Pub Date : 2020-06-01DOI: 10.22038/RCM.2020.49785.1325
Razieh Amirfakhrian, Atieh Yaghobi, R. Ghaderi, S. Hashemy, K. Ghazvini
Introduction: In recent decades, the inappropriate use of antibiotics and the existence of transferable resistant elements have caused the emergence of multidrug-resistant (MDR) gram-negative organisms. Antimicrobial resistance is becoming one of the major challenges to public health and has caused morbidity and mortality worldwide. The purpose of this study was the assessment of the prevalence and frequency of colistin resistance among gram-negative bacilli (Enterobacteriaceae, Acinetobacter spp., and Pseudomonas spp.) in Iran and around the world. Methods: For this systematic review and meta-analysis, we searched international and national databases, including PubMed, Google Scholar, SID, and Magiran, from 1998 to 2018 for articles and abstracts describing colistin resistance among gram-negative bacilli. We have included 92 studies that met our inclusion criteria, and the outcomes were combined using a random-effects model to derive the event rate of colistin resistance among gram-negative bacilli. Data were analyzed by the Comprehensive Meta-Analysis Software (V2), and the heterogeneity of the studies was assessed using the I2 index. Results: Out of the 11050 papers identified, 92 studies met the strict inclusion criteria and were finally included. The overall event rate of colistin resistance among gram-negative bacilli (GNB) was about 6.6%, while the event rate of colistin resistance among Acinetobacter spp. (n = 18504) was 2.8% (summary: 95% confidence interval (CI): [0.02, 0.041], P = 0.001, I2 = 70, df (Q) = 36, Q-value = 121.924). The colistin resistance among Pseudomonas spp. (n = 15094) was 3% (95% CI: [0.022, 0.041], P = 0.001, I2 = 68.3, df (Q) = 25, Q-value = 85.648), and the colistin resistance among Enterobacteriaceae spp. (n = 44772) was 0.8% (95% CI: [0.004, 0.014], P = 0.001, I2 = 87.6, df (Q) = 15, Q-value = 71.291). Therefore, the event rate of resistance to colistin among GNB was relatively low (6.6%). Conclusion: The event rate of resistance to colistin among GNB was low. Therefore, this antimicrobial agent can still be administered as a suitable option against GNB that are resistant to other antibiotics such as carbapenems.
{"title":"Colistin Resistance Burden among Clinical Isolates of Gram-negative Rods: A Systematic Review and Meta-analysis","authors":"Razieh Amirfakhrian, Atieh Yaghobi, R. Ghaderi, S. Hashemy, K. Ghazvini","doi":"10.22038/RCM.2020.49785.1325","DOIUrl":"https://doi.org/10.22038/RCM.2020.49785.1325","url":null,"abstract":"Introduction: In recent decades, the inappropriate use of antibiotics and the existence of transferable resistant elements have caused the emergence of multidrug-resistant (MDR) gram-negative organisms. Antimicrobial resistance is becoming one of the major challenges to public health and has caused morbidity and mortality worldwide. The purpose of this study was the assessment of the prevalence and frequency of colistin resistance among gram-negative bacilli (Enterobacteriaceae, Acinetobacter spp., and Pseudomonas spp.) in Iran and around the world. Methods: For this systematic review and meta-analysis, we searched international and national databases, including PubMed, Google Scholar, SID, and Magiran, from 1998 to 2018 for articles and abstracts describing colistin resistance among gram-negative bacilli. We have included 92 studies that met our inclusion criteria, and the outcomes were combined using a random-effects model to derive the event rate of colistin resistance among gram-negative bacilli. Data were analyzed by the Comprehensive Meta-Analysis Software (V2), and the heterogeneity of the studies was assessed using the I2 index. Results: Out of the 11050 papers identified, 92 studies met the strict inclusion criteria and were finally included. The overall event rate of colistin resistance among gram-negative bacilli (GNB) was about 6.6%, while the event rate of colistin resistance among Acinetobacter spp. (n = 18504) was 2.8% (summary: 95% confidence interval (CI): [0.02, 0.041], P = 0.001, I2 = 70, df (Q) = 36, Q-value = 121.924). The colistin resistance among Pseudomonas spp. (n = 15094) was 3% (95% CI: [0.022, 0.041], P = 0.001, I2 = 68.3, df (Q) = 25, Q-value = 85.648), and the colistin resistance among Enterobacteriaceae spp. (n = 44772) was 0.8% (95% CI: [0.004, 0.014], P = 0.001, I2 = 87.6, df (Q) = 15, Q-value = 71.291). Therefore, the event rate of resistance to colistin among GNB was relatively low (6.6%). Conclusion: The event rate of resistance to colistin among GNB was low. Therefore, this antimicrobial agent can still be administered as a suitable option against GNB that are resistant to other antibiotics such as carbapenems.","PeriodicalId":21081,"journal":{"name":"Reviews in Clinical Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41737139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-06-01DOI: 10.22038/RCM.2020.49087.1320
K. Ghazvini, M. Youssefi, M. Keikha
Abstract Helicobacter pylori is one of the most common bacteria in the stomach, colonizing about one-half of the population in the world, while most of them remain asymptomatic throughout their lives and gastric cancer (GC) occurs in only 1-2% of people. It seems that the final outcomes of Helicobacter pylori infection are dependent on bacterial virulence factors, host genetic characteristics, and the environmental conditions. In this study, we compared the expression of 20 known virulence factors associated with the development of GC in the isolated Helicobacter pylori strains from the Colombian patients belonging to the regions with low and high GC risks. Based on the results of the present study, it was found that the 20 studied virulence factors are closely related with each other and regulate their expressions through the required intermediates. We also showed that the Helicobacter pylori strains belonging to the region with high GC risk were more virulent and have developed into GC by destroying the intercellular bindings, cell skeletal dysregulation, and cell survival and proliferation stimulation, while the H. pylori strains in the region with low GC risk expressed virulence factors related to the chronic inflammation and apoptosis; adhesion factors were also different in both groups.
{"title":"The evaluating expression profile of virulence factors in Helicobacter pylori strains by system biology; an example from Colombia","authors":"K. Ghazvini, M. Youssefi, M. Keikha","doi":"10.22038/RCM.2020.49087.1320","DOIUrl":"https://doi.org/10.22038/RCM.2020.49087.1320","url":null,"abstract":"Abstract Helicobacter pylori is one of the most common bacteria in the stomach, colonizing about one-half of the population in the world, while most of them remain asymptomatic throughout their lives and gastric cancer (GC) occurs in only 1-2% of people. It seems that the final outcomes of Helicobacter pylori infection are dependent on bacterial virulence factors, host genetic characteristics, and the environmental conditions. In this study, we compared the expression of 20 known virulence factors associated with the development of GC in the isolated Helicobacter pylori strains from the Colombian patients belonging to the regions with low and high GC risks. Based on the results of the present study, it was found that the 20 studied virulence factors are closely related with each other and regulate their expressions through the required intermediates. We also showed that the Helicobacter pylori strains belonging to the region with high GC risk were more virulent and have developed into GC by destroying the intercellular bindings, cell skeletal dysregulation, and cell survival and proliferation stimulation, while the H. pylori strains in the region with low GC risk expressed virulence factors related to the chronic inflammation and apoptosis; adhesion factors were also different in both groups.","PeriodicalId":21081,"journal":{"name":"Reviews in Clinical Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45750753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-06-01DOI: 10.22038/RCM.2020.49481.1323
K. Ghazvini, M. Youssefi, M. Keikha
The evaluation of microbial community of lower respiratory tracts microbiota in tuberculosis patients and healthy individuals using MetagenomicsAbstractMycobacterium tuberculosis is remained as global challenge which is considered as the top cause of human death in worldwide. the role of lower respiratory tracts microbiota interaction with the immune system to determining the final outcomes of infection with M. tuberculosis has gained attention in recent years. The aim of the present study was detection and comparison of microbial diversity and population community of lower respiratory tracts the microflora in pulmonary tuberculosis and healthy individuals using high throughput sequencing data by metagenomics. We found that microbial taxa were similar between TB and normal except Tenericutes which supplemented in microflora of pulmonary tuberculosis cases. Moreover, the abundance of bacterial genera is significantly divers between TB and healthy groups. Keywords: Mycobacterium tuberculosis; Microbiota; Tuberculosis; 16S rRNA; MetagenomicsAlthough it’s a century since Robert Koch introduced the Mycobacterium tuberculosis as a causative agent of tuberculosis (TB), this remains one of the leading causes of death throughout the globe (1-2). According to WHO reports in 2020, about 10 million individuals have become infected with tuberculosis, and 1.5 million have died in 2019 (3). In recent years, tuberculosis eradication seems to be impossible due to the inefficacy of the BCG vaccine in adults, the proliferation of patients with immunodeficiency, HIV pandemics, and drug-resistance TB (4-7).
摘要结核分枝杆菌被认为是世界范围内人类死亡的头号杀手，是一个全球性的挑战。近年来，下呼吸道微生物群与免疫系统的相互作用在决定结核分枝杆菌感染的最终结局中的作用已引起人们的关注。本研究的目的是利用宏基因组学的高通量测序数据检测和比较肺结核患者和健康人群下呼吸道的微生物多样性和种群群落。结果发现，结核菌群与正常菌群基本一致，但结核菌群中有微量菌群存在。此外，结核病组和健康组之间的细菌属丰度明显不同。关键词:结核分枝杆菌;微生物群;肺结核;16 s rRNA;虽然罗伯特·科赫(Robert Koch)将结核分枝杆菌(Mycobacterium tuberculosis)作为结核病(TB)的病原体引入已有一个世纪，但它仍然是全球范围内导致死亡的主要原因之一(1-2)。根据世卫组织2020年的报告，全球约有1000万人感染结核病，2019年有150万人死亡(3)。近年来，由于成人卡介苗无效、免疫缺陷患者激增、艾滋病毒大流行和耐药结核病，结核病根除似乎是不可能的(4-7)。
{"title":"The evaluation of the microbial community of lower respiratory tracts microbiota in tuberculosis patients and healthy individuals using Metagenomics","authors":"K. Ghazvini, M. Youssefi, M. Keikha","doi":"10.22038/RCM.2020.49481.1323","DOIUrl":"https://doi.org/10.22038/RCM.2020.49481.1323","url":null,"abstract":"The evaluation of microbial community of lower respiratory tracts microbiota in tuberculosis patients and healthy individuals using MetagenomicsAbstractMycobacterium tuberculosis is remained as global challenge which is considered as the top cause of human death in worldwide. the role of lower respiratory tracts microbiota interaction with the immune system to determining the final outcomes of infection with M. tuberculosis has gained attention in recent years. The aim of the present study was detection and comparison of microbial diversity and population community of lower respiratory tracts the microflora in pulmonary tuberculosis and healthy individuals using high throughput sequencing data by metagenomics. We found that microbial taxa were similar between TB and normal except Tenericutes which supplemented in microflora of pulmonary tuberculosis cases. Moreover, the abundance of bacterial genera is significantly divers between TB and healthy groups. Keywords: Mycobacterium tuberculosis; Microbiota; Tuberculosis; 16S rRNA; MetagenomicsAlthough it’s a century since Robert Koch introduced the Mycobacterium tuberculosis as a causative agent of tuberculosis (TB), this remains one of the leading causes of death throughout the globe (1-2). According to WHO reports in 2020, about 10 million individuals have become infected with tuberculosis, and 1.5 million have died in 2019 (3). In recent years, tuberculosis eradication seems to be impossible due to the inefficacy of the BCG vaccine in adults, the proliferation of patients with immunodeficiency, HIV pandemics, and drug-resistance TB (4-7).","PeriodicalId":21081,"journal":{"name":"Reviews in Clinical Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41893942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-06-01DOI: 10.22038/RCM.2020.49961.1326
F. Heydarian, N. Ghasemi, E. Bakhtiari, Hasan Golmakani, Mohammad Heidarian
Introduction: Febrile seizure (FS) is a highly frequent presenting complaint in children. It is defined as a seizure that occurs in children between 6 to 60 months related to a fever of 38°C or more without any other explanatory causes of seizure such as evidence of central nervous system (CNS) infection or a previous seizure without fever. The aim od study is to evaluate mean folic acid serum levels in febrile children with or without seizures.Methods: The mean folic acid serum levels and demographic data of 100 children aged 6 to 60 months, admitted to the Ghaem Hospital of Mashhad, Iran in 2018-2019, were collected, where the patients with febrile seizure were considered as the case group and the febrile ones without seizure as the control group. The inclusion criteria were children aged 6 to 60 months with febrile seizures who were admitted to the pediatric ward. The exclusion criteria were having a past medical history of seizure, meningitis, or encephalitis.Results: There were 49 febrile convulsive children (cases) and 51 febrile children without a seizure (controls). The mean serum folic acid level was 7.07 and 9.89 ng/ml for cases and controls respectively (P-value < 0.001).Conclusion: Children with febrile seizures had significantly lower serum folic acid levels than febrile children without a seizure.
{"title":"Investigating the correlation between serum folic acid level and febrile seizures in children: A clinical study","authors":"F. Heydarian, N. Ghasemi, E. Bakhtiari, Hasan Golmakani, Mohammad Heidarian","doi":"10.22038/RCM.2020.49961.1326","DOIUrl":"https://doi.org/10.22038/RCM.2020.49961.1326","url":null,"abstract":"Introduction: Febrile seizure (FS) is a highly frequent presenting complaint in children. It is defined as a seizure that occurs in children between 6 to 60 months related to a fever of 38°C or more without any other explanatory causes of seizure such as evidence of central nervous system (CNS) infection or a previous seizure without fever. The aim od study is to evaluate mean folic acid serum levels in febrile children with or without seizures.Methods: The mean folic acid serum levels and demographic data of 100 children aged 6 to 60 months, admitted to the Ghaem Hospital of Mashhad, Iran in 2018-2019, were collected, where the patients with febrile seizure were considered as the case group and the febrile ones without seizure as the control group. The inclusion criteria were children aged 6 to 60 months with febrile seizures who were admitted to the pediatric ward. The exclusion criteria were having a past medical history of seizure, meningitis, or encephalitis.Results: There were 49 febrile convulsive children (cases) and 51 febrile children without a seizure (controls). The mean serum folic acid level was 7.07 and 9.89 ng/ml for cases and controls respectively (P-value < 0.001).Conclusion: Children with febrile seizures had significantly lower serum folic acid levels than febrile children without a seizure.","PeriodicalId":21081,"journal":{"name":"Reviews in Clinical Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47327359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-06-01DOI: 10.22038/RCM.2020.50148.1327
A. Bhargava, A. Jaiman, H. Lal, M. Patralekh
Introduction: In this era of social distancing, dependence on electronic gadgets and devices is ever increasing. Possibility of transmission of COVID -19 from these devices cannot be ruled out. Currently, prevention is the only antidote; considering the mounting evidence of transmission of COVID-19 virus primarily through respiratory droplets and fomites. Gadgets are one of the most frequently touched appliances; being often used during or after patient examination, while handling specimens or during various patient procedures. Collecting data regarding mobile sanitization is prudent at these times. The aim of this systematic review is to summarize published evidence on mobile sanitization in these COVID times.Methods: PubMed search on “COVID and mobile phone” revealed only 4 articles related to this topic; therefore we have assimilated data from various organizations, websites and articles and have suggested methodology for sanitization of mobile phones and other gadgets.Results: Infection control practices which include information, communication, education and evaluation are the pre-eminent weapons in the fight against hospital transmitted SARS-CoV-2. Minimizing mobile phone usage, sanitizing them with endorsed biocidal agents and advancements in the field of ultraviolet cabinets is a priority.Conclusion: At the same time we shouldn’t forget that sanitization is only one aspect of prevention of this disease; maintaining hand hygiene, use of masks and social distancing must be followed at all times.
{"title":"Beware the Trojan horse","authors":"A. Bhargava, A. Jaiman, H. Lal, M. Patralekh","doi":"10.22038/RCM.2020.50148.1327","DOIUrl":"https://doi.org/10.22038/RCM.2020.50148.1327","url":null,"abstract":"Introduction: In this era of social distancing, dependence on electronic gadgets and devices is ever increasing. Possibility of transmission of COVID -19 from these devices cannot be ruled out. Currently, prevention is the only antidote; considering the mounting evidence of transmission of COVID-19 virus primarily through respiratory droplets and fomites. Gadgets are one of the most frequently touched appliances; being often used during or after patient examination, while handling specimens or during various patient procedures. Collecting data regarding mobile sanitization is prudent at these times. The aim of this systematic review is to summarize published evidence on mobile sanitization in these COVID times.Methods: PubMed search on “COVID and mobile phone” revealed only 4 articles related to this topic; therefore we have assimilated data from various organizations, websites and articles and have suggested methodology for sanitization of mobile phones and other gadgets.Results: Infection control practices which include information, communication, education and evaluation are the pre-eminent weapons in the fight against hospital transmitted SARS-CoV-2. Minimizing mobile phone usage, sanitizing them with endorsed biocidal agents and advancements in the field of ultraviolet cabinets is a priority.Conclusion: At the same time we shouldn’t forget that sanitization is only one aspect of prevention of this disease; maintaining hand hygiene, use of masks and social distancing must be followed at all times.","PeriodicalId":21081,"journal":{"name":"Reviews in Clinical Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44848183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-04-07DOI: 10.22038/RCM.2020.44030.1295
Seyed Reza Habibzadeh, Mahdi Foroughian, Esmaeil Rayat Dost
Medial collateral ligament (MCL) injury is highly common in athletes and the elderly. This ligament is in the knee region and is often at the risk of injury. Severe pain and motor limitation are the most important signs in the acute phase of the injury. In patients receiving anticoagulants, damage to the knee joint may lead to intra-articular bleeding, which exacerbates the symptoms and prolongs the recovery period. The present study aimed to describe the case of a 76-year-old woman with a sudden spin on the left knee while getting off a car. After a few minutes of walking, the patients felt pain, heard a pop-like sound on the injured knee, and was unable to walk, experiencing pain in the knee. The patient was transferred to the emergency department by the caregivers. The present case report was focused on the MCL injury in a patient receiving an anticoagulant due to atrial fibrillation.
{"title":"Medial Collateral Ligament Knee Injury in a Patient Receiving Rivaroxaban: A Cause of Acute Hemarthrosis","authors":"Seyed Reza Habibzadeh, Mahdi Foroughian, Esmaeil Rayat Dost","doi":"10.22038/RCM.2020.44030.1295","DOIUrl":"https://doi.org/10.22038/RCM.2020.44030.1295","url":null,"abstract":"Medial collateral ligament (MCL) injury is highly common in athletes and the elderly. This ligament is in the knee region and is often at the risk of injury. Severe pain and motor limitation are the most important signs in the acute phase of the injury. In patients receiving anticoagulants, damage to the knee joint may lead to intra-articular bleeding, which exacerbates the symptoms and prolongs the recovery period. The present study aimed to describe the case of a 76-year-old woman with a sudden spin on the left knee while getting off a car. After a few minutes of walking, the patients felt pain, heard a pop-like sound on the injured knee, and was unable to walk, experiencing pain in the knee. The patient was transferred to the emergency department by the caregivers. The present case report was focused on the MCL injury in a patient receiving an anticoagulant due to atrial fibrillation.","PeriodicalId":21081,"journal":{"name":"Reviews in Clinical Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46906800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-04-07DOI: 10.22038/RCM.2020.45474.1298
F. Rezaeetalab, Mahnaz Mozdourian
Wilson’s disease is a rare genetic disorder, which is associated with clinical manifestations such as liver dysfunction, psychological and neurological issues, and specific laboratory findings demonstrating the increased urinary excretion of copper and copper accumulation in the body. Wilson’s disease is occasionally presented by atypical features, which delay the diagnosis of this rare disorder. This study aimed to describe the case of a patient with pulmonary and portal hypertension as a primary manifestation of Wilson’s disease. A young male patient was admitted to the emergency department due to the deterioration of respiratory symptoms and overall weakness. The patient had a history of dyspnea and fatigue, which was diagnosed as idiopathic pulmonary hypertension. In the previous admission, the liver function test of the patient was not disrupted, and serum/urinary copper and ceruloplasmin levels were normal. In the current admission, the patient had elevated bilirubin and enzyme levels, as well as abnormal copper and ceruloplasmin levels. Moreover, portal hypertensive gastropathy and Kayser-Fleischer ring were detected in further investigations, confirming the diagnosis of Wilson’s disease. To the best of our knowledge, this was the first report on Wilson’s disease initially presented with pulmonary and portal hypertension.
{"title":"Pulmonary Hypertension as an Initial Presentation of Wilson’s Disease: A Case Report","authors":"F. Rezaeetalab, Mahnaz Mozdourian","doi":"10.22038/RCM.2020.45474.1298","DOIUrl":"https://doi.org/10.22038/RCM.2020.45474.1298","url":null,"abstract":"Wilson’s disease is a rare genetic disorder, which is associated with clinical manifestations such as liver dysfunction, psychological and neurological issues, and specific laboratory findings demonstrating the increased urinary excretion of copper and copper accumulation in the body. Wilson’s disease is occasionally presented by atypical features, which delay the diagnosis of this rare disorder. This study aimed to describe the case of a patient with pulmonary and portal hypertension as a primary manifestation of Wilson’s disease. A young male patient was admitted to the emergency department due to the deterioration of respiratory symptoms and overall weakness. The patient had a history of dyspnea and fatigue, which was diagnosed as idiopathic pulmonary hypertension. In the previous admission, the liver function test of the patient was not disrupted, and serum/urinary copper and ceruloplasmin levels were normal. In the current admission, the patient had elevated bilirubin and enzyme levels, as well as abnormal copper and ceruloplasmin levels. Moreover, portal hypertensive gastropathy and Kayser-Fleischer ring were detected in further investigations, confirming the diagnosis of Wilson’s disease. To the best of our knowledge, this was the first report on Wilson’s disease initially presented with pulmonary and portal hypertension.","PeriodicalId":21081,"journal":{"name":"Reviews in Clinical Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42672422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-04-07DOI: 10.22038/RCM.2020.45952.1304
M. Sabermoghaddam, E. Bakhtiari, M. Alipour
Intoduction: Sore throat is a common postoperative complication in patients undergoing general anesthesia. Several factors contribute to this complication, and the airway management method plays a pivotal role in this regard. The present study aimed to assess the effect of diphenhydramine gargling on sore throat in patients undergoing cataract surgery with laryngeal mask insertion. Methods: This placebo-controlled, double-blind, clinical trial was conducted on two groups of intervention and control. The patients in the intervention group gargled 8 cc (20 mg) of diphenhydramine diluted to 20 cc with normal saline 20 minutes before anesthesia induction. The control group patients gargled 20 cc of normal saline 20 minutes before anesthesia induction. The score of sore throat severity was determined based on the visual analogue scale during recovery three, six, 12, and 24 hours postoperatively. Results: Initially, 176 candidates of eye surgery using laryngeal mask airway (LMA) were enrolled in the study, and three patients were excluded from the intervention group due to withdrawal. In the intervention group, 36 patients (42.9%) were female, and 48 patients (57.1%) were male. In the control group, 46 patients (52.3%) were female, and 42 patients (47.7%) were male. The mean age of the subjects was 59.5±16.74 and 57.94±15.74 years in the intervention and controls groups, respectively. No significant differences were observed between the groups in terms of age and gender (P=0.53 and P=0.29, respectively). The mean score of pain severity was 0.3±0.14 and 1.7±0.14 in the intervention and control groups, respectively, which indicated a significant difference between the groups at each measurement point (P<0.001). However, the reported pain severity scores were not correlated with age, gender, mask size, and duration of surgery. Conclusion: Gargling 20 milligrams of diphenhydramine suspension 20 minutes prior to LMA insertion in the patients undergoing eye surgery significantly reduced the post-anesthesia sore throat compared to the control group. Moreover, sore throat had no associations with the age, gender, duration of surgery, and mask size of the patients.
{"title":"Effect of Diphenhydramine Gargling on Sore Throat in Patients Undergoing Cataract Surgery with Laryngeal Mask Insertion","authors":"M. Sabermoghaddam, E. Bakhtiari, M. Alipour","doi":"10.22038/RCM.2020.45952.1304","DOIUrl":"https://doi.org/10.22038/RCM.2020.45952.1304","url":null,"abstract":"Intoduction: Sore throat is a common postoperative complication in patients undergoing general anesthesia. Several factors contribute to this complication, and the airway management method plays a pivotal role in this regard. The present study aimed to assess the effect of diphenhydramine gargling on sore throat in patients undergoing cataract surgery with laryngeal mask insertion. Methods: This placebo-controlled, double-blind, clinical trial was conducted on two groups of intervention and control. The patients in the intervention group gargled 8 cc (20 mg) of diphenhydramine diluted to 20 cc with normal saline 20 minutes before anesthesia induction. The control group patients gargled 20 cc of normal saline 20 minutes before anesthesia induction. The score of sore throat severity was determined based on the visual analogue scale during recovery three, six, 12, and 24 hours postoperatively. Results: Initially, 176 candidates of eye surgery using laryngeal mask airway (LMA) were enrolled in the study, and three patients were excluded from the intervention group due to withdrawal. In the intervention group, 36 patients (42.9%) were female, and 48 patients (57.1%) were male. In the control group, 46 patients (52.3%) were female, and 42 patients (47.7%) were male. The mean age of the subjects was 59.5±16.74 and 57.94±15.74 years in the intervention and controls groups, respectively. No significant differences were observed between the groups in terms of age and gender (P=0.53 and P=0.29, respectively). The mean score of pain severity was 0.3±0.14 and 1.7±0.14 in the intervention and control groups, respectively, which indicated a significant difference between the groups at each measurement point (P<0.001). However, the reported pain severity scores were not correlated with age, gender, mask size, and duration of surgery. Conclusion: Gargling 20 milligrams of diphenhydramine suspension 20 minutes prior to LMA insertion in the patients undergoing eye surgery significantly reduced the post-anesthesia sore throat compared to the control group. Moreover, sore throat had no associations with the age, gender, duration of surgery, and mask size of the patients.","PeriodicalId":21081,"journal":{"name":"Reviews in Clinical Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46132719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-03DOI: 10.22038/RCM.2020.45709.1302
A. Al-Janabi
Aspergillosis is a common fungal infection with systemic characteristics, which is caused by various species of Aspergillus. The infection could develop in immunocompromised and immunocompetent patients under specific circumstances. Based on the clinical features and type of invasion, aspergillosis could be classified into four main categories, including invasive pulmonary aspergillosis (IPA), noninvasive aspergilloma, semi-invasive chronic pulmonary aspergillosis, and allergic bronchopulmonary aspergillosis (ABPA). Treatment with immunosuppressive drugs for inflammatory diseases, such as rheumatoid arthritis (RA), increases the infection rate with aspergillosis. RA is an autoimmune disease characterized by several chronic symptoms in the joints, including pain, stiffness, and chronic synovitis. Previous studies have denoted an association between RA and aspergillosis. Inhibitory drugs of tumor necrosis factors and steroids are widely used in the treatment of RA. ABPA and IPA are the most commonly diagnosed diseases in patients with RA. The present study aimed to review the effects of RA and its treatment on the development of aspergillosis.
{"title":"Therapeutic effects of Rheumatoid Arthritis on Aspergillosis development","authors":"A. Al-Janabi","doi":"10.22038/RCM.2020.45709.1302","DOIUrl":"https://doi.org/10.22038/RCM.2020.45709.1302","url":null,"abstract":"Aspergillosis is a common fungal infection with systemic characteristics, which is caused by various species of Aspergillus. The infection could develop in immunocompromised and immunocompetent patients under specific circumstances. Based on the clinical features and type of invasion, aspergillosis could be classified into four main categories, including invasive pulmonary aspergillosis (IPA), noninvasive aspergilloma, semi-invasive chronic pulmonary aspergillosis, and allergic bronchopulmonary aspergillosis (ABPA). Treatment with immunosuppressive drugs for inflammatory diseases, such as rheumatoid arthritis (RA), increases the infection rate with aspergillosis. RA is an autoimmune disease characterized by several chronic symptoms in the joints, including pain, stiffness, and chronic synovitis. Previous studies have denoted an association between RA and aspergillosis. Inhibitory drugs of tumor necrosis factors and steroids are widely used in the treatment of RA. ABPA and IPA are the most commonly diagnosed diseases in patients with RA. The present study aimed to review the effects of RA and its treatment on the development of aspergillosis.","PeriodicalId":21081,"journal":{"name":"Reviews in Clinical Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44373070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-03-03DOI: 10.22038/RCM.2019.43744.1291
E. Heidari, M. Emadzadeh, E. Khodashenas, Farideh Najm Sarvari, H. Ahanchian, A. Heidari, Mahdi Mottaghi
Introduction: Bronchiolitis is the main cause of lower respiratory tract infection during the first year of life. This systematic review aimed to assess the effectiveness of systemic corticosteroids in the treatment of bronchiolitis in children aged less than two years during their first hospitalization.Methods: This systematic review was conducted via searching in databases such as PubMed, Scopus, Web of Science, and Cochrane Library until August 2019. Randomized clinical trials regarding the effects of systemic corticosteroids on children with bronchiolitis aged less than two years were evaluated in the retrieved studies. The quality of the studies was assessed based on the Jadad scale. Result: Three studies were included in this systematic review. In two studies, dexamethasone versus placebo were used, and in one study, prednisolone was applied. In one study, use of dexamethasone versus placebo resulted in the faster resolution of respiratory distress, shorter duration of respiratory distress syndrome, reduced oxygen therapy time, and reduced length of hospital stay. In another study, children receiving treatment with dexamethasone had no significant difference in the clinical score, respiratory rate, and pulmonary function compared to the control group. In another study, use of prednisolone within two weeks led to the partial improvement of rhinitis, wheezing, breathing problems, nocturnal respiratory symptoms, and coughing. However, no significant difference was observed between the prednisolone treatment and control groups after 12 months.Conclusion: Despite the improvements in respiratory symptoms, evidence is scarce regarding the effectiveness of systemic corticosteroids in the treatment of bronchiolitis in children aged less than two years. Therefore, well-designed randomized clinical trials on large sample sizes are required in this regard.
简介:毛细支气管炎是一岁以下呼吸道感染的主要原因。本系统综述旨在评估全身性皮质类固醇治疗首次住院年龄小于2岁的儿童毛细支气管炎的有效性。方法:截至2019年8月，通过检索PubMed、Scopus、Web of Science、Cochrane Library等数据库进行系统评价。在检索到的研究中评估了系统性皮质类固醇对两岁以下毛细支气管炎儿童的影响的随机临床试验。研究的质量根据Jadad量表进行评估。结果:本系统综述纳入了3项研究。在两项研究中，使用地塞米松和安慰剂，在一项研究中，使用强的松龙。在一项研究中，使用地塞米松与安慰剂相比，呼吸窘迫的缓解速度更快，呼吸窘迫综合征持续时间更短，氧疗时间缩短，住院时间缩短。在另一项研究中，与对照组相比，接受地塞米松治疗的儿童在临床评分、呼吸频率和肺功能方面没有显著差异。在另一项研究中，在两周内使用强的松龙导致鼻炎、喘息、呼吸问题、夜间呼吸道症状和咳嗽的部分改善。然而，12个月后，强的松龙治疗组与对照组之间没有明显差异。结论:尽管呼吸道症状有所改善，但关于全身皮质类固醇治疗两岁以下儿童毛细支气管炎的有效性的证据很少。因此，在这方面需要设计良好的大样本量随机临床试验。
{"title":"Systemic Corticosteroids for Bronchiolitis in Children Aged Less than Two Years: A Systematic Review","authors":"E. Heidari, M. Emadzadeh, E. Khodashenas, Farideh Najm Sarvari, H. Ahanchian, A. Heidari, Mahdi Mottaghi","doi":"10.22038/RCM.2019.43744.1291","DOIUrl":"https://doi.org/10.22038/RCM.2019.43744.1291","url":null,"abstract":"Introduction: Bronchiolitis is the main cause of lower respiratory tract infection during the first year of life. This systematic review aimed to assess the effectiveness of systemic corticosteroids in the treatment of bronchiolitis in children aged less than two years during their first hospitalization.Methods: This systematic review was conducted via searching in databases such as PubMed, Scopus, Web of Science, and Cochrane Library until August 2019. Randomized clinical trials regarding the effects of systemic corticosteroids on children with bronchiolitis aged less than two years were evaluated in the retrieved studies. The quality of the studies was assessed based on the Jadad scale. Result: Three studies were included in this systematic review. In two studies, dexamethasone versus placebo were used, and in one study, prednisolone was applied. In one study, use of dexamethasone versus placebo resulted in the faster resolution of respiratory distress, shorter duration of respiratory distress syndrome, reduced oxygen therapy time, and reduced length of hospital stay. In another study, children receiving treatment with dexamethasone had no significant difference in the clinical score, respiratory rate, and pulmonary function compared to the control group. In another study, use of prednisolone within two weeks led to the partial improvement of rhinitis, wheezing, breathing problems, nocturnal respiratory symptoms, and coughing. However, no significant difference was observed between the prednisolone treatment and control groups after 12 months.Conclusion: Despite the improvements in respiratory symptoms, evidence is scarce regarding the effectiveness of systemic corticosteroids in the treatment of bronchiolitis in children aged less than two years. Therefore, well-designed randomized clinical trials on large sample sizes are required in this regard.","PeriodicalId":21081,"journal":{"name":"Reviews in Clinical Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46201549","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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