204.04","DOIUrl":"10.5923/j.cmd.20120204.04","url":null,"abstract":"Seven years ago, I systemically reviewed single cell techniques with genomic and proteomic analyses which was called Single-Cell Genomic Analysis. After many years of arduous work, single cell techniques with downstream genomic and proteomic analysis have been applied to clinical fields including molecular pathology, molecular genetics, forensic medicine and biomarker discovery. On top of that, dynamic cell-sorting technique combined with downstream cell culture and genomic analysis of stem cell for regeneration medicine and cancer stem cell for differentiation have also been greatly developed in clinical fields. More importantly, tissue level sampling with in silico analysis has been applied in therapeutic targeting for advanced neoplastic disease. Recent development in sorting homogeneous cells in vitro (or single cells technique), ex vivo (dynamic analysis or small number of cell culture with downstream genomic analysis) and insilico (tissue level sampling with in silico analysis) have allowed physician scientists with a choice to select one of these above techniques with genomic analysis to apply to their clinical research fields. To fully understand these modern techniques, this manual will review recently developed methods or clinical genomic analysis in vitro, in silico and ex vivo. In the review paper, I will also introduce how to utilize these techniques in different clinical fields. The manual will also address some of the challenges for clinical genomics analysis and diagnosis due to mixed cells from clinical specimens.","PeriodicalId":101352,"journal":{"name":"Clinical medicine and diagnostics","volume":"2 4","pages":"37-44"},"PeriodicalIF":0.0,"publicationDate":"2012-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71416493","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}

引用次数: 0

Diagnostic performance of serum bone turnover marker lysylpyridinoline in diabetic foot osteomyelitis: a preliminary study 血清骨转换标志物赖氨酸吡啶在糖尿病足骨髓炎中的诊断性能:初步研究

Clinical medicine and diagnostics

Pub Date : 1900-01-01 DOI: 10.5923/J.CMD.20160603.02

O. G. Hayes, V. Vangaveti, U. Malabu

Objectives: The aim of the study was to determine whether serum levels of lysylpyridinoline (LP) differ between diabetic foot osteomyelitis (DFO) and diabetic foot ulcers without osteomyelitis (cellulitis). Methods: A case controlled study was designed comparing the aforementioned groups. Subjects were classified as osteomyelitis and controls based on the International Working Group diagnostic criteria. Serum LP samples were analysed using enzyme linked immunosorbent assay. Results: The serum LP levels were significantly higher in the DFO group (n: 16) than the control group (n: 11): LP median ± SD of 9.3 ± 3.5 nmol/l, interquartile range (IQR) 6.8-11.2 in DFO compared to 2.1 nmol/l 3.5, IQR 0.7-4.2 in the controls, p=0.001. The receiver operator characteristic curve in the DFO was 0.9. The diagnostic sensitivity, specificity, positive and negative predictive values were 100%, 77.8%, 89.0% and 100% respectively. Conclusions: This appears to be the first evidence of serum LP elevation in diabetic foot osteomyelitis with potential diagnostic value in clinical setting.

目的:本研究的目的是确定糖尿病足骨髓炎(DFO)和无骨髓炎(蜂窝组织炎)的糖尿病足溃疡患者血清赖基吡啶啉(LP)水平是否存在差异。方法:设计病例对照研究，对上述两组进行比较。受试者根据国际工作组诊断标准分为骨髓炎组和对照组。采用酶联免疫吸附法分析血清LP样品。结果:DFO组(n: 16)血清LP水平显著高于对照组(n: 11): LP中位数±SD为9.3±3.5 nmol/l，四分位数间差(IQR)为6.8 ~ 11.2，对照组为2.1 nmol/l 3.5, IQR为0.7 ~ 4.2,p=0.001。DFO的受者操作者特征曲线为0.9。诊断敏感性为100%，特异性为77.8%，阳性预测值为89.0%，阴性预测值为100%。结论:这似乎是糖尿病足骨髓炎患者血清LP升高的第一个证据，具有潜在的临床诊断价值。

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引用次数: 0

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