Objective: Establishment of brucellosis spondylitis of imaging classification; provision reference for clinical treatment methods. Methods: Form January 2008 to July 2012, 89 cases imaging data confirmed by clinical examination and laboratory of brucellosis spondylitis patients were analyzed retrospectively, based on X-ray, CT and MRI imaging of their clinical manifestations- Vertebral inflammatory infiltration and extent of the damage, the extent of damage to the intervertebral space, periostitis inflammatory changes, paraspinal abscess, spinal cord, cauda equina and nerve root compression. All this imaging indicators above were the evaluation criteria. Acquisition and analysis of the imaging data was implemented by the blinded reading group which was composed of Imaging Center physicians and orthopedic surgeons. According to these imaging performances, develop the imaging classification. Results: Brucellosis spondylitis image was made up of I-VI type: type I: vertebral inflammation; type II: Discitis; type III: periostitis; type IV: abscess; type V: spinal nerve and type VI: compound. The group of 54 cases accounted for 60.67% of the compound, in which the incidence of type I Image companied by type II was maximum: 22 cases accounted for 40.74% (22/54) and second type II Image and companied by V type was 20 cases: accounted for 37.03% (20/54). In the group, 35 cases of simple type accounted for 39.33%: type I: 4 cases; type II: 12 cases; type III: 3 cases; type IV: 2 cases; type: 4 cases. Simple and complex type of type II imaging accounted for 59.55% (53/89) the highest occurrence rate, in which the type I was 47 cases: accounted for 52.81% (47/89). Based on imaging classification, 67 cases was treated by surgery, in which 59 cases was treated by debridement and 8 cases was treated by percutaneous minimally invasive surgery, 22 cases was not treated by surgery. The group of 89 cases had been followed for 1 year: 83 cases had been cured without prognosis, and 6 cases had been improved. Conclusion: Brucellosis spondylitis images classification has a reference value and guiding significance for the strategies of clinical treatment. According to this classification, simply type I, type II, type III, and IV type can be used in clinical conservative treatment, and when the evolution of the disease has surgical indications, or type V and VI type the patients should be treated actively by surgery
{"title":"Imaging study to establish the classification criteria of brucellar spondylitis based on MRI findings","authors":"","doi":"10.33140/mcr.08.03.08","DOIUrl":"https://doi.org/10.33140/mcr.08.03.08","url":null,"abstract":"Objective: Establishment of brucellosis spondylitis of imaging classification; provision reference for clinical treatment methods. Methods: Form January 2008 to July 2012, 89 cases imaging data confirmed by clinical examination and laboratory of brucellosis spondylitis patients were analyzed retrospectively, based on X-ray, CT and MRI imaging of their clinical manifestations- Vertebral inflammatory infiltration and extent of the damage, the extent of damage to the intervertebral space, periostitis inflammatory changes, paraspinal abscess, spinal cord, cauda equina and nerve root compression. All this imaging indicators above were the evaluation criteria. Acquisition and analysis of the imaging data was implemented by the blinded reading group which was composed of Imaging Center physicians and orthopedic surgeons. According to these imaging performances, develop the imaging classification. Results: Brucellosis spondylitis image was made up of I-VI type: type I: vertebral inflammation; type II: Discitis; type III: periostitis; type IV: abscess; type V: spinal nerve and type VI: compound. The group of 54 cases accounted for 60.67% of the compound, in which the incidence of type I Image companied by type II was maximum: 22 cases accounted for 40.74% (22/54) and second type II Image and companied by V type was 20 cases: accounted for 37.03% (20/54). In the group, 35 cases of simple type accounted for 39.33%: type I: 4 cases; type II: 12 cases; type III: 3 cases; type IV: 2 cases; type: 4 cases. Simple and complex type of type II imaging accounted for 59.55% (53/89) the highest occurrence rate, in which the type I was 47 cases: accounted for 52.81% (47/89). Based on imaging classification, 67 cases was treated by surgery, in which 59 cases was treated by debridement and 8 cases was treated by percutaneous minimally invasive surgery, 22 cases was not treated by surgery. The group of 89 cases had been followed for 1 year: 83 cases had been cured without prognosis, and 6 cases had been improved. Conclusion: Brucellosis spondylitis images classification has a reference value and guiding significance for the strategies of clinical treatment. According to this classification, simply type I, type II, type III, and IV type can be used in clinical conservative treatment, and when the evolution of the disease has surgical indications, or type V and VI type the patients should be treated actively by surgery","PeriodicalId":186238,"journal":{"name":"Medical & Clinical Research","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133875005","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}
Objectives: Coronavirus disease (COVID-19) continues to cause considerable morbidity and mortality worldwide. The complication in patients with severe COVID-19 disease include arrhythmias, peri-myocarditis (PM), and heart failure (HF). The important role of echocardiogram (ECHO) and cardiac MRI (CMRI) in the diagnosis of myocarditis in COVID-19 patients in Saudi Arabia has not been assessed. The objective is to assess the diagnostic value of ECHO and CMRI and define phenotypes patterns in the COVID 19 subgroup. Methods: In this retrospective study, adults with suspected COVID-19 presented with dyspnea and cardiovascular comorbidities were studied between January 2021 and December 2021. We collected 329 patients, (LVEF by ECHO was 44±11%). Fifty-two percent (173/329), had HF (HFrEF or HFpEF), thirty-six percent presented with acute coronary syndrome ACS (120/329), and four percent had adult congenital heart disease (ACHD). CMRI was performed in 160 patients (LVEF is 40±11%), and fifty-two were COVID-19 positive. Based on the Lake Louis criteria, CMRI was performed at siemens 3 T can identify myocardial function and damage using Late Gadolinium Enhancement (LGE) images phenotypes pattern were described as normal, ischemic, or nonischemic (peri-myocarditis). LVEF was divided by CMRI as (EF≥50 or EF<50%). Comparison of Cardiac MRI LGE in the COVID 19 subgroups according to the LVEF was analyzed. The average time interval from diagnosis to CMRI was 4-8weeks. Results: Sixty percent of patients (221/329) were confirmed COVID-19 infection, the mean age is 54±13 years. Ten patients were diagnosed with pulmonary embolism (2/10 were ACHD). Peri-myocarditis patterns were found in sixty percent of COVID-19 patients (31/52), five percent (3/52) had an ischemic pattern, and thirty- five percent (18/52) had normal LGE (X2 =21.8 and P value<0.001). However, in COVID-19 negative patients, Eighty percent (85/108) had an ischemic pattern, and twenty percent (23/108) had normal LGE. (X2 =37.7 and P value<0.001). Conclusion: In this observational study, CMRI confirms its high diagnostic tool in evaluating myocarditis activity. In COVID-19 patients, two third of the population were found to have peri-myocarditis, with half of them reporting LVEF was ≥50 %. (X2 =67.1 and P value<0.001).
{"title":"The diagnostic utility of cardiac imaging (echocardiogram and cardiac magnetic resonance) in covid 19 patients and cardiac complications: retrospective cohort study in Saudi Arabia","authors":"","doi":"10.33140/mcr.08.03.07","DOIUrl":"https://doi.org/10.33140/mcr.08.03.07","url":null,"abstract":"Objectives: Coronavirus disease (COVID-19) continues to cause considerable morbidity and mortality worldwide. The complication in patients with severe COVID-19 disease include arrhythmias, peri-myocarditis (PM), and heart failure (HF). The important role of echocardiogram (ECHO) and cardiac MRI (CMRI) in the diagnosis of myocarditis in COVID-19 patients in Saudi Arabia has not been assessed. The objective is to assess the diagnostic value of ECHO and CMRI and define phenotypes patterns in the COVID 19 subgroup. Methods: In this retrospective study, adults with suspected COVID-19 presented with dyspnea and cardiovascular comorbidities were studied between January 2021 and December 2021. We collected 329 patients, (LVEF by ECHO was 44±11%). Fifty-two percent (173/329), had HF (HFrEF or HFpEF), thirty-six percent presented with acute coronary syndrome ACS (120/329), and four percent had adult congenital heart disease (ACHD). CMRI was performed in 160 patients (LVEF is 40±11%), and fifty-two were COVID-19 positive. Based on the Lake Louis criteria, CMRI was performed at siemens 3 T can identify myocardial function and damage using Late Gadolinium Enhancement (LGE) images phenotypes pattern were described as normal, ischemic, or nonischemic (peri-myocarditis). LVEF was divided by CMRI as (EF≥50 or EF<50%). Comparison of Cardiac MRI LGE in the COVID 19 subgroups according to the LVEF was analyzed. The average time interval from diagnosis to CMRI was 4-8weeks. Results: Sixty percent of patients (221/329) were confirmed COVID-19 infection, the mean age is 54±13 years. Ten patients were diagnosed with pulmonary embolism (2/10 were ACHD). Peri-myocarditis patterns were found in sixty percent of COVID-19 patients (31/52), five percent (3/52) had an ischemic pattern, and thirty- five percent (18/52) had normal LGE (X2 =21.8 and P value<0.001). However, in COVID-19 negative patients, Eighty percent (85/108) had an ischemic pattern, and twenty percent (23/108) had normal LGE. (X2 =37.7 and P value<0.001). Conclusion: In this observational study, CMRI confirms its high diagnostic tool in evaluating myocarditis activity. In COVID-19 patients, two third of the population were found to have peri-myocarditis, with half of them reporting LVEF was ≥50 %. (X2 =67.1 and P value<0.001).","PeriodicalId":186238,"journal":{"name":"Medical & Clinical Research","volume":"250 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128720528","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: Stunting (height or age below 2 SD) is a major public health worldwide; however published studies regarding food and feeding malpractices of both mothers and their children and its impact on stunting are scarce in South-Kivu Province. Methods: We conducted a longitudinal study in rural area of Lwiro. One hundred thirty six mother-infant pairs were concerned by the study. The data was entered in Excel and analyzed by SPSS (Statistical Analysis Software) version 26.0. WHO Anthropometrics software helped to calculate Z score. The descriptive statistic was performed to determine the prevalence of independents variables. In addition, a multinomial logistic was run to establish predictor’s factors of all stages of stunting. A multinomial logistic regression model was fitted to calculate the odds ratios and their related 95% confidence interval for all stages of stunting by socioeconomic, household characteristic and food malpractice. Results: The study highlights a low prevalence (3/130, 2.3%) of underweight, a critical prevalence (32.7%) of wasting and a very high prevalence (84.6%) of stunting in the study region. Of the last, (35.4%, 46/130), (26.9%, 35/130) and (22.3%29/130) are severely, mildly and marginally stunted respectively. However, a high prevalence of overweight (38.1%, 51/134) and a low prevalence of obese mothers (11/134, 8.2%) are observed in the region. A statistically association between severe stunting of children and to be married and living with a husband and living in Cegera village, p=0.04 and p=0.034 respectively. Thereby, children from Cegera’s region are eighteen, nine and forty-two more likely to be severe, moderate and mild stunting. Secondly, the result showed that spacing pregnancy for 2 to 3 years was statically associated with moderately stunted (p=0.028). Children from aforementioned mothers were seven and three times more likely to be moderate and mild malnourished. The results found that children who were weighted low at birth were protected against severe stunting (OR<1), but were exposed to both moderate and mildly stunting (OR>1). Likewise, children born smaller were predisposed to both moderate and mildly stunting (OR>1). In fact, children from lactating mothers who have not changed meal during lactation were around three more likely to be severe and moderate stunting, respectively. Regarding feeding behavior of the infants, being exclusively breastfed within 6 month has protected against all the three stages (OR<1) of stunting. Not breastfeeding the infants at day times was statistically associated with two stage of stunting (severe and moderate) (p=0.032 and 0.036). On the other hand, complementary feeding with porridge and with fruits were statistically associated with severe stunted (p=0.000 and 0.029) and moderate stunting (p=0.000 and 0.005). In fact, children fed with cow milk, powder milk, porridge,
{"title":"A high prevalence of stunting in six-moth children is associated with food behavior of mother and common infant feeding in rural area of Lwiro, a longitudinal study.","authors":"","doi":"10.33140/mcr.08.03.05","DOIUrl":"https://doi.org/10.33140/mcr.08.03.05","url":null,"abstract":"Background: Stunting (height or age below 2 SD) is a major public health worldwide; however published studies regarding food and feeding malpractices of both mothers and their children and its impact on stunting are scarce in South-Kivu Province. Methods: We conducted a longitudinal study in rural area of Lwiro. One hundred thirty six mother-infant pairs were concerned by the study. The data was entered in Excel and analyzed by SPSS (Statistical Analysis Software) version 26.0. WHO Anthropometrics software helped to calculate Z score. The descriptive statistic was performed to determine the prevalence of independents variables. In addition, a multinomial logistic was run to establish predictor’s factors of all stages of stunting. A multinomial logistic regression model was fitted to calculate the odds ratios and their related 95% confidence interval for all stages of stunting by socioeconomic, household characteristic and food malpractice. Results: The study highlights a low prevalence (3/130, 2.3%) of underweight, a critical prevalence (32.7%) of wasting and a very high prevalence (84.6%) of stunting in the study region. Of the last, (35.4%, 46/130), (26.9%, 35/130) and (22.3%29/130) are severely, mildly and marginally stunted respectively. However, a high prevalence of overweight (38.1%, 51/134) and a low prevalence of obese mothers (11/134, 8.2%) are observed in the region. A statistically association between severe stunting of children and to be married and living with a husband and living in Cegera village, p=0.04 and p=0.034 respectively. Thereby, children from Cegera’s region are eighteen, nine and forty-two more likely to be severe, moderate and mild stunting. Secondly, the result showed that spacing pregnancy for 2 to 3 years was statically associated with moderately stunted (p=0.028). Children from aforementioned mothers were seven and three times more likely to be moderate and mild malnourished. The results found that children who were weighted low at birth were protected against severe stunting (OR<1), but were exposed to both moderate and mildly stunting (OR>1). Likewise, children born smaller were predisposed to both moderate and mildly stunting (OR>1). In fact, children from lactating mothers who have not changed meal during lactation were around three more likely to be severe and moderate stunting, respectively. Regarding feeding behavior of the infants, being exclusively breastfed within 6 month has protected against all the three stages (OR<1) of stunting. Not breastfeeding the infants at day times was statistically associated with two stage of stunting (severe and moderate) (p=0.032 and 0.036). On the other hand, complementary feeding with porridge and with fruits were statistically associated with severe stunted (p=0.000 and 0.029) and moderate stunting (p=0.000 and 0.005). In fact, children fed with cow milk, powder milk, porridge,","PeriodicalId":186238,"journal":{"name":"Medical & Clinical Research","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128180319","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}
Left ventricular non compaction (LVNC) is a type of congenital cardiomyopathy characterized by the presence of prominent intertrabecular recesses that typically affect the apical portion of the left ventricular cavity. These recesses give a distinctive phenotype to the affected myocardium that has been described as “sponge-like”. Devastating complications have been observed in those patients with LVNC, including heart failure requiring heart transplantation in selected cases, life-threatening arrhythmias, thromboembolic events including stroke and transient ischemic attack and sudden cardiac death. This report follows the case of a 62-year-old female patient with recurrent chest pain for several years and extensive negative work and recent echocardiography showed increased left ventricle trabeculations, suspicious for LVNC, later confirmed by cardiac magnetic resonance (CMR).
{"title":"Left ventricular non-compaction: Underdiagnosed disease with fatal outcomes","authors":"","doi":"10.33140/mcr.08.03.06","DOIUrl":"https://doi.org/10.33140/mcr.08.03.06","url":null,"abstract":"Left ventricular non compaction (LVNC) is a type of congenital cardiomyopathy characterized by the presence of prominent intertrabecular recesses that typically affect the apical portion of the left ventricular cavity. These recesses give a distinctive phenotype to the affected myocardium that has been described as “sponge-like”. Devastating complications have been observed in those patients with LVNC, including heart failure requiring heart transplantation in selected cases, life-threatening arrhythmias, thromboembolic events including stroke and transient ischemic attack and sudden cardiac death. This report follows the case of a 62-year-old female patient with recurrent chest pain for several years and extensive negative work and recent echocardiography showed increased left ventricle trabeculations, suspicious for LVNC, later confirmed by cardiac magnetic resonance (CMR).","PeriodicalId":186238,"journal":{"name":"Medical & Clinical Research","volume":"51 12","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120920934","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}
Cancer is single most important risk factor for developing thromboembolism (VTE). Cancer patients are at increased risk of bleeding due to various reasons [1]. Low molecular weight heparin (LMWH) remained the standard of care for many years [2]. Direct acting oral anticoagulants (DOACs) are simpler to administer and equally effective and safe as compared to LMWH [2]. However, there are several concerns associated with DOACs in cancer patients. They are related to drug-to-drug interactions and risk of bleeding in gastrointestinal and urothelial malignancies [3]. Authors have comprehensively summarized the available evidence related to managing venous thromboembolism in cancer patients.
{"title":"Managing cancer associated thrombosis (cat): a dedicated service may help","authors":"","doi":"10.33140/mcr.08.03.03","DOIUrl":"https://doi.org/10.33140/mcr.08.03.03","url":null,"abstract":"Cancer is single most important risk factor for developing thromboembolism (VTE). Cancer patients are at increased risk of bleeding due to various reasons [1]. Low molecular weight heparin (LMWH) remained the standard of care for many years [2]. Direct acting oral anticoagulants (DOACs) are simpler to administer and equally effective and safe as compared to LMWH [2]. However, there are several concerns associated with DOACs in cancer patients. They are related to drug-to-drug interactions and risk of bleeding in gastrointestinal and urothelial malignancies [3]. Authors have comprehensively summarized the available evidence related to managing venous thromboembolism in cancer patients.","PeriodicalId":186238,"journal":{"name":"Medical & Clinical Research","volume":"36 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115277996","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}
Introduction: Cystinosis is a rare autosomal recessive metabolic disease. It occurs due to a chromosomal mutation that allows the accumulation of this amino acid in lysosomes. Cystine can form crystals in various tissues such as the kidneys, pancreas, thyroid, testicles, bone marrow, brain, eye, and muscles. In the eyes, crystals can cause deposits on the cornea and conjunctiva. In the cornea, deposits occur in the periphery and anterior stroma. As the disease progresses, the crystals move centripetally and posteriorly. Oral and topical treatments with cysteamine have been described. The ophthalmologic solution of cysteamine 0.55% used continuously every 2 hours has shown good results. Clinical Case: Patient in a routine ophthalmologic exam, with findings of cystine crystals in the cornea and past kidney transplantation without diagnosis. Discussion: The patient’s past history is relevant and corroborates with the ophthalmological findings. The patient had severe kidney disease, requiring kidney transplantation, but the disease was not elucidated. Therefore, the ophthalmological examination was fundamental for the diagnosis of the case
{"title":"Cystinosis in a routine ophthalmologic evaluation","authors":"","doi":"10.33140/mcr.08.03.02","DOIUrl":"https://doi.org/10.33140/mcr.08.03.02","url":null,"abstract":"Introduction: Cystinosis is a rare autosomal recessive metabolic disease. It occurs due to a chromosomal mutation that allows the accumulation of this amino acid in lysosomes. Cystine can form crystals in various tissues such as the kidneys, pancreas, thyroid, testicles, bone marrow, brain, eye, and muscles. In the eyes, crystals can cause deposits on the cornea and conjunctiva. In the cornea, deposits occur in the periphery and anterior stroma. As the disease progresses, the crystals move centripetally and posteriorly. Oral and topical treatments with cysteamine have been described. The ophthalmologic solution of cysteamine 0.55% used continuously every 2 hours has shown good results. Clinical Case: Patient in a routine ophthalmologic exam, with findings of cystine crystals in the cornea and past kidney transplantation without diagnosis. Discussion: The patient’s past history is relevant and corroborates with the ophthalmological findings. The patient had severe kidney disease, requiring kidney transplantation, but the disease was not elucidated. Therefore, the ophthalmological examination was fundamental for the diagnosis of the case","PeriodicalId":186238,"journal":{"name":"Medical & Clinical Research","volume":"129 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114716400","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}
Today, there are said to be some 590 million people of all ages around the world, who are suffering from a range of swallowing problems– probably about 4 million in the UK, either living at home or as residents in some 20,000 Care Homes, with perhaps another 25,000 as patients in hospital every day. Professor David Smithard, of the Lewisham and Greenwich NHS Trust, has been leading a national campaign for some years to raise the general awareness of Dysphagia and to improve the treatment of patients with varying conditions. He and his team at the Queen Elizabeth Hospital have now completed a detailed Review of the use of carbonated water (CW) in the treatment of Dysphagia, which has just been published and can be accessed here: https://www.mdpi.com/2308-3417/8/1/6 The Review concludes that further evidence-based research is essential before CW can be adopted as standard in clinical practice–but that although the amount of evidence is small, there is a suggestion that swallows are safer and that secretion management improves, and consequently, until further studies are undertaken, Carbonated Water should be limited to individual patient use. My experience as a Dysphagia sufferer is that the use of CW has resulted in life-changing benefits, and this paper is devoted to describing how CW worked for me, and what the practical requirements are, so that many others may be able to benefit as I have done. The paper has three sections: My Personal Experience, Practical Considerations and Conclusions.
{"title":"LIFE-CHANGING BUBBLES’-How carbonated water can relieve swallowing problems for many dysphagia sufferers worldwide","authors":"Mirams John","doi":"10.33140/mcr.08.03.04","DOIUrl":"https://doi.org/10.33140/mcr.08.03.04","url":null,"abstract":"Today, there are said to be some 590 million people of all ages around the world, who are suffering from a range of swallowing problems– probably about 4 million in the UK, either living at home or as residents in some 20,000 Care Homes, with perhaps another 25,000 as patients in hospital every day. Professor David Smithard, of the Lewisham and Greenwich NHS Trust, has been leading a national campaign for some years to raise the general awareness of Dysphagia and to improve the treatment of patients with varying conditions. He and his team at the Queen Elizabeth Hospital have now completed a detailed Review of the use of carbonated water (CW) in the treatment of Dysphagia, which has just been published and can be accessed here: https://www.mdpi.com/2308-3417/8/1/6 The Review concludes that further evidence-based research is essential before CW can be adopted as standard in clinical practice–but that although the amount of evidence is small, there is a suggestion that swallows are safer and that secretion management improves, and consequently, until further studies are undertaken, Carbonated Water should be limited to individual patient use. My experience as a Dysphagia sufferer is that the use of CW has resulted in life-changing benefits, and this paper is devoted to describing how CW worked for me, and what the practical requirements are, so that many others may be able to benefit as I have done. The paper has three sections: My Personal Experience, Practical Considerations and Conclusions.","PeriodicalId":186238,"journal":{"name":"Medical & Clinical Research","volume":"123 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133673100","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}
Time slowly undermines all, and the medical team members are no exception. According to their genetics, interaction with inanimate and animate surrounds, and ambiance characteristics, they can expand or contract their abilities to perform successful work. How much can they waste away from their background to remain influential in practice?
{"title":"Professionals’ work impairment perspective in the digital era","authors":"","doi":"10.33140/mcr.08.02.01","DOIUrl":"https://doi.org/10.33140/mcr.08.02.01","url":null,"abstract":"Time slowly undermines all, and the medical team members are no exception. According to their genetics, interaction with inanimate and animate surrounds, and ambiance characteristics, they can expand or contract their abilities to perform successful work. How much can they waste away from their background to remain influential in practice?","PeriodicalId":186238,"journal":{"name":"Medical & Clinical Research","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116854522","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}
Introduction: The aim of this study was to evaluate the clinical efficacy of allergen-specific nasal immunotherapy (LNIT) by observing the improvement in the patient’s quality of life, and the side effects of this route of immunotherapy. Methods: From a cohort of 2687 patients with perennial rhinitis treated at the Clinical and Experimental Immunology Service-Hospital Geral-Santa Casa da Misericórdia do Rio de Janeiro for 5 years, a total of one hundred thirty six patients positive in the prick test for Dermatophagoides pteronyssinus (Dp) and Dermatophagoides farinae (Df), were divided into two groups of cases (n=108) and controls (n=28) undergoing or not LNIT, both submitted to the same type of control treatment for the same amount of time. Both groups were classified into mild, moderate and severe rhinitis. Quality of life was assessed based on a questionnaire for Rhinoconjunctivitis, carried out at each visit, with a rating from 0 to 6 according to the increasing degree of difficulty in performing common tasks or nasal, ocular or other symptoms. Results: No systemic side effects or bronchospasms were observed in the cases. Both patients and controls with moderate and severe rhinitis had quality of life grades 3 and 4; 5 and 6 respectively, before immunotherapy. Comparison of cases with controls during the controller medication phase associated with nasal immunotherapy (cases) showed an improvement in quality of life for both (Grades: 0-2, after 5 weeks). Full use of the controller medication was 15 weeks followed by more eighteen weeks with half doses. Patients under LNIT, when the control medication was withdrawn after the sixth series of nasal immunotherapy, maintained the improvement in quality of life with grades of 0-1, not requiring regular and frequent use of symptomatic therapy. Until the final evaluation time, three years and two months, the patients who remained until the end of the immunotherapy regimen (n=89) did not present or significantly reduced the need for control medication, remaining with a degree of quality of life: Degree: 0 and 1.The controls, in the period of 33 weeks of return for consultations, with the withdrawal of the controller medication, reported that they needed the frequent use of controller medicines due to the recurrence of symptoms. The quality of life questionnaire showed a worsening, with grades ranging from 3 to 5, when evaluated in this phase without regular symptomatic medication. Conclusions: The of LNIT performed with full concentrations, did not show secondary reactions with risks to patients and that the effect of inducing tolerance to the antigens of Dermatophagoides sp. was achieved, based on the observation of the decrease in the use of control medications for signs and symptoms and mainly by the improvement in the patients’ quality of life.
{"title":"Evaluation of local nasal immunotherapy to Dermatophagoides sp. in patients with allergic rhinitis","authors":"","doi":"10.33140/mcr.08.02.03","DOIUrl":"https://doi.org/10.33140/mcr.08.02.03","url":null,"abstract":"Introduction: The aim of this study was to evaluate the clinical efficacy of allergen-specific nasal immunotherapy (LNIT) by observing the improvement in the patient’s quality of life, and the side effects of this route of immunotherapy. Methods: From a cohort of 2687 patients with perennial rhinitis treated at the Clinical and Experimental Immunology Service-Hospital Geral-Santa Casa da Misericórdia do Rio de Janeiro for 5 years, a total of one hundred thirty six patients positive in the prick test for Dermatophagoides pteronyssinus (Dp) and Dermatophagoides farinae (Df), were divided into two groups of cases (n=108) and controls (n=28) undergoing or not LNIT, both submitted to the same type of control treatment for the same amount of time. Both groups were classified into mild, moderate and severe rhinitis. Quality of life was assessed based on a questionnaire for Rhinoconjunctivitis, carried out at each visit, with a rating from 0 to 6 according to the increasing degree of difficulty in performing common tasks or nasal, ocular or other symptoms. Results: No systemic side effects or bronchospasms were observed in the cases. Both patients and controls with moderate and severe rhinitis had quality of life grades 3 and 4; 5 and 6 respectively, before immunotherapy. Comparison of cases with controls during the controller medication phase associated with nasal immunotherapy (cases) showed an improvement in quality of life for both (Grades: 0-2, after 5 weeks). Full use of the controller medication was 15 weeks followed by more eighteen weeks with half doses. Patients under LNIT, when the control medication was withdrawn after the sixth series of nasal immunotherapy, maintained the improvement in quality of life with grades of 0-1, not requiring regular and frequent use of symptomatic therapy. Until the final evaluation time, three years and two months, the patients who remained until the end of the immunotherapy regimen (n=89) did not present or significantly reduced the need for control medication, remaining with a degree of quality of life: Degree: 0 and 1.The controls, in the period of 33 weeks of return for consultations, with the withdrawal of the controller medication, reported that they needed the frequent use of controller medicines due to the recurrence of symptoms. The quality of life questionnaire showed a worsening, with grades ranging from 3 to 5, when evaluated in this phase without regular symptomatic medication. Conclusions: The of LNIT performed with full concentrations, did not show secondary reactions with risks to patients and that the effect of inducing tolerance to the antigens of Dermatophagoides sp. was achieved, based on the observation of the decrease in the use of control medications for signs and symptoms and mainly by the improvement in the patients’ quality of life.","PeriodicalId":186238,"journal":{"name":"Medical & Clinical Research","volume":"34 1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132564742","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}
It had been more than three years COVID-19 appeared in the world. Since Arizona Governor Doug Ducey had declared a State of Emergency to combat COVID-19 on March 11, 2020, the state had gone through three Reopening Phases. ABC and NBC News reported that the state had the highest new cases per capital in the world during Arizona’s Reopening Phase 2 winter surge in 2020. The state had been in Reopening Phase 3 since March 5, 2021. Arizona is about the same size as Italy. The study examined three years of the state’s COVID-19 pandemic. On December 28, 2022, there were 2,378,334 COVID-19 cases, 127,887 hospitalizations, 32,182 deaths, and 13,599,422 vaccine doses administered. The COVID-19 virus had been persistence. The virus continued to mutate, multiple, and spread. New variants emerged and resisted vaccines and therapeutics. During the three years, case numbers rose (542,653 in 2020, 838,835 in 2021, and 996,846 in 2022) and there has been periodic case surges. Between 2021and 2022, the case hospitalization and death percentages had declined.
{"title":"Arizona and COVID-19: Three-Year Experience 2020-22","authors":"","doi":"10.33140/mcr.07.046","DOIUrl":"https://doi.org/10.33140/mcr.07.046","url":null,"abstract":"It had been more than three years COVID-19 appeared in the world. Since Arizona Governor Doug Ducey had declared a State of Emergency to combat COVID-19 on March 11, 2020, the state had gone through three Reopening Phases. ABC and NBC News reported that the state had the highest new cases per capital in the world during Arizona’s Reopening Phase 2 winter surge in 2020. The state had been in Reopening Phase 3 since March 5, 2021. Arizona is about the same size as Italy. The study examined three years of the state’s COVID-19 pandemic. On December 28, 2022, there were 2,378,334 COVID-19 cases, 127,887 hospitalizations, 32,182 deaths, and 13,599,422 vaccine doses administered. The COVID-19 virus had been persistence. The virus continued to mutate, multiple, and spread. New variants emerged and resisted vaccines and therapeutics. During the three years, case numbers rose (542,653 in 2020, 838,835 in 2021, and 996,846 in 2022) and there has been periodic case surges. Between 2021and 2022, the case hospitalization and death percentages had declined.","PeriodicalId":186238,"journal":{"name":"Medical & Clinical Research","volume":"37 6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116613804","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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