Clinical investigation最新文献

{"title":"Clostridium difficile infection in obstetrics and gynecology patients","authors":"B. Ștefănescu, G. Constantin","doi":"10.37532/2041-6792.2020.10(1).160","DOIUrl":"https://doi.org/10.37532/2041-6792.2020.10(1).160","url":null,"abstract":"The incidence of nosocomial infections or, in other words, healthcare-associated infections, is bigger in developing countries. World Health Organisation (WHO) estimates that as much as 15% of all hospitalized patients will contract an infection related to medical procedures. Nosocomial pathogens are represented by viruses, bacteria, fungal and parasites. The pathway of contamination is different and these could be represented by environmental sources, healthcare staff or other infected patients. Over the past decades, Clostridium difficile infection became more and more frequent in hospitalized patients. Unfortunately, not all the cases are reported and some of the patients are diagnosed with time after discharge, in other medical services. Gynecologic surgery, as well as obstetric patients already, have numerous risk factors for infection. The addition of Clostridium difficile infection in these patients could be catastrophal. Thus, the reported rising incidence of Clostridium difficile infection in gynecological and obstetric patients should be alarming and unacceptable since the pathogen is transmitted from one infected patient to another through unproperly cleaned medical staff hands. Although the main risk factor for Clostridium difficile infection is the use of broad-spectrum antibiotics, the treatment is also antibiotic. Thus, the overuse of prophylactic antibiotherapy in patients undergoing gynecologic surgery should not be recommended.s.","PeriodicalId":10369,"journal":{"name":"Clinical investigation","volume":"2013 1","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86467682","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":"Rationale for a randomized, placebo-controlled, Phase 2 study of Rejuveinix (RJX) in COVID-19 patients with acute lung injury and hypoxemic respiratory failure","authors":"Kristina Cabala, Jackie Earabino, Peter Pacult, F. Uckun","doi":"10.37532/2041-6792.2020.10(3).168","DOIUrl":"https://doi.org/10.37532/2041-6792.2020.10(3).168","url":null,"abstract":"New drug products that can effectively improve the ability of supportive care to reduce the risk of ARDS or its mortality rate in COVID-19 patients are urgently needed. Rejuveinix (RJX) is a formulation of physiologically compatible active ingredients, including several vitamins, such as ascorbic acid, cyanocobalamin, thiamine hydrochloride, riboflavin 5' phosphate, niacinamide, pyridoxine hydrochloride, calcium d-pantothenate that exhibited promising anti-ARDS activity in animal models of sepsis and ARDS as well as clinical studies in patients with sepsis, septic shock, and ARDS. RJX could favorably affect the patient journey in COVID-19 at multiple stages, including (i) prevention of progression of mild disease, (ii) faster resolution of ARDS, prevention of multi-organ failure, and reduction of case mortality during respiratory failure, and (iii) improved long-term healing after recovery. Here we are reporting the critical design elements for a two-cohort, two-part placebo-controlled, and double-blind Phase II study of RJX in COVID-19 patients.","PeriodicalId":10369,"journal":{"name":"Clinical investigation","volume":"120 1","pages":"62-66"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77890722","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":"Clinical impact potential of Rejuveinix (RJX) for prevention of fatal acute respiratory distress syndrome (ARDS) and multi-organ failure in COVID-19 patients.","authors":"F. Uckun, J. Ervin, K. Şahin, Joy Powell, Natalie M. Pizzimenti, Jackie Earabino, H. V. Wyk, Mariette van Wyk, Peter Pacult, T. K. Şahin, Kristina Cabala","doi":"10.37532/2041-6792.2020.10(2).167","DOIUrl":"https://doi.org/10.37532/2041-6792.2020.10(2).167","url":null,"abstract":"RJX is an Intravenous (IV) formulation of known physiologically compatible compounds that is being developed for more effective supportive therapy of patients with sepsis, including COVID-19 patients with viral sepsis and Acute Respiratory Distress Syndrome (ARDS). The RJX formulation is a solution of buffered acid products, electrolyte components, and vitamins, including ascorbic acid, cyanocobalamin, thiamine hydrochloride, riboflavin 5' phosphate, niacinamide, pyridoxine hydrochloride, and calcium d-pantothenate, and magnesium sulfate heptahydrate, a mineral with a negative oxidation-reduction potential. The components of RJX exhibited promising activity in clinical studies involving ARDS patients and/or non-clinical studies in animal models of ARDS. The published data from these clinical and non-clinical studies provided the medical-scientific rationale for our clinical development strategy for RJX and a clinical study in COVID-19 patients.","PeriodicalId":10369,"journal":{"name":"Clinical investigation","volume":"42 1","pages":"177-184"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82459742","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":"Healthy Behaviours and Depression among Overweight and Obese: A Social Taboo in Pakistan","authors":"A. Hussain, M. Malik, Sadia Shabnum, Ayisha Hashmi","doi":"10.37532/2041-6792.2020.10(3).170","DOIUrl":"https://doi.org/10.37532/2041-6792.2020.10(3).170","url":null,"abstract":"Introduction: Obesity has become a serious global epidemic which poses a major health hazard to the human being. Globally, changing trends such as high intake of fast food, sedentary lifestyle, industrialization, and urbanization are significant key factors that are leading to an increase in the burden of overweight and obesity. The rise in obesity has also been linked been with depression and an increase in stigma and discrimination towards such obese individuals. Objectives: The aim of the present study is to assess health behavior and depression among overweight/obese adults in Pakistan. Methodology: A descriptive cross-sectional study design was used. Two different data collection tools i.e. Health Behavior Questionnaire (HBQ) and Hospital Anxiety and Depression Score (HADS) were used. The questionnaire was self-administered to a sample of 382 overweight/obese adults residing in Islamabad and Rawalpindi Pakistan calculated by using Raosoft and selected by convenience sampling technique. After data collection, data were coded and analyzed statistically by using Mann-Whitney and Kruskal Wallis Test. Results: The results of the study highlighted that the healthy eating factor score and amount ate factor score was significantly high among females with a p-value of 0.029 and 0.008 respectively where the amount of sleep factor score with (p=0.000) was significantly high among males with a p-value of 0.001. The study results showed that emotional eating factor score, amount eaten factor score, convenience food factor score, TV watching factor score, travel to work factor score, and early maturation factor score was significantly high among adults with an age group of 48-57 years. Conclusion: This study concluded that health behavior is linked with gender, marital status, age, physical activity, and educational qualification of adults whereas stress was associated with physical activity and qualification of adults. Females had unhealthy eating habits where males have bad sleep patterns. The stress factor has an inverse relationship with qualification and physical activity. Healthcare professionals should design innovative interventions to improve healthy eating behavior and reduce depression and stigma associated with obesity.","PeriodicalId":10369,"journal":{"name":"Clinical investigation","volume":"60 1","pages":"75-89"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77180527","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 knowledge of oral hygiene and oral hygiene habits during pregnancy and puerperium","authors":"Vesna Liber, R. Fureš, Sanja Malinac Malojčić, Žana Stanić, M. Gredičak, Z. Hrgović, Sanja Jaska, Dora Fureš","doi":"10.37532/2041-6792.2020.10(3).171","DOIUrl":"https://doi.org/10.37532/2041-6792.2020.10(3).171","url":null,"abstract":"OBJECTIVES. We wanted to explore the knowledge and attitudes of pregnant women and women after giving birth to oral health. Likewise, we wanted to determine whether there was any awareness of oral hygiene during pregnancy in the aforementioned population. Our aim was to establish the correlation between oral hygiene habits in relation to age, level of education and place of residence (urban / rural) and to determine the importance of the role of experts in further education of the patient. STUDY DESIGN. A cross-sectional study. PATIENTS AND METHODS. The subjects were patients admitted to the department of maternal and puerpera in the maternity ward of the General Hospital Zabok and Croatian veterans in the period from 1 December 2016 till 15 February 2017. Data for statistical analysis were obtained on the basis of an anonymous questionnaire of 15 questions. RESULTS. Nearly half of pregnant women and women after delivery (49%) believe that oral hygiene does not affect the outcome of pregnancy. In Planned Parenthood pregnancy 70% of women with the lowest levels of education are not going to control dental examinations. Over 90% of highly educated respondents used additional oral hygiene products, while only 20% of women with low levels of education used additional products. The results showed that 71% of women thought they had not received enough oral health information from their doctor. Also, in 60% of respondents, primary data on oral hygiene and health were not received by health professionals but from other sources. CONCLUSION. The obtained data show that almost half of the respondents did not develop the habit of awareness of the need for oral hygiene. The prevalence of monitoring the level of education but are weaker indicators correlate with low skill levels. The emphasis of the modern approach to the prevention of, and given that over half of the surveyed women does not the necessary knowledge of oral health opens space for continuing education and the promotion of information programs by the health system.","PeriodicalId":10369,"journal":{"name":"Clinical investigation","volume":"10 1","pages":"53-61"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87965551","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":"Selectively targeting TGF-β with Trabedersen/OT-101 in treatment of evolving and mild ards inCOVID-19","authors":"F. Uckun, L. Hwang, V. Trieu","doi":"10.37532/2041-6792.2020.10(2).166","DOIUrl":"https://doi.org/10.37532/2041-6792.2020.10(2).166","url":null,"abstract":"Based on the role of TGF- β in the immunopathology of ARDS, we and others have proposed the use of TGF-β inhibitors for the treatment of COVID-19 pneumonia and ARDS. TGF-b targeting is employed as a strategy to stimulate the immune system of advanced-stage cancer patients in an attempt to overcome the immunosuppression and T-cell exhaustion within the tumor microenvironment. Nevertheless, we do not anticipate any worsening of existing ARDS or Cytokine Storm/Cytokine Release Syndrome (CRS) of COVID-19 patients as a treatment-emergentt complication with our contemplated use of the anti-TGF-β RNA therapeutic OT-101. That is because (i) inhibitors of TGF-β signaling are not associated with ARDS, Cytokine Storm/CRS, or systemic capillary leak, (ii) OT-101 did not cause any pulmonary toxicity, non-infectious pneumonitis, CRS, systemic or pulmonary capillary leak or ARDS in any of the 61 patients with advanced solid tumors enrolled in Phase I/II study (ClinicalTrials.gov identifier: NCT00844064) who received much longer periods of OT-101 therapy, and (iii) OT-101 did not cause in human subjects an elevation of TNF-α, IL-6 or IL-10 levels associated with CRS and ARDS in COVID-19 patients - likewise, OT-101 did not induce production of these inflammatory cytokines in cultures of human white blood cells. We postulate that because of the significance of the TGF-β pathway on the development of ARDS and T cell exhaustion, treatment with OT-101 may prevent the progression of evolving or mild ARDS and help facilitate the recovery of lymphocytopenia and T-cell exhaustion in COVID-19 patients.","PeriodicalId":10369,"journal":{"name":"Clinical investigation","volume":"14 1","pages":"35-44"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85606027","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 phase 1 study on midostaurin plus panobinostat in unfit acute myeloid leukemia and high-risk myelodysplastic syndrome","authors":"C. Ng, W. Jen, L. Koh, M. Ooi, E. Chan, M. Mogro, Shi Wang, Jianbiao Zhou, W. Chng","doi":"10.37532/2041-6792.2020.10(2).165","DOIUrl":"https://doi.org/10.37532/2041-6792.2020.10(2).165","url":null,"abstract":"Introduction: Midostaurin is a non-specific FLT3 inhibitor that showed anti-leukemic activity against both FLT3 mutated as well as unmutated Acute Myeloid Leukemia (AML) in early phase studies. Panobinostat, a potent oral pan-acetylase inhibitor had also shown significant anti-leukemic signals in early phase studies. In the preclinical study, our group had previously reported synergistic anti-leukemic activity when an FLT3 inhibitor was used in combination with an HDAC inhibitor in vitro as well as in vivo animal study. The current study is our first bench-to-bedside study to further evaluate this combination therapy in AML patients. Method: Elderly AML who were either newly diagnosed and declined Hypomethylating Agent (HMA) or who failed HMA, MDS-RAEB-2, and relapsed refractory AML who were unfit for intensive chemotherapy or have no other treatment option were eligible regardless of FLT3 mutation status. The classical 3+3 dose escalation method was applied. Dose level 1 for Midostaurin was 50 mg bd and Panobinostat was 10 mg 3 times per week. Dose escalations were planned with only one drug escalation at a time on every level. Midostaurin was administered daily as a continuous cycle while Panobinostat was given for the first 3 weeks of a 4 weeks cycle. Dose-limiting toxicities were defined as grade 3 or more non-haematologic toxicities occurring within the first cycle. Chronic toxicity is defined as recurrent or persistent adverse events that are possibly related to investigational products. Response assessments were done at post cycle 2 and cycle 4. Concomitant treatment with hydroxyurea was allowed up to cycle 1 day 14 to control leukocytosis if needed. Results: A total of 7 patients have been recruited with a median age of 71 years old (range: 47 to 82 years). 2 patients had MDS-RAEB2, one with Acute myelomonocytic leukemia, 3 had AML with myelodysplasia-related changes (AML-MRC) and one with de novo FLT3-ITD AML. One of the AML-MRC had FLT3-ITD mutation and another had FLT3-TKD mutation. 4 out of 7 had prior HMA therapy, the remaining three were treatment naive. 2 patients were not evaluable for DLT and response assessment due to progressive disease during cycle 1. 2 completed 2 cycles, the other 3 completed 4, 5 and 9 cycles respectively. No DLT was observed within cycle 1. Significant grade 1-2 treatment emerging adverse events were anorexia (4/5), fatigue (3/5), nausea (2/5), and dysgeusia (2/5). These toxicities persist beyond cycle 1 with increasing frequency. Grade 2 fatigue was observed in 4 patients, grade 2 anorexia in 4 patients, grade 1 dysgeusia in 4 patients, and grade 3 lipase elevation in one patient. 4 out of 5 patients developed severe grade 4 thrombocytopenia requiring regular platelet transfusion. Two had baseline grade 4 thrombocytopenia but the severity worsen after 1 cycle of treatment. These were thought to be chronic toxicities because the symptoms were largely resolved or improved during dose interruptions. In view ","PeriodicalId":10369,"journal":{"name":"Clinical investigation","volume":"38 1","pages":"28-34"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73223212","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 retrospective study of Spondylodiscitis with clinical, imaging and therapeutic correlations","authors":"B. Brogna, Aless, R. Coppola, E. Bignardi","doi":"10.37532/2041-6792.2020.10(1).162","DOIUrl":"https://doi.org/10.37532/2041-6792.2020.10(1).162","url":null,"abstract":"Introduction: Diagnosing Spondylodiscitis (SD) can be challenging in clinical practice with highly variable outcomes. The aim of this study is to retrospectively analyze the clinical, laboratory, imaging findings of patients with SD treated at our hospital between January 2017 and December 2018. We also evaluated the SD evolution during a short follow-up at 4 and 6 weeks. Methods: The epidemiological, clinical, microbiological, laboratory findings (White Blood Count (WBC), C-Reactive Protein (CRP) and Erythrocyte Sedimentation rate (ESR)), Imaging (CT/MRI) and treatment data of 38 patients with SD were studied retrospectively. The laboratory findings (CRP, ESR) and the CT/MRI examinations during the follow-ups at 4 and 6 weeks were evaluated. Based on imaging (CT/MRI) we divided SD into the following 5 types based on morphological features observed: spondylitis or discitis (ST/DS), SD, SD with paravertebral abscesses (SD-PA), SD with epidural abscess (SD-EP) and SD with paravertebral and epidural abscesses (SD-PEA). Results: The most common complaint was pain (95%) and the main comorbidity was septicemia (42%). Staphylococcus aureus was found in 45% of the cases. The WBC was elevated in 32% of the patients. Both the CRP and ESR decreased during the follow-up. SD was found in 31% of the cases, SD-PA in 26% of the cases, ST/DS in 19% of the cases, SD-PEA in 13% of the cases and SD-EP in 11% of the cases. At the follow-up at week 4, SD-PA, SD-EP and SD-PEA had decreased and were found respectively in 21%, 5% and 5% of the cases. In the follow-up at week 6, SD-PA, SD-EP and SD-PEA were found respectively in 10%, 8% and 3% of the patients. Conservative treatment with antibiotic therapy was applied in 63% of the cases. Surgical treatment was given to 21% of the patients and an interventional procedure was done on 16% of the patients. Conclusion: SD diagnosis and management continues to be based on a multidisciplinary approach. Re-imaging in the critical period of 4-6 weeks with the monitoring of systemic inflammatory markers can be a good follow-up strategy.","PeriodicalId":10369,"journal":{"name":"Clinical investigation","volume":"20 1","pages":"6-14"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82566912","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":"Antibiotic induced changes to mitochondria result in potential contributions to carcinogenesis.","authors":"Jorma Jyrkkanen","doi":"10.37532/2041-6792.2020.10(1).163","DOIUrl":"https://doi.org/10.37532/2041-6792.2020.10(1).163","url":null,"abstract":"Mitochondrial job and creation of toxic mix by antibiotic Mitochondria, a primitive endosymbiotic bacteria, related to extant SARII marine bacteria and Rickettsias, in eukaryotes is responsible for Oxidative Phosphorylation (OP) and ATP and NAD production, when exposed to clinically equivalent doses of antibiotics that target bacteria (cipromycin, ampicillin, kanamycin), exhibited a decline in glutathione titre, an increase in Reactive Oxygen (ROS) and an increase in lipid peroxide [1,2]. Modes of action of antibiotics on mitochondria and microbiome 1. Quinolones: Commonly prescribed antibacterial organofluorine compounds that act by inhibition of bacterial DNA synthesis and result in rapid cell death [3]. They could be expected to do collateral damage to mitochondria and the human microbiome. This group contains Ofloxacin, Norfloxacin (Noroxin), Ciprofloxacin (Cipro), Moxifloxacin (Avelox)","PeriodicalId":10369,"journal":{"name":"Clinical investigation","volume":"19 1","pages":"15-17"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76242452","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":"Characteristics of diabetic ketoacidosis in adult patients in Bahrain","authors":"H. Radhi, Maryam Abdalla El-Amin, A. Sarwani, M. FatemaHusain, Eel","doi":"10.37532/2041-6792.2020.10(1).164","DOIUrl":"https://doi.org/10.37532/2041-6792.2020.10(1).164","url":null,"abstract":"Introduction: DKA has long been considered and studied as a complication of type 1 diabetes in children, only a few studies showed the magnitude of the DKA among adults and type 2 DM. Objective: To evaluate the burden of adult admissions with DKA in Salmaniya Medical Complex-Bahrain, and try to identify the different trends. Methods: Retrospective study; data collected from medical records of adult patients, age 14 and above, who were admitted to Salmaniya medical complex with DKA in the period between January 2017 to December 2018 and fulfilled our inclusion criteria. The data included basic demographic information, and progress during admission. Results: We included 224 DKA admissions, the median age was 31.2 years, the rate of readmission was high as 33 patients were responsible for 102 admissions, mostly type 1 (93.5%) (p-value=0.011). In the analysis, we divided them into subgroups of new diagnoses 32 (14.3%), type 1 DM 147 (65.6%), type 2 DM 45 (20.1). Type 2 DM had higher comorbidities 25 (55.6%) (p-value<0.006), and higher antibiotic use 30 (66.7%) (p-value=<0.0001). Type 2 DM with DKA had 9.5 times higher risk for mortality compared to Type 1 DM with DKA, interestingly type 1 DM group had significantly lower hospital length of stay than the rest groups (2.7 vs 5.3 and 5.0) days. The total mortality was 5 (2.2%) Conclusion: DKA admissions are associated with significant morbidity, effort must be targeted at reducing the number of admissions, and mortality, possibly by enforcing health education, offering psychosocial support, creating policies to ensure continuous insulin supply and involving the primary care centers in the management of hyperglycemia and early DKA.","PeriodicalId":10369,"journal":{"name":"Clinical investigation","volume":"20 1","pages":"18-27"},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81147311","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}