Pub Date : 2020-01-01DOI: 10.1080/2331205X.2020.1776468
T. Numata, H. Miyagawa, H. Kawamoto, Masahiro Yoshida, H. Utsumi, Mitsuo Hashimoto, S. Minagawa, Hiromichi Hara, J. Araya, K. Kuwano
Abstract Mepolizumab significantly reduces the number of annual exacerbations (AEs) and the maintenance dose of systemic corticosteroids (CSs) in patients with severe eosinophilic asthma (SEA). However, there are few studies based on real life with a long-term observational period in Japan. Between July 2016 and December 2019, 24 Japanese patients received mepolizumab at Jikei University Hospital for at least 12 months. We retrospectively evaluated these characteristics, AEs and CS doses. To elucidate the predictors of the enhanced responders, we performed multivariate logistic regression analysis. After introduction, asthma symptoms improved and were maintained for over a year. The number of AEs and CS doses significantly decreased. In the subgroup analysis, the younger than 65 years-old, body mass index (BMI) < 25 kg/m2, eosinophilic chronic rhinosinusitis, or eosinophil count ≥ 400/mm3 exhibited effective reductions in either AEs or CS doses with mepolizumab treatment. The percentage change in the AEs (≤ −75%) was significantly decreased in the patients with a BMI < 25 using multivariate logistic regression analysis (odds ratio 31, 95% confidence interval: 1.4–700, P = 0.03). In real-life, BMI < 25 could be a predictor for reductions in AEs with mepolizumab treatment in the patients with SEA. Abbreviations IL, interleukin; CS, corticosteroid; SEA, severe eosinophilic asthma; BMI, body mass index; ECRS, eosinophilic chronic rhinosinusitis; CRSwNP, chronic rhinosinusitis with nasal polyps
{"title":"Predictors of the enhanced response to mepolizumab treatment for severe eosinophilic asthma: A retrospective, long-term study","authors":"T. Numata, H. Miyagawa, H. Kawamoto, Masahiro Yoshida, H. Utsumi, Mitsuo Hashimoto, S. Minagawa, Hiromichi Hara, J. Araya, K. Kuwano","doi":"10.1080/2331205X.2020.1776468","DOIUrl":"https://doi.org/10.1080/2331205X.2020.1776468","url":null,"abstract":"Abstract Mepolizumab significantly reduces the number of annual exacerbations (AEs) and the maintenance dose of systemic corticosteroids (CSs) in patients with severe eosinophilic asthma (SEA). However, there are few studies based on real life with a long-term observational period in Japan. Between July 2016 and December 2019, 24 Japanese patients received mepolizumab at Jikei University Hospital for at least 12 months. We retrospectively evaluated these characteristics, AEs and CS doses. To elucidate the predictors of the enhanced responders, we performed multivariate logistic regression analysis. After introduction, asthma symptoms improved and were maintained for over a year. The number of AEs and CS doses significantly decreased. In the subgroup analysis, the younger than 65 years-old, body mass index (BMI) < 25 kg/m2, eosinophilic chronic rhinosinusitis, or eosinophil count ≥ 400/mm3 exhibited effective reductions in either AEs or CS doses with mepolizumab treatment. The percentage change in the AEs (≤ −75%) was significantly decreased in the patients with a BMI < 25 using multivariate logistic regression analysis (odds ratio 31, 95% confidence interval: 1.4–700, P = 0.03). In real-life, BMI < 25 could be a predictor for reductions in AEs with mepolizumab treatment in the patients with SEA. Abbreviations IL, interleukin; CS, corticosteroid; SEA, severe eosinophilic asthma; BMI, body mass index; ECRS, eosinophilic chronic rhinosinusitis; CRSwNP, chronic rhinosinusitis with nasal polyps","PeriodicalId":10470,"journal":{"name":"Cogent Medicine","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86894225","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 : 2020-01-01DOI: 10.1080/2331205X.2020.1804093
Darunee Hongwiset, S. Yotsawimonwat, Chokchai Wongsinsup, Saowarunee Sangsrijan, C. Sornsuvit
Abstract A rapid, sensitive and reliable LC-MS/MS method for the determination of galantamine in plasma was developed and validated for the pharmacokinetic study of galantamine hydrobromide 8 mg prolonged-release capsules. The plasma sample was prepared by simple liquid-liquid extraction with dichloromethane. Chromatographic separation was performed on a Hypurity C4 (150 x 4.6 mm, particle size 5.0 µm) using isocratic acetonitrile: 10 mM ammonium formate (90:10) as a mobile phase at a flow rate of 0.8 mL/min. Galantamine was detected by mass spectrometry using the electrospray ion source in the selected reaction monitoring mode. Carbamazepine was used as an internal standard (IS). The extraction recovery was 105.45–111.84% for galantamine and 107.35% for IS. Linearity was found within the calibration range of 0.39–62.5 ng/mL. The intra-day and inter-day accuracy were achieved with the mean concentrations of the quality control samples as 91.92–100.97% and 94.29–102.07%, respectively. The intra-day and inter-day precision were expressed as %CV of 1.34–6.11% and 3.31–5.01%. The long-term stability study showed that galantamine was stabled in plasma for at least 50 days at −30°C. This validated method was proven to be useful for the pharmacokinetic study of galantamine hydrobromide in healthy Thai volunteers. After the oral administration of one tablet in fasting conditions, Tmax and Cmax were found to be 5.61 ± 1.71 hours and 25.96 ± 4.18 ng/mL, respectively, whereas T1/2 was found to be 9.89 ± 1.48 hours.
{"title":"Determination of galantamine in human plasma by LC-MS/MS using carbamazepine as an internal standard: Method validation and application to a pharmacokinetic study of galantamine hydrobromide prolonged-release capsules in healthy Thai volunteers","authors":"Darunee Hongwiset, S. Yotsawimonwat, Chokchai Wongsinsup, Saowarunee Sangsrijan, C. Sornsuvit","doi":"10.1080/2331205X.2020.1804093","DOIUrl":"https://doi.org/10.1080/2331205X.2020.1804093","url":null,"abstract":"Abstract A rapid, sensitive and reliable LC-MS/MS method for the determination of galantamine in plasma was developed and validated for the pharmacokinetic study of galantamine hydrobromide 8 mg prolonged-release capsules. The plasma sample was prepared by simple liquid-liquid extraction with dichloromethane. Chromatographic separation was performed on a Hypurity C4 (150 x 4.6 mm, particle size 5.0 µm) using isocratic acetonitrile: 10 mM ammonium formate (90:10) as a mobile phase at a flow rate of 0.8 mL/min. Galantamine was detected by mass spectrometry using the electrospray ion source in the selected reaction monitoring mode. Carbamazepine was used as an internal standard (IS). The extraction recovery was 105.45–111.84% for galantamine and 107.35% for IS. Linearity was found within the calibration range of 0.39–62.5 ng/mL. The intra-day and inter-day accuracy were achieved with the mean concentrations of the quality control samples as 91.92–100.97% and 94.29–102.07%, respectively. The intra-day and inter-day precision were expressed as %CV of 1.34–6.11% and 3.31–5.01%. The long-term stability study showed that galantamine was stabled in plasma for at least 50 days at −30°C. This validated method was proven to be useful for the pharmacokinetic study of galantamine hydrobromide in healthy Thai volunteers. After the oral administration of one tablet in fasting conditions, Tmax and Cmax were found to be 5.61 ± 1.71 hours and 25.96 ± 4.18 ng/mL, respectively, whereas T1/2 was found to be 9.89 ± 1.48 hours.","PeriodicalId":10470,"journal":{"name":"Cogent Medicine","volume":"50 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90833880","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 : 2020-01-01DOI: 10.1080/2331205X.2020.1716447
C. Tata, D. Ndinteh, B. Nkeh-Chungag, O. O. Oyedeji, C. Sewani-rusike
Abstract Senecio serratuloides commonly referred to as “two day cure” is used in folk medicine for treating hypertension and wounds in South Africa. This study was aimed at isolating and testing the antihypertensive effects of bioactive compounds from S. serratuloides. Senecio serratuloides was serially extracted using solvents of increasing polarity. Phytochemical analysis, antioxidant capacity and antihypertensive properties of fractions were investigated. Bioactive compounds were isolated from ethyl acetate and methanol fractions, their antihypertensive effects and effect on urine norepinephrine concentration were determined. Ethyl acetate and methanol fractions had all eight phytochemicals tested, better antioxidant capacity and significantly (p < 0.001) prevented the increase in blood pressure induced by Nω-Nitro-l-arginine methyl ester hydrochloride. The isolated bioactive compounds were phytosteroids and Estran-3-one, 17-(acetyloxy)-2-methyl-, (2à,5à,17á) – which was isolated from methanol fraction had significantly (p < 0.001) better antihypertensive effects through the 4-h period of the study. Senecio serratuloides may be a potential source of antihypertensive lead compounds.
{"title":"Fractionation and bioassay-guided isolation of antihypertensive components of Senecio serratuloides","authors":"C. Tata, D. Ndinteh, B. Nkeh-Chungag, O. O. Oyedeji, C. Sewani-rusike","doi":"10.1080/2331205X.2020.1716447","DOIUrl":"https://doi.org/10.1080/2331205X.2020.1716447","url":null,"abstract":"Abstract Senecio serratuloides commonly referred to as “two day cure” is used in folk medicine for treating hypertension and wounds in South Africa. This study was aimed at isolating and testing the antihypertensive effects of bioactive compounds from S. serratuloides. Senecio serratuloides was serially extracted using solvents of increasing polarity. Phytochemical analysis, antioxidant capacity and antihypertensive properties of fractions were investigated. Bioactive compounds were isolated from ethyl acetate and methanol fractions, their antihypertensive effects and effect on urine norepinephrine concentration were determined. Ethyl acetate and methanol fractions had all eight phytochemicals tested, better antioxidant capacity and significantly (p < 0.001) prevented the increase in blood pressure induced by Nω-Nitro-l-arginine methyl ester hydrochloride. The isolated bioactive compounds were phytosteroids and Estran-3-one, 17-(acetyloxy)-2-methyl-, (2à,5à,17á) – which was isolated from methanol fraction had significantly (p < 0.001) better antihypertensive effects through the 4-h period of the study. Senecio serratuloides may be a potential source of antihypertensive lead compounds.","PeriodicalId":10470,"journal":{"name":"Cogent Medicine","volume":"49 8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73027670","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 : 2020-01-01DOI: 10.1080/2331205X.2020.1783129
L. Gonah, T. Maphosa
Abstract Abstract MDR-TB has created an additional burden in TB control due to limited treatment options and the generally poor treatment outcomes. We investigated association of MDR-TB treatment outcomes and HIV status in Zimbabwe. The study was a retrospective cohort study of case records from National TB Surveillance System of MDR-TB patients (>16 years) who were culture proven at diagnosis and started treatment between January 2013 and December 2016. Cox proportional hazard regression models were used to assess risk factors associated with mortality. Kaplan–Meier curves were used to determine whether survival probabilities differed for HIV-co-infected and HIV-negative MDR-TB patients. 201 case records were considered for study; 174 cases (87%) started MDR-TB treatment; 11% died before treatment initiation, and 2% did not start treatment. Among 174 cases who were analyzed, 92 were HIV-positive and 82 were HIV-negative. Sixty-three (36%) died during follow up. Number of deaths was not significantly different in patients with or without HIV infection (p = 0.17). Age (25–59 years) (hazard ratio 2.58, 95% CI 1.44–6.77, p = <0.0001) and previous TB treatment (hazard ratio 4.52, 95% CI 1.94–14.2, p = 0.001) were independent predictors of death. Fewer deaths occurred in HIV-infected MDR-TB patients on highly active antiretroviral treatment than those who were not given this therapy (p = 0.01). Treatment outcomes for MDR-TB are likely to be negatively affected by untreated HIV, individual factors and health system factors. National TB control programmes need to be tailored at improving these determinants of MDR-TB and HIV diagnosis and treatment, to improve treatment outcomes.
由于有限的治疗选择和普遍较差的治疗结果，耐多药结核病给结核病控制带来了额外的负担。我们调查了津巴布韦耐多药结核病治疗结果与艾滋病毒状况的关系。该研究是一项回顾性队列研究，对2013年1月至2016年12月期间诊断并开始治疗的耐多药结核病患者(>16岁)的国家结核病监测系统病例记录进行了研究。采用Cox比例风险回归模型评估与死亡率相关的危险因素。Kaplan-Meier曲线用于确定hiv合并感染和hiv阴性耐多药结核病患者的生存概率是否存在差异。201例病例记录纳入研究;174例(87%)开始耐多药结核病治疗;11%在开始治疗前死亡，2%未开始治疗。在174例分析病例中，92例hiv阳性，82例hiv阴性。63例(36%)在随访期间死亡。感染HIV或未感染HIV的患者的死亡人数无显著差异(p = 0.17)。年龄(25-59岁)(风险比2.58,95% CI 1.44-6.77, p = <0.0001)和既往结核病治疗(风险比4.52,95% CI 1.94-14.2, p = 0.001)是死亡的独立预测因素。接受高效抗逆转录病毒治疗的艾滋病毒感染耐多药结核病患者的死亡率低于未接受这种治疗的患者(p = 0.01)。耐多药结核病的治疗结果可能受到未经治疗的艾滋病毒、个人因素和卫生系统因素的负面影响。国家结核病控制规划需要针对改善耐多药结核病和艾滋病毒诊断和治疗的这些决定因素进行调整，以改善治疗结果。
{"title":"Association of MDR-TB treatment outcomes and HIV status in Zimbabwe: A retrospective study","authors":"L. Gonah, T. Maphosa","doi":"10.1080/2331205X.2020.1783129","DOIUrl":"https://doi.org/10.1080/2331205X.2020.1783129","url":null,"abstract":"Abstract Abstract MDR-TB has created an additional burden in TB control due to limited treatment options and the generally poor treatment outcomes. We investigated association of MDR-TB treatment outcomes and HIV status in Zimbabwe. The study was a retrospective cohort study of case records from National TB Surveillance System of MDR-TB patients (>16 years) who were culture proven at diagnosis and started treatment between January 2013 and December 2016. Cox proportional hazard regression models were used to assess risk factors associated with mortality. Kaplan–Meier curves were used to determine whether survival probabilities differed for HIV-co-infected and HIV-negative MDR-TB patients. 201 case records were considered for study; 174 cases (87%) started MDR-TB treatment; 11% died before treatment initiation, and 2% did not start treatment. Among 174 cases who were analyzed, 92 were HIV-positive and 82 were HIV-negative. Sixty-three (36%) died during follow up. Number of deaths was not significantly different in patients with or without HIV infection (p = 0.17). Age (25–59 years) (hazard ratio 2.58, 95% CI 1.44–6.77, p = <0.0001) and previous TB treatment (hazard ratio 4.52, 95% CI 1.94–14.2, p = 0.001) were independent predictors of death. Fewer deaths occurred in HIV-infected MDR-TB patients on highly active antiretroviral treatment than those who were not given this therapy (p = 0.01). Treatment outcomes for MDR-TB are likely to be negatively affected by untreated HIV, individual factors and health system factors. National TB control programmes need to be tailored at improving these determinants of MDR-TB and HIV diagnosis and treatment, to improve treatment outcomes.","PeriodicalId":10470,"journal":{"name":"Cogent Medicine","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75028360","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 : 2020-01-01DOI: 10.1080/2331205X.2020.1780065
Sara J. Gould, E. Knowling, R. Smola, K. Titer, K. Martin
Abstract Cadaver-based simulation has been used in many surgical and subspecialty fields to teach procedural skills. We developed a cadaver-based simulation curriculum to enhance internal medicine residents’ comfort with arthrocentesis. 29 internal medicine residents in postgraduate years 1–3 participated in the cadaver-based simulation session. Multidisciplinary faculty precepted the course, with assistance from rheumatology fellows. Landmark-based and ultrasonography-guided injections were performed on cadaver shoulder and knee joints. Residents reported an average of 1.63 arthrocentesis procedures performed prior to the simulation session. They reported a comfort level of 1.74 on the pre-simulation session survey. This comfort level improved by 70.11% to 2.94 following the simulation session. The effect was sustained at 4–6-week follow-up, with residents reporting a comfort level of 2.94. Cadaver-based procedural skills sessions increased self-reported trainee comfort with arthrocentesis. We recommend that such simulation sessions should be adopted into formal internal medicine residency training.
{"title":"Efficacy of a cadaver-based procedural skills lab for internal medicine residents","authors":"Sara J. Gould, E. Knowling, R. Smola, K. Titer, K. Martin","doi":"10.1080/2331205X.2020.1780065","DOIUrl":"https://doi.org/10.1080/2331205X.2020.1780065","url":null,"abstract":"Abstract Cadaver-based simulation has been used in many surgical and subspecialty fields to teach procedural skills. We developed a cadaver-based simulation curriculum to enhance internal medicine residents’ comfort with arthrocentesis. 29 internal medicine residents in postgraduate years 1–3 participated in the cadaver-based simulation session. Multidisciplinary faculty precepted the course, with assistance from rheumatology fellows. Landmark-based and ultrasonography-guided injections were performed on cadaver shoulder and knee joints. Residents reported an average of 1.63 arthrocentesis procedures performed prior to the simulation session. They reported a comfort level of 1.74 on the pre-simulation session survey. This comfort level improved by 70.11% to 2.94 following the simulation session. The effect was sustained at 4–6-week follow-up, with residents reporting a comfort level of 2.94. Cadaver-based procedural skills sessions increased self-reported trainee comfort with arthrocentesis. We recommend that such simulation sessions should be adopted into formal internal medicine residency training.","PeriodicalId":10470,"journal":{"name":"Cogent Medicine","volume":"86 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88533912","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 : 2020-01-01DOI: 10.1080/2331205X.2020.1841391
N. Ezinne, K. Ekemiri, Ali A. Khan
Abstract Abstract: Superior oblique palsy is known to be caused by a defect of the trochlear nerve which could lead to horizontal and most times noticeable vertical misalignment of the eye. A case of superior oblique palsy (SOP) determined during a routine eye examination of a 16-year-old female with a complaint of blurring of vision at far and near with intermittent vertical diplopia while reading was presented. She showed right hypertropia and left exotropia of 10ΔBD and 9ΔBI, respectively, at far with fast recovery on right head tilt. Also, 12ΔBI and 12ΔBD for near with the left eye fixing. Parks–Bielschowsky three-step test showed that the patient’s hypertropia and vision increased on the right in the primary position while diplopia decreases when chin is depressed and her head is tilted to the left. Congenital superior oblique palsy can present with vertical diplopia in childhood or adulthood when contralateral head tilt is no longer enough to compensate for the vertical imbalance due to the decompensation of the vertical fusional reserve. Therefore, child’s old pictures are very important in confirming longstanding SOP and patching can be used to relief the diplopia.
{"title":"Superior oblique palsy: A case report","authors":"N. Ezinne, K. Ekemiri, Ali A. Khan","doi":"10.1080/2331205X.2020.1841391","DOIUrl":"https://doi.org/10.1080/2331205X.2020.1841391","url":null,"abstract":"Abstract Abstract: Superior oblique palsy is known to be caused by a defect of the trochlear nerve which could lead to horizontal and most times noticeable vertical misalignment of the eye. A case of superior oblique palsy (SOP) determined during a routine eye examination of a 16-year-old female with a complaint of blurring of vision at far and near with intermittent vertical diplopia while reading was presented. She showed right hypertropia and left exotropia of 10ΔBD and 9ΔBI, respectively, at far with fast recovery on right head tilt. Also, 12ΔBI and 12ΔBD for near with the left eye fixing. Parks–Bielschowsky three-step test showed that the patient’s hypertropia and vision increased on the right in the primary position while diplopia decreases when chin is depressed and her head is tilted to the left. Congenital superior oblique palsy can present with vertical diplopia in childhood or adulthood when contralateral head tilt is no longer enough to compensate for the vertical imbalance due to the decompensation of the vertical fusional reserve. Therefore, child’s old pictures are very important in confirming longstanding SOP and patching can be used to relief the diplopia.","PeriodicalId":10470,"journal":{"name":"Cogent Medicine","volume":"66 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90177957","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 : 2020-01-01DOI: 10.1080/2331205X.2020.1853895
Perpetua Tanyi, A. Pelser
Abstract Abstract: Like any other country in sub-Saharan Africa, Nigeria’s elderly population too is increasing rapidly. In Nigeria, those aged 65 years and above (the elderly) make up 3.1% or 5.9 million of the total population of 191 million, which in crude numbers represents an increase of 600 000 during the 5 year period 2012-2017. Many older people in Nigeria are exposed to multiple health problems, to such an extent that there is a need for an extended health care programme and support for sustainable good quality of life. This study explored older people’s perceptions of an “elderly-friendly” facility based at the University of Benin Teaching Hospital (UBTH) in Edo state, Nigeria. Thirty participants were interviewed between the months of March and December 2018. With the help of a key informant who is also staff of the geriatric section of the hospital a purposive sampling technique was used to select 10 in-patients and 19 out-patients among older adults for the study. A qualitative content analysis was conducted. Elderly-friendly services, the expectation from government and hospital management, and health policy related to senior citizens were developed as main themes. Most of the participants were satisfied with the treatment by the health personnel. The study found that the geriatric unit has very few trained health personnel. Elderly-friendly hospital guidelines and policy were however not developed in the hospital. Older people health record folders, health insurance for the elderly, support and advocacy for older people’s health and benefit, and the hospital environment at large, lack elderly-friendly infrastructures. Some of the common concerns raised by the older patients include the absence of wheelchairs, lifts rails, comfortable beds, and readable signage displayed throughout the hospital to facilitate orientation of the hospital environment. Bed heights were reported as inappropriate for older persons, while the waiting areas were deemed uncomfortable for the elderly. Government policy on the elderly is seen as the main obstacle to promoting an elderly-friendly environment and health care services in UBTH. The facilities and infrastructure in the hospital, elderly-related health policies, elderly-friendly personnel and elderly-care advocacy, should be developed.
{"title":"Towards an “age-friendly-hospital”: Older persons’ perceptions of an age-friendly hospital environment in Nigeria.","authors":"Perpetua Tanyi, A. Pelser","doi":"10.1080/2331205X.2020.1853895","DOIUrl":"https://doi.org/10.1080/2331205X.2020.1853895","url":null,"abstract":"Abstract Abstract: Like any other country in sub-Saharan Africa, Nigeria’s elderly population too is increasing rapidly. In Nigeria, those aged 65 years and above (the elderly) make up 3.1% or 5.9 million of the total population of 191 million, which in crude numbers represents an increase of 600 000 during the 5 year period 2012-2017. Many older people in Nigeria are exposed to multiple health problems, to such an extent that there is a need for an extended health care programme and support for sustainable good quality of life. This study explored older people’s perceptions of an “elderly-friendly” facility based at the University of Benin Teaching Hospital (UBTH) in Edo state, Nigeria. Thirty participants were interviewed between the months of March and December 2018. With the help of a key informant who is also staff of the geriatric section of the hospital a purposive sampling technique was used to select 10 in-patients and 19 out-patients among older adults for the study. A qualitative content analysis was conducted. Elderly-friendly services, the expectation from government and hospital management, and health policy related to senior citizens were developed as main themes. Most of the participants were satisfied with the treatment by the health personnel. The study found that the geriatric unit has very few trained health personnel. Elderly-friendly hospital guidelines and policy were however not developed in the hospital. Older people health record folders, health insurance for the elderly, support and advocacy for older people’s health and benefit, and the hospital environment at large, lack elderly-friendly infrastructures. Some of the common concerns raised by the older patients include the absence of wheelchairs, lifts rails, comfortable beds, and readable signage displayed throughout the hospital to facilitate orientation of the hospital environment. Bed heights were reported as inappropriate for older persons, while the waiting areas were deemed uncomfortable for the elderly. Government policy on the elderly is seen as the main obstacle to promoting an elderly-friendly environment and health care services in UBTH. The facilities and infrastructure in the hospital, elderly-related health policies, elderly-friendly personnel and elderly-care advocacy, should be developed.","PeriodicalId":10470,"journal":{"name":"Cogent Medicine","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79311988","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 : 2020-01-01DOI: 10.1080/2331205X.2020.1794500
G. A. João, D. Rodriguez, L. D. Tavares, R. L. Rica, Nelson Cavas Júnior, V. Reis, F. L. Pontes Júnior, J. Baker, D. Bocalini, A. F. Júnior
Abstract Abstract An accurate method for quantifying associated metabolic cost has yet to be developed for a strength training session (ST). The aim of this study was to quantify the energy expenditure (EE) in an ST session composed of eight exercises at moderate intensity using indirect calorimetry and, from the values obtained, develop a prediction equation for estimating EE. Fifteen males (22.9 ± 2.61 years old), with at least 12 months of experience in ST performed one session of strength training composed of 8 exercises. Three sets of repetitions were performed until concentric failure for each exercise at 75% of 1-repetition maximum (75% of 1RM). The model demonstrated that session time and load volume of ST was a significant predictor of EE (p < 0.05). We found that the energy cost of an ST session at an intensity of 75% of 1RM could be predicted using the equation of Y’ = −473.595 + −1.2110(X1) + 17.5723(X2) (R2 = 0.61, p < 0.05). Where X1 = load-volume (no. of sets x no. of repetitions); X2 = session time (minutes). Although our equation may have limited accuracy, our regression formula accounted for 61% of the variability in a strength training session at a moderate intensity of 75% of 1RM. Session time in the total variability of EE in ST was an important consideration.
{"title":"Energy expenditure estimation of a moderate-intensity strength training session","authors":"G. A. João, D. Rodriguez, L. D. Tavares, R. L. Rica, Nelson Cavas Júnior, V. Reis, F. L. Pontes Júnior, J. Baker, D. Bocalini, A. F. Júnior","doi":"10.1080/2331205X.2020.1794500","DOIUrl":"https://doi.org/10.1080/2331205X.2020.1794500","url":null,"abstract":"Abstract Abstract An accurate method for quantifying associated metabolic cost has yet to be developed for a strength training session (ST). The aim of this study was to quantify the energy expenditure (EE) in an ST session composed of eight exercises at moderate intensity using indirect calorimetry and, from the values obtained, develop a prediction equation for estimating EE. Fifteen males (22.9 ± 2.61 years old), with at least 12 months of experience in ST performed one session of strength training composed of 8 exercises. Three sets of repetitions were performed until concentric failure for each exercise at 75% of 1-repetition maximum (75% of 1RM). The model demonstrated that session time and load volume of ST was a significant predictor of EE (p < 0.05). We found that the energy cost of an ST session at an intensity of 75% of 1RM could be predicted using the equation of Y’ = −473.595 + −1.2110(X1) + 17.5723(X2) (R2 = 0.61, p < 0.05). Where X1 = load-volume (no. of sets x no. of repetitions); X2 = session time (minutes). Although our equation may have limited accuracy, our regression formula accounted for 61% of the variability in a strength training session at a moderate intensity of 75% of 1RM. Session time in the total variability of EE in ST was an important consideration.","PeriodicalId":10470,"journal":{"name":"Cogent Medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72700477","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 : 2020-01-01DOI: 10.1080/2331205X.2020.1807083
L. Sánchez-Chapul, J. F. Valencia-León, Mario Acevedo-Mora, Zendy F Fuentes-Corona, E. Estrada-Camarena, J. U. Baños-Vázquez, Egner Hernández-Zamudio, José. a Rangel-Sánchez, Israel Gutiérrez-García, G. Martínez-Nava, Sigifredo Salgado-Aguilar, L. Téllez-Cárdenas, D. Mirabent-Amor, José Gilberto Fanco-Sánchez, Luis A. Bonilla-Arcuate, A. Luna-Angulo, A. López-Macay
Abstract Overweight and inadequate physical fitness are critical variables that impact directly on the health, wellbeing of service members and military readiness, characteristics required to overcome dangerous situations during sea rescues and in the first line of combat in the Mexican Navy. Here we determined the impact of body composition (BC) on physical fitness components (PFC) [cardiorespiratory fitness (CRF) and muscle strength-resistance (MSR)] of 110 marines, rescue swimmers, and divers of the Mexican Navy classified as overweight. We found significant differences in medians of BC and PFC among groups (p < 0.001). The WHO and military BMI showed 59 (54%) and 16 (15%) individuals as overweight, respectively. All groups showed CRF adequate for their age, but only 26 (51%) and 14 (24%) classified as normal and overweight (WHO), respectively, had adequate CFR (METs ˃12) (p = 0.003) for physical demands of military tasks. BMI in overweight at expenses of high BFP, without cardiovascular risk represents an operational task advantage that will lead to reach the balance between physical fitness, health, and military readiness.
{"title":"Impact of body composition on physical fitness components in the Mexican Navy: Is overweight an issue?","authors":"L. Sánchez-Chapul, J. F. Valencia-León, Mario Acevedo-Mora, Zendy F Fuentes-Corona, E. Estrada-Camarena, J. U. Baños-Vázquez, Egner Hernández-Zamudio, José. a Rangel-Sánchez, Israel Gutiérrez-García, G. Martínez-Nava, Sigifredo Salgado-Aguilar, L. Téllez-Cárdenas, D. Mirabent-Amor, José Gilberto Fanco-Sánchez, Luis A. Bonilla-Arcuate, A. Luna-Angulo, A. López-Macay","doi":"10.1080/2331205X.2020.1807083","DOIUrl":"https://doi.org/10.1080/2331205X.2020.1807083","url":null,"abstract":"Abstract Overweight and inadequate physical fitness are critical variables that impact directly on the health, wellbeing of service members and military readiness, characteristics required to overcome dangerous situations during sea rescues and in the first line of combat in the Mexican Navy. Here we determined the impact of body composition (BC) on physical fitness components (PFC) [cardiorespiratory fitness (CRF) and muscle strength-resistance (MSR)] of 110 marines, rescue swimmers, and divers of the Mexican Navy classified as overweight. We found significant differences in medians of BC and PFC among groups (p < 0.001). The WHO and military BMI showed 59 (54%) and 16 (15%) individuals as overweight, respectively. All groups showed CRF adequate for their age, but only 26 (51%) and 14 (24%) classified as normal and overweight (WHO), respectively, had adequate CFR (METs ˃12) (p = 0.003) for physical demands of military tasks. BMI in overweight at expenses of high BFP, without cardiovascular risk represents an operational task advantage that will lead to reach the balance between physical fitness, health, and military readiness.","PeriodicalId":10470,"journal":{"name":"Cogent Medicine","volume":"1B 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87101761","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 : 2020-01-01DOI: 10.1080/2331205X.2020.1736250
Yunlei Deng, Ying Shu, Rong Gong
Abstract Calciphylaxis is a rare, life-threatening syndrome of vascular calcification, and the pathogenesis of the disease is not well demonstrated. Here, we presented a 33-year-old Chinese male, treated with continuous ambulatory peritoneal dialysis (CAPD) for 5 years with recent onset of calciphylaxis was described. The initial laboratorial workup showed severely elevated intact parathyroid, procalcitonin and serum phosphorus. The main signs were massive pumps in his shoulder and sternum, and necrotic ulcer covered with a black eschar on the right middle finger. The main incentive of calciphylaxis might be the misuse of vitamin-D receptor analogs.
{"title":"Calciphylaxis in patient with peritoneal dialysis: A case report","authors":"Yunlei Deng, Ying Shu, Rong Gong","doi":"10.1080/2331205X.2020.1736250","DOIUrl":"https://doi.org/10.1080/2331205X.2020.1736250","url":null,"abstract":"Abstract Calciphylaxis is a rare, life-threatening syndrome of vascular calcification, and the pathogenesis of the disease is not well demonstrated. Here, we presented a 33-year-old Chinese male, treated with continuous ambulatory peritoneal dialysis (CAPD) for 5 years with recent onset of calciphylaxis was described. The initial laboratorial workup showed severely elevated intact parathyroid, procalcitonin and serum phosphorus. The main signs were massive pumps in his shoulder and sternum, and necrotic ulcer covered with a black eschar on the right middle finger. The main incentive of calciphylaxis might be the misuse of vitamin-D receptor analogs.","PeriodicalId":10470,"journal":{"name":"Cogent Medicine","volume":"77 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78754689","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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