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A CLASSIFICATION SYSTEM FOR POST-ACUTE SEQUELAE OF SARS CoV-2 INFECTION SARS冠状病毒感染急性后后遗症的分类系统
Pub Date : 2022-03-29 DOI: 10.47316/cajmhe.2022.3.1.04
Leonard A. Jason, Mohammed F. Islam
This study aimed to contribute to the development of a research case definition for post-acute sequelae of SARS CoV-2 infection (PASC) using a PASC data set and experiences from case definitions developed for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS).  Our database included patients with PASC who provided self-report symptomology during the onset of infection and the time of survey completion (post-infection).  We found that we could distinguish between those with mild, moderate, and severe PASC.  Regarding the proportion meeting an ME/CFS case definition, we found 0% in the mildly impaired group, 30.6% to 62.6% in the moderately impaired group, and 74.3% to 89.0% in the severely impaired group. Based on these preliminary data, we propose a 5-part classification system for PASC.  Axis 1 involves the variant of the COVID infection and the type of documentation of the infection. Axis 2 involves the time elapsed since infection. Axis 3 involves the type of medical collateral damage to different organs. Axis 4 involves functional impairment classified into three categories: mild, moderate, or severe.  Finally, Axis 5 is the identified symptoms. Finally, if the patient has been sick for 6 or more months, it is important to determine whether the person has met the ME/CFS criteria.  This proposed 5-part classification system for PASC might bring considerable clarity to diagnosing PASC.   
本研究旨在利用PASC数据集和肌痛性脑脊髓炎/慢性疲劳综合征(ME/CFS)病例定义的经验,为SARS CoV-2感染急性后后遗症(PASC)的研究病例定义做出贡献。我们的数据库包括在感染开始时和调查完成时(感染后)提供自我报告症状的PASC患者。我们发现我们可以区分轻度、中度和重度PASC。对于符合ME/CFS病例定义的比例,我们发现轻度受损组为0%,中度受损组为30.6% ~ 62.6%,重度受损组为74.3% ~ 89.0%。基于这些初步数据,我们提出了一个由5部分组成的PASC分类体系。轴1涉及COVID感染的变体和感染的文件类型。轴2涉及自感染以来经过的时间。轴3涉及不同器官的医学附带损伤类型。轴4涉及功能障碍,分为轻度、中度和重度三类。最后,轴5是已识别的症状。最后,如果患者已经患病6个月或更长时间,确定患者是否符合ME/CFS标准是很重要的。本文提出的PASC的五部分分类体系可能会使PASC的诊断更加清晰。
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引用次数: 7
SEASONAL VARIATIONS AND BEHÇET’S DISEASE ACTIVITY 季节变化和behÇet的疾病活动
Pub Date : 2022-03-29 DOI: 10.47316/cajmhe.2022.3.1.02
D. Üsküdar Cansu, C. Korkmaz
Behçet’s disease (BD) is a systemic vasculitis with mucocutaneous manifestations such as recurrent oral ulcers and genital ulcers in addition to major organ involvements including the vascular and central nervous systems. Many studies have found that the prevalence of clinical symptoms of BD varies by geographical region. The course of BD is characterized by relapses and remissions. Infectious agents and altered microbiomes have been blamed for exacerbations of the disease. Stress, physical exhaustion, mechanical oral trauma, and hormonal effects have been specifically associated with flare-ups. A seasonal pattern in the activation of certain diseases, such as rheumatoid arthritis and systemic lupus erythematosus, has been reported. However, the relationship, if any, between the seasonal changes and the symptoms and organ involvements of BD has yet to be determined. In this review, we discussed whether clinical findings in BD patients are related to the seasons in terms of activation.
behet病(BD)是一种全身血管炎,除主要器官包括血管和中枢神经系统受累外,还具有粘膜皮肤表现,如复发性口腔溃疡和生殖器溃疡。许多研究发现,双相障碍临床症状的患病率因地理区域而异。BD的病程以复发和缓解为特征。传染因子和改变的微生物群被认为是导致疾病恶化的原因。压力,体力消耗,机械性口腔创伤和荷尔蒙的影响都特别与发作有关。在某些疾病,如类风湿关节炎和系统性红斑狼疮的激活季节性模式,已被报道。然而,季节变化与双相障碍的症状和器官累及之间的关系,如果有的话,还有待确定。在这篇综述中,我们讨论了BD患者的临床表现是否与季节激活有关。
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引用次数: 0
HOSPITAL-MEDIA RELATIONSHIP AND PATIENTS’ PRIVACY: CODIFYING THE ETHICAL GUIDELINE 医院-媒体关系与患者隐私:伦理准则的编纂
Pub Date : 2022-03-29 DOI: 10.47316/cajmhe.2022.3.1.06
P. Salari, Mahshad Noroozi, A. Parsapour
The hospital-media relationship could be mutually beneficial. Appealing to maximum readers and surviving in business are priorities in journalism. Without adherence to an ethical framework and main ethical principles including privacy and confidentiality, some detrimental impacts may occur. Thus, we aimed at codifying an ethical guideline for hospital-media relationship in Iran to maintain a proper and ethical relationship by emphasizing on patients’ privacy and confidentiality. The study was performed using the qualitative approach in two phases. The current policies and relevant reports in the literature were reviewed and their contents were analyzed. Subsequently, the first draft of the guideline was codified which was followed by the second phase in which the draft was finalized by two focus groups. Finally, a draft of an ethical guideline consisting of 79 articles in 6 themes was developed including the general principles, work flow in hospital-media relationship, duties of hospital representative, physicians’ guide, media guide, and patients’ guide. The guideline focuses on patients’ privacy, confidentiality and the privacy of the healthcare system in mutual hospital-media relationships. It is suggested that by implementing the guideline, the patients’ right would be respected and the public trust to the healthcare system will be fostered.
医院和媒体的关系可能是互惠互利的。吸引最多的读者和在商业中生存是新闻业的首要任务。如果不遵守道德框架和主要的道德原则,包括隐私和保密,可能会产生一些有害的影响。因此,我们旨在编纂伊朗医院与媒体关系的道德准则,通过强调患者的隐私和保密来维持适当和道德的关系。本研究采用定性方法分两个阶段进行。回顾了现行政策和文献中的相关报道,并对其内容进行了分析。随后,准则的第一份草案被编纂,随后是第二阶段,其中草案由两个焦点小组定稿。最后,制定了包括一般原则、医院与媒体关系的工作流程、医院代表的职责、医生指南、媒体指南和患者指南在内的6个主题的79条道德准则草案。该指南侧重于医院与媒体相互关系中的患者隐私、保密性和医疗保健系统的隐私。建议通过实施该指南,尊重患者的权利,培养公众对医疗保健系统的信任。
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引用次数: 0
CYTOKINES AS POTENTIAL MARKERS OF COVID-19 SEVERITY AND OUTCOMES 细胞因子作为COVID-19严重程度和结果的潜在标志物
Pub Date : 2022-03-29 DOI: 10.47316/cajmhe.2022.3.1.01
Y. Fedorchenko, O. Zimba
The continual propagation of SARS-CoV-2 has changed health care systems globally. Ranging degrees of clinical severity in COVID-19 patients have been noted in numerous literature sources. Cytokines play a crucial role in the development of key immunological processes in COVID-19. SARS-CoV-2 causes imbalance of the immune system and might culminate in cytokine storm and multiple organ involvement. The prevailing role of some special cytokines might serve as indicators of disease severity. Further stratification of patients in the context of specific cytokines can be beneficial for diagnosing disease stages. It can prevent critical states owing to timely diagnosis and targeted therapy. Targeting peculiar cytokines can markedly reduce complications. The aim of this article is to comprehensively overview the role of the main cytokines in COVID-19 pathogenesis and distinguish prognostic factors. Insights into specific cytokine involvement in COVID-19 pathogenesis may open new avenues for diagnosing hyperinflammatory COVID-19, predicting its outcomes and providing individualized cytokine-targeted therapeutic approaches.
SARS-CoV-2的持续传播改变了全球的卫生保健系统。许多文献资料都指出了COVID-19患者的临床严重程度。细胞因子在COVID-19关键免疫过程的发展中发挥关键作用。SARS-CoV-2导致免疫系统失衡,并可能最终导致细胞因子风暴和多器官受累。一些特殊细胞因子的主导作用可能作为疾病严重程度的指标。在特定细胞因子的背景下进一步分层患者可能有利于诊断疾病分期。及时诊断和靶向治疗可预防危重状态。靶向特殊细胞因子可显著减少并发症。本文旨在全面综述主要细胞因子在COVID-19发病机制中的作用,并区分预后因素。对COVID-19发病机制中特定细胞因子参与的深入了解可能为诊断高炎症性COVID-19、预测其预后以及提供个性化的细胞因子靶向治疗方法开辟新的途径。
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引用次数: 0
SMOKING AND BUERGER’S DISEASE: FROM HYPOTHESES TO EVIDENCE SYNTHESIS 吸烟与伯格氏病:从假设到证据综合
Pub Date : 2022-03-29 DOI: 10.47316/cajmhe.2022.3.1.03
B. Fazeli, Mitra Masoudian
Early after the definition of thromboangiitis obliterans (TAO), it was noticed that TAO patients are almost always tobacco smokers. Later on, the relationship between continued smoking and TAO prognosis was documented. Consequently, smoking came to be considered as the main cause of TAO. However, it is still unknown why, amongst millions of smokers, only a small number develop TAO. It also remains unknown why, of the TAO patients who continue smoking, only half of them show aggravation and undergo amputations. The aims of this review are to investigate evidence in support of or against the relationship between TAO and smoking, according to the TAO-related literature published from 1908 to January 2022, and to discover the possible role of smoking in TAO pathophysiology. Taken together, it appears that smoking predisposes TAO patients toward the potential harmful effects of the main aetiology and helps the main aetiology to develop vascular lesions. Therefore, smoking cessation would almost always be helpful for improving the prognosis of TAO patients and reducing disease manifestation. However, concluding that smoking is not the main aetiology of TAO would open a new door to finding the true main aetiology of TAO and to discovering the appropriate treatment and medical management of patients who fail to stop smoking.
早在血栓闭塞性脉管炎(TAO)的定义后,人们就注意到TAO患者几乎都是吸烟者。后来,继续吸烟与TAO预后之间的关系被证实。因此,吸烟被认为是导致TAO的主要原因。然而,尚不清楚为什么在数百万吸烟者中,只有少数人发展为TAO。同样不清楚的是,为什么在继续吸烟的TAO患者中,只有一半表现出病情恶化并进行截肢。本综述的目的是根据1908年至2022年1月期间发表的与TAO相关的文献,调查支持或反对TAO与吸烟之间关系的证据,并发现吸烟在TAO病理生理中的可能作用。综上所述,吸烟似乎使TAO患者容易受到主要病因的潜在有害影响,并有助于主要病因发展血管病变。因此,戒烟几乎总是有助于改善TAO患者的预后,减少疾病的表现。然而,吸烟不是TAO的主要病因的结论将为发现TAO的真正主要病因以及发现戒烟失败患者的适当治疗和医疗管理打开一扇新的大门。
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引用次数: 0
PLAGIARISM AND ITS REPERCUSSIONS: A PRIMER ON RESPONSIBLE SCIENTIFIC WRITING 剽窃及其影响:负责任的科学写作入门
Pub Date : 2022-03-29 DOI: 10.47316/cajmhe.2022.3.1.05
P. Mehta, Sayan Mukherjee
Background: Plagiarism, in simple words meaning theft of ideas or text, is a grave scientific misconduct that is talked about frequently, however is notable in its conspicuous absence from the formal educational curriculum. Students and young researchers tend to engage in this malpractice, intentionally or unintentionally, due to various reasons. Aim: In this review, we aim to discuss a clear concept about plagiarism from its origin to its consequences, with special considerations about its status in the COVID-19 pandemic. This lucid conceptualization will help young authors invest in original research in terms of both the idea and the script, avoiding unnecessary rejections and breach in medical ethics. Search Strategy: An electronic search strategy was performed on MEDLINE using the following keywords: “Plagiarism” OR “Plagiarism AND reasons” OR “Plagiarism AND consequences OR retractions” OR “Plagiarism AND detection”. Results: Of 2112 articles obtained, 36 were selected for the review. The main reasons for this malpractice were pressure for publication under a limited time frame along with a lack of training for scientific writing. The forms of plagiarism observed include intentional and unintentional, theft of ideas, copying verbatim, graphics, self-plagiarism and translational plagiarism. Use of various software are available for detection of plagiarism like iThenticate, Turnitin Feedback Studio, Grammarly etc along with careful reviewing by authors, reviewers and editors can detect this menace and help maintain originality in science. The consequences can be severe, ranging from defamation to monetary to legal action against the authors. Conducting interactive workshops on scientific writing along with promoting creativity in thought at the level of grass-root education is the key to preventing the scientific misconduct of plagiarism amongst students and young researchers. Conclusion: Plagiarism is a serious scientific misconduct that must be discussed with students and young researchers, and its prevention is the key to fostering growth in medical science and academics.
背景:剽窃,简单来说就是窃取思想或文本,是一种经常被谈论的严重的科学不端行为,然而,在正规教育课程中却明显缺席。由于各种原因,学生和年轻的研究人员往往有意无意地从事这种不当行为。目的:在这篇综述中,我们旨在从剽窃的起源到其后果讨论一个明确的概念,并特别考虑其在COVID-19大流行中的地位。这种清晰的概念化将有助于年轻作者在想法和剧本方面投入原创性研究,避免不必要的拒绝和违反医学伦理。搜索策略:在MEDLINE上使用以下关键词进行电子搜索策略:“抄袭”或“抄袭和原因”或“抄袭和后果或撤回”或“抄袭和检测”。结果:在获得的2112篇文章中,有36篇入选。这种不当行为的主要原因是在有限的时间框架内出版的压力以及缺乏科学写作的培训。所观察到的抄袭形式包括有意和无意、剽窃思想、逐字复制、图形复制、自我抄袭和翻译抄袭。使用各种软件可用于检测抄袭,如iThenticate, Turnitin Feedback Studio, Grammarly等,以及作者,评论者和编辑的仔细审查,可以检测到这种威胁,并帮助保持科学的原创性。后果可能很严重,从诽谤到金钱,再到对作者采取法律行动。在基层教育层面开展科学写作互动研讨会,促进思想创新,是防止学生和青年科研人员抄袭等科学不端行为的关键。结论:抄袭是一种严重的科学不端行为,必须与学生和年轻研究人员讨论,预防抄袭是促进医学科学和学术发展的关键。
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引用次数: 3
QUALITY PEER REVIEW IS ESSENTIAL FOR SCHOLARLY PUBLISHING 高质量的同行评议对学术出版至关重要
Pub Date : 2022-03-29 DOI: 10.47316/cajmhe.2022.3.1.08
İ. Coşkun Benlidayı
QUALITY PEER REVIEW IS ESSENTIAL FOR SCHOLARLY PUBLISHING
高质量的同行评议对学术出版至关重要
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引用次数: 1
PERSONAL CONFLICTS OF INTEREST IN THE PUBLISHING ENTERPRISE: FOCUS ON JOURNAL EDITORS 出版企业中的个人利益冲突:以期刊编辑为中心
Pub Date : 2021-12-28 DOI: 10.47316/cajmhe.2021.2.4.05
J. A. Teixeira da Silva
Editors play a central role and form an essential link in the publication process. Consequently, they hold considerable influence as to how the literature is molded, and what eventually gets published. In addition to their standard editorial responsibilities, holding that amount of power, editors have extremely high responsibilities to declare any conflicts of interest (COIs) internal to, and external to, the peer review process, particularly those involving personal relationships and networks. This is because they also exist in the peer community, can be high-profile public figures, and form a very unique and restricted – in terms of size, membership and exclusivity – set of individuals. Consequently, editors need to declare their COIs openly, transparently, and publicly on their editor board profiles, and as part of their curriculum vitae. Without such declarations, the greater risk is that editors might have unregulated freedom to enforce their own individual or group biases, through hidden relationships and networks, including the possibility of hiding instances of favoritism, cronyism and nepotism. In the worst-case scenario, this might reflect editorial corruption. Hidden COIs in authors, which tend to be the focus of the academic publishing establishment, including in codes of conduct and ethical guidelines such as those by COPE and the ICMJE, tend to down-play editorial COIs, or restrict them to scrutiny during the peer review process. This opinion piece examines whether there is a systemic problem with under-reported editorial COIs, particularly personal and non-financial COIs, that extend beyond the peer review process and their editorial positions. Greater awareness, debate, and education of this issue are needed.
编辑在出版过程中起着核心作用,是必不可少的环节。因此,他们对文学的塑造方式和最终出版的内容有着相当大的影响。除了他们的标准编辑责任之外,拥有如此多的权力,编辑还负有极高的责任,要宣布同行评审过程内部和外部的任何利益冲突(coi),特别是那些涉及个人关系和网络的利益冲突。这是因为他们也存在于同行社区中,可以是高调的公众人物,并形成一个非常独特和有限的个人群体——就规模、成员资格和排他性而言。因此,编辑需要公开、透明和公开地在他们的编辑委员会简介中声明他们的coi,并将其作为简历的一部分。如果没有这样的声明,更大的风险是,编辑可能会有不受监管的自由,通过隐藏的关系和网络,包括隐藏偏袒、任人唯亲和裙带关系的可能性,来强化他们自己的个人或群体偏见。在最坏的情况下,这可能反映出编辑腐败。作者隐藏的coi往往是学术出版机构关注的焦点,包括COPE和ICMJE的行为准则和道德准则,它们往往低估编辑coi,或将其限制在同行评议过程中的审查范围内。这篇评论文章探讨了是否存在一个系统性问题,即未充分报告的编辑coi,特别是个人和非金融的coi,超出了同行评议过程及其编辑立场。需要提高对这一问题的认识、辩论和教育。
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引用次数: 1
MEDICAL HUMANITIES AND ITS ROLE IN SHAPING ETHICS IN MEDICAL GRADUATES 医学人文学科及其在塑造医学毕业生伦理道德中的作用
Pub Date : 2021-12-28 DOI: 10.47316/cajmhe.2021.2.4.04
P. Mehta, Sakir Ahmed
Medicine as a field is unique in the sense that the skill to relate to people weighs heavier on the doctor than the skill required to practise it. Medical humanities is an interdisciplinary field that considers issues of health in the context of history, philosophy, social studies, and anthropology among others, enabling students to change their practice from “looking” to “seeing” the patient as a whole. Unfortunately, current medical training is focused on academics with students left on their own to acquire communication and ancillary skills. In the core medical curriculum, a structured training in medical humanities remains lacking. Herein, we discuss the need, student’s perspectives, and the approach going forward in the inculcation of medical humanities in the medical training with a particular focus on medical ethics.
医学作为一个领域是独一无二的,因为对医生来说,与人交往的技能比行医所需的技能更重要。医学人文学科是一个跨学科的领域,在历史、哲学、社会研究和人类学等背景下考虑健康问题,使学生将他们的实践从“看”到“看”病人作为一个整体。不幸的是,目前的医学培训主要集中在学术上,学生们只能靠自己学习沟通和辅助技能。在核心医学课程中,仍然缺乏对医学人文学科的结构化培训。在此,我们讨论了医学人文教育在医学培训中的必要性、学生的观点和未来的方法,特别关注医学伦理学。
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引用次数: 0
THE RESEARCHER 研究人员
Pub Date : 2021-12-28 DOI: 10.4324/9780203129951-17
U. Kumar
THE RESEARCHER
研究人员
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引用次数: 0
期刊
Central Asian Journal of Medical Hypotheses and Ethics
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