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Investigation of Anaemia in Geriatric patients Admitted to Norfolk & Norwich University teaching Hospital Old People’s Medicine/Geriatric Department 诺福克&诺维奇大学教学医院老年医学/老年科老年患者贫血的调查研究
Pub Date : 2021-10-21 DOI: 10.31579/2767-7370/024
Emmanuel Tigalya, Lamabadusuriya Lamabadusuriya, Yasmine Karachiwala
Aims To assess if anaemia detected in geriatric patients admitted to the Old Peoples Medicine Department at Norfolk and Norwich University Teaching Hospital was investigated with appropriate laboratory tests- haematinics and iron level tests. Also increase awareness among doctors of the high prevalence of anaemia in geriatric patients and the need to investigate to start treat if indicated. Target population or scope All patients aged 80 and above admitted under the care of NNUH OPM department on a given day incidentally found to have anaemia. Criteria All over 80 year olds admitted to hospital found incidentally to have low HB (anaemia) should be investigated by having elemental iron level and haematinic checks; Iron level check Vitamin B12 and folate check Ferritin Target population or scope All patients aged 80 and above admitted under the care of NNUH OPM department on a given day incidentally found to have anaemia.
目的评估诺福克和诺威奇大学教学医院老年医学部门收治的老年患者是否进行了适当的实验室检查——血化学和铁水平测试。还要提高医生对老年患者贫血高发率的认识,并在有指征时进行调查以开始治疗的必要性。目标人群或范围所有80岁及以上的病人在某一天偶然发现有贫血症。所有80岁以上住院的偶然发现低血红蛋白(贫血)的老人应通过元素铁水平和血清学检查进行调查;铁水平检查维生素B12和叶酸检查铁蛋白目标人群或范围所有80岁及以上患者在某一天偶然发现有贫血。
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引用次数: 0
Covid Reinfection versus Asymptomatic Carrier State: A Case Report 新冠再感染与无症状感染者状态:1例报告
Pub Date : 2021-10-21 DOI: 10.31579/2767-7370/023
Joy C. Ekezie, T. Rogo
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), first discovered in China in December 2019, has been implicated in the current coronavirus disease 2019 (COVID-19) pandemic. Although much has been learned about the virus which peaked with the development of the vaccine, there is still a lot of unanswered questions. Maximum duration of positive SARS-CoV-2 real-time reverse transcriptase polymerase chain reaction (RT-PCR) from symptom onset may be up to 3 months [1], however it is not known if the continued detection of the viral genome implies prolonged infectivity or presence of a non-viable virus [2]. Most people with COVID-19 develop antibodies after resolution of acute infection [2]. The exact duration of these antibodies in the body is unknown, but some studies have shown that both memory T-cells and B-cells can persist up to 6 to 8 months after acute SARS-CoV-2 infection [3]. These SARS-CoV-2 antibodies may confer some immunity to the person after the acute infection and have been associated with protection against subsequent infection in nonhuman primates by the same viral strain during the early recovery phase [4]. In humans, however, it is unknown to what extent this immune response indicates a protective immunity to subsequent infection with SARS-CoV-2 [5]. Few cases of reinfection have been documented worldwide with varying symptom severity; the first case in the US was published in January 2021 (reinfection occurred in June 2020) [5]. None of the initial cases reported the presence of SARS-CoV-2 antibodies at the time of reinfection. We present a patient who tested positive to SARS-CoV-2 RT-PCR twice in 10 months (Table 1). At both times, she was asymptomatic and the second time, she had coexisting SARS-CoV-2 antibodies.
2019年12月在中国首次发现的严重急性呼吸综合征冠状病毒2型(SARS-CoV-2)与当前的2019冠状病毒病(COVID-19)大流行有关。尽管人们对这种随着疫苗研制而达到顶峰的病毒有了很多了解,但仍有许多未解之谜。从症状出现到SARS-CoV-2实时逆转录酶聚合酶链反应(RT-PCR)阳性的最长持续时间可能长达3个月[1],但尚不清楚病毒基因组的持续检测是否意味着延长传染性或存在非活病毒[2]。大多数COVID-19患者在急性感染消退后产生抗体[2]。这些抗体在体内的确切持续时间尚不清楚,但一些研究表明,记忆t细胞和b细胞在急性SARS-CoV-2感染后可持续长达6至8个月[3]。这些SARS-CoV-2抗体可能在急性感染后赋予人一定的免疫力,并在早期恢复阶段保护非人类灵长类动物免受同一病毒株的后续感染[4]。然而,在人类中,尚不清楚这种免疫反应在多大程度上表明对随后感染SARS-CoV-2的保护性免疫[5]。世界范围内记录的再感染病例很少,症状严重程度不一;美国第一例病例于2021年1月公布(2020年6月再次感染)[5]。最初的病例在再次感染时均未报告存在SARS-CoV-2抗体。我们报告了一位在10个月内两次SARS-CoV-2 RT-PCR检测呈阳性的患者(表1)。两次,她都无症状,第二次,她同时存在SARS-CoV-2抗体。
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引用次数: 0
Intergenerational Facility Alternatives: Transitioning Care Options for Aging Parents and Children with Autism 代际设施选择:老年父母和自闭症儿童的过渡护理选择
Pub Date : 2021-08-13 DOI: 10.31579/2767-7370/020
H. Wolf, Benjamin Chmieleski, Jeanneane Wood-Nartker
Purpose: The objective was twofold: 1) summarize research-informed environmental characteristics into Mostafa’s seven ASPECTSS™ criteria for people who are aging, and for children who have autism, and 2) apply those characteristics within the context of a Green House planned intergenerational facility providing support to adult child with autism, and their parent(s). Background: The rate of Autism Spectrum Disorder (ASD) diagnoses is increasing, making it important to design spaces for people with ASD. Approximately 85% of children with ASD live with their parents (Mykyta, 2012). Ahrentzen & Steele (2010) identified the need to develop housing options for people with ASD. Method: Design considerations from a literature review were organized into two tables: 1) aging adults and 2) people who have ASD. Shared characteristics were placed into a third table using Mostafa’s seven ASPECTSS™ criteria, and then applied to the intergenerational facility plan to demonstrate the effectiveness of intentional planning by caregivers and the design community. Results: When integrating Mostafa’s ASPECTSS™ framework, and the intergenerational Green House Model, the application of design choices within housing demonstrates that appropriately designed space can positively impact persons and families with autism, regardless of age. Conclusion: Findings show numerous overlapping design criteria for people with autism and aging adults that can lead to effective environmental solutions for both. This facility type has the potential to minimize family fracture since aging parents are supported in their ability to care for their child with autism.
目的:目标有两个:1)将研究信息的环境特征总结为穆斯塔法针对老年人和自闭症儿童的七个ASPECTSS™标准,2)将这些特征应用于温室计划的代际设施的背景下,该设施为自闭症成年儿童及其父母提供支持。背景:自闭症谱系障碍(ASD)的诊疗率正在上升,因此为ASD患者设计空间变得非常重要。大约85%的自闭症儿童与父母住在一起(Mykyta, 2012)。Ahrentzen和Steele(2010)认为有必要为自闭症患者提供住房选择。方法:将文献综述中的设计考虑分为两个表:1)老年人和2)ASD患者。使用Mostafa的七个ASPECTSS™标准将共享特征放入第三个表中,然后将其应用于代际设施规划,以证明护理人员和设计界有意规划的有效性。结果:将Mostafa的ASPECTSS™框架和代际温室模型结合起来,设计选择在住房中的应用表明,无论年龄大小,适当设计的空间都可以对自闭症患者和家庭产生积极影响。结论:研究结果表明,针对自闭症患者和老年人的许多重叠设计标准可以为两者提供有效的环境解决方案。这种设施类型有可能最大限度地减少家庭破裂,因为年迈的父母有能力照顾患有自闭症的孩子。
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引用次数: 0
A Didactic Dilemma in Emerging Societies: Devaluing Journal Club in Medical Working out 新兴社会的教学困境:贬低医学锻炼中的期刊俱乐部
Pub Date : 2021-08-13 DOI: 10.31579/2767-7370/019
Saeed Shoja Shafti
A journal club is a scholastic conference in which a group of persons discuss issued articles, providing an opportunity for a shared effort to keep up with the current writings. The emphasis of journal clubs has supposedly shifted over the years. What was once a setting in which the world's recent literature was analyzed became a setting for talking over clinical issues raised by the writings and, most recently, a setup for learning critical reading abilities to physicians or other associated authorities. Nevertheless, so far there is no generally accepted definition of journal club, even though this academic method has been around for more than a century and has evolved basically during this period. In the present paper, conceptual and applied features of journal club, especially in developing countries, is surveyed, to discuss an apparent underrating of journal club in some medical departments, which could be due to misunderstanding of new philosophies, or to talk about the necessity of modification of an academic misconduct, which could be attributable to didactic unawareness.
期刊俱乐部是一种学术会议,一群人在其中讨论已发表的文章,为共同努力跟上当前的作品提供了机会。按理说,这些年来,杂志俱乐部的侧重点已经发生了变化。曾经是分析世界近期文献的场所,现在变成了讨论文献中提出的临床问题的场所,最近,还变成了向医生或其他相关权威学习批判性阅读能力的场所。然而,尽管这种学术方法已经存在了一个多世纪,并且基本上是在这一时期发展起来的,但到目前为止,还没有一个公认的期刊俱乐部的定义。本文调查了期刊俱乐部的概念和应用特征,特别是在发展中国家,讨论了一些医学部门对期刊俱乐部的明显低估,这可能是由于对新哲学的误解,或者讨论了修改学术不端行为的必要性,这可能是由于教学上的无意识。
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引用次数: 0
Prevalence of Different Types of Leukemia and Associated Factors among Children in Children's Cancer Units at Al-Kuwait Hospital, Sana'a City: A Cross-Sectional Study 萨那市科威特医院儿童癌症病房儿童中不同类型白血病的患病率及相关因素:一项横断面研究
Pub Date : 2021-08-13 DOI: 10.31579/2767-7370/018
H. Al-Shamahy, Monya Abdullah Yahya El-Zine, Abdulrahman M Alhadi, Abdulrahman A. IshaK
Introduction: Leukemia is a heterogeneous group of hematological disorders that is made up of several diverse and biologically distinct subgroups. Leukemia is the 11th and10th most common cause of cancer morbidity and mortality worldwide, respectively. There are insufficient data on the prevalence and associated factors of leukemia in Yemen, particularly in the study area. Aims: This cross-sectional study aims to determine the prevalence of different types of leukemia and associated factors among children with leukemia in the pediatric cancer units of Al-Kuwait Hospital, Sana'a City. Materials and Methods: A cross-sectional study was conducted on children with leukemia who were treated selectively in the pediatric leukemia units of Kuwait University Hospital in Sana'a. Group diagnostics and histopathological diagnoses were formed in line with the French, American and British classifications of leukemia in children in the pediatric leukemia units, over a period of 5 years. Factors associated with become infected with leukemia that were studied included ages, gender, and regarding outcomes. The association of death and recovery with different age groups and leukemia types was also studied through rates and calculation of OR, CI, chi-square test and p values ​​through probability tables. Results: 244 leukemia patients were diagnosed, treated and followed; there was association of leukemia with younger age group; 50% were in the age group 1-5 years and with mean ± SD age= 6.44 ± 3.7 years. There was significant association with male gender (66.7%). There was non-significant association between high mortality and the 6-10 year age group [(8/78; 10.2%), with OR = 2.6, p = 0.060, and with the AML [(4/38; 10.5%), OR = 2.1)]. Considering, the cure rates association with ages, roughly there were similar cure rates occurred in the different age groups. Also, there was high cure rate in the JCM (2/3; 66%), with OR = 2.9. And with the CML (7/11; 63.6%; OR = 2.60. Conclusion: In the current study an association between leukemia and younger age group, with males was found. An association between high mortality and the 6-10 year age group, with AML was found. Also, there was no association between ages and cure rate but a high cure rate occurred with JCM and CML.
白血病是一种异质性的血液系统疾病,由几个不同的和生物学上不同的亚群组成。白血病分别是全球癌症发病率和死亡率的第11位和第10位最常见原因。在也门,特别是在研究地区,关于白血病患病率和相关因素的数据不足。目的:本横断面研究旨在确定在萨那市科威特医院儿科癌症病房白血病儿童中不同类型白血病的患病率及相关因素。材料和方法:对在萨那科威特大学医院儿科白血病病房选择性治疗的白血病儿童进行了一项横断面研究。在5年的时间里,根据法国、美国和英国儿科白血病单位的儿童白血病分类,形成了组诊断和组织病理学诊断。被研究的与白血病感染相关的因素包括年龄、性别和预后。并通过概率表计算OR、CI、卡方检验和p值,研究不同年龄组和白血病类型的死亡率和康复率的相关性。结果:244例白血病患者得到诊断、治疗和随访;白血病与低龄人群有相关性;50%为1 ~ 5岁年龄组,平均±SD年龄= 6.44±3.7岁。与男性有显著相关性(66.7%)。高死亡率与6-10岁年龄组无显著相关性[(8/78;10.2%), OR = 2.6, p = 0.060,与AML [(4/38;10.5%),或= 2.1)]。考虑到治愈率与年龄的关系,不同年龄组的治愈率大致相似。JCM的治愈率也很高(2/3;66%), OR = 2.9。CML (7/11;63.6%;或= 2.60。结论:在目前的研究中发现了白血病与年轻年龄组和男性之间的联系。发现高死亡率与6-10岁年龄组AML之间存在关联。此外,年龄与治愈率无相关性,但JCM和CML的治愈率较高。
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引用次数: 1
Unindustrialized Nations and Migration of Work Force: Evaluation of Human Capital during Globalization Era 非工业化国家与劳动力迁移:全球化时代人力资本评价
Pub Date : 2021-08-13 DOI: 10.31579/2767-7370/017
Saeed Shoja Shafti
Among four essential features of globalization, which have been identified by the International Monetary Fund, immigration and leaving fatherland, has an important place, because it is about the human capital, which is the basis for social motion, organization, and evolution. During the last three decades of the 20th century, and continuing through the first two decades of the 21st century, there has been an increasing inflow of immigration to the world’s most highly developed countries. Parallel to the said move, brain drain, as well, is defined as the migration of educated workers in search of higher salaries, better standard of living and quality of life, access to advanced technology and more stable political circumstances in different places around the world. Limited career structures, poor intellectual stimulation, lack of research funding, threats of violence; and absence of good schooling are among the well-known motives for migration. By the way, brain drain has long been regarded as a serious restraint on the development of poor countries. While early literature supports the view that skilled migration is definitely damaging for those left behind, there are several recent studies that suggest that migration may in fact foster human capital formation and growth in sending countries. Before globalization, psychological problems of immigrants, like acculturation, had already a specific place in psychiatry. Now, while with increasing number of migrants, new accommodations and programs for responding to psychosocial complications of this huge number of refugees, outcasts, or valid émigrés seems more mandatory than before, the move toward universal measures, diagnoses and treatments of mental illness is inconsistent with the belief that mental distress is culturally and socially mediated. In the present article, the aforesaid circumstances, with reference to developing societies, have been surveyed from different perspectives.
在国际货币基金组织确定的全球化的四个基本特征中,移民和离开祖国占有重要地位,因为它涉及到人力资本,而人力资本是社会运动、组织和进化的基础。在20世纪的最后三十年,并持续到21世纪的头二十年,世界上最发达国家的移民流入不断增加。与此同时,人才外流也被定义为受过教育的工人在世界各地寻求更高的工资、更好的生活水平和生活质量、获得先进技术和更稳定的政治环境的迁移。职业结构有限,智力刺激不足,缺乏研究经费,暴力威胁;缺乏良好的教育是众所周知的移民动机之一。顺便说一下,人才流失一直被认为是贫穷国家发展的严重制约因素。虽然早期文献支持这样一种观点,即技术移民对那些被留下来的人肯定是有害的,但最近的几项研究表明,移民实际上可能促进人力资本的形成和输出国的增长。在全球化之前,移民的心理问题,如文化适应,已经在精神病学中占有特定的位置。现在,随着移民人数的不断增加,为应对这一庞大数量的难民、被抛弃者或合法的移民/变性人的社会心理并发症而设立的新住所和项目似乎比以前更有强制性,但对精神疾病采取普遍措施、诊断和治疗的做法,与精神痛苦是文化和社会调解的信念不一致。在本文中,就发展中社会而言,从不同的角度考察了上述情况。
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引用次数: 1
Functional Interdependency between Intestinal Microbiota and Biological Clock 肠道微生物群与生物钟的功能相互依赖
Pub Date : 2021-05-03 DOI: 10.31579/2767-7370/015
P. D. Gupta
In the human body, practically all organs work in coordination in co-operation with other organs since they are regulated by neurological, hormonal, environmental signals. Scientists have lately found out another regulatory factor the intestinal microbiota. The quality and the quantity of microbiota are also dependent on many internal and external factors. The composition of the intestinal microbiota also affects those systems which are regulated by circadian rhythms, in other words, circadian rhythms and microbiota is a two-way street. In this review, we have discussed the cross-talk between these two regulators.
在人体中,几乎所有的器官都受神经、激素和环境信号的调节,因此它们都是在与其他器官协调合作中工作的。科学家们最近发现了另一个调节因素——肠道菌群。微生物群的质量和数量也取决于许多内部和外部因素。肠道微生物群的组成也会影响那些受昼夜节律调节的系统,换句话说,昼夜节律和微生物群是双向的。在这篇综述中,我们讨论了这两个监管机构之间的串扰。
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引用次数: 0
Natural Mechanisms and Methods of Protection against Coronavirus COVID-19 预防冠状病毒COVID-19的自然机制和方法
Pub Date : 2021-02-24 DOI: 10.15520/JMRHS.V4I2.316
E. Bryndin
Our planet is a living creature that has its own protective viral mechanism. Viruses are activated when people too zealously intervene in the natural processes on the planet and worsen the environment. With a decrease in the spiritual level of society, a deterioration in ecology, climate change, a decrease in the frequency of the Schumann resonator supporting the energy healthy state of the body, pollution of water and soil, and other catastrophic disorders of natural processes on the planet, an epidemic and the process of mutation of viruses begins, as a result of which more and more of their species appear. For the people will rise against the people and the kingdom against the kingdom, and there will be earthquakes in places, and there will be smoothness and turmoil. This is the beginning of Mark's disease (13:8). The article discusses natural mechanisms and methods of protection against coronavirus.
我们的星球是一个有生命的生物,它有自己的病毒保护机制。当人们过于热心地干预地球上的自然过程并使环境恶化时,病毒就会被激活。随着社会精神水平的下降,生态的恶化,气候的变化,舒曼共振器支持身体能量健康状态的频率的减少,水和土壤的污染,以及地球上自然过程的其他灾难性紊乱,流行病和病毒变异的过程开始了,其结果是越来越多的物种出现。因为民要起来攻击民,国要起来攻击国,多处必有地震,又有平靖,又有扰乱。这是马可病的开始(13:8)。本文讨论了冠状病毒的自然保护机制和方法。
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引用次数: 2
The Longer we Dwell on our Misfortunes, the Greater is their Power to Harm us 我们沉湎于不幸的时间越长,它们对我们的伤害就越大
Pub Date : 2021-02-22 DOI: 10.31579/JNMIR/003
Arig Mussa
Remarkably, there is no place for inaccuracies and errors in modern era of value-based care medicine. The high stress clinical setting and the challenging demands within the medical field, to enhance improvement in patient safety culture. It is a difficult experience for health care practitioners to witness expected patient tragedies, and affect the most resilient health providers. Intended harm and negligence due to vindictiveness is extremely rare; yet, we treat our caregivers who are involved in human error and system failures with blame, shame, and, what may be most destructive and abandonment.
值得注意的是,在以价值为基础的现代护理医学中,没有不准确和错误的地方。高压力的临床环境和医疗领域的挑战性要求,以加强患者安全文化的改善。对于卫生保健从业人员来说,目睹预期的病人悲剧是一种艰难的经历,并影响到最具弹性的卫生服务提供者。因报复而造成的故意伤害和过失极为罕见;然而,对于那些因人为失误和系统故障而受伤的看护人,我们总是责备、羞愧,甚至是最具破坏性的抛弃。
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引用次数: 0
Pelvic Osteosarcoma: Resection and Reconstruction Using a Customised Plate 骨盆骨肉瘤:使用定制钢板切除和重建
Pub Date : 2021-02-22 DOI: 10.31579/JNMIR.2021/002
Z. Alaya
Introduction Primitive bone tumours of the pelvis represent a considerable challenge for carcinologic surgeons. Resections made in the acetabular zone could disrupt the continuity of the pelvic ring. The morbidity that comes after such a procedure requires a reconstruction surgery in order to improve the functional outcome. In this aim, multiple techniques have been reported. Case report We report the case of a 23-year-old male with no medical history diagnosed with a right pelvic bone osteosarcoma located in Enneking zones I and II. He first underwent neoadjuvant chemotherapy followed by a large resection of the whole bone. A reconstruction was then made using a vascularized fibular autologous graft and stabilized by a long customized lombo-femoral plate. Recovery of walking was possible using crutches. No recurrence was note at one year follow-up. Conclusion Malignant primitive tumours of the pelvis threaten the vital and functional prognoses of patients. It is now possible to perform conservative resections in more than 80% of case without compromising the survival of patients or their functional outcome.
骨盆的原始骨肿瘤对肿瘤外科医生来说是一个相当大的挑战。在髋臼区切除可能会破坏骨盆环的连续性。手术后的并发症需要进行重建手术以改善功能。为了达到这个目的,已经报道了多种技术。我们报告一例23岁男性,无病史,诊断为右骨盆骨骨肉瘤位于Enneking I区和II区。他首先接受了新辅助化疗,然后进行了大面积的全骨切除。然后使用带血管的腓骨自体移植物进行重建,并用定制的长长隆股钢板进行稳定。使用拐杖可以恢复行走。随访1年无复发。结论骨盆原发恶性肿瘤威胁着患者的生命和功能预后。现在有可能在80%以上的病例中进行保守切除,而不会影响患者的生存或其功能结果。
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引用次数: 1
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