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Detail Investigation of Frequent Nocturia and its Improvement by the Administration of Diuretic 尿频夜尿的详细调查及利尿剂的改善
Pub Date : 2022-07-23 DOI: 10.33805/2690-2613.125
Shimamura Tadao, B. Hiroshi, Takemura Masahiko, Shunto Jouji, Ogawa Hiroko, Nakanishi Miwako, Watanabe Osami, Nagahiro Shinji
Background: For elderly people, nocturia has been often found associated with other diseases. Case presentation: The case is 88-year-old male with hypertension, Cardiovascular Disease (CVD), Diabetes, Chronic Kidney Disease (CKD). He developed nocturia and insomnia, and then checked daily water balance by himself. Results: Basic situation showed water intake/urine volume were 750mL/1030mL/day, in which urine ratio of day/night was 27%/73% with waking up twice during night. He was given furosemide 20mg, per os at 1500h. Same study showed 960mL/1090 mL, and urine ratio as 77%/23% with no waking up. Discussion and Conclusion: From some reports, Odds Ratio (OR) for combination of nocturia shows 1.25 for hypertension, 1.23/1.74 for CVD (mild/severe). Consequently, current treatment would contribute adequate managements for nocturia problem.
背景:在老年人中,夜尿症常伴有其他疾病。病例介绍:患者为男性,88岁,合并高血压、心血管疾病、糖尿病、慢性肾病。他出现夜尿症和失眠,然后自己检查每天的水分平衡。结果:基本情况摄水量/尿量为750mL/1030mL/d,其中昼/夜尿比为27%/73%,夜间醒2次。1500h给予速尿20mg / s。同样的研究显示,在没有醒来的情况下,尿比为960mL/ 1090ml,为77%/23%。讨论与结论:从一些报道来看,夜尿合并高血压的比值比为1.25,心血管疾病(轻/重度)的比值比为1.23/1.74。因此,目前的治疗将有助于夜尿症的适当管理。
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引用次数: 0
Perspectives of Music and Sports for Satisfactory Anti-Aging Daily Life 从音乐和体育的角度看日常生活的抗衰老
Pub Date : 2022-02-28 DOI: 10.33805/2690-2613.124
Takenaka Yuko, Konoike Seiji, B. Hiroshi
Aging societies have been observed in Japan and other developed countries worldwide. In the light of anti-aging medicine, authors have continued several approaches such as Integrative Medicine (IM), music therapy, art therapy, frailty, rehabilitation, sports medicine and masters’ athletics. For successful aging, three important factors are necessary, which are i) no illness or disability, to maintain physical/cognitive function, to continue social participation and contribution. Music has large power similar to language and communication and clinical effects physically, psychologically and socially. Various plays of the activities for elderly such as music and sports can bring processes towards achieving successful aging.
老龄化社会在日本和世界其他发达国家已经出现。在抗衰老医学方面,作者继续采用了结合医学(IM)、音乐疗法、艺术疗法、虚弱、康复、运动医学和硕士竞技等几种方法。对于成功的老龄化,有三个重要的因素是必要的,即i)没有疾病或残疾,保持身体/认知功能,继续参与和贡献社会。音乐具有类似于语言和交流的巨大力量,对身体、心理和社会都有临床作用。老年人的各种活动,如音乐和体育运动,可以为实现成功的老龄化带来过程。
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引用次数: 1
Failure To Rescue, What Can Be Done To Prevent It? 救援失败,如何预防?
Pub Date : 2021-11-20 DOI: 10.33805/2690-2613.123
Duarte de Brito Tiago Marçal Pedro, P. Maria, Machado Humberto
Introduction: Failure to Rescue (FTR) is the failure to prevent a patient’s death after a complication. It measures the ability of a hospital to prevent the death of patients who develop one or more complication that was not present at the time of admission. Therefore, the aim of this study is to review the factors that contribute to FTR, and the measures and strategies that can be applied to prevent the FTR events, in order to discuss the best way to improve patient outcomes in the hospital setting. Methods: A search was conducted on PUBMED retrieving a total of 464 articles. A review of the selected articles’ bibliography was conducted to find other relevant articles. Sixty studies were reviewed in this paper.Results: Patient factors as increasing age, comorbidities and frailty increase the risk of FTR, as well as an increasing number of complications. Several hospital factors, nursing care, and microsystem also influence FTR. Some track and Trigger Systems (TTS) and Early Warning Scores (EWS) have been shown to predict clinical deterioration. On the other hand, machine learning systems have outperformed EWS. Rapid response teams have become the standard approach to delivery and escalation of care, and cognitive aids and crisis checklists also have potential to help reduce FTR. Conclusion: Patient and hospital factors are often non-modifiable; thus, microsystem factors could be a target for improvement. Creating clinical pathways can improve surveillance, and communication tools like SBAR can help relay information. EWS, machine learning models and continuous monitoring are strategies that can help detect clinical deterioration. In the efferent limb rapid response teams have shown to reduce FTR.
简介:抢救失败(FTR)是指在并发症发生后未能阻止患者死亡。它衡量的是医院防止出现入院时不存在的一种或多种并发症的患者死亡的能力。因此,本研究的目的是回顾导致FTR的因素,以及可用于预防FTR事件的措施和策略,以便讨论改善医院环境中患者预后的最佳方法。方法:在PUBMED检索共464篇文献。对所选文章的参考书目进行了审查,以找到其他相关文章。本文对60项研究进行了综述。结果:年龄增加、合并症和虚弱等患者因素增加了FTR的风险,并发症数量也增加了。一些医院因素、护理和微系统也会影响FTR。一些跟踪和触发系统(TTS)和早期预警评分(EWS)已被证明可以预测临床恶化。另一方面,机器学习系统的表现优于EWS。快速反应小组已成为提供和升级护理的标准方法,认知辅助工具和危机检查清单也有可能有助于减少FTR。结论:患者和医院因素往往不可改变;因此,微系统因素可能是一个改进的目标。建立临床途径可以改善监测,像SBAR这样的通信工具可以帮助传递信息。EWS、机器学习模型和持续监测是有助于检测临床恶化的策略。在传出肢体快速反应小组已经显示出减少FTR。
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引用次数: 1
Mitochondrial DNA Diversity of the Nangan Islanders Living in the Mazu Archipelago of the Taiwan Strait 台湾海峡马祖群岛南岸岛民线粒体DNA多样性研究
Pub Date : 2021-08-16 DOI: 10.33805/2690-2613.121
Chen Zong-Sian, Trejaut Jean, Loo Jun-Hun, Lai Ying-Hui, Huang Jin-yuan, Lin Marie
This study investigates the genetic relationship of the Mazu peoples on the east coast of China in the Taiwan Strait. Using partial and complete mitochondrial DNA (mtDNA) sequences, we compare Mazu with surrounding East Asia populations. Mazu shows no exclusive affinities with either Southeast or Northeast Asia. High genetic diversity and a very high number of exclusive haplogroups of various Asian origins suggest that Mazu resulted from a process of continuous resettlement that started when it first became an archipelago at the end of the last glacial maximum and that continued till the last century. As a result, genetic drift did not contribute to an exclusive Mazu profile. The structure of haplogroups that show signatures of the Neolithic era (N9a10a), or influx from Island Southeast Asia (F1a4a) suggest recent gene flows and Mazu relationship with it's pre-Neolithic era (presence of pre-E1a or R9/pre-F from Liangdao man) was not seen.
摘要本研究探讨台湾海峡中国东岸妈祖族的遗传关系。利用部分和完整的线粒体DNA (mtDNA)序列,我们将妈祖与周边东亚人群进行了比较。妈祖与东南亚或东北亚都没有排他性的联系。高度的遗传多样性和大量亚洲起源的专属单倍群表明,妈祖是一个持续不断的重新定居过程的结果,这个过程从上一次冰川高峰结束时它第一次成为群岛开始,一直持续到上个世纪。因此,遗传漂变并不能形成一个独有的妈祖族谱。显示新石器时代特征的单倍群结构(N9a10a)或来自东南亚岛屿的涌入(F1a4a)表明,最近的基因流动和妈祖与其前新石器时代的关系(梁岛人的pre-E1a或R9/pre-F的存在)没有被发现。
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引用次数: 2
The Importance of Time in Range (TIR) for Continuous Glucose Monitoring (CGM) in the Clinical Practice for Diabetes 时间范围(TIR)在糖尿病临床实践中连续血糖监测(CGM)的重要性
Pub Date : 2021-07-29 DOI: 10.33805/2690-2613.119
H. Bando
As to the development of treatment for diabetes, Continuous Glucose Monitoring (CGM) has been recently prevalent rapidly. By the analysis of real-time CGM, Ambulatory Glucose Profile (AGP) has been used. It includes time in range (TIR, 70-180 mg/dL), time above range (TAR, >181mg/dL), time below range (TBR, <69 mg/dL), Glycemic Variability (GV), Glucose Management Indicator (GMI), Glycemic variability, Coefficient Of Variation (CV%) and so on. TIR value indicating approximately 70% seems to correlate closely with the HbA1c level of 6.77.0%. Marked discordance of HbA1c values has been found between laboratory HbA1c and estimated HbA1c (eA1c) using GMI from CGM.
在糖尿病治疗的发展中,连续血糖监测(CGM)近年来迅速普及。通过对实时CGM的分析,采用了动态葡萄糖谱(AGP)。它包括在范围内的时间(TIR, 70-180 mg/dL),在范围内的时间(TAR, >181mg/dL),在范围内的时间(TBR, <69 mg/dL),血糖变异性(GV),葡萄糖管理指标(GMI),血糖变异性,变异系数(CV%)等。TIR值约为70%,与HbA1c水平6.77.0%密切相关。实验室HbA1c值与使用CGM GMI估计的HbA1c (eA1c)之间存在明显的不一致。
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引用次数: 0
COVID-19 Pneumonia with Atrial Fibrillation, Coronary Spasm, and Wavy Triple Sign (Yasser’s Sign); Dramatic Reversal at Home Management COVID-19肺炎合并心房颤动、冠状动脉痉挛和波浪形三征(亚瑟氏征);家庭管理的戏剧性逆转
Pub Date : 2021-07-27 DOI: 10.33805/2639.6807.130
Y. Elsayed
Rationale: A novel COVID-19 with a severe acute respiratory syndrome or pneumonia had arisen in Wuhan, China in December 2019. Emerging atrial fibrillation in COVID-19 patients is highly significant in cardiovascular medicine. A newly coronary artery spasm in the presentation of COVID-19 infection has certainly a risk impact on both morbidity and mortality of COVID-19 patients. Wavy triple an electrocardiographic sign (Yasser Sign) is an innovated sign of hypocalcaemia linked to tachypnea and acute respiratory distress.Patient concerns: An elderly male COVID-19 patient presented to physician outpatient clinic with bilateral pneumonia, atrial fibrillation, evidence of coronary artery spasm, and Wavy triple an electrocardiographic sign (Yasser Sign). Diagnosis: COVID-19 pneumonia with coronary artery spasm and the Wavy triple an electrocardiographic sign (Yasser Sign). Interventions: Chest CT scan, electrocardiography, oxygenation, and echocardiography. Outcomes: Gradual dramatic clinical, electrocardiographic, and radiological improvement had happened. Lessons: The reversal of electrocardiographic ST-segment depressions in a COVID-19 patient after adding oral nitroglycerine is an indicator for the presence of coronary artery spasm. It signifies the role of the anti-infective drugs, anticoagulants, antiplatelet, and steroids in COVID-19 patients with bilateral pneumonia, AF, coronary artery spasm are effective therapies. The disappearance of AF after initial therapy may a guide for a good prognosis in this case study. The evanescence of Wavy triple ECG sign as a hallmark for the existence of the Movable-weaning phenomenon of hypocalcaemia is recommended for further wide-study.
理由:2019年12月,中国武汉出现了一种新型COVID-19合并严重急性呼吸系统综合征或肺炎。新冠肺炎患者出现心房颤动在心血管医学中具有重要意义。新冠状动脉痉挛对COVID-19患者的发病率和死亡率都有一定的风险影响。波形三a心电图征象(亚西尔征象)是一种与呼吸急促和急性呼吸窘迫相关的低钙血症的创新征象。患者关注:老年男性新冠肺炎患者,双侧肺炎,心房颤动,冠状动脉痉挛证据,波浪型三a心电图征象(亚西尔征)就诊于医师门诊。诊断:新型冠状动脉肺炎合并冠状动脉痉挛及波浪型三a心电图征象(亚西尔征)。干预措施:胸部CT扫描,心电图,氧合和超声心动图。结果:临床、心电图和放射学逐渐显著改善。经验教训:添加口服硝酸甘油后,COVID-19患者心电图st段压低的逆转是冠状动脉痉挛存在的一个指标。这表明抗感染药物、抗凝、抗血小板、类固醇药物在COVID-19患者双侧肺炎、房颤、冠状动脉痉挛中的作用是有效的治疗方法。在这个病例研究中,房颤在初始治疗后消失可能是一个良好预后的指导。波浪三重心电图征象的消失是低钙可动-脱机现象存在的标志,值得进一步广泛研究。
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引用次数: 0
Masking Tape Art-Work May Provide Beneficial Positive Effects 胶带艺术作品可以提供有益的积极影响
Pub Date : 2021-02-18 DOI: 10.33805/2690-2613.117
S. Nagahiro, Kei Tanaka, H. Bando, M. Bando, Maki Nishizaki, Satoko Goto
Background: The authors and colleagues have been involved in treatment and care for the elderly with rehabilitation, Integrative Medicine (IM), art in hospitals for artworks using masking tape. Combined together, we conducted a pilot study for medical application of masking tape art-work for elderly subjects. Subjects and Methods: Subjects enrolled were 12 elderly patients with dementia regularly coming to day care center for rehabilitation (M/F 3/9, 78-100 years, 88.3±6.0 years). As methods, masking tape has been known as Washi Tape (wa=Japanese and shi=paper), which is adhesive tape easily to stick and peel off for decorative work. Protocol included i) working 2-3 times a week, ii) sticking masking tape on a rough sketch paper, iii) evaluation of several biomarkers before and after the intervention. Results: i) Artworks were performed satisfactory for each case, ii) grasping power (right) showed increasing tendency from 13.5±7.7kg to 14.8±6.8kg (p=0.11), iii) vitality test showed significantly increase (p=0.02). Discussion and Conclusion: Artworks of masking tape seem to be beneficial for improving grasping power and psychological condition. This study included other biomarkers such as Mini-Mental State Examination (MMSE), pinch power, language word test and Barthel index. We plan to develop further detail analyses in the future research.
背景:作者及其同事参与了老年人的康复治疗和护理,中西医结合(IM),医院艺术作品使用胶带。结合这两方面,我们进行了一项针对老年受试者的掩蔽胶带艺术作品的医学应用的试点研究。对象与方法:选取12例定期来日托中心进行康复治疗的老年痴呆患者(M/F 3/9, 78-100岁,88.3±6.0岁)。作为方法,掩蔽胶带被称为Washi tape (wa=日语和shi=纸),这是一种易于粘贴和剥离的胶带,用于装饰工作。方案包括i)每周工作2-3次,ii)在粗糙的草图纸上粘贴遮蔽胶带,iii)在干预前后评估几种生物标志物。结果:i)每个病例的艺术品都得到了满意的处理,ii)抓握力(右)从13.5±7.7kg增加到14.8±6.8kg (p=0.11), iii)活力测试明显增加(p=0.02)。讨论与结论:胶带艺术品似乎有利于提高抓握力和心理状态。本研究还包括其他生物指标,如迷你精神状态检查(MMSE)、捏力、语言单词测试和Barthel指数。我们计划在未来的研究中进行更详细的分析。
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引用次数: 2
Improved Hypertension by Investigating Circadian Rhythm of Blood Pressure 通过研究血压昼夜节律改善高血压
Pub Date : 2021-01-22 DOI: 10.33805/2690-2613.116
T. Shimamura, H. Bando, S. Nagahiro, M. Nakanishi, Osami Watanabe
Case: The case is 86-year-old male hypertensive patient with anti-hypertensive drug for 5 years. He has been provided Amlodipine besilate 5mg at 0800h and doxazosin mesylate 2mg at 2300h for long. In June 2020, he noticed unstable fluctuation of Blood Pressure (BP) during morning, afternoon and night. Results: Then, he checked the circadian rhythm of BP, which showed higher BP in early morning, decreasing BP 0800-1000h, minimum BP during 1000-1400h, increasing BP during 1400-1800h and stable BP during 1800-2400h. Due to the result, he changed to take amlodipine at 2300h. Consequently, his BP gradually became stable during 24 hours after 2 weeks. Discussion: Some factors may exist for contributing improved BP fluctuation. They include a) pathophysiological characteristics of BP circadian rhythm, b) effective time for anti-hypertensive drug, c) accuracy of the obtained BP data and d) the social and psychological reliability of the patient. Regarding d) he was engaged in research and development work as a senior researcher at a chemical company. He has been also a member of New Elderly Association (NEA), which was established by Shigeaki Hinohara. He lives on the philosophy of Hinohara-ism for long, associated with stable mind and body.
病例:86岁男性高血压患者,降压药5年。长期给予苯磺酸氨氯地平5mg, 0800h,甲磺酸多沙唑嗪2mg, 2300h。2020年6月,他发现早上、下午和晚上的血压波动不稳定。结果:检查血压昼夜节律,清晨血压升高,0800-1000h血压下降,1000-1400h血压最低,1400-1800h血压升高,1800-2400h血压稳定。因结果,于2300h改为服用氨氯地平。2周后24小时血压逐渐稳定。讨论:可能存在一些有助于改善血压波动的因素。它们包括a)血压昼夜节律的病理生理特征,b)降压药的有效时间,c)获得的血压数据的准确性和d)患者的社会和心理可靠性。d)他在一家化学公司担任高级研究员,从事研究和开发工作。他也是新老年人协会(NEA)的成员,该协会是由日原茂明创立的。他长期信奉日原主义哲学,与稳定的身心联系在一起。
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引用次数: 1
Pilot study of the SCFA Headspace Analysis of Streptococcus mutans Metabolites in Media with and without Polyols 含多元醇和不含多元醇培养基中变形链球菌代谢物的SCFA顶空分析的初步研究
Pub Date : 2020-01-09 DOI: 10.20944/preprints202001.0068.v1
S. H. Goudarzi, B. Kabat, M. Cannon, M. Gashkoff, Rachel Zurek
This pilot study of Streptococcus mutans ATCC 35668 grown in media with and without polyols (erythritol) measured the resultant metabolites, including the Short Chain Fatty Acids (SCFA) by using head space analysis. Brain Heart Infusion Broth (BHI2 or BHI10) supplemented with 2% or 10% sucrose containing no polyols or either erythritol or xylitol and Streptococcus mutans (ATCC 35668) was grown aerobically. After 48 hours of growth the supernatant were harvested and centrifuged to pellet bacteria. Supernatants were removed from bacterial pellets then submitted for SCFA analysis with an Agilent Technologies (Santa Clara, CA 95051) system configured from three components, a 5973-mass selective detector, a 6890N gas chromatographer, and a 7697A headspace sampler. Streptococcus mutans growing in BHI supplemented with 2% or 10% sucrose but containing no polyols produced the following short chain fatty acids: methyl isovalerate, acetic acid, propionic acid, butanoic acid, pentanoic acid, ethyl butaric acid, 4-methylvaleric acid, hexanoic acid. When the BHI broth supplemented with 2% or 10% sucrose containing erythritol was used as media for this Streptococcus mutans strain, the following were produced: ethanol, acetoin, and acetic acid. Our results would indicate that constituents of the bacteria media may affect the bacterial metabolite production.
本实验对变形链球菌ATCC 35668进行了初步研究,在含和不含多元醇(赤藓糖醇)的培养基中生长,通过头部空间分析测量了产生的代谢物,包括短链脂肪酸(SCFA)。脑心灌注肉汤(BHI2或BHI10)添加2%或10%的蔗糖,不含多元醇或赤四糖醇或木糖醇,以及变形链球菌(ATCC 35668)进行有氧培养。生长48小时后,收集上清液并离心成球细菌。从细菌微球中去除上清液,然后用Agilent Technologies (Santa Clara, CA 95051)系统进行SCFA分析,该系统由三个组件组成,5973-质量选择检测器,6890N气相色谱仪和7697A顶空取样器。在添加2%或10%蔗糖但不含多元醇的BHI中生长的变形链球菌产生以下短链脂肪酸:异戊酸甲酯、乙酸、丙酸、丁酸、戊酸、丁酸乙酯、4-甲基戊酸、己酸。将添加2%或10%蔗糖的BHI肉汤作为该变形链球菌菌株的培养基,可产生乙醇、乙糖苷和乙酸。我们的结果表明,细菌培养基的成分可能会影响细菌代谢物的产生。
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引用次数: 1
Knowledge, Attitudes and Practices of Women Attending One of the Health Facilities in Hhohho Region, Swaziland, in Relation to Cervical Cancer and Screening 在斯威士兰霍霍地区某一保健机构就诊的妇女关于子宫颈癌和筛查的知识、态度和做法
Pub Date : 2019-11-29 DOI: 10.33805/2690-2613.106
Gloria Phebeni, Nomsa Nxumalo-Magagula, R. N. Mkhonta, Tengetile R. Mathunjwa-Dlamini
Background: In women cervical cancer is the leading cause of death among all cancers in developing countries, but it can be controlled through prevention and early detection of precursor lesions. In 2013 there were 223 new cases of cervical cancer in Swaziland with an estimated 118 cervical cancer related deaths. Most clients suffering from cervical cancer were below the age of 40 years and were diagnosed in the late stage. The study determined knowledge, attitudes and practices of women in relation to cervical cancer screening and treatment at one of the health facilities in the Hhohho Region, in Swaziland.Methodology: A quantitative-descriptive approach was utilized among 56 participants selected using purposive sampling. Respondents were women who came for health care services at the Health Facility’s Antiretroviral Therapy (ART) Department. The collected data were entered into SPSS and analyzed using descriptive statistics and Pearson’s correlation.Findings: Ninety-four percent (94.6%) of the respondents reported to have heard of cervical cancer, and 96.4% reported that screening for cervical cancer could detect symptoms before they appeared. Only 1.8% was aware of the association between cervical cancer and the Human Papilloma Virus (HPV). Thirty-seven percent (37.5%) of the respondents reported to have ever screened for cervical cancer. The major reasons reported for not screening were busy work schedule, and being turned back by nurses. There was a significant relationship between level of education and knowledge of risk factors for cervical cancer (r=0.306, p=0.022). Data also supported a significant relationship between age of the respondents and knowledge on how to protect self from getting cervical cancer(r=-0.402, p=0.002). Data supported a significant relationship between knowledge on risk factors and knowledge on how to protect self from acquiring cervical cancer (r=0.295, p=0.027).Recommendations: It is recommended that nursing practice should also focus on the provision of services to the working class by offering cervical cancer screening services on weekends and public holidays. Nurses need to be more responsive to clients’ health needs and avoid turning clients back.
背景:在发展中国家,妇女宫颈癌是所有癌症中导致死亡的主要原因,但可以通过预防和早期发现前驱病变来控制。2013年,斯威士兰有223例新的宫颈癌病例,估计有118例与宫颈癌有关的死亡。大多数子宫颈癌患者的年龄在40岁以下,并且是在晚期被诊断出来的。该研究确定了妇女在斯威士兰Hhohho地区的一个保健设施进行宫颈癌筛查和治疗方面的知识、态度和做法。方法:采用定量描述性方法对56名参与者进行有目的抽样。应答者是到卫生机构抗逆转录病毒治疗部门寻求保健服务的妇女。将收集到的数据输入SPSS,并使用描述性统计和Pearson相关进行分析。调查结果:94%(94.6%)的受访者表示听说过子宫颈癌,96.4%的受访者表示子宫颈癌筛查可以在症状出现之前发现。只有1.8%的人知道宫颈癌和人类乳头瘤病毒(HPV)之间的联系。37%(37.5%)的受访者表示曾接受子宫颈癌筛检。据报道,不进行筛查的主要原因是工作繁忙,被护士拒之门外。受教育程度与宫颈癌危险因素知晓程度之间存在显著相关(r=0.306, p=0.022)。数据还支持受访者的年龄与如何保护自己免受宫颈癌的知识之间存在显著关系(r=-0.402, p=0.002)。数据支持对危险因素的了解与如何保护自己免受宫颈癌的知识之间存在显著关系(r=0.295, p=0.027)。建议:建议护理工作也应侧重于为工薪阶层提供服务,在周末和公众假期提供子宫颈癌筛查服务。护士需要对病人的健康需求作出更积极的反应,避免把病人赶走。
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引用次数: 2
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Edelweiss Journal of Biomedical Research and Review
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