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Predictors and Outcomes of Intraoperative Blood Transfusion in Cirrhotic Veterans 肝硬化退伍军人术中输血的预测因素和结果
Pub Date : 2023-06-04 DOI: 10.58877/japaj.v1i2.33
Awni Shahait, Adam Pearl, K. Saleh
Background: Cirrhotic patients are at increased risk of postoperative complications and mortality following any surgical procedure. One of the independent predators of adverse outcomes is intraoperative transfusion (IOT). In this study we examine the profile of cirrhotic patients requiring IOT to determine its predictors. Methods: The Veterans Affairs Surgical Quality Improvement Program (VASQIP) was utilized to identify all patients with cirrhosis and ascites who underwent any non-liver transplant procedures from 2008 to 2015. Univariate and multivariate regression were used to identify predictors of increased risk of IOT and associated outcomes. Results: A total of 1,957 cirrhotic patients were identified, of which only 358 (18.8%) required IOT ≥1 unit. IOT group were older, more frail, higher Model for End-stage Liver Disease (MELD) score, anemic (hematocrit <30%), hypoalbuminemic. This group also had more emergent procedures, higher rates of preoperative sepsis, longer operative time, longer postoperative length of stay, and higher morbidity and mortality rates. On multivariate logistic regression, pancreatic resections, open hernia repair, anemia, gastric resections, hypoalbuminemia, acute renal failure, emergency procedure, preoperative sepsis, and preoperative weight loss >10% were significant predictors of IOT. Conclusion: IOT in cirrhotic patients is associated with worse outcomes. Pancreatic procedures, open hernia repair, and gastric resection were associated with increased IOT. This aid in preoperative planning and blood products preparation. 
背景:肝硬化患者在任何外科手术后并发症和死亡率的风险都增加。术中输血(IOT)是造成不良后果的独立因素之一。在这项研究中,我们研究了需要物联网的肝硬化患者的概况,以确定其预测因素。方法:利用退伍军人事务外科质量改进计划(VASQIP)对2008年至2015年接受任何非肝移植手术的所有肝硬化和腹水患者进行识别。使用单变量和多变量回归来确定物联网风险增加的预测因素和相关结果。结果:共发现1,957例肝硬化患者,其中只有358例(18.8%)需要IOT≥1个单位。IOT组年龄较大、体弱多病、终末期肝病模型(MELD)评分较高、贫血(红细胞压积10%)是IOT的显著预测因子。结论:肝硬化患者的IOT与较差的预后相关。胰腺手术、开放式疝修补术和胃切除术与IOT增加相关。这有助于术前计划和血液制品准备。
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引用次数: 0
Real-World Use of Belantamab Mafodotin in Relapsed/Refractory Multiple Myeloma: A Systematic Review 贝兰他单-马福多汀在复发/难治性多发性骨髓瘤中的实际应用:系统回顾
Pub Date : 2023-06-04 DOI: 10.58877/japaj.v1i2.56
Abdelrahman Nanah, Samer Al Hadidi
Belantamab mafodotin is an antibody drug conjugate directed against B-cell maturation antigen and was approved by the Food and Drug Administration under accelerated approval for use in the US in August 2020 for adult patients with relapsed or refractory multiple myeloma who have received at least 4 prior therapies, including an anti-CD38 monoclonal antibody, a proteasome inhibitor, and an immunomodulatory drug. In November 2022 belantamab mafodotin was withdrawn from the US market after failure of a required confirmatory trial. In our review, we provide a systematic review on the use of belantamab mafodotin efficacy and safety in a real-world setting.
Belantamab mafodotin是一种针对b细胞成熟抗原的抗体药物偶联物,已于2020年8月获得美国食品和药物管理局(fda)的加速批准,用于复发或难治性多发性骨髓瘤成年患者,这些患者先前接受过至少4种治疗,包括抗cd38单克隆抗体、蛋白酶体抑制剂和免疫调节药物。2022年11月,belantamab mafodotin在一项验证性试验失败后从美国市场撤出。在我们的综述中,我们对在现实环境中使用belantamab mafodotin的有效性和安全性进行了系统的综述。
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引用次数: 1
Passenger lymphocyte syndrome from Transfusion Medicine's standpoint: Short Communication 从输血医学的角度看乘客淋巴细胞综合征:短沟通
Pub Date : 2023-06-04 DOI: 10.58877/japaj.v1i2.66
Mohammad Barouqa, H. Jum'ah, Yousef Janbek, M. Reyes Gil
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引用次数: 0
Comparison of Hospitalization and Post-Hospitalization Outcomes among Family Medicine Hospitalists and Internal Medicine Hospitalists in a Tertiary Center: A Prospective Cohort Study 某三级医疗中心家庭医学住院医师与内科住院医师住院和住院后结局的比较:一项前瞻性队列研究
Pub Date : 2023-01-27 DOI: 10.58877/japaj.v1i1.11
Moaath K. Mustafa Ali, S. Mustafa, M. Sabha, M. Banifadel, K. Aburayyan, M. Awad, M. Ghanim, A. Ramahi, Z. Nesheiwat
Background: There is a lack of studies comparing hospitalization and post-hospitalization outcomes between internal medicine (IM) hospitalists and family medicine (FM) hospitalists.  Objective: To compare the length of stay (LOS), hospital cost, and 30-day all-cause readmission rate among patients treated by IM hospitalists and FM hospitalists.   Design and Setting: Prospective cohort study in a referral center. Propensity score matching was used to balance baseline characteristics between comparative arms. Participants: 747 patients 18 years and older who were admitted to hospitalist services. Intervention: Treatment by IM hospitalists and FM hospitalists. Main Measures:  LOS, hospital cost, and 30-day all-cause readmission. Treatment arms were compared by two methods. We compared patients who were seen by FM exclusively with those treated exclusively by IM services. Covariate adjusted differences in outcomes were estimated by multivariable regression. For a secondary set of analyses, exposure to FM and IM was converted to a continuous independent variable. Key Results: Forty, 333, and 374 patients were seen by FM, IM, and a combination of both services, respectively. Using average treatment on the treated as the estimand, FM care provided a shorter weight-adjusted LOS by 0.5 days (CI: -0.92- -0.04, P =0.026) compared to IM, but no difference in hospital cost (-126, CI: -906-653, P=.74).  There was no difference in adjusted hazard for 30-day readmission between FM and IM (HR: 2, CI: 0.67-6.2, P =0.062). Propensity weight-adjusted multiple regression models of the complete cohort (n=747) did not show any difference in any outcomes with increased exposure to FM care.  Conclusions: Understanding variation in practices and outcomes between different hospitalist models opens opportunities to improve care and decrease the length of stay.
背景:目前缺乏比较内科(IM)和家庭医学(FM)住院医师住院和住院后结局的研究。目的:比较IM和FM住院患者的住院时间(LOS)、住院费用和30天全因再入院率。设计与环境:转诊中心的前瞻性队列研究。倾向评分匹配用于平衡比较组之间的基线特征。参与者:747名18岁及以上住院治疗的患者。干预:IM医院和FM医院的治疗。主要措施:LOS、住院费用、30天全因再入院。两种方法对治疗组进行比较。我们比较了只接受FM治疗的患者和只接受IM治疗的患者。通过多变量回归估计经协变量调整后的结果差异。对于第二组分析,暴露于FM和IM被转换为一个连续的独立变量。主要结果:FM、IM和两种服务的结合分别治疗了40例、333例和374例患者。以被治疗者的平均治疗作为估计,FM护理比IM提供了更短的0.5天的体重调整LOS (CI: -0.92- -0.04, P= 0.026),但在医院费用方面没有差异(-126,CI: -906-653, P= 0.74)。调频组与调频组30天再入院调整危险度无差异(HR: 2, CI: 0.67-6.2, P =0.062)。整个队列(n=747)的倾向权重调整多元回归模型未显示FM护理暴露增加的任何结果有任何差异。结论:了解不同医院模式之间实践和结果的差异,为改善护理和缩短住院时间提供了机会。
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引用次数: 0
Primary Plasma Cell Leukemia 原发性浆细胞白血病
Pub Date : 2023-01-27 DOI: 10.58877/japaj.v1i1.21
Samer Al Hadidi
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引用次数: 3
Knowledge of medical students in Jordan regarding monkeypox outbreak 约旦医学生对猴痘疫情的了解
Pub Date : 2023-01-27 DOI: 10.58877/japaj.v1i1.10
Mohammad Al Mse`adeen, Sadeen Zein Eddin, Saja Zuaiter, Hanaa K. Mousa, Eman M. Abd el-Sattar, Mohammad Daradkeh, M. Al-Jafari, Namareq Al Mse’adeen, Mohammad Abu-Jeyyab
Abstract Introduction Human Monkeypox (HMP) is an infectious disease attributed to the orthopoxvirus. HMP was firstly documented in humans in 1970 in the Congo. Since May 2022, multiple cases of HMP were identified in several non-endemic countries including some Middle Eastern countries.  Objective  This study aims to assess the knowledge about HMP among medical students in Jordan. Methodology  A cross-sectional study was conducted using online based questionnaire. A sample of 565 medical students completed the questionnaire during May 2022. The questionnaire collected data regarding source of knowledge, causative organism, natural host, mode of transmission, incubation period, signs and symptoms, duration diagnosis prevention, treatment and complications of the disease. Results Males constituted (39.6 %) of the total sample. Significantly higher rate of knowledge was detected among males (35.7%) vs. females χ2 =10.0, P = 0.002, fifth (60.9%) and sixth (43.8%), vs. first, second and third academic years, χ2 = 83, P<0.001. Correct knowledge about signs and symptoms showed the highest rate (43.0%), followed by an Incubation period, duration and prevention of disease, (33.3%, 32.6% & 31.0%, respectively). On the other hand lowest knowledge exhibited regarding; natural host (5.0%), mode of transmission, (9.2%), psychosocial impact, (9.2%), vulnerable age group (14.2%), and complications (14.2%). Majority of students (82.3%) claimed that their knowledge was earned from social media followed by TV (16.3 %,), and the    university (8,5%).TV had the highest rate (47.8%) with adequate knowledge, χ2 =20.6, p <0.001            interestingly, 71,7% of the respondents had inadequate knowledge about the outbreak and 70,7% of them, the social media was their source of knowledge.   Conclusion Gender and higher academic year are significantly associated with adequate knowledge. Social media is significantly associated with inadequate knowledge among students.   Key words: Knowledge, Monkeypox, Social Media, Infectious Disease
人类猴痘(HMP)是一种由正痘病毒引起的传染病。HMP于1970年在刚果首次在人类中被记录。自2022年5月以来,在包括一些中东国家在内的若干非流行国家发现了多例HMP病例。目的了解约旦医学生对HMP的认知情况。方法采用在线调查问卷进行横断面研究。565名医学生于2022年5月完成问卷调查。问卷收集了有关该病的知识来源、病原生物、自然宿主、传播方式、潜伏期、体征和症状、病程、诊断、预防、治疗和并发症等方面的数据。结果男性占总样本的39.6%。男生(35.7%)的知识知晓率明显高于女生(χ2 =10.0, P = 0.002),五年级(60.9%)和六年级(43.8%)的知识知晓率明显高于一、二、三年级(χ2 = 83, P<0.001)。正确了解体征和症状的比例最高(43.0%),其次是潜伏期、病程和疾病预防(分别为33.3%、32.6%和31.0%)。另一方面,最低的知识表现为:自然宿主(5.0%)、传播方式(9.2%)、社会心理影响(9.2%)、脆弱年龄组(14.2%)和并发症(14.2%)。大多数学生(82.3%)声称他们的知识来自社交媒体,其次是电视(16.3%)和大学(8.5%)。电视中对疫情知识了解不足的比例最高(47.8%),χ2 =20.6, p <0.001,有趣的是,71.7%的受访者对疫情知识了解不足,其中71.7%的受访者将社交媒体作为他们的知识来源。结论性别、高学历与知识充分性显著相关。社交媒体与学生知识不足显著相关。关键词:知识,猴痘,社交媒体,传染病
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引用次数: 1
The smallest metastatic solitary vaginal nodule from a primary recto-sigmoid tumor – Case Report 原发直肠乙状结肠肿瘤中最小的转移性孤立性阴道结节1例
Pub Date : 2023-01-27 DOI: 10.58877/japaj.v1i1.16
M. K. Abou Chaar, Lara Rabah, Omar Tassabehji, A. Gharaibeh, Omar Jaber, F. Alawneh
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引用次数: 0
Gastro-esophageal reflux disease (GERD) among medical students during COVID-19 pandemic COVID-19大流行期间医学生胃食管反流病(GERD
Pub Date : 2023-01-27 DOI: 10.58877/japaj.v1i1.6
Mohammad Zaidan, Suzan Al-Hawash, N. Abu Farsakh, Khalid Khairallah
Abstract: Importance: Gastroesophageal reflux disease (GERD) is a common digestive disorder in which acid-containing contents in your stomach persistently leak back up into the esophagus, especially in stressful lifestyle such as medical students. Objective: The aim of this study is to estimate the prevalence of GERD in Medical students in Jordan, assess factors which affect the occurrence of GERD in the study population, access the stressors of medical students during the pandemic, assess, if any, effect is present related to COVID-19 pandemic, and to look for possible preventive measures for GERD. Design: cross-sectional study including a questionnaire of 6 questions of the duration of seven days prepared on google forms and electronically. Data was collected in the period between 31st January 2021 and 18th April 2021. Setting: Medical Faculties and hospitals in Jordan. Participants: population-based sample; medical students studying in Jordan. Main outcomes and Measures: Medical students' lifestyles are stressful, and a lot of risk factors attributed to GERD are common among medical students. COVID-19 infection is known to cause GI symptoms and as an infection, it could be a stressor especially during the pandemic. Statistical methods included descriptive analysis, Cramer's V statistics, and the Chi-square test as measures of effect sizes. Our findings were not significant enough to confirm that COVID-19 infection causes GERD. However, alternation in GERD symptoms was found to be significant. Results: Out of 1009 subjects, 43.4% were males, and 56.6% were females. The most common symptoms were heartburn and regurgitations and were found in 421 (41.7%) and 325 (32.2%) students, respectively. 199 (19.7%) of students were affected by COVID-19 but it was not statistically significant (P >0.05). However, alteration in the feeling of GERD symptoms in those who were infected with COVID-19 was found to be statistically significant (P < 0.05). Conclusion and relevance: Our findings suggest that the most frequent symptoms of GERD reported by medical students are heartburn and regurgitation. In addition to that, the students who were infected with COVID-19 were in the high-risk group. Therefore, more efforts and studies are needed to look for the pathophysiology of COVID-19 infection's effect on the GERD symptoms.   Keywords:  GERD, Regurgitation, COVID-19, Pandemic.
摘要/ Abstract摘要:胃食管反流病(GERD)是一种常见的消化系统疾病,主要表现为胃内含酸内容物持续倒流至食道,尤其是在医学生等生活压力较大的人群中。目的:本研究的目的是估计约旦医学生中GERD的患病率,评估影响研究人群中GERD发生的因素,了解大流行期间医学生的压力源,评估是否存在与COVID-19大流行相关的影响,并寻找可能的GERD预防措施。设计:横断面研究包括6个问题的问卷调查,持续7天,准备在谷歌表格和电子。数据收集于2021年1月31日至2021年4月18日期间。环境:约旦的医学院和医院。参与者:基于人群的样本;在约旦学习的医科学生主要结果和措施:医学生生活压力大,许多归因于胃食管反流的危险因素在医学生中很常见。已知COVID-19感染会引起胃肠道症状,作为一种感染,它可能是一种压力源,尤其是在大流行期间。统计方法包括描述性分析、克莱默V统计量和卡方检验作为效应量的测量方法。我们的研究结果不足以证实COVID-19感染导致反流。然而,胃反流症状的变化是显著的。结果:1009名受试者中,男性占43.4%,女性占56.6%。最常见的症状是胃灼热和反流,分别有421名(41.7%)和325名(32.2%)学生出现。199名(19.7%)学生感染新冠肺炎,但差异无统计学意义(P >0.05)。然而,感染COVID-19的患者胃食管反流症状感觉的改变有统计学意义(P < 0.05)。结论和相关性:我们的研究结果表明,医学生报告的胃反流最常见的症状是胃灼热和反流。此外,感染新冠肺炎的学生也属于高危人群。因此,COVID-19感染对胃食管反流症状影响的病理生理机制需要更多的努力和研究。关键词:反流,反流,COVID-19,大流行
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引用次数: 1
Clinical Informatics (A Jordanian physician’s perspective) 临床信息学(约旦医生的观点)
Pub Date : 2023-01-27 DOI: 10.58877/japaj.v1i1.27
EzzAddin Al Wahsh
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引用次数: 0
Pompe disease, a rare condition in two patients, case reports 庞贝病,一种罕见的疾病,在两个病人,病例报告
Pub Date : 2023-01-27 DOI: 10.58877/japaj.v1i1.23
O. Yousef, M. Al-Jafari, Mohammad Jaber, Mutayam Abu-Qudairi, Raja Al-Zreqat, Mohammad Abu-Jeyyab
Pompe disease, or type II glycogen storage disease, is a lysosomal storage disorder in which a deficiency in alpha-glucosidase results in the accumulation of glycogen, which eventually causes weakness to progressively increase and heart enlargement.  Infantile-onset and late-onset forms of Pompe illness are distinguished. The heart is the organ most impacted by glycogen buildup in infantile-onset Pompe illness. A late-onset form, however, frequently presents as a weakening of the skeletal muscles that worsens over time. The key factor used to make the diagnosis of Pompe illness is enzymology, which shows a lack of lysosomal acid alpha-glucosidase (GAA) activity, although molecular genetic testing for GAA mutations can also be used to confirm the diagnosis. Recombinant human a glucosidase alfa and a large multidisciplinary team are required for the treatment of patients with Pompe disease (rhGAA, MyozymeR). Two cases of Pompe disease are presented in this case-report. A 13-year-old female patient who is still alive and receiving enzyme replacement therapy, and a 5-month-old newborn who died from cardiomyopathy.
庞贝病,或II型糖原贮积病,是一种溶酶体贮积障碍,其中α -葡萄糖苷酶缺乏导致糖原积聚,最终导致虚弱逐渐加重和心脏增大。庞贝病的婴儿发病和晚发病形式是有区别的。在婴儿期发病的庞贝病中,心脏是受糖原积聚影响最大的器官。然而,晚发的形式,经常表现为骨骼肌的衰弱,随着时间的推移而恶化。用于诊断Pompe病的关键因素是酶学,酶学显示溶酶体酸α -葡萄糖苷酶(GAA)活性缺乏,尽管GAA突变的分子基因检测也可用于确诊。重组人α葡萄糖苷酶和一个庞大的多学科团队是庞贝病(rhGAA, MyozymeR)患者治疗所必需的。本文报告两例庞贝病。一名13岁的女性患者仍然活着并接受酶替代治疗,一名5个月大的新生儿死于心肌病。
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引用次数: 0
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