Background: Coronaviruses are a group of RNA viruses responsible for respiratory and gastrointestinal illness. Of this group two have been associated with pandemics in recent years. As of December 2019, a new coronavirus (SARS-CoV2) was reported in Wuhan, China which despite best efforts has spread internationally prompting panic and universal public-health measures. Methods : A literature review was conducted utilising the PubMed database in March 2020. Search terms included ‘Wuhan’ OR ‘Coronavirus’ OR ‘2019-nCoV’ OR ‘SARS-CoV2’ AND ‘pneumonia’ OR ‘Outbreak’ OR ‘Infection’. These were used in isolation and combination to yield results. Papers were selected if they explored the diagnosis, management, transmission and/or treatment of SARS-CoV2. Following these 68 papers were screened of which 48 papers were included in this review. Results & Discussion: Early studies highlight that SARS-CoV2 has an incubation period of between 3–7 days and commonly presents with fever (93%), cough (69.8%) and dyspnoea (34.5%) and prominent upper respiratory tract symptoms. Patients are predominantly male and there is high prevalence of significant comorbid disease in fatal cases (overall case: fatality ratio- 2–3%). Encouragingly, supportive treatments are mainstay with the need for invasive ventilation and extracorporeal life support (ECLS) low. Diagnosis of SARS-CoV2 is made by demonstration of the virus by RT-PCR of throat/lavage specimens; however given the propensity for false negatives, CT-imaging is being used diagnostically with characteristic findings reported and can even detect disease in the asymptomatic phase where transmission is possible. International interventions have been to adhere to 14-day observation periods for suspected cases, the wearing of N95 facemasks alongside social distancing and hand-hygiene due to fomites. While antiviral treatments have been trialled in case-series no clear consensus has been made regarding their use but it remains clear that concurrent antibiotics are mainstay with restrictive fluid replacement. Emerging therapies which may show benefit include chloroquine, remdesivir, tocilizumab, azithromycin and sunitinib with the discontinuation of ACE inhibitors proposed. Conclusion : SARS-CoV2’s impact is greatest in the elderly and comorbid. Research has indicated key targets which may be important in producing effective treatments and an efficacious vaccine. On-going aims must be to try to alter behaviours and limit viral spread through social distancing, good hand hygiene and Personal Protective Equipment (PPE). Future trials must attempt to prognosticate patients further and understand the role if any of redeployed treatments which have showed some promise. In addition, questions surrounding long term immunity require further investigation.
{"title":"SARS-Cov2: A Review of this Novel Coronavirus","authors":"E. Worku","doi":"10.31038/imroj.2020511","DOIUrl":"https://doi.org/10.31038/imroj.2020511","url":null,"abstract":"Background: Coronaviruses are a group of RNA viruses responsible for respiratory and gastrointestinal illness. Of this group two have been associated with pandemics in recent years. As of December 2019, a new coronavirus (SARS-CoV2) was reported in Wuhan, China which despite best efforts has spread internationally prompting panic and universal public-health measures. Methods : A literature review was conducted utilising the PubMed database in March 2020. Search terms included ‘Wuhan’ OR ‘Coronavirus’ OR ‘2019-nCoV’ OR ‘SARS-CoV2’ AND ‘pneumonia’ OR ‘Outbreak’ OR ‘Infection’. These were used in isolation and combination to yield results. Papers were selected if they explored the diagnosis, management, transmission and/or treatment of SARS-CoV2. Following these 68 papers were screened of which 48 papers were included in this review. Results & Discussion: Early studies highlight that SARS-CoV2 has an incubation period of between 3–7 days and commonly presents with fever (93%), cough (69.8%) and dyspnoea (34.5%) and prominent upper respiratory tract symptoms. Patients are predominantly male and there is high prevalence of significant comorbid disease in fatal cases (overall case: fatality ratio- 2–3%). Encouragingly, supportive treatments are mainstay with the need for invasive ventilation and extracorporeal life support (ECLS) low. Diagnosis of SARS-CoV2 is made by demonstration of the virus by RT-PCR of throat/lavage specimens; however given the propensity for false negatives, CT-imaging is being used diagnostically with characteristic findings reported and can even detect disease in the asymptomatic phase where transmission is possible. International interventions have been to adhere to 14-day observation periods for suspected cases, the wearing of N95 facemasks alongside social distancing and hand-hygiene due to fomites. While antiviral treatments have been trialled in case-series no clear consensus has been made regarding their use but it remains clear that concurrent antibiotics are mainstay with restrictive fluid replacement. Emerging therapies which may show benefit include chloroquine, remdesivir, tocilizumab, azithromycin and sunitinib with the discontinuation of ACE inhibitors proposed. Conclusion : SARS-CoV2’s impact is greatest in the elderly and comorbid. Research has indicated key targets which may be important in producing effective treatments and an efficacious vaccine. On-going aims must be to try to alter behaviours and limit viral spread through social distancing, good hand hygiene and Personal Protective Equipment (PPE). Future trials must attempt to prognosticate patients further and understand the role if any of redeployed treatments which have showed some promise. In addition, questions surrounding long term immunity require further investigation.","PeriodicalId":158740,"journal":{"name":"Internal Medicine Research Open Journal","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130941404","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}
A 49-year-old man, non-alcoholic forest worker, with no past medical history, consulted to the Emergency Department for fever and persistent abdominal pain for a week. The biological results including, C reactive protein (CRP), lipase, hepatic assessment were normal as well as contrast-enhanced abdominal Computed Tomography (CT). On the day after, the evolution was favorable under symptomatic treatment including nefopam and paracetamol and the patient was discharged from the hospital. One week later, the patient was admitted to the Emergency Department with an identical symptomatology. A posterior quadricipital peeling skin lesion, appeared two weeks earlier according to the patient, was observed (Figure 1a.) A gastroscopy, a colonoscopy, other abdominal CT and biological tests were performed. An inflammation biomarker elevation was observed (CRP: 180 mg/L and hyperleukocytosis: 13.3 G/L) without other biological abnormalities (lipase: 48 UI/L, ALAT: 48 UI/L). The endoscopic examinations and abdominal CT were normal. The patient was discharged from the hospital without any treatment. Half a month later, the patient was admitted to the Emergency Department for the third time and recurrence of the abdominal pain. The clinical examination found a hemodynamic stability, an abdominal pain of the left hypochondrium associated with a cutaneous ulcerative and non-progressive skin lesion in the same region as previously mentioned (Figure 1b.). The biological assessment found a very mild inflammatory syndrome (CRP 86 mg/L, Procalcitonin < 0.2 ng/mL, leukocytes 9.5 G/L), a high lipase level at 1714 IU/L without hepatocellular abnormalities. The third abdominal CT revealed an aspect of pancreatic necrosis with a pseudocyst (6 cm) at the tail of the pancreas, in contact with the splenic hile and the posterior wall of the stomach (Figure 1c.). The patient was hospitalized in Intensive Care Department with the diagnosis of pancreatitis.
{"title":"First Case Report of Pancreatitis in Lyme disease","authors":"A. Baisse, S. Parreau, A. Abdeh, N. Pichon","doi":"10.31038/imroj.2019423","DOIUrl":"https://doi.org/10.31038/imroj.2019423","url":null,"abstract":"A 49-year-old man, non-alcoholic forest worker, with no past medical history, consulted to the Emergency Department for fever and persistent abdominal pain for a week. The biological results including, C reactive protein (CRP), lipase, hepatic assessment were normal as well as contrast-enhanced abdominal Computed Tomography (CT). On the day after, the evolution was favorable under symptomatic treatment including nefopam and paracetamol and the patient was discharged from the hospital. One week later, the patient was admitted to the Emergency Department with an identical symptomatology. A posterior quadricipital peeling skin lesion, appeared two weeks earlier according to the patient, was observed (Figure 1a.) A gastroscopy, a colonoscopy, other abdominal CT and biological tests were performed. An inflammation biomarker elevation was observed (CRP: 180 mg/L and hyperleukocytosis: 13.3 G/L) without other biological abnormalities (lipase: 48 UI/L, ALAT: 48 UI/L). The endoscopic examinations and abdominal CT were normal. The patient was discharged from the hospital without any treatment. Half a month later, the patient was admitted to the Emergency Department for the third time and recurrence of the abdominal pain. The clinical examination found a hemodynamic stability, an abdominal pain of the left hypochondrium associated with a cutaneous ulcerative and non-progressive skin lesion in the same region as previously mentioned (Figure 1b.). The biological assessment found a very mild inflammatory syndrome (CRP 86 mg/L, Procalcitonin < 0.2 ng/mL, leukocytes 9.5 G/L), a high lipase level at 1714 IU/L without hepatocellular abnormalities. The third abdominal CT revealed an aspect of pancreatic necrosis with a pseudocyst (6 cm) at the tail of the pancreas, in contact with the splenic hile and the posterior wall of the stomach (Figure 1c.). The patient was hospitalized in Intensive Care Department with the diagnosis of pancreatitis.","PeriodicalId":158740,"journal":{"name":"Internal Medicine Research Open Journal","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132185918","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}
Luana Ramalho Jacob, A. Corrêa, Fernanda do Nascimento Maia, Carla Trevisan, Martins Ribeiro
Mucopolysaccharidoses (MPS) are a specific group of genetic diseases in which due to the accumulation of glycosaminoglycans (GAGs) in different organs and tissues, causes multisystemic changes that compromise the functionality and occupational performance of individuals. Occupational performance, understood as the participation and execution of activities of daily living, may be favoured using Assistive Technology (AT). Since there are no studies reporting the influence of AT on the occupational performance of children and adolescents with MPS, the objective of this study was to evaluate the occupational performance in self-care activities, based on the use of low-cost AT in children and adolescents with Mucopolysaccharidosis. Six individuals with MPS types I, IV-A and VI, aged 9 to 16 years participated. The instruments used for data collection were the Pediatric Disability Assessment Inventory (PEDI) self-care area only, and the Canadian Occupational Performance Measure (COPM). The results showed that the tasks that presented the greatest disabilities in the performance are the areas of dressing, personal hygiene and bath. Thus, TA resources were made for five activities related to dressing and one for personal hygiene. After the use of AT, there was a positive and significant change in occupational performance and satisfaction of these individuals. Thus, the use of AT can significantly improve the occupational performance of this population.
{"title":"Occupational Performance of Children and Adolescents with Mucopolysaccharidosis Using Assistive Technologies","authors":"Luana Ramalho Jacob, A. Corrêa, Fernanda do Nascimento Maia, Carla Trevisan, Martins Ribeiro","doi":"10.31038/imroj.2019421","DOIUrl":"https://doi.org/10.31038/imroj.2019421","url":null,"abstract":"Mucopolysaccharidoses (MPS) are a specific group of genetic diseases in which due to the accumulation of glycosaminoglycans (GAGs) in different organs and tissues, causes multisystemic changes that compromise the functionality and occupational performance of individuals. Occupational performance, understood as the participation and execution of activities of daily living, may be favoured using Assistive Technology (AT). Since there are no studies reporting the influence of AT on the occupational performance of children and adolescents with MPS, the objective of this study was to evaluate the occupational performance in self-care activities, based on the use of low-cost AT in children and adolescents with Mucopolysaccharidosis. Six individuals with MPS types I, IV-A and VI, aged 9 to 16 years participated. The instruments used for data collection were the Pediatric Disability Assessment Inventory (PEDI) self-care area only, and the Canadian Occupational Performance Measure (COPM). The results showed that the tasks that presented the greatest disabilities in the performance are the areas of dressing, personal hygiene and bath. Thus, TA resources were made for five activities related to dressing and one for personal hygiene. After the use of AT, there was a positive and significant change in occupational performance and satisfaction of these individuals. Thus, the use of AT can significantly improve the occupational performance of this population.","PeriodicalId":158740,"journal":{"name":"Internal Medicine Research Open Journal","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114871895","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}
D. Howard, S. Shapiro, D. J. Murphy, E. Overton, L. Chadwick, Jason M. Stein
Background: Effective hospital teams can improve outcomes, yet, traditional hospital staffing, leadership, and rounding practices discourage effective teamwork and communication. Under the Accountable Care Unit model, physicians are assigned to units, team members conduct daily structured interdisciplinary bedside rounds, and physicians and nurses are jointly responsible for unit outcomes. Objectives: To evaluate the impact of ACUs on patient outcomes. Design: Retrospective, pre-post design with concurrent controls. Patients: 23,406 patients admitted to ACU and non-ACU medical wards at a large academic medical center between January 1, 2008 and December 31, 2012. Measures: In-hospital mortality and discharge to hospice, length of stay, 30-day readmission. Results: Patients admitted to ACUs were less likely to be discharged dead or to hospice (-1.8 percentage point decline [95% CI: -3.3, -0.3; p = .015]) ACUs did not reduce 30 day readmission rates or have a significant effect on length-of-stay. Conclusions: Results suggest ACUs improved patient outcomes. However, it is difficult to identify the impact of ACUs against a backdrop of low inpatient mortality and the development of a hospice unit during the study period.
{"title":"The Impact of Accountable Care Units on Patient Outcomes","authors":"D. Howard, S. Shapiro, D. J. Murphy, E. Overton, L. Chadwick, Jason M. Stein","doi":"10.31038/imroj.2019414","DOIUrl":"https://doi.org/10.31038/imroj.2019414","url":null,"abstract":"Background: Effective hospital teams can improve outcomes, yet, traditional hospital staffing, leadership, and rounding practices discourage effective teamwork and communication. Under the Accountable Care Unit model, physicians are assigned to units, team members conduct daily structured interdisciplinary bedside rounds, and physicians and nurses are jointly responsible for unit outcomes. Objectives: To evaluate the impact of ACUs on patient outcomes. Design: Retrospective, pre-post design with concurrent controls. Patients: 23,406 patients admitted to ACU and non-ACU medical wards at a large academic medical center between January 1, 2008 and December 31, 2012. Measures: In-hospital mortality and discharge to hospice, length of stay, 30-day readmission. Results: Patients admitted to ACUs were less likely to be discharged dead or to hospice (-1.8 percentage point decline [95% CI: -3.3, -0.3; p = .015]) ACUs did not reduce 30 day readmission rates or have a significant effect on length-of-stay. Conclusions: Results suggest ACUs improved patient outcomes. However, it is difficult to identify the impact of ACUs against a backdrop of low inpatient mortality and the development of a hospice unit during the study period.","PeriodicalId":158740,"journal":{"name":"Internal Medicine Research Open Journal","volume":"61 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126136854","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}
Antibiotics used to treat zoonoses, such as campylobacteriosis and salmonellosis become less effective, new data from the European center for Disease Prevention and Control (ECDC) confirm this observation. Enterobacteria are the most common causes of community or nosocomial infections. Some of them produce beta-lactamases extended spectrum (ESBL) frequently associated with resistance to antibiotics. We conduct a retrospective study from positive levies of enterobacteria ESBL identified in adult patients hospitalized at the Quimper hospital, during the year 2016. 74 patients (48women) median age 80 years were included. 30% lifed in an institution, 21% had an history of infection of EBLSE, 62% had urinary tract infection, 12% intraabdominal infection, 9% respiratory infections. Distribution of Enterobacteriaceae was: E. coli (73%), E.cloacae complex (16%), K.pneumoniae (5.4%), Citrobacter freundii (2.7%), Citrobacter koseri(1.4%), Salmonella enterica (1.4%). Sensitivity profiles of antibiotics strains are presented. The strategies of antibiotic therapy are detailed and discussed. The most used molecule was ceftriaxone for probalistic treatment then fluoroquinolone, carbapenems and amoxicillinclavulanate for second line. The evolution was favorable for 64 patients, 8 deaths, 6 serious complications were notified.
{"title":"Enterobacteria Producing Extended Spectrum Beta- Lactamases : 74 Cases in a General Hospital in France","authors":"M. Geier","doi":"10.31038/imroj.2019413","DOIUrl":"https://doi.org/10.31038/imroj.2019413","url":null,"abstract":"Antibiotics used to treat zoonoses, such as campylobacteriosis and salmonellosis become less effective, new data from the European center for Disease Prevention and Control (ECDC) confirm this observation. Enterobacteria are the most common causes of community or nosocomial infections. Some of them produce beta-lactamases extended spectrum (ESBL) frequently associated with resistance to antibiotics. We conduct a retrospective study from positive levies of enterobacteria ESBL identified in adult patients hospitalized at the Quimper hospital, during the year 2016. 74 patients (48women) median age 80 years were included. 30% lifed in an institution, 21% had an history of infection of EBLSE, 62% had urinary tract infection, 12% intraabdominal infection, 9% respiratory infections. Distribution of Enterobacteriaceae was: E. coli (73%), E.cloacae complex (16%), K.pneumoniae (5.4%), Citrobacter freundii (2.7%), Citrobacter koseri(1.4%), Salmonella enterica (1.4%). Sensitivity profiles of antibiotics strains are presented. The strategies of antibiotic therapy are detailed and discussed. The most used molecule was ceftriaxone for probalistic treatment then fluoroquinolone, carbapenems and amoxicillinclavulanate for second line. The evolution was favorable for 64 patients, 8 deaths, 6 serious complications were notified.","PeriodicalId":158740,"journal":{"name":"Internal Medicine Research Open Journal","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114259550","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}
We present the emerging science of Mind Genomics, to understand people’s responses to health-related issues, specifically pain. Mind Genomics emerge out of short, affordable, scalable, east-to-run experiments. The topic, here pain, is deconstructed into four questions, each with four separate answers (elements.) The answers are combined into vignettes, presented to respondents, who rate the entire vignette. Emerging from the study are the ratings and the response times to the vignettes, both of which are deconstructed into the contributions of the different underlying elements which the vignettes comprise. The answers cannot be gamed, and the data quickly reveal what is important to the individual, as well as revealing the existence of new-to-the-world mind-sets which differ in the pattern of elements that they find important. Mind Genomics provides the opportunity to understand the person’s needs and wants for specific health as well as other experiential situations where human judgment is relevant.
{"title":"Expectations and Attitudes Regarding Chronic Pain Control: An Exploration Using Mind Genomics","authors":"A. Gere, D. Moskowitz, Ran Shifron, H. Moskowitz","doi":"10.31038/imroj.2019412","DOIUrl":"https://doi.org/10.31038/imroj.2019412","url":null,"abstract":"We present the emerging science of Mind Genomics, to understand people’s responses to health-related issues, specifically pain. Mind Genomics emerge out of short, affordable, scalable, east-to-run experiments. The topic, here pain, is deconstructed into four questions, each with four separate answers (elements.) The answers are combined into vignettes, presented to respondents, who rate the entire vignette. Emerging from the study are the ratings and the response times to the vignettes, both of which are deconstructed into the contributions of the different underlying elements which the vignettes comprise. The answers cannot be gamed, and the data quickly reveal what is important to the individual, as well as revealing the existence of new-to-the-world mind-sets which differ in the pattern of elements that they find important. Mind Genomics provides the opportunity to understand the person’s needs and wants for specific health as well as other experiential situations where human judgment is relevant.","PeriodicalId":158740,"journal":{"name":"Internal Medicine Research Open Journal","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116805496","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 : Disturbance of sodium and potassium chemistry is commonly present during an emergency medical admission; we analyse the interaction of these ions and relate K + / Na + Ratios to hospital mortality outcomes. Methods : All emergency medical admissions between 2002 and 2017 were studied. We log transformed sodium and potassium values and calculated their respective ratios as a predictor of 30-day mortality outcomes using a multivariable logistic model. Results: There were 106,586 admissions in 54,928 patients. Patients with higher K + / Na + ratios at admission were older at 66.5 years (IQR 47.0–79.3) compared with 59.0 years (IQR 39.9–75.5) and more likely to be female (51.9% vs. 45.5%). They had a higher 30-day hospital mortality rate – 5.4% vs 3.5% (p<0.001). Across consecutive deciles of K + , rising admission levels linearly predicted outcomes unlike Na + where falling levels linearly predicted an increased mortality. Disturbed K + / Na + balance (log ratio) was prognostic – 30-day mortality OR 1.12 (95%CI 1.11–1.13). Increasing age predicted an increased likelihood of an abnormal K + / Na + balance. Conclusion: Disturbed K + / Na + is linearly predictive of 30-day hospital mortality and is strongly age associated; possibly it is a consequence of Na + leaving the extracellular space (ECF) and K + transit to the ECF due to impaired cellular membrane homeostatic function.
背景:钠钾化学紊乱在急诊住院期间是常见的;我们分析了这些离子的相互作用，并将K + / Na +比率与医院死亡率结果联系起来。方法:对2002 - 2017年所有急诊住院患者进行研究。我们记录了转换后的钠和钾值，并使用多变量逻辑模型计算了它们各自的比率，作为30天死亡率结果的预测因子。结果:54928例患者共入院106586例。入院时K + / Na +比值较高的患者年龄为66.5岁(IQR为47.0-79.3)，而59.0岁(IQR为39.9-75.5)，女性比例更高(51.9%比45.5%)。他们的30天住院死亡率更高，分别为5.4%和3.5% (p<0.001)。在连续的K +十分位数中，入院率的上升线性预测了结果，而Na +的下降线性预测了死亡率的增加。干扰的K + / Na +平衡(对数比)是预后- 30天死亡率OR 1.12 (95%CI 1.11-1.13)。随着年龄的增长，K + / Na +平衡异常的可能性增加。结论:K + / Na +紊乱可线性预测住院30天死亡率，且与年龄密切相关;这可能是由于细胞膜稳态功能受损导致Na +离开细胞外空间(ECF)和K +转运到ECF的结果。
{"title":"Admission Potassium / Sodium Ratio Linearly Predicts Mortality Outcome Following an Emergency Medical Admission","authors":"R. Conway, D. Byrne, D. O’Riordan, B. Silke","doi":"10.31038/imroj.2019411","DOIUrl":"https://doi.org/10.31038/imroj.2019411","url":null,"abstract":"Background : Disturbance of sodium and potassium chemistry is commonly present during an emergency medical admission; we analyse the interaction of these ions and relate K + / Na + Ratios to hospital mortality outcomes. Methods : All emergency medical admissions between 2002 and 2017 were studied. We log transformed sodium and potassium values and calculated their respective ratios as a predictor of 30-day mortality outcomes using a multivariable logistic model. Results: There were 106,586 admissions in 54,928 patients. Patients with higher K + / Na + ratios at admission were older at 66.5 years (IQR 47.0–79.3) compared with 59.0 years (IQR 39.9–75.5) and more likely to be female (51.9% vs. 45.5%). They had a higher 30-day hospital mortality rate – 5.4% vs 3.5% (p<0.001). Across consecutive deciles of K + , rising admission levels linearly predicted outcomes unlike Na + where falling levels linearly predicted an increased mortality. Disturbed K + / Na + balance (log ratio) was prognostic – 30-day mortality OR 1.12 (95%CI 1.11–1.13). Increasing age predicted an increased likelihood of an abnormal K + / Na + balance. Conclusion: Disturbed K + / Na + is linearly predictive of 30-day hospital mortality and is strongly age associated; possibly it is a consequence of Na + leaving the extracellular space (ECF) and K + transit to the ECF due to impaired cellular membrane homeostatic function.","PeriodicalId":158740,"journal":{"name":"Internal Medicine Research Open Journal","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116471254","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}
This article reviews the research carried out by outstanding scientists to underscore the significant role played by Burroughs Wellcome Research Laboratories in erasing the differences in the objectives of scientists in academia and those in industry. These enlightened policies not only markedly advanced our fund of scientific knowledge in the biomedical sciences but led to the production of drugs that were of major benefit to mankind.
{"title":"Burroughs Wellcome: The Seminal Link between Academia and the Pharmaceutical Industry","authors":"R. Rubin","doi":"10.31038/imroj.2018341","DOIUrl":"https://doi.org/10.31038/imroj.2018341","url":null,"abstract":"This article reviews the research carried out by outstanding scientists to underscore the significant role played by Burroughs Wellcome Research Laboratories in erasing the differences in the objectives of scientists in academia and those in industry. These enlightened policies not only markedly advanced our fund of scientific knowledge in the biomedical sciences but led to the production of drugs that were of major benefit to mankind.","PeriodicalId":158740,"journal":{"name":"Internal Medicine Research Open Journal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127453042","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. H. Kim, Y. Yoon, Joon Cheol Song, Jeong Woon Jang, In-Sook Woo
Background : This study was conducted to evaluate serum cytokeratin 19-fragments (CYFRA 21–1), in addition to serum carbohydrate antigen 19–9 (CA 19–9), as a novel biomarker for the diagnosis and prognosis of pancreatic cancer. Methods: We performed a retrospective review of medical records of the patients whose serum CYFRA 21–1 and CA 19–9 levels were estimated in a single institute from March 2011 to February 2014. The sensitivity and specificity of CYFRA 21–1 and CA 19–9 for pancreatic cancer were assessed, and the overall survival of the patients was evaluated with respect to elevation of the CYFRA 21–1 levels. Results: Records of 57 patients diagnosed with pancreatic cancer and 110 healthy individuals (control group) were collected. CYFRA 21–1 had a sensitivity of 80.7%, specificity of 80%, positive predictive value of 67.6%, and negative predictive value of 88.9%, at a cut-off value of 1.93 ng/ml determined by a receiver operating characteristics (ROC) analysis. The area under ROC (AUC-ROC) curves of CYFRA 21–1 and CA 19–9 were 0.83 [95% confidence interval (CI), 0.764–0.884) and 0.874 (95% CI, 0.814–0.921), respectively without any statistically significant difference (p = 0.333). No correlation was observed between the CYFRA 21–1 levels and the serum total bilirubin levels. For overall survival, a CYFRA 21–1 level of ≥ 5 ng/ml indicated a poor prognosis among patients with pancreatic cancers (median survival, 4.4 vs. 9.5 months, p = 0.000). CYFRA 21–1 level was also found to be an independent prognostic factor in the multivariate analysis [hazard ratio, 2.277 (95% CI, 1.137–4.559), p = 0.020]. Conclusion : CYFRA 21–1 can be a valuable biomarker for the diagnosis and prognostic prediction of pancreatic cancer.
{"title":"Diagnostic and Prognostic Value of Serum Cyfra 21–1 Levels in Patients with Pancreatic Cancer","authors":"J. H. Kim, Y. Yoon, Joon Cheol Song, Jeong Woon Jang, In-Sook Woo","doi":"10.31038/imroj.2018342","DOIUrl":"https://doi.org/10.31038/imroj.2018342","url":null,"abstract":"Background : This study was conducted to evaluate serum cytokeratin 19-fragments (CYFRA 21–1), in addition to serum carbohydrate antigen 19–9 (CA 19–9), as a novel biomarker for the diagnosis and prognosis of pancreatic cancer. Methods: We performed a retrospective review of medical records of the patients whose serum CYFRA 21–1 and CA 19–9 levels were estimated in a single institute from March 2011 to February 2014. The sensitivity and specificity of CYFRA 21–1 and CA 19–9 for pancreatic cancer were assessed, and the overall survival of the patients was evaluated with respect to elevation of the CYFRA 21–1 levels. Results: Records of 57 patients diagnosed with pancreatic cancer and 110 healthy individuals (control group) were collected. CYFRA 21–1 had a sensitivity of 80.7%, specificity of 80%, positive predictive value of 67.6%, and negative predictive value of 88.9%, at a cut-off value of 1.93 ng/ml determined by a receiver operating characteristics (ROC) analysis. The area under ROC (AUC-ROC) curves of CYFRA 21–1 and CA 19–9 were 0.83 [95% confidence interval (CI), 0.764–0.884) and 0.874 (95% CI, 0.814–0.921), respectively without any statistically significant difference (p = 0.333). No correlation was observed between the CYFRA 21–1 levels and the serum total bilirubin levels. For overall survival, a CYFRA 21–1 level of ≥ 5 ng/ml indicated a poor prognosis among patients with pancreatic cancers (median survival, 4.4 vs. 9.5 months, p = 0.000). CYFRA 21–1 level was also found to be an independent prognostic factor in the multivariate analysis [hazard ratio, 2.277 (95% CI, 1.137–4.559), p = 0.020]. Conclusion : CYFRA 21–1 can be a valuable biomarker for the diagnosis and prognostic prediction of pancreatic cancer.","PeriodicalId":158740,"journal":{"name":"Internal Medicine Research Open Journal","volume":"191 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133949510","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}
James A Ducey, Ryan Malave, Iman Zahedi, Emmanual Keku, S. Bidaisee
Objective Conduct a cross-sectional study to gather data regarding texting while driving behaviors, identify vulnerable populations, as well as assess public opinions about receptiveness to interventions in Grenada, West Indies. This will inform efforts to curb motor vehicle accidents (MVAs) locally. Design and Methods An anonymous 16-item questionnaire assessing cell phone usage while driving was answered by Grenadian drivers recruited from across Grenada. The survey assessed incidence and prevalence of texting while driving, frequency of MVAs involving texting, participant risk perception, demographic data, as well as which interventions are perceived to be effective in reducing texting while driving. Drivers were approached in public car parks and roadsides by the study researchers to obtain their participation. From 191 survey responses, mean age was 37.05 ±10.038 years. 50.3% admitted to texting while driving. Statistically significant between group differences were documented with variables of gender (females comprise 59% of never texted group vs. comprising only 40% of texting while driving group, p=0.009), mean age (Never texted group39.3 years ± 11 vs. Texted while driving group 34.9 years ± 8, 0.003), and knowing anyone involved in a MVA due to texting while driving (texted while driving group 26% vs never texted group 5%, p≤0.001). of effects to these groups, safer technologies, as well as legislation may mitigate texting while driving’s consequence in Grenada.
{"title":"Cross-sectional Study Investigating Texting and Driving in Grenada, West Indies","authors":"James A Ducey, Ryan Malave, Iman Zahedi, Emmanual Keku, S. Bidaisee","doi":"10.31038/imroj.2018334","DOIUrl":"https://doi.org/10.31038/imroj.2018334","url":null,"abstract":"Objective Conduct a cross-sectional study to gather data regarding texting while driving behaviors, identify vulnerable populations, as well as assess public opinions about receptiveness to interventions in Grenada, West Indies. This will inform efforts to curb motor vehicle accidents (MVAs) locally. Design and Methods An anonymous 16-item questionnaire assessing cell phone usage while driving was answered by Grenadian drivers recruited from across Grenada. The survey assessed incidence and prevalence of texting while driving, frequency of MVAs involving texting, participant risk perception, demographic data, as well as which interventions are perceived to be effective in reducing texting while driving. Drivers were approached in public car parks and roadsides by the study researchers to obtain their participation. From 191 survey responses, mean age was 37.05 ±10.038 years. 50.3% admitted to texting while driving. Statistically significant between group differences were documented with variables of gender (females comprise 59% of never texted group vs. comprising only 40% of texting while driving group, p=0.009), mean age (Never texted group39.3 years ± 11 vs. Texted while driving group 34.9 years ± 8, 0.003), and knowing anyone involved in a MVA due to texting while driving (texted while driving group 26% vs never texted group 5%, p≤0.001). of effects to these groups, safer technologies, as well as legislation may mitigate texting while driving’s consequence in Grenada.","PeriodicalId":158740,"journal":{"name":"Internal Medicine Research Open Journal","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131796220","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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