Clinical investigation最新文献

{"title":"Acupuncture with Planning Treatment According to Diagnosis: A Trial Study of Protocol and its Effects for Stiff Shoulder","authors":"Wen-ping Zhang, A. Takeda, Kaito Mizuno, M. Kanehara, K. Takagi, Ryohei Ishiyama, S. Urata, K. Nishimura","doi":"10.4172/Clinical-Investigation.1000124","DOIUrl":"https://doi.org/10.4172/Clinical-Investigation.1000124","url":null,"abstract":"Background: In order to standardize an effective acupuncture therapy for chronic dull pain and stiffness of neck and shoulder, we made a protocol characterized with planning treatment according to diagnosis and examined its availability. Methods and findings: Thirty-two patients were categorized into three groups based on the pathophysiology of Traditional Chinese Medicine: Blood stasis due to Qi stagnancy (Group-1), Deficiency of Liver-blood (Group-2), Yin deficiency of Liver and Kidney (Group-3) according to their subjective symptoms and signs. Acupuncture treatment was performed once a week over a two week period in accordance with the protocol that was arranged to each group. The averaged VAS values after the 3rd therapy in the whole groups decreased significantly (p<0.01) as compared with that of the initial visit before therapy. Investigating each group, the averaged VAS value after the 3rd therapy in Group 1 was significantly (p<0.05) lower than that of the initial visit at baseline. In other groups, although the VAS scores showed a gradual decrease according to the treatment, there was unfortunately no significance in the changes of the VAS. There were no side effects in all the treatment of this study. Conclusions: These results indicate that the present study protocol would be effective in relieving the patient’s subjective symptoms, and it would alternatively provide an effective and safe medical treatment for stiff neck and shoulder, although it should be modified for Groups 2 and 3.","PeriodicalId":10369,"journal":{"name":"Clinical investigation","volume":"50 1","pages":"13-17"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81849406","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":"Comparison of neuromuscular fatigue in chronic stroke patients with healthy controls","authors":"Shweta Kotwani, Sharmishtha Gadgil, Parag Ranade","doi":"10.4172/CLINICAL-INVESTIGATION.1000140","DOIUrl":"https://doi.org/10.4172/CLINICAL-INVESTIGATION.1000140","url":null,"abstract":"Background and Introduction: Fatigue has been defined as a feeling of early exhaustion, weariness, lack of energy and aversion to effort. Glader et al suggest that survivors of stroke with fatigue have a higher fatality rate three years after stroke due to its association with sedentary lifestyle. Neuromuscular fatigue is defined as an activity induced impairment in the ability to exert force, and is quantified by the reduction in force that a muscle or muscles can exert following or during an activity. Fatigue of the paretic leg muscles is likely to greatly impact walking function post-stroke. Therefore, quantitative measures of neuromuscular fatigue of the paretic leg muscles are expected to be associated with walking function in people post-stroke. There is scant research, which specifically investigates neuromuscular fatigue following stroke. The purpose of the study was to assess and compare the contribution of neuromuscular fatigue in patients following stroke with age and gender matched healthy participants. Methodology: Subjects (N=80) were divided into experimental group (N=40) and control group (N=40) by purposive sampling. Patients who were already been diagnosed with chronic stroke (>6months) by Registered Medical Practitioner (RMP) were included in the study. The muscle activity of the quadriceps and hamstrings on the subject’s paretic as well as non-paretic side were recorded using Dual Bio Amp/Stimulator. Pre- fatigue inducing exercise (Electromyography) EMG signals (integral mean values in mVs) were recorded by performing Maximal Voluntary Contraction (MVC) of both the muscles. Post-fatigue inducing exercise EMG signals (integral mean values in mVs) by performing Sit-To-Stand test (STS). Visual Analog Fatigue Scale (VAFS) was used to assess the subjective levels of fatigue pre and post exercise while Fatigue Severity Scale (FSS) was used to assess chronic fatigue. Results: In paretic, non-paretic and control study group, the mean pre-fatigue EMG activity of hamstrings is significantly higher compared to mean post-fatigue EMG activity of hamstrings (P-value<0.001). In paretic, non-paretic and control study group, the mean pre-fatigue EMG activity of quadriceps is significantly higher compared to mean post-fatigue EMG activity of quadriceps (P-value<0.001). Conclusion: It was concluded that there is a difference seen in the peripheral neuromuscular fatigue in the chronic stroke individuals when compared with age and gender matched control group.","PeriodicalId":10369,"journal":{"name":"Clinical investigation","volume":"1 1","pages":"139-145"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88675993","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 challenging case of candida parapsilosis keratitis","authors":"Ping Guo, Jiaming Wang, Hong-Ju Xie, Bao-tao Lin, Ming Li, Zhong-hui Zou, Y. Zhang, Ying Zhu, A. Kheirkhah","doi":"10.4172/CLINICAL-INVESTIGATION.1000136","DOIUrl":"https://doi.org/10.4172/CLINICAL-INVESTIGATION.1000136","url":null,"abstract":"Purpose: To report challenges in the management of a patient with keratitis caused by Candida parapsilosis. Methods: An otherwise healthy 48-year-old man developed chronic corneal ulcer following ocular trauma. Microbiologic work up using smear, culture and In Vivo Confocal Microscopy, was negative. Lamellar and penetrating keratoplasty were performed to cure the infection. Results: The patient developed recurrence of the infection after lamellar keratoplasty. The interface recurrence was seen twice despite washing with antibiotics. Microbial culture finally revealed infection of C. parapsilosis which was sensitive to fluconazole and amphotericin B. Moreover, a repeat lamellar keratoplasty was followed by another recurrence. A penetrating keratoplasty was finally performed with no recurrence of infection during 10 months of follow-up. Conclusions: Diagnosis of the corneal infection by C. parapsilosis can be challenging due to recurrence of the infection after lamellar keratoplasty. A penetrating keratoplasty may be required for cure of yeast infection after repeated recurrence of the infection. In addition, yeast infection should be considered in patients with chronic keratitis.","PeriodicalId":10369,"journal":{"name":"Clinical investigation","volume":"41 1","pages":"109-112"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88016889","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":"Utilization of informatics for integrating biology and the bedside to access preliminary outcome data of post-operative complication of spine surgery associated with diabetes mellitus","authors":"Tomoko Tanaka, A. Mosa, N. Litofsky","doi":"10.4172/CLINICAL-INVESTIGATION.1000114","DOIUrl":"https://doi.org/10.4172/CLINICAL-INVESTIGATION.1000114","url":null,"abstract":"Study Design: Retrospective Study Objective: To evaluate the utility of Informatics for Integrating Biology and the Bedside database (i2b2) of University of Missouri in comparing post-operative outcomes after spinal surgery of patients with Diabetes Mellitus (DM) to those without. Summary of background data: Studies in cardiovascular surgery, orthopedic surgery, and spine surgery have shown an association of poor preoperative hyperglycemia control with worse outcomes. However, the details of that association are not well described. Outcomes of spine surgery gleaned from nationwide databases are not universally available; some require significant costs, while others are not always available to all investigators. Informatics for Integrating Biology and the Bedside (i2b2) is a National Institutes of Health -sponsored National Center for Biomedical Computing developed for researchers to search electronic medical records for de-identified patient data to facilitate research investigations. Methods: The Informatics for Integrating Biology and the Bedside (i2b2) database of University of Missouri was queried for various spine surgeries using categories of Non-DM patients, DM patients, and complications. Results: Between Jan. 1, 2000 and Sept. 30, 2015 a total of 26009 spine surgeries were performed at University of Missouri Health Care. Diabetes Mellitus (DM) was not present in 20834, with 5175 had DM. DM patients had a twofold higher incidence of wound infection, Deep Venous Thrombosis, and Urinary Tract Infection. Pulmonary Embolism and myocardial infarction were 3 times more common in DM. Stroke rate was 3.9 more likely in DM. Overall, comorbidities were 2.4 fold higher in DM. The estimated time to acquire the above data was 8 hours. Conclusions: Informatics for Integrating Biology and the Bedside is an excellent tool to extract preliminary data to develop hypothesis, test hypothesis, and gather preliminary report in a reasonable period of time. De-identified data allows researchers to perform acquire data without IRB approval.","PeriodicalId":10369,"journal":{"name":"Clinical investigation","volume":"13 1","pages":"67-73"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83696869","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":"Constraining Effect of Mild Portal Hypertension against the Negative Influence of Muscle Mass Loss in Cirrhosis after Esophageal Variceal Eradication","authors":"Kazufumi Kobayashi, H. Maruyama, Soichiro Kiyono, S. Ogasawara, E. Suzuki, Y. Ooka, T. Chiba, N. Kato, Tadashi Yamaguchi","doi":"10.4172/CLINICAL-INVESTIGATION.1000121","DOIUrl":"https://doi.org/10.4172/CLINICAL-INVESTIGATION.1000121","url":null,"abstract":"Background: To elucidate the role of muscle mass loss (MML) in the long-term outcome of cirrhosis after the endoscopic eradication of esophageal varices (EV). Methods and findings: This is a subgroup analysis of 82 prospectively enrolled cirrhosis patients with eradicated EV. A severe portal hypertension (PH) was defined by post-treatment hepatic venous pressure gradient ≥12 mmHg. MML was assessed by skeletal muscle index at the L3 lesion (cm2/m2) with the cut-off values of 38 for women and 42 for men (median observation period, 37.4 months). Twenty-four patients (29.3%) had MML. Multivariate analysis showed that a presence of hepatocellular carcinoma (P<0.0001) and a presence of MML (P=0.002) were significant prognostic factors. In the cohort with severe PH, the survival rate was significantly lower in patients with MML than in those without. However, in the cohort without severe PH, the survival rate showed no difference between patients with MML (100% at 1year, 50% at 3 years and 5 years) and those without (92.3% at 1 year and 3 years, 71.8% at 5 years; P=0.278). Conclusions: MML is an independent prognostic factor after the eradication of EV in cirrhosis, and the mild PH exerts a constraining effect against the negative influence of MML.","PeriodicalId":10369,"journal":{"name":"Clinical investigation","volume":"25 1","pages":"127-134"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89920397","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":"Post-antibiotic era is a worldwide challenge for health care: what to do ?","authors":"Asad U. Khan","doi":"10.4172/Clinical-Investigation.1000109","DOIUrl":"https://doi.org/10.4172/Clinical-Investigation.1000109","url":null,"abstract":"Medical Microbiology and Molecular Biology Laboratory, Interdisciplinary Biotechnology Unit, A.M.U, Aligarh 202002 India *Author for correspondence: asad.k@rediffmail.com Submitted Date: 12-May-2017 Accepted Date: 16-May-2017 Published Date: 19-May-2017 Letter to Editor In this 21st century, antibiotics are almost worn out due to global antibiotic resistance scenario. It has become a worldwide concern to cope with the existing situation, where, even last resorts of antibiotics are not effective against common infections. After the discovery of New-Delhi Metallo β-lactamase-1 (NDM-1) and its variants, evolving mutants, it is becoming difficult to use any β-lactam antibiotics, even carbapenems. Moreover, the use of colistin/polymyxin was one of the optimism to control such infections but MCR-1 discovery has turned down that prospect. Antibiotic resistance has now been recognized as serious global menace of 21st century to the mankind. Therefore, WHO has declared it as the priority research area and a “Global Action plan on antibiotic resistance” has already been launched to prevent this disaster taking to pre-antibiotic era.","PeriodicalId":10369,"journal":{"name":"Clinical investigation","volume":"7 1","pages":"41"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73678884","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 Practice and Safety of Injecting Insulin through Clothes among Patients with Diabetes in Bahrain","authors":"T. Husain, M. Majeda, Y. EbtihalAl, S. BasmaAl","doi":"10.4172/Clinical-Investigation.1000104","DOIUrl":"https://doi.org/10.4172/Clinical-Investigation.1000104","url":null,"abstract":"Background: The prevalence of diabetes mellitus has risen dramatically in the last two decades worldwide and it’s estimated to rise to 642 million in 2040.The prevalence rate of people with diabetic Mellitus in Kingdom of Bahrain is around 14.8% and that of type one diabetes is (3.4%) in 2007. Thousands of people are injecting insulin once or more than two times per day. Injecting insulin technique is vital to preserve correct dose, safety practice of administering insulin. Many people with diabetes have been observed to inject their insulin through clothes for long time and many of the antiseptic techniques which are recommended by the health care professionals are challenged to be unnecessary. Aim: To improve the practice of injecting insulin among diabetes mellitus patients. Objective: To identify possible factors associated with the practice of injecting insulin through clothes amongst patients with diabetes and its safety. Methods: A Cross sectional study. Sample size and sampling technique: The data were collected from 100 diabetic patients who were on insulin therapy in Bahrain. Self-administered questionnaire was formulated for data collection. It contained: demographic data, the practice of injecting insulin through clothes, the possible factors associated with injecting insulin through cloths, and its related complications. Results: Seventy-four (74%) of the subjects were females. Thirty (30%) participants are 20 years old or below. Thirty (30%) participants are injecting insulin through clothes. It was complicated by erythema in (9%), minor bleeding (3%), cellulitis (2%) and Pus (1%). Eight subjects (8%) needed medical treatment and one subject (1%) required surgical intervention for the complication. (17%) of the subjects were using this technique during emergency situations, (12%) of the subjects used it due to embarrassment. Experiencing high blood sugar after injecting through clothes was experienced in (7%) of the subjects. Conclusion: Injecting insulin through clothes is not unusual practice among patients with diabetes which is associated with complications.","PeriodicalId":10369,"journal":{"name":"Clinical investigation","volume":"98 1","pages":"7-10"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83604117","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":"Lidocaine is a Novel Antispasmodic Agent during Colonoscopy","authors":"K. Togashi, Daiki Nemoto, T. Koshimizu, A. Lefor","doi":"10.4172/CLINICAL-INVESTIGATION.1000113","DOIUrl":"https://doi.org/10.4172/CLINICAL-INVESTIGATION.1000113","url":null,"abstract":"","PeriodicalId":10369,"journal":{"name":"Clinical investigation","volume":"593 1","pages":"65-66"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77228973","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 management of contralateral axillary sentinel lymph nodes detected by lymphoscintigraphy in a patient of breast cancer that had never undergone breast related medical treatment","authors":"H. Ono, M. Tanabe, K. Kimura, Y. Miyagi, R. Horii, F. Akiyama, T. Iwase, S. Ohno","doi":"10.4172/CLINICAL-INVESTIGATION.1000106","DOIUrl":"https://doi.org/10.4172/CLINICAL-INVESTIGATION.1000106","url":null,"abstract":"In breast cancer, lymphoscintigraphy-based sentinel lymph node biopsy examinations usually show lymphatic drainage to the ipsilateral axilla, and sometimes to the extra-axillary regions. Drainage to the contralateral axilla is rarely observed in patients that have never undergone any medical treatment involving their breasts. We experienced a case of breast cancer in which bilateral sentinel lymph nodes were detected by lymphoscintigraphy in a patient that had never undergone any medical treatment involving her breasts. Here, we report a rare case and review the clinical and pathological features of several reported cases. In addition, we discuss the necessity of subjecting contralateral sentinel lymph nodes to a biopsy examination.","PeriodicalId":10369,"journal":{"name":"Clinical investigation","volume":"38 1","pages":"17-24"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85557949","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":"Effectiveness, safety and costs of labor induction with intravaginal misoprostol versus dinoprostone vaginal insert","authors":"Maria Asuncion Quijada Cazorla, A. Marques, J. Sanmartin, E. Amorós, J. C. M. Escoriza","doi":"10.4172/CLINICAL-INVESTIGATION.1000108","DOIUrl":"https://doi.org/10.4172/CLINICAL-INVESTIGATION.1000108","url":null,"abstract":"Background: Over the last decade, a lot of clinical reviews have been published, but they are heterogeneous and present disparity of outcomes. The best choice for inducing labor is not clear today. The objective of the study is to compare misoprostol with dinoprostone for labor induction including obstetrical and neonatal outcomes, side effects and costs. Methods and findings: From September 2012 to December 2013 a retrospective observational study was performed, including all pregnant women with medical indication of induction of labor. Three-hundred ten patients were included: 180 received 25μg of vaginal misoprostol and 130 received 10mg of vaginal dinoprostone. The study groups were similar with regard to age, parity, initial Bishop score and birth weight. Misoprostol group had higher percentage of entering active phase of labor within 24 hours (61.1% versus 45.4%; ORa=2.0 [1.3-3.3]). The cesarean section rate was lower with misoprostol (17.2% versus 24.6%; ORa=0.6 [0.3-1.1]). The Bishop score obtained with misoprostol was more favorable after ripening. The use of epidural analgesia was statistically higher in misoprostol group (81.7% versus 68.5%; ORa=2.4 [1.4-4.2]). The difference in time from the start of induction to delivery and adverse neonatal outcomes were similar in both groups. The hospital stay and the costs of hospital stay were significantly lower with misoprostol (€2690 versus €3152; pa=0.006). Conclusions: Misoprostol at doses of 25μg is more effective and more cost effective than vaginal dinoprostone, with the same safety in labor induction in women with unfavorable cervix.","PeriodicalId":10369,"journal":{"name":"Clinical investigation","volume":"112 1","pages":"33-39"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87939905","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}