Lin Song, P. Constanthin, N. Lin, Yong-jie Tian, L. An
Background: The human retrosplenial cortex (RSC) is the cortical region of the parietal lobe that lies directly behind the splenium of the corpus callosum. While recent fundamental research in animal models has suggested a very important role for the RSC in orientation, relatively few human cases of lesion to the RSC have been reported in the literature. Furthermore, those few cases have pointed at, in addition to the aforementioned role of this cortical structure in topographical orientation, a potential for other supplementary roles in higher-order cognitive functions such as memory processing and language. Cases presentation: In this article, we report two remarkably asymptomatic cases of extensive oncological lesions to the RSC in otherwise healthy patients younger than 35 years old. We report their surgical treatments and their release from our hospital. During the entire follow-up, patients never reported any issue with topographical orientation or language, which is remarkable compared to cases previously reported. Discussion and conclusions: We then discuss the available clinical literature about RSC lesions in human brain and the possible reasons for such a diversity of reported symptoms, or lack thereof, between cases for a seemingly similar radiological entity. Our cases reveal that understanding of the RSC and its lesions remain scarce and needs to be further investigated, both fundamentally and clinically.
{"title":"Injury to the human retrosplenial cortex: Two cases and a review of the literature","authors":"Lin Song, P. Constanthin, N. Lin, Yong-jie Tian, L. An","doi":"10.15761/TIM.1000230","DOIUrl":"https://doi.org/10.15761/TIM.1000230","url":null,"abstract":"Background: The human retrosplenial cortex (RSC) is the cortical region of the parietal lobe that lies directly behind the splenium of the corpus callosum. While recent fundamental research in animal models has suggested a very important role for the RSC in orientation, relatively few human cases of lesion to the RSC have been reported in the literature. Furthermore, those few cases have pointed at, in addition to the aforementioned role of this cortical structure in topographical orientation, a potential for other supplementary roles in higher-order cognitive functions such as memory processing and language. Cases presentation: In this article, we report two remarkably asymptomatic cases of extensive oncological lesions to the RSC in otherwise healthy patients younger than 35 years old. We report their surgical treatments and their release from our hospital. During the entire follow-up, patients never reported any issue with topographical orientation or language, which is remarkable compared to cases previously reported. Discussion and conclusions: We then discuss the available clinical literature about RSC lesions in human brain and the possible reasons for such a diversity of reported symptoms, or lack thereof, between cases for a seemingly similar radiological entity. Our cases reveal that understanding of the RSC and its lesions remain scarce and needs to be further investigated, both fundamentally and clinically.","PeriodicalId":23337,"journal":{"name":"Trends in Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77595502","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}
Due to weakened immune system, the oncological patients are highly at risk with regard to the COVID-19 pandemic. The aim of this article is to contribute with a supplement for the database on symptomatology and chest imaging appearance in patients infected with COVID-19. During the course of radiotherapy (RT), in four oncological patients we observed a variety of atypical clinical and laboratory expression: cough without fever, uroinfection with hematuria, gastrointestinal symptoms, leukopenia, which is difficult to associate with COVID-19 infection. In three out of seven patients, diffuse bilaterally ground glass opacities (GGO) are presented on the chest CT. In oncological patients infected with COVID-19, a less common symptomatology such as gastrointestinal discomfort, dry cough without fever, which is difficult to associate with this viral infection, are observed. The features of pneumonia are accompanied by leukopenia, lymphopenia and accelerated ESR. Hematuria, proteinuria, elevated transaminases and Gamma-glutamyl transferase (GGT) levels are result of vasculitis which affects parenchymal organs like kidneys and liver. The radiological features of COVID-19 pneumonia are not specific. The ground glass opacities (GGO) are bilateral, asymmetrical, peripheral and subpleural in location, with predilection for the lower lobes. CT detection is very useful in time course of the disease with checking severity and prognosis of the disease.
{"title":"COVID 19: Clinical characteristics in cancer patients and chest X-ray findings","authors":"L. Marinova, R. Georgiev, N. Evgeniev, H. Metev","doi":"10.15761/TIM.1000250","DOIUrl":"https://doi.org/10.15761/TIM.1000250","url":null,"abstract":"Due to weakened immune system, the oncological patients are highly at risk with regard to the COVID-19 pandemic. The aim of this article is to contribute with a supplement for the database on symptomatology and chest imaging appearance in patients infected with COVID-19. During the course of radiotherapy (RT), in four oncological patients we observed a variety of atypical clinical and laboratory expression: cough without fever, uroinfection with hematuria, gastrointestinal symptoms, leukopenia, which is difficult to associate with COVID-19 infection. In three out of seven patients, diffuse bilaterally ground glass opacities (GGO) are presented on the chest CT. In oncological patients infected with COVID-19, a less common symptomatology such as gastrointestinal discomfort, dry cough without fever, which is difficult to associate with this viral infection, are observed. The features of pneumonia are accompanied by leukopenia, lymphopenia and accelerated ESR. Hematuria, proteinuria, elevated transaminases and Gamma-glutamyl transferase (GGT) levels are result of vasculitis which affects parenchymal organs like kidneys and liver. The radiological features of COVID-19 pneumonia are not specific. The ground glass opacities (GGO) are bilateral, asymmetrical, peripheral and subpleural in location, with predilection for the lower lobes. CT detection is very useful in time course of the disease with checking severity and prognosis of the disease.","PeriodicalId":23337,"journal":{"name":"Trends in Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73744045","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}
R. Bagheri, F. Keihanian, K. Ghazvini, M. Ahmadi, Seyed Ali Noorbakhsh Koomleh
Background: Recent investigations emphasize the beneficial learning chances for practitioners and the promising for make better healthcare support to deprived peoples who have no access to healthcare system appropriately. In Iran, all residents in the last year of their education should go to underserved areas for a month to give service the populations in those areas in healthcare centers. In this study we evaluated the attitude of residents participated in this one-month program for first time in Eastern Iran, Khorasan Razavi. Materials and method: This was a descriptive-analytical research study. We included all residents in their last year of education period occupied in Imam Reza and Qaem Hospitals and passed the one-month program of service to underserved regions population (two general educational centers) in Mashhad, 2015. The tool of research was a researcher-made questionnaire that its reliability and validity was confirmed in a pilot study. All data was entered in SPSS software version 21. Results: 49 last year residents were included in the study. The mean of their age was 34.17±4.75 years’ old. 31 of them was male (63.3%) and 18 were female (36.7%). 98% of them was residence in Mashhad (Capital of Khorasan Razavi Province). 28 participants answered the interest of work in the program: 14 subjects (50%): bad, 10 subjects (35.71%): good and 4 subjects (14.29%): moderate. In order to duration of program, most of residents expressed that it was enough (35, 74.47%), 8 of them (17.02%) indicated that it was not enough and others said that they did not have any comment (4, 8.51%). Conclusion: The system of medical training in mission is the unique in the world. In other studies, or programs, we can see that some voluntaries who participate in medical healthcare missions, however here, in Iran, this is a part of medical education. This can help physicians to be familiar with common problems in their specialties in last year of their education.
{"title":"Medical assistants' attitude toward one-month education mission in deprived regions in Eastern of Iran","authors":"R. Bagheri, F. Keihanian, K. Ghazvini, M. Ahmadi, Seyed Ali Noorbakhsh Koomleh","doi":"10.15761/TIM.1000246","DOIUrl":"https://doi.org/10.15761/TIM.1000246","url":null,"abstract":"Background: Recent investigations emphasize the beneficial learning chances for practitioners and the promising for make better healthcare support to deprived peoples who have no access to healthcare system appropriately. In Iran, all residents in the last year of their education should go to underserved areas for a month to give service the populations in those areas in healthcare centers. In this study we evaluated the attitude of residents participated in this one-month program for first time in Eastern Iran, Khorasan Razavi. Materials and method: This was a descriptive-analytical research study. We included all residents in their last year of education period occupied in Imam Reza and Qaem Hospitals and passed the one-month program of service to underserved regions population (two general educational centers) in Mashhad, 2015. The tool of research was a researcher-made questionnaire that its reliability and validity was confirmed in a pilot study. All data was entered in SPSS software version 21. Results: 49 last year residents were included in the study. The mean of their age was 34.17±4.75 years’ old. 31 of them was male (63.3%) and 18 were female (36.7%). 98% of them was residence in Mashhad (Capital of Khorasan Razavi Province). 28 participants answered the interest of work in the program: 14 subjects (50%): bad, 10 subjects (35.71%): good and 4 subjects (14.29%): moderate. In order to duration of program, most of residents expressed that it was enough (35, 74.47%), 8 of them (17.02%) indicated that it was not enough and others said that they did not have any comment (4, 8.51%). Conclusion: The system of medical training in mission is the unique in the world. In other studies, or programs, we can see that some voluntaries who participate in medical healthcare missions, however here, in Iran, this is a part of medical education. This can help physicians to be familiar with common problems in their specialties in last year of their education.","PeriodicalId":23337,"journal":{"name":"Trends in Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74760609","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: Chronic liver disease is a major health problem and important causes of mortality and morbidity. Cirrhosis is associated with cardiovascular abnormalities. QT interval prolongation is one of the electrophysiological indicators of cirrhotic cardiomyopathy. So in this study we evaluated the QTc interval prolongation and cirrhosis severity in non-alcoholic patients admitted in Razi hospital in Rasht during 2011-2012. Material & methods: This survey was conducted as a cross-sectional descriptive study. A 12-lead surface ECG and echocardiographic study was obtained from all subjects. A 12-lead electrocardiogram recorded at 50 mm/second to measure the QT interval. The mean QT interval in every 12 leads was documented for each patient. The QT corrected for RR (QTc) was calculated. The quantitative and qualitative data were analyzed by Chi-square, ANOVA, Linear regression test and Fisher’s exact tests. Results: The mean of age was 52.78±15.2. Sixty-three persons were male, and others were female. The most common cause of cirrhosis in our study population was Hepatitis C virus. Prolonged QTc interval was seen in 48% of subjects. There was no significant correlation between age and mean of laboratory data and QTc prolongation (P>0.05). There was no significant correlation between causes of cirrhosis and QTc prolongation (P>0.05). There was significant correlation between severity of cirrhosis and QTc (P=0.020). Conclusion: Majority of patients with cirrhosis showed QTc interval prolongation, which related significantly with worsening the severity of the disease, regardless of the etiology of cirrhosis.
{"title":"QTc interval prolongation and cirrhosis severity in non-alcoholic patients","authors":"A. Saeidinia, A. Salari, A. Shafaghi, M. Ofoghi","doi":"10.15761/TIM.1000235","DOIUrl":"https://doi.org/10.15761/TIM.1000235","url":null,"abstract":"Introduction: Chronic liver disease is a major health problem and important causes of mortality and morbidity. Cirrhosis is associated with cardiovascular abnormalities. QT interval prolongation is one of the electrophysiological indicators of cirrhotic cardiomyopathy. So in this study we evaluated the QTc interval prolongation and cirrhosis severity in non-alcoholic patients admitted in Razi hospital in Rasht during 2011-2012. Material & methods: This survey was conducted as a cross-sectional descriptive study. A 12-lead surface ECG and echocardiographic study was obtained from all subjects. A 12-lead electrocardiogram recorded at 50 mm/second to measure the QT interval. The mean QT interval in every 12 leads was documented for each patient. The QT corrected for RR (QTc) was calculated. The quantitative and qualitative data were analyzed by Chi-square, ANOVA, Linear regression test and Fisher’s exact tests. Results: The mean of age was 52.78±15.2. Sixty-three persons were male, and others were female. The most common cause of cirrhosis in our study population was Hepatitis C virus. Prolonged QTc interval was seen in 48% of subjects. There was no significant correlation between age and mean of laboratory data and QTc prolongation (P>0.05). There was no significant correlation between causes of cirrhosis and QTc prolongation (P>0.05). There was significant correlation between severity of cirrhosis and QTc (P=0.020). Conclusion: Majority of patients with cirrhosis showed QTc interval prolongation, which related significantly with worsening the severity of the disease, regardless of the etiology of cirrhosis.","PeriodicalId":23337,"journal":{"name":"Trends in Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87418228","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}
Birth defects (BD) have a significant impact on the health and further development of the child and its adaptation in society. The purpose of this study was to document the epidemiological features of BD in longlivers from Precarpathian region (West Ukraine). Methods : cytogenetic, clinical, genealogical. Results : The medical history of BDs, somatic pathology and karyotyping was observed in 486 longlivers aged 90-102 from Ivano-Frankivsk region (West Ukraine) during 17 years (1998–2014 yy). In the group of 486 longlivers there were 15 (3.1%) patients with BD which in our study were isolated. The following defects have been diagnosed: cleft lip and cleft palate (2 men and 1 female), genital organs (1 man) and musculoskeletal system (2 men and 9 female). So patients lived for so long and it did not really affect the quality of their lives). In the longlivers prevailed cleft lip with or without palate, syndactyly and congenital complete absence of upper limb and significant difference was found (p<0.05) in Eurocat. Stable chromosomal aberrations in any longlivers person is not identified. In a group of 15 longlivers with BDs and in the group of 130 longlivers without BDs, there were no significant differences (p>0.05) in the frequency of chromosomal aberrations. Conclusion Our study also showed that no significantly risk of BDs among longlivers 3.1% and population of Ukraine -2.32% and Eurocat- 2.55%. The spectrum of chromosomal aberrations of the proband with BD and longlivers without BD had no significant difference (p>0.05) among them.
{"title":"The frequency and spectrum of birth defects among 486 longlivers from Ivano-Frankivsk region (West Ukraine)","authors":"R. Kozovyi, L. Kovalchuk, N. Kitsera","doi":"10.15761/TIM.1000245","DOIUrl":"https://doi.org/10.15761/TIM.1000245","url":null,"abstract":"Birth defects (BD) have a significant impact on the health and further development of the child and its adaptation in society. The purpose of this study was to document the epidemiological features of BD in longlivers from Precarpathian region (West Ukraine). Methods : cytogenetic, clinical, genealogical. Results : The medical history of BDs, somatic pathology and karyotyping was observed in 486 longlivers aged 90-102 from Ivano-Frankivsk region (West Ukraine) during 17 years (1998–2014 yy). In the group of 486 longlivers there were 15 (3.1%) patients with BD which in our study were isolated. The following defects have been diagnosed: cleft lip and cleft palate (2 men and 1 female), genital organs (1 man) and musculoskeletal system (2 men and 9 female). So patients lived for so long and it did not really affect the quality of their lives). In the longlivers prevailed cleft lip with or without palate, syndactyly and congenital complete absence of upper limb and significant difference was found (p<0.05) in Eurocat. Stable chromosomal aberrations in any longlivers person is not identified. In a group of 15 longlivers with BDs and in the group of 130 longlivers without BDs, there were no significant differences (p>0.05) in the frequency of chromosomal aberrations. Conclusion Our study also showed that no significantly risk of BDs among longlivers 3.1% and population of Ukraine -2.32% and Eurocat- 2.55%. The spectrum of chromosomal aberrations of the proband with BD and longlivers without BD had no significant difference (p>0.05) among them.","PeriodicalId":23337,"journal":{"name":"Trends in Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84154684","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. Yousefi, Babak Kardarian, Seyed Mojtaba Hashemi, S. Noorbakhsh
Background: Functional constipation and its-related predisposing factors are so frequent among medical staff. The aim of study: To determine the prevalence of functional constipation and its relation to psychological disorders among Iranian medical interns. Methods: This multicenter, cross-sectional study was performed on 369 medical interns working at 5 main educational hospitals affiliated by universities of medical sciences in Iran during 2016-2017. The questionnaires related to the ROME criteria definitive for functional constipation were raised to confirm or reject definitive diagnosis of disease. To assess depression, anxiety and stress status of the participants, it was used the Persian version of the DASS-21 questionnaire that was previously validated by the Iranian researchers. Results: Overall, the prevalence of functional constipation in medical interns was 26.3%; and was more frequent in female gender (p=0.043). It was not related to depression in cases (p=0.1) or baseline parameters (marital status, body mass index, severity of depression, or degree of stress status). But was related to severity of anxiety (p=0.004) and irregular eating breakfast (p=0.041); deliberately ignoring defecation (p=0.010). Conclusion: It can be concluded high prevalence of functional constipation in medical interns especially in female gender, cases with low rate of eating breakfast, and deliberately ignoring defecation all might indicate the major role for anxiety in functional constipation in Iranian medical interns. Thus, the psychologic consults programs for modifying the anxiety in cases with functional constipation might be helpful.
{"title":"The relation between anxiety and functional constipation: A multicenter study in Iranian medical interns","authors":"A. Yousefi, Babak Kardarian, Seyed Mojtaba Hashemi, S. Noorbakhsh","doi":"10.15761/tim.1000227","DOIUrl":"https://doi.org/10.15761/tim.1000227","url":null,"abstract":"Background: Functional constipation and its-related predisposing factors are so frequent among medical staff. The aim of study: To determine the prevalence of functional constipation and its relation to psychological disorders among Iranian medical interns. Methods: This multicenter, cross-sectional study was performed on 369 medical interns working at 5 main educational hospitals affiliated by universities of medical sciences in Iran during 2016-2017. The questionnaires related to the ROME criteria definitive for functional constipation were raised to confirm or reject definitive diagnosis of disease. To assess depression, anxiety and stress status of the participants, it was used the Persian version of the DASS-21 questionnaire that was previously validated by the Iranian researchers. Results: Overall, the prevalence of functional constipation in medical interns was 26.3%; and was more frequent in female gender (p=0.043). It was not related to depression in cases (p=0.1) or baseline parameters (marital status, body mass index, severity of depression, or degree of stress status). But was related to severity of anxiety (p=0.004) and irregular eating breakfast (p=0.041); deliberately ignoring defecation (p=0.010). Conclusion: It can be concluded high prevalence of functional constipation in medical interns especially in female gender, cases with low rate of eating breakfast, and deliberately ignoring defecation all might indicate the major role for anxiety in functional constipation in Iranian medical interns. Thus, the psychologic consults programs for modifying the anxiety in cases with functional constipation might be helpful.","PeriodicalId":23337,"journal":{"name":"Trends in Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89234139","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}
Objective: Using representative nationwide Korea Health Panel Survey data, this study examined differences and factors influencing the level of satisfaction with EMS among the elderly. Method: This study used cross-sectional analyses with 2016 KHPS data released to the public in 2019. Using both descriptive and logistic regression analyses, this paper analyzed data from the 2016 Korean Health Panel Survey (n=4,216). Results: 4,216 respondents, 15.09% were dissatisfied and 84.91% were satisfied. In logistic multivariate analysis, Age (OR, 0.817; 95%CI:0.679-0.983; p=0.032), (OR, 095%CI:0.773-0.933; p<0.01), of ER (OR, or a proxy p<0.01), for ER (OR, 95%CI:0.565-0.888; p<0.01), in the ER (OR, 95%CI:0.613- 0.939; p=0.011, and post-services measures (OR, 0.862;95%CI:0.782-0.950; p<0.01) were inversely associated with the satisfaction of EMS. Residence (OR, 1.325; 95%CI:1.287-1.616; p<0.01) and health status (OR, 1.353;95%CI:1.125-1.627; p<0.01) were significantly associated with EMS satisfaction. Conclusion: such an age, residence, health status, the respondent is a or a proxy, and of ER had significant differences in EMS satisfaction. In addition, waiting time, reasons for visiting the emergency room, and post-service measures were factors that affected satisfaction that could be used as an indicator of the quality of emergency medical services.
目的:利用具有代表性的全国韩国健康小组调查数据，研究老年人EMS满意度的差异及其影响因素。方法:本研究使用2019年向公众发布的2016年KHPS数据进行横断面分析。使用描述性和逻辑回归分析，本文分析了2016年韩国健康小组调查(n= 4216)的数据。结果:4216名被调查者中，不满意的占15.09%，满意的占84.91%。logistic多因素分析中，年龄(OR, 0.817;95%置信区间:0.679—-0.983;p=0.032)， (OR, 095%CI:0.773-0.933;p<0.01)， ER (OR，或代理p<0.01)， ER (OR, 95%CI:0.565-0.888;p<0.01)， ER组(OR, 95%CI:0.613- 0.939;p=0.011，离职后测量(OR, 0.862;95%CI:0.782-0.950;p<0.01)与EMS满意度呈负相关。居住地(OR, 1.325;95%置信区间:1.287—-1.616;p<0.01)和健康状况(OR, 1.353;95%CI:1.125 ~ 1.627;p<0.01)与EMS满意度显著相关。结论:年龄、居住地、健康状况、被调查者是本人还是代理人，以及对急诊的满意度有显著差异。此外，等候时间、去急诊室的原因和服务后措施是影响满意度的因素，可以作为紧急医疗服务质量的指标。
{"title":"Factors affecting satisfaction with emergency medical services among elderly Koreans","authors":"Ju Moon Park, A. Sohn","doi":"10.15761/TIM.1000251","DOIUrl":"https://doi.org/10.15761/TIM.1000251","url":null,"abstract":"Objective: Using representative nationwide Korea Health Panel Survey data, this study examined differences and factors influencing the level of satisfaction with EMS among the elderly. Method: This study used cross-sectional analyses with 2016 KHPS data released to the public in 2019. Using both descriptive and logistic regression analyses, this paper analyzed data from the 2016 Korean Health Panel Survey (n=4,216). Results: 4,216 respondents, 15.09% were dissatisfied and 84.91% were satisfied. In logistic multivariate analysis, Age (OR, 0.817; 95%CI:0.679-0.983; p=0.032), (OR, 095%CI:0.773-0.933; p<0.01), of ER (OR, or a proxy p<0.01), for ER (OR, 95%CI:0.565-0.888; p<0.01), in the ER (OR, 95%CI:0.613- 0.939; p=0.011, and post-services measures (OR, 0.862;95%CI:0.782-0.950; p<0.01) were inversely associated with the satisfaction of EMS. Residence (OR, 1.325; 95%CI:1.287-1.616; p<0.01) and health status (OR, 1.353;95%CI:1.125-1.627; p<0.01) were significantly associated with EMS satisfaction. Conclusion: such an age, residence, health status, the respondent is a or a proxy, and of ER had significant differences in EMS satisfaction. In addition, waiting time, reasons for visiting the emergency room, and post-service measures were factors that affected satisfaction that could be used as an indicator of the quality of emergency medical services.","PeriodicalId":23337,"journal":{"name":"Trends in Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81286436","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}
N. Loori, J. Ahmadzadeh, Kazhal Mobaraki, Ensiyeh Jamshidi, N. Gholizadeh, R. Majdzadeh
Purpose: The aim of this study is to examine the impacts of Iranian participatory research in practice. Materials/methods: A review of participatory studies conducted to find out published articles (Persian or English) in Iran. The keywords “knowledge translation, knowledge utilization, participatory research, participatory action research, outcome assessment, impact assessment, results” were searched in several domestic and international databases such as Pubmed, Medline, Embase, Iranmedex, SID and Iranpsych. This study included papers published during 2006-2008, to ensure that enough time (ten years) had passed for changes to track the short and long-term effects of researches in the next part as a cross-sectional study. Results: The findings of the cross-sectional study indicated that the greatest changes occurred at participation (92.3%) and empowerment (76.9%) levels in people/ patients; participation and capacity building (38.5%) in researchers; participation and awareness (30.8%) in health care providers groups of stakeholders. Also, the highest scores were attributed to inter-sectoral collaboration (38.5%, 53.8%) and decision-making (30.8%, 38.5%) in health policy-makers and organizational managers, respectively. Conclusions: Community-based participatory research can have a great impact on community participation in the research process, as well as on capacity building and knowledge sharing among researchers. It can also have moderate effects on improving managerial decision-making and inter-sectoral collaboration among organizational managers. translation,
{"title":"Iranian participatory research impacts: A knowledge translation perspective","authors":"N. Loori, J. Ahmadzadeh, Kazhal Mobaraki, Ensiyeh Jamshidi, N. Gholizadeh, R. Majdzadeh","doi":"10.15761/TIM.1000244","DOIUrl":"https://doi.org/10.15761/TIM.1000244","url":null,"abstract":"Purpose: The aim of this study is to examine the impacts of Iranian participatory research in practice. Materials/methods: A review of participatory studies conducted to find out published articles (Persian or English) in Iran. The keywords “knowledge translation, knowledge utilization, participatory research, participatory action research, outcome assessment, impact assessment, results” were searched in several domestic and international databases such as Pubmed, Medline, Embase, Iranmedex, SID and Iranpsych. This study included papers published during 2006-2008, to ensure that enough time (ten years) had passed for changes to track the short and long-term effects of researches in the next part as a cross-sectional study. Results: The findings of the cross-sectional study indicated that the greatest changes occurred at participation (92.3%) and empowerment (76.9%) levels in people/ patients; participation and capacity building (38.5%) in researchers; participation and awareness (30.8%) in health care providers groups of stakeholders. Also, the highest scores were attributed to inter-sectoral collaboration (38.5%, 53.8%) and decision-making (30.8%, 38.5%) in health policy-makers and organizational managers, respectively. Conclusions: Community-based participatory research can have a great impact on community participation in the research process, as well as on capacity building and knowledge sharing among researchers. It can also have moderate effects on improving managerial decision-making and inter-sectoral collaboration among organizational managers. translation,","PeriodicalId":23337,"journal":{"name":"Trends in Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87358974","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}
Mechanical ventilation in internal medicine wards is challenging. Weaning the patients from mechanical ventilation (MV) is an even bigger challenge. The aim of this study was to characterize the mechanically ventilated patient`s population in an internal medicine ward, their weaning rate, and one-year mortality and survival rate. Methods : The study was designed as a retrospective study. We collected and analyzed data on MV patients that were hospitalized during 2016-2017 in Internal Medicine Department B, Hasharon Hospital, Rabin Medical Center, Israel. The data was analyzed according to age, gender, ethnicity, background diseases, functional status at admission, marital status and residence of the patient (home or nursing facility). We followed the patients for one year after first admission and analyzed survival and mortality rate, weaning rate, readmission, and reintubation rates. Results : Data were collected from 200 computerized patient records who were ventilated and admitted to Internal Medicine Department B during 2016-2017. A significant statistical relationship was found between the age of the patients (over 75 years) and mortality after one year. There was also a significant statistical relationship between the patient's independence and residence (home or nursing facility) for the first year after intubation. Only 6% of the elderly non-ambulatory patients who came from nursing homes survived one year after discharge. No relationship was found between the patient's gender, ethnicity or marital status for survival or mortality after one year. There was also no relationship between where the intubation took place (home/hospital/ward) and survival or mortality. Conclusions : Older MV patients coming from nursing homes and in need of nursing care had the lowest survival rates. When discussing intubation with the patient, family, medical and nursing staff and interns, these factors should be presented along with an in-depth discussion and awareness of the dying patient law.
{"title":"Mechanically ventilated patients in internal medicine wards: Survival and outcome one-year post-discharge","authors":"Bathish Jlal, M. Mahmud, B. Galina, Zeidman Aliza","doi":"10.15761/TIM.1000243","DOIUrl":"https://doi.org/10.15761/TIM.1000243","url":null,"abstract":"Mechanical ventilation in internal medicine wards is challenging. Weaning the patients from mechanical ventilation (MV) is an even bigger challenge. The aim of this study was to characterize the mechanically ventilated patient`s population in an internal medicine ward, their weaning rate, and one-year mortality and survival rate. Methods : The study was designed as a retrospective study. We collected and analyzed data on MV patients that were hospitalized during 2016-2017 in Internal Medicine Department B, Hasharon Hospital, Rabin Medical Center, Israel. The data was analyzed according to age, gender, ethnicity, background diseases, functional status at admission, marital status and residence of the patient (home or nursing facility). We followed the patients for one year after first admission and analyzed survival and mortality rate, weaning rate, readmission, and reintubation rates. Results : Data were collected from 200 computerized patient records who were ventilated and admitted to Internal Medicine Department B during 2016-2017. A significant statistical relationship was found between the age of the patients (over 75 years) and mortality after one year. There was also a significant statistical relationship between the patient's independence and residence (home or nursing facility) for the first year after intubation. Only 6% of the elderly non-ambulatory patients who came from nursing homes survived one year after discharge. No relationship was found between the patient's gender, ethnicity or marital status for survival or mortality after one year. There was also no relationship between where the intubation took place (home/hospital/ward) and survival or mortality. Conclusions : Older MV patients coming from nursing homes and in need of nursing care had the lowest survival rates. When discussing intubation with the patient, family, medical and nursing staff and interns, these factors should be presented along with an in-depth discussion and awareness of the dying patient law.","PeriodicalId":23337,"journal":{"name":"Trends in Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90510131","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: Preventive policies and harmful lockdowns in Italy, Western Europe, the United States, as well as in other developing countries worldwide seem unable to contain the intensive care burden and deaths for severe acute respiratory syndrome coronavirus 2 (COVID-19), especially in nursing homes. Prompted by the limited evidence available, we wonder why until now only one publication (JAMA Otolaryngol Head Neck Surg doi:10.1001/jamaoto.2020.1622) has documented how repetitive nasal rinsing and gargling with hypertonic saline (a solution three to four times as salty as normotonic saline) could quickly contribute as an adjunctive cost-free weapon to current health policies for use against new coronavirus 2019 (SARS-CoV-2) infections at an early stage, also in quarantined people, and in developing countries. Case presentation: We report the case of a 54-year-old asymptomatic SARS-CoV-2 infected physician (positive nasopharyngeal swab test) quarantined in Rome in whom hypertonic saline nasal rinsing and gargling several times a day at home induced a rapid successful response. The infected physician remained asymptomatic, and serum immunoglobulin IgG for SARS-CoV-2 tested negative two months after the infection. Discussion and conclusions: Our case report, describing at more than two months after the SARS-CoV-2 infection negative serum IgG, seemingly supports recent evidence suggesting that asymptomatic subjects treated early with hypertonic saline solutions avoid multi-organ inflammation needing intensive care. In the current urgency state, health authorities could advocate hypertonic saline nasal rinsing and gargling as an adjunctive inexpensive procedure for SARS-CoV-2 “wash-out”. This proven, generally safe saline expedient might help as an adjunctive weapon like handwashing to combat the SARS-CoV-2 infection early in developed and developing countries, or returning as second COVID-19 waves.
{"title":"Hypertonic saline nasal irrigation and gargling as an inexpensive practical adjunctive weapon to combat asymptomatic SARS-CoV-2 infections. A case report","authors":"Paola Rosati, U. Giordano, C. Concato","doi":"10.15761/TIM.1000249","DOIUrl":"https://doi.org/10.15761/TIM.1000249","url":null,"abstract":"Background: Preventive policies and harmful lockdowns in Italy, Western Europe, the United States, as well as in other developing countries worldwide seem unable to contain the intensive care burden and deaths for severe acute respiratory syndrome coronavirus 2 (COVID-19), especially in nursing homes. Prompted by the limited evidence available, we wonder why until now only one publication (JAMA Otolaryngol Head Neck Surg doi:10.1001/jamaoto.2020.1622) has documented how repetitive nasal rinsing and gargling with hypertonic saline (a solution three to four times as salty as normotonic saline) could quickly contribute as an adjunctive cost-free weapon to current health policies for use against new coronavirus 2019 (SARS-CoV-2) infections at an early stage, also in quarantined people, and in developing countries. Case presentation: We report the case of a 54-year-old asymptomatic SARS-CoV-2 infected physician (positive nasopharyngeal swab test) quarantined in Rome in whom hypertonic saline nasal rinsing and gargling several times a day at home induced a rapid successful response. The infected physician remained asymptomatic, and serum immunoglobulin IgG for SARS-CoV-2 tested negative two months after the infection. Discussion and conclusions: Our case report, describing at more than two months after the SARS-CoV-2 infection negative serum IgG, seemingly supports recent evidence suggesting that asymptomatic subjects treated early with hypertonic saline solutions avoid multi-organ inflammation needing intensive care. In the current urgency state, health authorities could advocate hypertonic saline nasal rinsing and gargling as an adjunctive inexpensive procedure for SARS-CoV-2 “wash-out”. This proven, generally safe saline expedient might help as an adjunctive weapon like handwashing to combat the SARS-CoV-2 infection early in developed and developing countries, or returning as second COVID-19 waves.","PeriodicalId":23337,"journal":{"name":"Trends in Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91227440","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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