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Haematological abnormalities in patients with severe community acquired pneumonia who did not require mechanical ventilation and in patients with severe pulmonary tuberculosis 不需要机械通气的严重社区获得性肺炎患者和严重肺结核患者的血液学异常
Pub Date : 2019-01-01 DOI: 10.15761/tim.1000207
G. Bozóky, É. Ruby
During the 10-year follow-up period (2008-2019) authors analyzed the different hematological changes in 1280 hospitalized patients with sever community acquired pneumonia (CAP) who did not require mechanical ventilation. The severity of illness was identified by the „pneumonia serverity index” and by the „CURB” (confusion, urea nitrogen, respiratory rate, blood pressure) severity scores. Normochromic-normocytic type of aneamia was diagnosed in 12% of patients: hypocromic microcytic type of anemia was observed on 8% of patients: immune-mediated-hemolytic anemia occurred in 6 patients. Usual degree of leucocytosis with left shifted periferial blood smear was detected in 32% of patients: extreme degree of leucocytosis was observed in 20%, leucopenia (granulocytopaenia) occured in 16% of patients. Elevated plateled count was defined in 18% while thrombocytopaenia was found in 6% of patients. Authors prospectively followed 380 patients with pulmnary tuberculosis according to the characteristics of chest radiograph and sputum Ziehl-Neelsen’s stain positivity, and a result of quantiferon test. In 380 patients with severe pulmonary tuberculosis anemia was present in 52% of patients: leukocytosis occured in 20% leucopenia, granulocytopedia and lymphopenia was observed in 16% of patients. Elevated platelet count occured in 26% which was compicated with deep vein leg thrombosis in 18 patients. Dysmyelopoietic bone marrow alteration with peripheal pancytopenia was diagnosed in one case as the result of mycobacterial sespsis. This survey has revealed that the various haematological abnormalities are common in cases of community acquired pneumonia, and in patients with severe pulmonary tuberculosis. The other clinical consequence is that the special haematological alterations, such as extreme leucocytosis, leucopenia, granulocytopenia and severe degree of anemia are useful indicators of the severity of lower respiratory tract infection. *Correspondence to: Géza Bozóky, Department of Pulmology and Internal Medicine, Hospital of Bács-Kiskun County Municipality, Bács-Kiskun County, E-mail: bozokyg@freemail.hu Received: September 03, 2019; Accepted: September 20, 2019; Published: September 24, 2019 Introduction Community acquired pneumonia (CAP) is an important healthcare concern, and is the most common cause of death associated with infectious disease and the sixth most comon cause of death [1-3]. The annual incidence rate in the USA 6/1000 in the 18-39 age group, and 34/1000 in people aged 75 [3]. Admission to the hospital in patients with CAP is needed in 20-40% and about 5-10% of these patients are admitted to intnsive care unit (ICU) [3,4]. The mortality rate of CAP in outpatients setting is in the range of <1-5%, but among patients who require hospitalization, the rate averages 12% [1,3]. Severe CAP (sepsis syndrome and septic shock syndrome) has been separeted from cases of less severe pneumonia requiring hopsitalization, because of the high mortality rate
在10年随访期间(2008-2019),作者分析了1280例不需要机械通气的重症社区获得性肺炎(CAP)住院患者的不同血液学变化。疾病的严重程度由“肺炎严重程度指数”和“CURB”(意识混乱、尿素氮、呼吸频率、血压)严重程度评分来确定。12%的患者诊断为正色-正红细胞型贫血;8%的患者观察到低色-小细胞型贫血;6例患者发生免疫介导性溶血性贫血。32%的患者外周血涂片左移可见正常程度的白细胞增多,20%的患者有严重程度的白细胞增多,16%的患者有白细胞减少(粒细胞减少)。血小板计数升高的患者占18%,血小板减少的患者占6%。根据胸片特点、痰Ziehl-Neelsen染色阳性、定量子试验结果,对380例肺结核患者进行前瞻性随访。380例重症肺结核患者中,52%的患者出现贫血,20%的患者出现白细胞减少,16%的患者出现粒细胞增多和淋巴细胞减少。血小板计数升高占26%,并发下肢深静脉血栓18例。骨髓增生异常伴外周血全血细胞减少症1例,诊断为分枝杆菌脓毒症。这项调查显示,在社区获得性肺炎病例和严重肺结核患者中,各种血液学异常是常见的。另一个临床后果是特殊的血液学改变,如白细胞极度减少、白细胞减少、粒细胞减少和严重贫血程度,是判断下呼吸道感染严重程度的有用指标。*通讯:Bács-Kiskun县市府医院内科内科gsamza Bozóky, Bács-Kiskun县,E-mail: bozokyg@freemail.hu收稿时间:2019年9月3日;录用日期:2019年9月20日;社区获得性肺炎(CAP)是一个重要的医疗保健问题,是与传染病相关的最常见死亡原因,也是第六大常见死亡原因[1-3]。美国18-39岁人群年发病率为6/1000,75岁人群年发病率为34/1000[3]。20-40%的CAP患者需要住院治疗,其中约5-10%的患者入住重症监护病房(ICU)[3,4]。门诊CAP的死亡率在50%左右,感染性休克或需要使用降压药和急性肾功能衰竭。在10年随访期间(2008-2018年),我们前瞻性分析了1280例不需要机械通气的重症CAP住院患者的不同血液学变化。在本调查的另一部分,我们根据胸片和Ziehl-Neelsen染色阳性的特征,以及与血液学变化相关的量化子试验,回顾性随访了380例肺结核患者。
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引用次数: 0
Pseudo tumor cerebri caused by Brucellosis: Case report 布鲁氏菌病致假性脑瘤1例
Pub Date : 2019-01-01 DOI: 10.15761/tim.1000215
M. Ranjbar, Sohrab Aghabeigi, Fatemeh Tahanian, Ahmad Hezarjaribi, S. Nemati
Brucellosis is a bacterial zoonotic infection. In endemic areas, brucellosis can manifest with various types of neurological symptoms. Among them, meningitis is the most frequent presentation. Pseudotumor like presentation is also rarely reported. In this report, the patient is a 47-year-old female presenting with pseudotumor cerebri and normal cerebrospinal fluid analysis who finally diagnosed with brucellosis. This case report suggests that neurobrucellosis as a differential diagnosis of psudotumor cerebri especially in endemic areas.
布鲁氏菌病是一种细菌性人畜共患感染。在流行地区,布鲁氏菌病可表现为各种类型的神经系统症状。其中,脑膜炎是最常见的表现。假瘤样表现也很少报道。在本报告中,患者是一名47岁女性,表现为假性脑瘤,脑脊液分析正常,最终诊断为布鲁氏菌病。本病例报告提示神经布鲁氏菌病作为脑假瘤的鉴别诊断,特别是在流行地区。
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引用次数: 0
Development of antifungal paper from Trametes versicolor containing orange oil against fungal skin infections: A model based on in vitro studies 含橙油的彩板草抗真菌纸的研制:基于体外研究的模型
Pub Date : 2019-01-01 DOI: 10.15761/TIM.1000186
Sirimas Sukmas, T. Aewsiri, N. Matan
Introduction: Mould infection on the human skin is one of important effects of mould on human health. Skin mould infection is normally caused by Aspegillus, Penicillium and Rhizopus. To date, orange oil has been applied in the present study to inhibit mould infection by adding it into fungal paper. Fungal paper made from Trametes versicolor was used to absorb and slow down the release of orange oil vapour. Therefore, the objective of this work was to investigate the effect of orange oil in fungal paper on growth of infected skin mould as a model in vitro test. Methods: Orange oil and the main component (limonene) was prepared in the Malt Extract Agar (MEA) and added into fungal paper made from T. versicolor at concentrations of 0 (control), 20, 40, 60, 80 and 100 μg g−1. Each of mycelium and spores of Aspergillus niger, Aspergillus flavus, Penicillium chrysogenum and Rhizopus spp were placed on the MEA. A spore of mould was sprayed on the fungal paper. Results: Using 60 μg g−1 of orange oil in MEA and 80 μg g−1 of orange oil in the fungal paper exhibited complete inhibition of growth of all moulds in this test. Limonene alone could not inhibit all moulds in this test; therefore, some minor components of orange can play a significant role in mould growth inhibition. Moreover, fungal paper made from T. versicolor exhibited slow release of orange oil components with active to inhibit mould at least 30 days. Conclusions: Thus, this research demonstrated the potential of fungal paper containing orange oil to control the growth of infected moulds and that this combination could be applied in medicine to control infection of skin in the future. *Correspondence to: Narumol Matan, Food Science and Technology, School of Agricultural Technology, Walailak University, Nakhon Si Thammarat 80160, Thailand and Research Center of Excellence in Innovation of Essential oil, Walailak University, Nakhon Si Thammarat 80160, Thailand, Tel: 6675672359; Fax: 6675672971; E-mail: nnarumol@wu.ac.th; nnarumol@yahoo.com
人体皮肤霉菌感染是霉菌对人体健康的重要影响之一。皮肤霉菌感染通常是由曲霉、青霉和根霉引起的。迄今为止,本研究已将橙油添加到真菌纸中,以抑制霉菌感染。用彩板菌制成的真菌纸来吸收和减缓橙油蒸汽的释放。因此,本研究以真菌纸中的橙油为模型,探讨其对感染皮肤霉菌生长的影响。方法:在麦芽提取物琼脂(MEA)中制备橙油和主要成分柠檬烯,分别以0(对照)、20、40、60、80和100 μg−1的浓度加入到由花枝霉制成的真菌纸中。将黑曲霉、黄曲霉、黄化青霉和根霉的菌丝体和孢子分别置于MEA上。将霉菌孢子喷在真菌纸上。结果:在MEA中添加60 μg−1的橙油,在真菌纸中添加80 μg−1的橙油,对本试验中所有霉菌的生长均有完全的抑制作用。单用柠檬烯不能抑制所有霉菌;因此,橙中的一些微量成分可以起到显著的抑制霉菌生长的作用。此外,以紫皮霉为原料制成的真菌纸,其橙油成分释放缓慢,对霉菌的抑制作用至少为30天。结论:本研究证明了含橙油真菌纸具有控制感染霉菌生长的潜力,该组合可在未来用于医学上控制皮肤感染。*通讯:Narumol Matan,食品科学与技术,Walailak大学农业技术学院,Nakhon Si Thammarat 80160,泰国;Narumol Matan, Walailak大学精油创新卓越研究中心,Nakhon Si Thammarat 80160,泰国,电话:6675672359;传真:6675672971;电子邮件:nnarumol@wu.ac.th;nnarumol@yahoo.com
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引用次数: 0
Serum potassium levels in Thai patients with T2DM and eGFR greater than or equal to 90 ml/min/1.73 m2 泰国T2DM和eGFR患者血清钾水平大于或等于90ml /min/1.73 m2
Pub Date : 2019-01-01 DOI: 10.15761/TIM.1000178
J. Janma, S. Changsirikulchai, P. Sangthawan, N. S. Thokanit, S. Rattanamongkolgul, B. Thinkhamrop
Background: Disturbances in potassium levels can occur in patients with renal dysfunction. This study’s aim is to describe the serum potassium (sK) levels in Thai patients with type 2 Diabetes (T2DM) with or without hypertension (HT) and with estimated glomerular filtration rates (eGFR) greater than or equal to 90 ml/ minute/1.73 m 2 . Methods : There was a cross sectional study performed throughout Thailand in 2016 for assessment on the quality of care among patients diagnosed with T2DM and HT. We selected a subgroup of patients who had data of sK levels and eGFR value greater than or equal to 90 ml/minute/1.73 m 2 for analyses. Results: There were 3,719 subjects who met the inclusion criteria. The mean (SD) eGFR was 102.59 (9.12) ml/minute/1.73m 2 . The mean (SD)sK level was 4.11 (0.52) mEq/L. The mean (SD) SBP and DBP were 130.86 (15.47) and 76.15 (10.14) mmHg, respectively. The sK levels were categorized into 3 groups: low, normal and high at <3.5, 3.5-5.0 and >5 mEq/L, respectively. The prevalence of hypokalemia was 6.7 % and level less than 3 mEq/L was found in 55.6% of the hypokalemic population. The percentage of hypokalemia was found to be high in the group with diuretic usage. The prevalence of hyperkalemia was 2.9% and levels more than 5.5 mEq/L was found in 21.7% of the hyperkalemic group. Conclusions : The hypokalemia and hyperkalemia in T2DM with or without hypertension and eGFR≥90 ml/minute/1.73 m 2 can be found. The sK levels less than 3 mEq/L could be related to diuretic usage. Therefore, patients who are prescribed diuretics or renin angiotensin aldosterone blockades should have sK levels regularly monitored.
背景:肾功能不全患者可出现钾水平紊乱。本研究的目的是描述伴有或不伴有高血压(HT)且肾小球滤过率(eGFR)大于或等于90 ml/ min /1.73 m2的泰国2型糖尿病(T2DM)患者的血清钾(sK)水平。方法:2016年在泰国进行了一项横断面研究,评估诊断为T2DM和HT的患者的护理质量。我们选择了一组sK水平和eGFR值大于或等于90 ml/min /1.73 m2的患者进行分析。结果:3719名受试者符合纳入标准。平均(SD) eGFR为102.59 (9.12)ml/min /1.73 m3 / 2。sK均值(SD)为4.11 (0.52)mEq/L。收缩压和舒张压的平均(SD)分别为130.86(15.47)和76.15 (10.14)mmHg。sK水平分为低、正常和高3组,分别为5 mEq/L。低血钾患病率为6.7%,低血钾人群中低于3 mEq/L的比例为55.6%。在使用利尿剂的组中发现低钾血症的百分比较高。高钾血症的患病率为2.9%,21.7%的高钾血症组高于5.5 mEq/L。结论:伴有或不伴有高血压且eGFR≥90ml /min /1.73 m2的T2DM患者均存在低钾血症和高钾血症。sK水平低于3 mEq/L可能与利尿剂的使用有关。因此,服用利尿剂或肾素血管紧张素醛固酮阻滞剂的患者应定期监测sK水平。
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引用次数: 1
Association between noise annoyance and hearing loss caused by chronic exposure to noise among the workers of an automotive industry 汽车工业工人因长期接触噪音而引起的噪音烦恼与听力丧失之间的关系
Pub Date : 2019-01-01 DOI: 10.15761/tim.1000203
I. Alimohammadi, Fakhradin Ahmadi Kanrash, J. Abolghasemi, S. Vosoughi, Kazem Rahmani, M. Chalak, M. Anbari
Background: As a physical pollutant in the workplace, noise has physiological and psychological consequences for people. Objective: The aim of this study was to investigate the relationship between annoyance and hearing loss in the people exposed to chronic noise in the automotive industry. Methods: 250 workers exposed to sound pressure in the work environment were randomly selected. The DANPLEX-AS54 audiometry device was also used to measure the workers’ hearing levels. Furthermore, an annoyance inventory containing questions numbered 1 to 11 to indicate the level of annoyance was used as well. Results: using Pearson correlation coefficient to evaluate hearing levels and annoyance, we found out a significant positive relationship between annoyance and hearing level at frequencies of 2000, 4000 and 8000 in the left ear, and frequency of 6000 in the right ear (P <0.001). Also, there was a significant relationship between annoyance and NIHL (noise-induced hearing loss) in the left ear, and general conditions (both ears) (P <0.001). Conclusion: The results of this study, showed that there was a significant positive relationship between noise annoyance and hearing loss among the workers, and the likelihood of noise annoyance increased with the incidence of hearing loss. *Correspondence to: Fakhradin Ahmadi kanrash, MSc Student, Department of Occupational Health Engineering, Student Research Committee, School of Public Health, Iran University of Medical Sciences, Tehran, Iran, E-mail: F_ahmadi1367@yahoo.com
背景:噪声作为工作场所的一种物理污染物,对人的生理和心理都有影响。目的:本研究的目的是探讨长期暴露在汽车工业噪音中的人的烦恼与听力损失之间的关系。方法:随机选取工作环境中声压暴露工人250人。同时使用DANPLEX-AS54测听仪测量工人的听力水平。此外,还使用了一个烦恼清单,其中包含编号为1到11的问题,以表明烦恼的程度。结果:运用Pearson相关系数对听力水平与烦恼程度进行评价,发现左耳烦恼程度与听力水平在2000、4000、8000频次及右耳6000频次呈正相关(P <0.001)。此外,左耳烦恼与NIHL(噪声性听力损失)和一般情况(双耳)之间存在显著关系(P <0.001)。结论:本研究结果显示,噪音烦恼与工人的听力损失之间存在显著的正相关关系,并且噪音烦恼的可能性随着听力损失的发生而增加。*通信对象:伊朗德黑兰伊朗医科大学公共卫生学院职业卫生工程系学生研究委员会硕士学生Fakhradin Ahmadi kanrash, E-mail: F_ahmadi1367@yahoo.com
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引用次数: 0
The effectiveness of positive thinking training on self-efficacy and emotion regulation in men with hemophilia 积极思考训练对血友病患者自我效能感和情绪调节的影响
Pub Date : 2019-01-01 DOI: 10.15761/TIM.1000200
M. Beiranvand, Majid Keramati Moghadam, R. Sabounchi, Mahmoud Delphan, Azam Ghafuori, Roghayeh Keramati Moghadam
Study design: A semi-experimental study (pre-test, post-test, and follow-up with the control group). Summary and background data: Hemophilia as an inherited bleeding creates fundamental changes in the quality of life of hemophiliac population. Patients with hemophilia need to improve the positive relationship with themselves and others by a positive thinking training and the avoidance of negative thoughts as a coping strategy against the problems of their life. Objectives of the study: The purpose of this study was to examine the effectiveness of positive thinking training on self-efficacy and emotion regulation in men with hemophilia. Method: In the present study, 30 patients with hemophilia were selected among all patients with hemophilia (N=129) of Lorestan province. They were randomly assigned to the experimental group (N=15) and control group (N=15). The subjects completed self-efficacy and emotion regulation questionnaires. Seligman’s positive thinking training program was administered to the experiment group in eight 120-minute sessions and the control group received no training. The collected data were analyzed using Covariance statistics method and SPPS software (version 21). Results: The results of this study showed that the self-efficacy and emotion regulation increased significantly in the experimental group when compared to control group. Conclusion: The positive thinking training helps patients with hemophilia to avoid negative thoughts and apply better strategies to cope effectively with problems. Patients’ information processing works more efficiently by positive thinking and it increases self-efficacy and emotion regulation. *Correspondence to: Majid Keramati Moghadam, Department of Sport Management, Faculty of Physical Education and Sport Sciences, Islamic Azad University Borujerd Branch, Borujerd, Iran, Tel: +99166638717; E-mail: majid.keramatimoghadam@gmail.com
研究设计:半实验研究(前测、后测和对照组随访)。摘要和背景资料:血友病作为一种遗传性出血,对血友病患者的生活质量产生了根本性的改变。血友病患者需要通过积极的思维训练来改善与自己和他人的积极关系,避免消极的想法作为应对生活问题的策略。研究目的:本研究旨在探讨积极思考训练对血友病患者自我效能感和情绪调节的影响。方法:选取洛雷斯坦省所有血友病患者中30例血友病患者(N=129)。随机分为实验组(N=15)和对照组(N=15)。受试者完成自我效能感和情绪调节问卷。塞利格曼的积极思维训练计划在实验组中进行了8次120分钟的训练,对照组没有接受任何训练。采用协方差统计方法和SPPS软件(版本21)对收集到的数据进行分析。结果:本研究结果显示,实验组的自我效能感和情绪调节能力较对照组显著提高。结论:积极思维训练有助于血友病患者避免消极思维,运用更好的策略有效应对问题。积极思考能提高患者的信息处理效率,提高自我效能感和情绪调节能力。*通讯:伊朗伊斯兰阿扎德大学博鲁杰德分校体育教育与体育科学学院体育管理系Majid Keramati Moghadam,电话:+99166638717;电子邮件:majid.keramatimoghadam@gmail.com
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引用次数: 8
Comparison of five viral nucleic acid extraction kits for the efficient extraction of viral DNA and RNA from cell-free samples 五种病毒核酸提取试剂盒从无细胞样品中高效提取病毒DNA和RNA的比较
Pub Date : 2019-01-01 DOI: 10.15761/tim.1000202
Bandar Ali Suliman
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引用次数: 0
Reflections of health leaders’ experiences related dengue solutions from transmitting a technology of larval indices surveillance system in southern Thailand 在泰国南部传播幼虫指数监测系统技术对卫生领导有关登革热解决方案经验的反思
Pub Date : 2019-01-01 DOI: 10.15761/TIM.1000179
Charuai Suwanbamrung
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引用次数: 5
Key feature, clinical reasoning problem. Puzzle and scenario writing: Are there any differences between them in evaluating clinical reasoning? 关键特征,临床推理问题。拼图和情景写作:它们在评估临床推理方面有什么区别吗?
Pub Date : 2019-01-01 DOI: 10.15761/TIM.1000188
E. Boushehri, A. Monajemi, Kamran, S. Arabshahi
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引用次数: 3
Crossing age boundaries; Falls clinic serves as frailty clinic beyond age category 跨越年龄界限;跌倒诊所是超越年龄范畴的虚弱诊所
Pub Date : 2019-01-01 DOI: 10.15761/TIM.1000184
Kawa Amin
As a person ages, they are subject to an increased risk of longterm medical conditions, falls, frailty, dementia, dependence and comorbidities [1]. Frailty itself is regarded as a chronic medical condition with potential progression [2]. Older adults with frailty conditions are more likely to be admitted to the Emergency Department [3,4]. One of the most common admission causes, especially in secondary care, is falls [5,6]. Falls are regarded as one of the earliest signs of frailty [7] and are one of the highest complications resulting in hospital admission [5,8].
随着年龄的增长,他们面临长期医疗状况、跌倒、虚弱、痴呆、依赖和合并症的风险增加[1]。虚弱本身被认为是一种具有潜在进展的慢性疾病[2]。有虚弱状况的老年人更有可能被送往急诊科[3,4]。最常见的入院原因之一,尤其是在二级护理中,是跌倒[5,6]。跌倒被认为是身体虚弱的最早迹象之一[7],也是导致住院的最高并发症之一[5,8]。
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引用次数: 0
期刊
Trends in Medicine
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