{"title":"Charecteristics of Pressure Sore of Spinal Cord Injury Patients Attentded at Crp","authors":"Mahbub Hossain","doi":"10.52845/cmi/2022-3-2-5","DOIUrl":"https://doi.org/10.52845/cmi/2022-3-2-5","url":null,"abstract":"","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":"35 1","pages":""},"PeriodicalIF":3.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78528454","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":"Prevalence and Determinants of Retinopathy among Patients with Diabetes Mellitus: Thiqar 2022","authors":"Wajida Saa'd Bunyan","doi":"10.52845/cmi/2022-3-2-4","DOIUrl":"https://doi.org/10.52845/cmi/2022-3-2-4","url":null,"abstract":"","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":"5 1","pages":""},"PeriodicalIF":3.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72759157","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 Outcome Of Corona Virus Disease-19 Patients In An Infectious Disease Center, Olodo, Ibadan, Oyo State, Nigeria","authors":"O. Alonge","doi":"10.52845/cmi/2022-3-2-2","DOIUrl":"https://doi.org/10.52845/cmi/2022-3-2-2","url":null,"abstract":"","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":"71 1","pages":""},"PeriodicalIF":3.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74474142","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}
J. Lakey, Adam P Good, A. Wells, Ben Katz, Michael Alexander, D. Klokol, Mike K. S. Chan, M. Wong, D. Cox
{"title":"Maldi-Tof Analysis of Mitochondrial Peptides","authors":"J. Lakey, Adam P Good, A. Wells, Ben Katz, Michael Alexander, D. Klokol, Mike K. S. Chan, M. Wong, D. Cox","doi":"10.52845/cmi/2022-3-2-3","DOIUrl":"https://doi.org/10.52845/cmi/2022-3-2-3","url":null,"abstract":"","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":"43 1","pages":""},"PeriodicalIF":3.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85590684","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":"Is Spike Protein-Related Myocarditis Becoming a Common Disease?","authors":"Doepp, Manfred Md","doi":"10.52845/cmi/2022-3-1-5","DOIUrl":"https://doi.org/10.52845/cmi/2022-3-1-5","url":null,"abstract":"","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":"33 1","pages":""},"PeriodicalIF":3.0,"publicationDate":"2022-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74494332","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":"Primary malignant largeB-cell non-Hodgkin’s lymphoma of the scalpand cranial vault: a case report and an overview","authors":"Mehdi Borni","doi":"10.52845/cmi/2022-3-1-1","DOIUrl":"https://doi.org/10.52845/cmi/2022-3-1-1","url":null,"abstract":"","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":"14 1","pages":""},"PeriodicalIF":3.0,"publicationDate":"2022-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78687028","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}
Background: Malnutrition, which is a powerful predictor of morbidity and mortality, is common in patients undergoing hemodialysis. There-fore, adequate nutrition is very important for such patients. Nutritional management in hemodialysis patients is a very important factor for prognosis , a better overall outcome and quality of life. Objectives: The current study mainly aimed to determine the nutritional status and prevalence of malnutrition and to investigate the relationship between nutritional markers, anthropometric parameters such as body mass index (BMI), and routine laboratory parameters with SGA in patients undergoing hemodialysis. Patients and Methods: A cross-sectional study was carried out on HD patients in Hawari Nephro Center and Nephro Unit of Beng-hazi Medical Center from December 2019 to January 2020. A total of 155 HD patients were recruited for this study and assessed for nutritional status include both Male and females aged 18 years and over with regular hemodialysis. Outcome measures: Measurements included questionnaire that elicited information on social demographic characteristics, Patient’s medical history , and duration of hemodialysis. Anthropometry, biochemical parameters were measured. Seven-Point Subjective Global Assessment (7-point SGA) was used to assess the nutritional state of HD patients. Biochemical tests were obtained during the study period from medical files of the studied patients. Data were analyzed using descriptive statistics. The Chi-Square test was applied to examine the study data. Results: Data shows that 58% of HDP were well-nourished while the remaining 39%, 3%had mild-to-severe malnutrition. Regarding the prevalence of malnutrition in both gender, males group was mor preva-lent of malnourished than female group. SGA score results indicated some significant correlations with patient’s post dialysis BMI and albumin ,however, there was a negative correlation between demographic characteristics as gender, income, education level, comorbid disease , clinical variable such as duration and frequency of HD and some biochemical tests as electrolytes, phosphorous ,hemoglobin, cholesterol with SGA scores. In addition, results show that insignificant correlation between nutrients intake, meals pattern of HD patients with SGA. Conclusions: Observations of nutritional status are necessary to maintain the health status of dialysis patients. Every strategy should be used to avoid complications of hemodialysis manifested in uremic state including anorexia, nausea, vomiting leading to malnutrition, fluid and electrolyte imbalance leading to volume overload, hyperkalemia, metabolic acidosis, and hyperphosphatemia, as well as abnormalities related to hormonal or systemic dysfunction such as hypertension, anemia, hyperlipidemia, and bone disease, Timely diagnosis of protein-energy-wasting (PEW) is important for early initiation of nutritional intervention and treatment. In addition, education plans should be prepared t
{"title":"Study of the nutritionalstatus of end-stage renal disease patients onmaintenance hemodialysis in Hawary Kidney center and nephrology unit atBenghazi Medical Center","authors":"Safia S. Elramli","doi":"10.52845/cmi/2022-3-1-4","DOIUrl":"https://doi.org/10.52845/cmi/2022-3-1-4","url":null,"abstract":"Background: Malnutrition, which is a powerful predictor of morbidity and mortality, is common in patients undergoing hemodialysis. There-fore, adequate nutrition is very important for such patients. Nutritional management in hemodialysis patients is a very important factor for prognosis , a better overall outcome and quality of life. Objectives: The current study mainly aimed to determine the nutritional status and prevalence of malnutrition and to investigate the relationship between nutritional markers, anthropometric parameters such as body mass index (BMI), and routine laboratory parameters with SGA in patients undergoing hemodialysis. Patients and Methods: A cross-sectional study was carried out on HD patients in Hawari Nephro Center and Nephro Unit of Beng-hazi Medical Center from December 2019 to January 2020. A total of 155 HD patients were recruited for this study and assessed for nutritional status include both Male and females aged 18 years and over with regular hemodialysis. Outcome measures: Measurements included questionnaire that elicited information on social demographic characteristics, Patient’s medical history , and duration of hemodialysis. Anthropometry, biochemical parameters were measured. Seven-Point Subjective Global Assessment (7-point SGA) was used to assess the nutritional state of HD patients. Biochemical tests were obtained during the study period from medical files of the studied patients. Data were analyzed using descriptive statistics. The Chi-Square test was applied to examine the study data. Results: Data shows that 58% of HDP were well-nourished while the remaining 39%, 3%had mild-to-severe malnutrition. Regarding the prevalence of malnutrition in both gender, males group was mor preva-lent of malnourished than female group. SGA score results indicated some significant correlations with patient’s post dialysis BMI and albumin ,however, there was a negative correlation between demographic characteristics as gender, income, education level, comorbid disease , clinical variable such as duration and frequency of HD and some biochemical tests as electrolytes, phosphorous ,hemoglobin, cholesterol with SGA scores. In addition, results show that insignificant correlation between nutrients intake, meals pattern of HD patients with SGA. Conclusions: Observations of nutritional status are necessary to maintain the health status of dialysis patients. Every strategy should be used to avoid complications of hemodialysis manifested in uremic state including anorexia, nausea, vomiting leading to malnutrition, fluid and electrolyte imbalance leading to volume overload, hyperkalemia, metabolic acidosis, and hyperphosphatemia, as well as abnormalities related to hormonal or systemic dysfunction such as hypertension, anemia, hyperlipidemia, and bone disease, Timely diagnosis of protein-energy-wasting (PEW) is important for early initiation of nutritional intervention and treatment. In addition, education plans should be prepared t","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":"94 1","pages":""},"PeriodicalIF":3.0,"publicationDate":"2022-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90436484","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}
Pub Date : 2022-01-01DOI: 10.1177/11795468221144352
Samiullah Arshad, Rachel D Cutting, Daniel J Stephens, Ythan H Goldberg, Claudius Mahr, Mahender Vyasabattu, Ahmed H Abdelfattah, Gaurang N Vaidya
Left ventricular assist devices (LVADs) have revolutionized the management of patients with advanced heart failure refractory to medical therapy. Current indications of LVADs include Bridge to Transplantation (BTT), Destination Therapy (DT) for long-term use, Bridge to the Decision (BTD) used as a temporary measure, and lastly Bridge to Recovery (BTR). Here, we briefly review the clinical evidence and the molecular mechanisms behind myocardial recovery following LVAD placement. We also share institutional protocols used at 2 major medical centers in the USA.
{"title":"A Peek at LVADs Pumping to Recovery.","authors":"Samiullah Arshad, Rachel D Cutting, Daniel J Stephens, Ythan H Goldberg, Claudius Mahr, Mahender Vyasabattu, Ahmed H Abdelfattah, Gaurang N Vaidya","doi":"10.1177/11795468221144352","DOIUrl":"https://doi.org/10.1177/11795468221144352","url":null,"abstract":"<p><p>Left ventricular assist devices (LVADs) have revolutionized the management of patients with advanced heart failure refractory to medical therapy. Current indications of LVADs include Bridge to Transplantation (BTT), Destination Therapy (DT) for long-term use, Bridge to the Decision (BTD) used as a temporary measure, and lastly Bridge to Recovery (BTR). Here, we briefly review the clinical evidence and the molecular mechanisms behind myocardial recovery following LVAD placement. We also share institutional protocols used at 2 major medical centers in the USA.</p>","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":"16 ","pages":"11795468221144352"},"PeriodicalIF":3.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/fe/e4/10.1177_11795468221144352.PMC9806425.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10839644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.1177/11795468221141302
Blerina Asllanaj, Mark Olson, Yi McWhorter
The clinical features of severe hypothyroidism vary in presentation, ranging from subclinical symptoms to multiorgan failure referred to as myxedema coma. The cornerstone treatments of myxedema coma include aggressive thyroid hormone replacement combined with excellent supportive care in the intensive care unit. We report a rare case of a 56-year-old female with history of hypothyroidism treated with levothyroxine, who developed myxedema coma post-pericardial window surgery for a large pericardial effusion. She was supported with substantial doses of vasopressors and inotropes for shock. In addition, she was initiated on lung-protection ventilation for acute respiratory distress syndrome. After the diagnosis of myxedema coma was made, she was started on intravenous levothyroxine and hydrocortisone with great sustained clinical response. This case illustrated myxedema coma as an unusual cause of shock in post-operative patients with past medical history of hypothyroidism.
{"title":"Myxedema Coma: A Rare Case of Shock Post-Pericardial Window Procedure.","authors":"Blerina Asllanaj, Mark Olson, Yi McWhorter","doi":"10.1177/11795468221141302","DOIUrl":"https://doi.org/10.1177/11795468221141302","url":null,"abstract":"<p><p>The clinical features of severe hypothyroidism vary in presentation, ranging from subclinical symptoms to multiorgan failure referred to as myxedema coma. The cornerstone treatments of myxedema coma include aggressive thyroid hormone replacement combined with excellent supportive care in the intensive care unit. We report a rare case of a 56-year-old female with history of hypothyroidism treated with levothyroxine, who developed myxedema coma post-pericardial window surgery for a large pericardial effusion. She was supported with substantial doses of vasopressors and inotropes for shock. In addition, she was initiated on lung-protection ventilation for acute respiratory distress syndrome. After the diagnosis of myxedema coma was made, she was started on intravenous levothyroxine and hydrocortisone with great sustained clinical response. This case illustrated myxedema coma as an unusual cause of shock in post-operative patients with past medical history of hypothyroidism.</p>","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":"16 ","pages":"11795468221141302"},"PeriodicalIF":3.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b7/cc/10.1177_11795468221141302.PMC9726846.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10324000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-01-01DOI: 10.1177/11795468221095875
Timothy W. Jones, A. Chase, R. Bruning, Naphun Nimmanonda, S. Smith, A. Sikora
Introduction: De-resuscitation practices in septic patients with heart failure (HF) are not well characterized. This study aimed to determine if diuretic initiation within 48 hours of intensive care unit (ICU) admission was associated with a positive fluid balance and patient outcomes. Methods: This single-center, retrospective cohort study included adult patients with an established diagnosis of HF admitted to the ICU with sepsis or septic shock. The primary outcome was the incidence of positive fluid balance in patients receiving early (<48 hours) versus late (>48 hours) initiation of diuresis. Secondary outcomes included hospital mortality, ventilator-free days, and hospital and ICU length of stay. Continuous variables were assessed using independent t-test or Mann-Whitney U, while categorical variables were evaluated using the Pearson Chi-squared test. Results: A total of 101 patients were included. Positive fluid balance was significantly reduced at 72 hours (−139 mL vs 4370 mL, P < .001). The duration of mechanical ventilation (4 vs 5 days, P = .129), ventilator-free days (22 vs 18.5 days, P = .129), and in-hospital mortality (28 (38%) vs 12 (43%), P = .821) were similar between groups. In a subgroup analysis excluding patients not receiving renal replacement therap (RRT) (n = 76), early diuretics was associated with lower incidence of mechanical ventilation (41 [73.2%] vs 20 (100%), P = .01) and reduced duration of mechanical ventilation (4 vs 8 days, P = .018). Conclusions: Diuretic use within 48 hours of ICU admission in septic patients with HF resulted in less incidence of positive fluid balance. Early diuresis in this unique patient population warrants further investigation.
导读:脓毒症合并心力衰竭(HF)患者的去复苏实践尚未得到很好的描述。本研究旨在确定在重症监护病房(ICU)入院48小时内开始使用利尿剂是否与体液平衡阳性和患者预后相关。方法:这项单中心、回顾性队列研究纳入了确诊为心衰并伴有脓毒症或感染性休克入住ICU的成年患者。主要结局是早期(48小时)开始利尿的患者体液平衡阳性的发生率。次要结局包括住院死亡率、无呼吸机天数、住院和ICU住院时间。连续变量采用独立t检验或Mann-Whitney U检验，分类变量采用Pearson卡方检验。结果:共纳入101例患者。72小时时阳性体液平衡显著降低(- 139 mL vs 4370 mL, P < 0.001)。机械通气持续时间(4天vs 5天，P = .129)、无呼吸机天数(22天vs 18.5天，P = .129)和住院死亡率(28天(38%)vs 12天(43%)，P = .821)组间相似。在排除未接受肾脏替代治疗(RRT)的患者(n = 76)的亚组分析中，早期利尿剂与较低的机械通气发生率(41 [73.2%]vs 20 (100%)， P = 0.01)和缩短机械通气持续时间(4天vs 8天，P = 0.018)相关。结论:脓毒症合并心衰患者入住ICU后48小时内使用利尿剂可降低体液平衡阳性的发生率。这一独特患者群体的早期利尿值得进一步研究。
{"title":"Early Diuretics for De-resuscitation in Septic Patients With Left Ventricular Dysfunction","authors":"Timothy W. Jones, A. Chase, R. Bruning, Naphun Nimmanonda, S. Smith, A. Sikora","doi":"10.1177/11795468221095875","DOIUrl":"https://doi.org/10.1177/11795468221095875","url":null,"abstract":"Introduction: De-resuscitation practices in septic patients with heart failure (HF) are not well characterized. This study aimed to determine if diuretic initiation within 48 hours of intensive care unit (ICU) admission was associated with a positive fluid balance and patient outcomes. Methods: This single-center, retrospective cohort study included adult patients with an established diagnosis of HF admitted to the ICU with sepsis or septic shock. The primary outcome was the incidence of positive fluid balance in patients receiving early (<48 hours) versus late (>48 hours) initiation of diuresis. Secondary outcomes included hospital mortality, ventilator-free days, and hospital and ICU length of stay. Continuous variables were assessed using independent t-test or Mann-Whitney U, while categorical variables were evaluated using the Pearson Chi-squared test. Results: A total of 101 patients were included. Positive fluid balance was significantly reduced at 72 hours (−139 mL vs 4370 mL, P < .001). The duration of mechanical ventilation (4 vs 5 days, P = .129), ventilator-free days (22 vs 18.5 days, P = .129), and in-hospital mortality (28 (38%) vs 12 (43%), P = .821) were similar between groups. In a subgroup analysis excluding patients not receiving renal replacement therap (RRT) (n = 76), early diuretics was associated with lower incidence of mechanical ventilation (41 [73.2%] vs 20 (100%), P = .01) and reduced duration of mechanical ventilation (4 vs 8 days, P = .018). Conclusions: Diuretic use within 48 hours of ICU admission in septic patients with HF resulted in less incidence of positive fluid balance. Early diuresis in this unique patient population warrants further investigation.","PeriodicalId":10419,"journal":{"name":"Clinical Medicine Insights. Cardiology","volume":"7 1","pages":""},"PeriodicalIF":3.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73341577","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}
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