首页 > 最新文献

Rambam Maimonides Medical Journal最新文献

英文 中文
Salivary Biomarker Levels and Oral Health Status of Children with Cerebral Palsy and Their Healthy Siblings: A Comparative Study. 脑瘫儿童及其健康兄弟姐妹唾液生物标志物水平与口腔健康状况的比较研究
IF 1.5 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2021-04-29 DOI: 10.5041/RMMJ.10437
Palanichamy Anjugam, Veerabadhran Mahesh Mathian, Murugesan Gawthaman, Selvaraj Vinod, Easwaramurthy Yamuna Devi

Background: The dental needs of cerebral palsy children are an area of study much in need of attention. The neglect of this aspect should be rectified, and simpler diagnostic methodologies should be established and used to serve this purpose.

Aim: This study aimed to determine oral health status and salivary biomarkers (salivary flow rate, pH, buffering capacity) among children with cerebral palsy (CP), to compare their data with that of their healthy siblings, and to evaluate the relationship between salivary biomarkers and dental caries.

Methods: A total of 30 CP children (study group) and 30 normal healthy siblings (controls) were selected between the ages of 5 and 12 years. Salivary biomarkers were assessed, and oral health status was examined.

Statistical analysis: Chi-square test was used for comparison of oral health status. Unpaired t test was used to compare caries indexes (decay/filled teeth-primary dentition [dft] and decay/missing/filled teeth-permanent dentition [DMFT]) and salivary biomarkers between the groups. Pearson correlation was used to find the correlation between salivary biomarkers and caries.

Results: The dft scores were significantly higher in the study group (P<0.05). The pH values and salivary flow rates were significantly lower in the study group (P<0.05 and P<0.001, respectively). There was a significant correlation between DMFT scores and salivary flow rate in the study group (P<0.05).

Conclusion: Low pH and low salivary flow rate might be risk factors for dental caries in CP populations; moreover, the significant correlation between DMFT score and salivary flow rate suggests that salivary flow rate could be used as a screening tool for assessing at-risk subjects in such populations.

背景:脑瘫儿童的牙科需求是一个非常需要关注的研究领域。应该纠正对这方面的忽视,应该建立和使用更简单的诊断方法来达到这一目的。目的:本研究旨在测定脑瘫儿童的口腔健康状况和唾液生物标志物(唾液流速、pH值、缓冲能力),并将其与健康兄弟姐妹的数据进行比较,并评估唾液生物标志物与龋病的关系。方法:选取5 ~ 12岁的CP患儿30例(研究组)和正常健康兄弟姐妹30例(对照组)。评估唾液生物标志物,并检查口腔健康状况。统计学分析:口腔健康状况比较采用卡方检验。采用非配对t检验比较各组龋病指数(蛀牙/补牙-初级牙列[dft]和蛀牙/缺牙/补牙-恒牙列[DMFT])和唾液生物标志物。采用Pearson相关性分析唾液生物标志物与龋病的相关性。结论:低pH值和低唾液流率可能是CP人群发生龋病的危险因素;此外,DMFT评分与唾液流率之间的显著相关性表明,唾液流率可以作为评估这些人群中高危受试者的筛查工具。
{"title":"Salivary Biomarker Levels and Oral Health Status of Children with Cerebral Palsy and Their Healthy Siblings: A Comparative Study.","authors":"Palanichamy Anjugam,&nbsp;Veerabadhran Mahesh Mathian,&nbsp;Murugesan Gawthaman,&nbsp;Selvaraj Vinod,&nbsp;Easwaramurthy Yamuna Devi","doi":"10.5041/RMMJ.10437","DOIUrl":"https://doi.org/10.5041/RMMJ.10437","url":null,"abstract":"<p><strong>Background: </strong>The dental needs of cerebral palsy children are an area of study much in need of attention. The neglect of this aspect should be rectified, and simpler diagnostic methodologies should be established and used to serve this purpose.</p><p><strong>Aim: </strong>This study aimed to determine oral health status and salivary biomarkers (salivary flow rate, pH, buffering capacity) among children with cerebral palsy (CP), to compare their data with that of their healthy siblings, and to evaluate the relationship between salivary biomarkers and dental caries.</p><p><strong>Methods: </strong>A total of 30 CP children (study group) and 30 normal healthy siblings (controls) were selected between the ages of 5 and 12 years. Salivary biomarkers were assessed, and oral health status was examined.</p><p><strong>Statistical analysis: </strong>Chi-square test was used for comparison of oral health status. Unpaired t test was used to compare caries indexes (decay/filled teeth-primary dentition [dft] and decay/missing/filled teeth-permanent dentition [DMFT]) and salivary biomarkers between the groups. Pearson correlation was used to find the correlation between salivary biomarkers and caries.</p><p><strong>Results: </strong>The dft scores were significantly higher in the study group (P<0.05). The pH values and salivary flow rates were significantly lower in the study group (P<0.05 and P<0.001, respectively). There was a significant correlation between DMFT scores and salivary flow rate in the study group (P<0.05).</p><p><strong>Conclusion: </strong>Low pH and low salivary flow rate might be risk factors for dental caries in CP populations; moreover, the significant correlation between DMFT score and salivary flow rate suggests that salivary flow rate could be used as a screening tool for assessing at-risk subjects in such populations.</p>","PeriodicalId":46408,"journal":{"name":"Rambam Maimonides Medical Journal","volume":"12 2","pages":""},"PeriodicalIF":1.5,"publicationDate":"2021-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8092958/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38862321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 4
Delayed Presentation of Children to Healthcare Facilities due to COVID-19 Lockdown, Leading to Severe Complications. 由于COVID-19封锁,儿童延迟到医疗机构就诊,导致严重并发症。
IF 1.5 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2021-04-29 DOI: 10.5041/RMMJ.10431
Yonatan Yeshayahu

During the coronavirus disease 2019 (COVID-19) pandemic, the increasing fear of leaving home and entering hospitals, together with guidelines to the public from Israel's Ministry of Health recommending the use of telemedicine rather than physical visits to the doctor, led to delayed diagnoses of non-COVID-19-related medical conditions. This research letter presents a cluster of severe medical conditions that were delayed in diagnosis due to postponed presentation to healthcare facilities during the COVID-19 pandemic. Ewing sarcoma, severe hemolytic anemia, endocarditis requiring surgery, and septic hip requiring surgery are some examples of cases we encountered with delayed diagnoses. This led to the appearance of a rather low burden of disease in the pediatric population during the pandemic, and pediatric hospitals and clinics experienced a very low volume of activity. Given the low burden of COVID-19 in children, and the well-defined separation between infected and non-infected areas within the hospitals, we should consider improving the guidelines and messages conveyed to the public regarding the importance of prompt medical assessment for other medical conditions, even during a pandemic, along with reassurance of the safety of entering medical facilities given the strict isolation procedures being observed. Conclusion: Medical associations should reconsider the messages being sent to the public during future outbreaks, and encourage medical assessment.

在2019年冠状病毒病(COVID-19)大流行期间,人们越来越害怕离开家和进入医院,再加上以色列卫生部向公众发布的指南建议使用远程医疗,而不是亲自去看医生,导致与COVID-19无关的医疗状况的诊断被延误。本研究信函介绍了在COVID-19大流行期间由于推迟向医疗机构就诊而延误诊断的一系列严重疾病。尤因肉瘤、严重溶血性贫血、需要手术的心内膜炎和需要手术的脓毒性髋关节是我们遇到的延迟诊断的一些例子。这导致大流行期间儿科人口的疾病负担相当低,儿科医院和诊所的活动量非常低。鉴于2019冠状病毒病对儿童的负担较低,以及医院内感染区和非感染区有明确的区分,我们应该考虑改进向公众传达的指导方针和信息,即即使在大流行期间,也要对其他医疗状况进行及时医疗评估,同时在遵守严格隔离程序的情况下,确保进入医疗设施的安全性。结论:医学协会应重新考虑在未来疫情期间向公众发送的信息,并鼓励医学评估。
{"title":"Delayed Presentation of Children to Healthcare Facilities due to COVID-19 Lockdown, Leading to Severe Complications.","authors":"Yonatan Yeshayahu","doi":"10.5041/RMMJ.10431","DOIUrl":"https://doi.org/10.5041/RMMJ.10431","url":null,"abstract":"<p><p>During the coronavirus disease 2019 (COVID-19) pandemic, the increasing fear of leaving home and entering hospitals, together with guidelines to the public from Israel's Ministry of Health recommending the use of telemedicine rather than physical visits to the doctor, led to delayed diagnoses of non-COVID-19-related medical conditions. This research letter presents a cluster of severe medical conditions that were delayed in diagnosis due to postponed presentation to healthcare facilities during the COVID-19 pandemic. Ewing sarcoma, severe hemolytic anemia, endocarditis requiring surgery, and septic hip requiring surgery are some examples of cases we encountered with delayed diagnoses. This led to the appearance of a rather low burden of disease in the pediatric population during the pandemic, and pediatric hospitals and clinics experienced a very low volume of activity. Given the low burden of COVID-19 in children, and the well-defined separation between infected and non-infected areas within the hospitals, we should consider improving the guidelines and messages conveyed to the public regarding the importance of prompt medical assessment for other medical conditions, even during a pandemic, along with reassurance of the safety of entering medical facilities given the strict isolation procedures being observed. Conclusion: Medical associations should reconsider the messages being sent to the public during future outbreaks, and encourage medical assessment.</p>","PeriodicalId":46408,"journal":{"name":"Rambam Maimonides Medical Journal","volume":"12 2","pages":""},"PeriodicalIF":1.5,"publicationDate":"2021-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8092957/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25361357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 6
Long-Term Quality of Life after Endoscopic Pituitary Adenoma Surgery with Nasoseptal Flap Reconstruction. 鼻中隔瓣重建垂体腺瘤内镜手术后的长期生活质量。
IF 1.5 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2021-04-29 DOI: 10.5041/RMMJ.10435
Shadi Shinnawi, Ilya Kopaev, Shorook Na'ara, Ayelet Eran, Gil Sviri, Dmitry Ostrovsky, Ziv Gil

Introduction: Endoscopic endonasal transsphenoidal surgery (EETS) on the pituitary gland is considered safe and efficacious. The nasoseptal flap (NSF) is sometimes used to prevent or repair postoperative cerebrospinal fluid (CSF) leaks. Few investigators have quantified long-term quality-of-life (QOL) outcomes regarding sinonasal measures after EETS, with or without involvement of the NSF. This study assesses whether the septal flap affects sinonasal QOL outcomes for patients receiving EETS for pituitary adenoma.

Methods and materials: This is a retrospective study of patients who underwent EETS between 2013 and 2018. A total of 62 adults completed the Sinonasal Outcome Test-22 (SNOT-22) at least one year after the surgery. Outcome measures were compared between patients who underwent EETS with and without septal flap reconstruction.

Results: For the entire cohort, there were 14 patients (22.6%) who had septal flap reconstruction and 48 patients (77.4%) who did not. Patient demographics, tumor characteristics, surgical outcomes, and duration between surgery and completion of the questionnaire were similar for both groups. The mean SNOT-22 scores in the no reconstruction (NR) group and the nasoseptal flap reconstruction (NSFR) group were similar (P=0.9). In terms of SNOT-22 subdomains (rhinologic symptoms, extranasal rhinologic symptoms, ear/facial symptoms, psychological dysfunction, and sleep dysfunction), no significant differences were found when comparing the groups.

Conclusion: As compared with no reconstructive involvement, NSF utilization does not affect the QOL and nasal symptoms of patients undergoing EETS.

内镜下经鼻蝶窦垂体手术(EETS)被认为是安全有效的。鼻中隔皮瓣(NSF)有时用于预防或修复术后脑脊液(CSF)泄漏。很少有研究者量化EETS后鼻窦测量的长期生活质量(QOL)结果,无论是否有NSF的参与。本研究评估鼻中隔皮瓣是否影响垂体腺瘤患者接受EETS治疗的鼻窦生活质量。方法和材料:这是一项对2013年至2018年期间接受EETS治疗的患者的回顾性研究。共有62名成年人在手术后至少一年完成了鼻窦预后测试-22 (SNOT-22)。结果测量比较接受EETS的患者与不接受鼻中隔皮瓣重建的患者。结果:在整个队列中,14例(22.6%)患者进行了鼻中隔瓣重建,48例(77.4%)患者未进行鼻中隔瓣重建。两组患者的人口统计学特征、肿瘤特征、手术结果以及手术和完成问卷之间的持续时间相似。无鼻中隔瓣重建组(NR)和鼻中隔瓣重建组(NSFR)的SNOT-22平均评分相近(P=0.9)。在SNOT-22亚域(鼻症状、鼻外鼻症状、耳/面部症状、心理功能障碍和睡眠功能障碍)方面,组间比较无显著差异。结论:与无重建受术者相比,NSF的使用对EETS患者的生活质量和鼻症状没有影响。
{"title":"Long-Term Quality of Life after Endoscopic Pituitary Adenoma Surgery with Nasoseptal Flap Reconstruction.","authors":"Shadi Shinnawi,&nbsp;Ilya Kopaev,&nbsp;Shorook Na'ara,&nbsp;Ayelet Eran,&nbsp;Gil Sviri,&nbsp;Dmitry Ostrovsky,&nbsp;Ziv Gil","doi":"10.5041/RMMJ.10435","DOIUrl":"https://doi.org/10.5041/RMMJ.10435","url":null,"abstract":"<p><strong>Introduction: </strong>Endoscopic endonasal transsphenoidal surgery (EETS) on the pituitary gland is considered safe and efficacious. The nasoseptal flap (NSF) is sometimes used to prevent or repair postoperative cerebrospinal fluid (CSF) leaks. Few investigators have quantified long-term quality-of-life (QOL) outcomes regarding sinonasal measures after EETS, with or without involvement of the NSF. This study assesses whether the septal flap affects sinonasal QOL outcomes for patients receiving EETS for pituitary adenoma.</p><p><strong>Methods and materials: </strong>This is a retrospective study of patients who underwent EETS between 2013 and 2018. A total of 62 adults completed the Sinonasal Outcome Test-22 (SNOT-22) at least one year after the surgery. Outcome measures were compared between patients who underwent EETS with and without septal flap reconstruction.</p><p><strong>Results: </strong>For the entire cohort, there were 14 patients (22.6%) who had septal flap reconstruction and 48 patients (77.4%) who did not. Patient demographics, tumor characteristics, surgical outcomes, and duration between surgery and completion of the questionnaire were similar for both groups. The mean SNOT-22 scores in the no reconstruction (NR) group and the nasoseptal flap reconstruction (NSFR) group were similar (P=0.9). In terms of SNOT-22 subdomains (rhinologic symptoms, extranasal rhinologic symptoms, ear/facial symptoms, psychological dysfunction, and sleep dysfunction), no significant differences were found when comparing the groups.</p><p><strong>Conclusion: </strong>As compared with no reconstructive involvement, NSF utilization does not affect the QOL and nasal symptoms of patients undergoing EETS.</p>","PeriodicalId":46408,"journal":{"name":"Rambam Maimonides Medical Journal","volume":"12 2","pages":""},"PeriodicalIF":1.5,"publicationDate":"2021-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8092951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38862318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Retrospective Evaluation of Factors Affecting Lymph Node Retrieval Following Gastrectomies with Oncologic Intent. 有肿瘤目的的胃切除术后影响淋巴结恢复的因素的回顾性评价。
IF 1.5 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2021-04-29 DOI: 10.5041/RMMJ.10434
Steven Fuchs, Itamar Ashkenazi

Background: Adequate lymphadenectomy is an important factor affecting survival in gastric cancer patients. Retrieval and examination of at least 15 lymph nodes is recommended in order to properly stage gastric malignancies. The objectives of this study were to evaluate the proportion of patients undergoing inadequate lymphadenectomies and possible risk factors for inadequate surgery.

Methods: This was a retrospective study that included patients, 18 years and older, who underwent gastrectomies with oncologic intent in the Hillel Yaffe Medical Center. We analyzed the association of demographic, clinical, and pathological variables with adequate number of lymph nodes.

Results: The retrieval of less than 15 lymph nodes was reported in 51% (53/104) patients undergoing gastrectomies with oncologic intent. The extent of surgery was the only variable associated with inadequate lymphadenectomy on univariate analysis: subtotal/proximal versus total gastrectomy (P=0.047). Differences observed for previous surgery (P=0.193), T stage (P=0.053), N stage (P=0.051), and lymphovascular invasion (P=0.14) did not reach significance. Subtotal/proximal gastrectomy resulted in inadequate resection of lymph nodes in 56% of the patients, while this occurred in only 30% of the patients undergoing total gastrectomy (relative risk 1.865; 95% CI 0.93, 3.741). Logistic regression confirmed that only subtotal/proximal versus total gastrectomy was associated with inadequate number of lymph nodes resected (P=0.043).

Discussion and conclusion: In this study we analyzed the association of patient, tumor, and surgery-related factors on adequate lymphadenectomy in patients undergoing gastrectomies for possible gastric cancer. Larger extent of the surgery (total, rather than subtotal/proximal gastrectomy) was revealed to be the only indicator positively associated with adequate lymphadenectomy.

背景:充分的淋巴结切除术是影响胃癌患者生存的重要因素。为了正确分期胃恶性肿瘤,推荐至少15个淋巴结的恢复和检查。本研究的目的是评估接受不适当淋巴结切除术的患者比例以及不适当手术的可能危险因素。方法:这是一项回顾性研究,包括18岁及以上在Hillel Yaffe医学中心接受肿瘤目的胃切除术的患者。我们分析了人口统计学、临床和病理变量与淋巴结数量充足的关系。结果:51%(53/104)有肿瘤目的的胃切除术患者的淋巴结切除少于15个。在单因素分析中,手术范围是与淋巴结切除不充分相关的唯一变量:胃次全切除术/近端切除术与全胃切除术(P=0.047)。既往手术(P=0.193)、T期(P=0.053)、N期(P=0.051)、淋巴血管侵犯(P=0.14)差异均无统计学意义。胃大部/近端切除术导致56%的患者未完全切除淋巴结,而在全胃切除术患者中仅30%出现这种情况(相对风险为1.865;95% ci 0.93, 3.741)。Logistic回归证实,只有次全/近端胃切除术与全胃切除术与淋巴结切除数量不足相关(P=0.043)。讨论与结论:在本研究中,我们分析了患者、肿瘤和手术相关因素与可能发生胃癌的胃切除术患者充分切除淋巴结的关系。更大的手术范围(全胃切除术,而不是胃次全切除术/近端切除术)是与充分的淋巴结切除术呈正相关的唯一指标。
{"title":"Retrospective Evaluation of Factors Affecting Lymph Node Retrieval Following Gastrectomies with Oncologic Intent.","authors":"Steven Fuchs,&nbsp;Itamar Ashkenazi","doi":"10.5041/RMMJ.10434","DOIUrl":"https://doi.org/10.5041/RMMJ.10434","url":null,"abstract":"<p><strong>Background: </strong>Adequate lymphadenectomy is an important factor affecting survival in gastric cancer patients. Retrieval and examination of at least 15 lymph nodes is recommended in order to properly stage gastric malignancies. The objectives of this study were to evaluate the proportion of patients undergoing inadequate lymphadenectomies and possible risk factors for inadequate surgery.</p><p><strong>Methods: </strong>This was a retrospective study that included patients, 18 years and older, who underwent gastrectomies with oncologic intent in the Hillel Yaffe Medical Center. We analyzed the association of demographic, clinical, and pathological variables with adequate number of lymph nodes.</p><p><strong>Results: </strong>The retrieval of less than 15 lymph nodes was reported in 51% (53/104) patients undergoing gastrectomies with oncologic intent. The extent of surgery was the only variable associated with inadequate lymphadenectomy on univariate analysis: subtotal/proximal versus total gastrectomy (P=0.047). Differences observed for previous surgery (P=0.193), T stage (P=0.053), N stage (P=0.051), and lymphovascular invasion (P=0.14) did not reach significance. Subtotal/proximal gastrectomy resulted in inadequate resection of lymph nodes in 56% of the patients, while this occurred in only 30% of the patients undergoing total gastrectomy (relative risk 1.865; 95% CI 0.93, 3.741). Logistic regression confirmed that only subtotal/proximal versus total gastrectomy was associated with inadequate number of lymph nodes resected (P=0.043).</p><p><strong>Discussion and conclusion: </strong>In this study we analyzed the association of patient, tumor, and surgery-related factors on adequate lymphadenectomy in patients undergoing gastrectomies for possible gastric cancer. Larger extent of the surgery (total, rather than subtotal/proximal gastrectomy) was revealed to be the only indicator positively associated with adequate lymphadenectomy.</p>","PeriodicalId":46408,"journal":{"name":"Rambam Maimonides Medical Journal","volume":"12 2","pages":""},"PeriodicalIF":1.5,"publicationDate":"2021-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8092954/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38942472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Alternating and Concurrent True Hyperkalemia and Pseudohyperkalemia in Adult Sickle Cell Disease. 成人镰状细胞病交替和并发的真高钾血症和假高钾血症。
IF 1.5 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2021-04-29 DOI: 10.5041/RMMJ.10439
Macaulay Amechi Onuigbo, Heng Tan, Sarah E Sherman

Sickle cell disease (SCD) predisposes the patient to recurrent episodes of acute painful hemolytic crisis. Sickle cell nephropathy (SCN) is not uncommon in adult patients, and renal manifestations of SCN include renal ischemia, microinfarcts, renal papillary necrosis, and renal tubular abnormalities with variable clinical presentations. Intravascular hemolysis and reduced glomerular filtration rate with renal tubular dysfunction predispose to true hyperkalemia. Hemolytic crisis can be complicated by sepsis, leading to significant degrees of thrombocytosis, and thrombocytosis is a well-defined cause of pseudohyperkalemia. We describe a 40-year-old African American male patient with sickle cell anemia who exhibited alternating episodes of true hyperkalemia and pseudohyperkalemia, during consecutive hospital admissions. Clearly, true hyperkalemia is a potentially lethal condition. At the same time, the institution of inappropriate and intensive treatment of pseudohyperkalemia leading to severe hypokalemia is also potentially lethal. The need for this caution is most imperative with the recent introduction of the safer and more potent potassium binders, patiromer and sodium zirconium cyclosilicate.

镰状细胞病(SCD)易使患者反复发作急性疼痛溶血危象。镰状细胞肾病(SCN)在成人患者中并不少见,SCN的肾脏表现包括肾缺血、微梗死、肾乳头状坏死和肾小管异常,临床表现不一。血管内溶血和肾小球滤过率降低伴肾小管功能障碍易导致真正的高钾血症。溶血危机可合并败血症,导致显著程度的血小板增多,血小板增多是假性高钾血症的明确原因。我们描述了一位40岁的非裔美国男性镰状细胞性贫血患者,他在连续住院期间表现出真实高钾血症和假性高钾血症的交替发作。显然,真正的高钾血症是一种潜在的致命疾病。同时,假性高钾血症的不适当和强化治疗导致严重低钾血症的制度也可能是致命的。由于最近引入了更安全、更有效的钾结合剂、聚吡咯和环硅酸锆钠,这种谨慎的需要是最迫切的。
{"title":"Alternating and Concurrent True Hyperkalemia and Pseudohyperkalemia in Adult Sickle Cell Disease.","authors":"Macaulay Amechi Onuigbo,&nbsp;Heng Tan,&nbsp;Sarah E Sherman","doi":"10.5041/RMMJ.10439","DOIUrl":"https://doi.org/10.5041/RMMJ.10439","url":null,"abstract":"<p><p>Sickle cell disease (SCD) predisposes the patient to recurrent episodes of acute painful hemolytic crisis. Sickle cell nephropathy (SCN) is not uncommon in adult patients, and renal manifestations of SCN include renal ischemia, microinfarcts, renal papillary necrosis, and renal tubular abnormalities with variable clinical presentations. Intravascular hemolysis and reduced glomerular filtration rate with renal tubular dysfunction predispose to true hyperkalemia. Hemolytic crisis can be complicated by sepsis, leading to significant degrees of thrombocytosis, and thrombocytosis is a well-defined cause of pseudohyperkalemia. We describe a 40-year-old African American male patient with sickle cell anemia who exhibited alternating episodes of true hyperkalemia and pseudohyperkalemia, during consecutive hospital admissions. Clearly, true hyperkalemia is a potentially lethal condition. At the same time, the institution of inappropriate and intensive treatment of pseudohyperkalemia leading to severe hypokalemia is also potentially lethal. The need for this caution is most imperative with the recent introduction of the safer and more potent potassium binders, patiromer and sodium zirconium cyclosilicate.</p>","PeriodicalId":46408,"journal":{"name":"Rambam Maimonides Medical Journal","volume":"12 2","pages":""},"PeriodicalIF":1.5,"publicationDate":"2021-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8092952/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38862324","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
COVID-19 and Treatment and Immunization of Children-The Time to Redefine Pediatric Age Groups is Here. COVID-19与儿童的治疗和免疫接种——重新定义儿科年龄组的时候到了。
IF 1.5 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2021-04-29 DOI: 10.5041/RMMJ.10433
Klaus Rose, Jane M Grant-Kels, Earl B Ettienne, Oishi Tanjinatus, Pasquale Striano, David Neubauer

Children are infected with coronavirus disease 2019 (COVID-19) as often as adults, but with fewer symptoms. During the first wave of the COVID-19 pandemic, multisystem inflammatory syndrome (MIS) in children (MIS-C), with symptoms similar to Kawasaki syndrome, was described in young minors testing positive for COVID-19. The United States (US) Centers for Disease Control and Prevention (CDC) defined MIS-C as occurring in <21-year-olds, triggering hundreds of PubMed-listed papers. However, postpubertal adolescents are no longer children biologically; the term MIS-C is misleading. Furthermore, MIS also occurs in adults, termed MIS-A by the CDC. Acute and delayed inflammations can be triggered by COVID-19. The 18th birthday is an administrative not a biological age limit, whereas the body matures slowly during puberty. This blur in defining children leads to confusion regarding MIS-C/MIS-A. United States and European Union (EU) drug approval is handled separately for children, defined as <18-year-olds, ascribing non-existent physical characteristics up to the 18th birthday. This blur between the administrative and the physiological meanings for the term child is causing flawed demands for pediatric studies in all drugs and vaccines, including those against COVID-19. Effective treatment of all conditions, including COVID-19, should be based on actual physiological need. Now, the flawed definition for children in the development of drugs and vaccines and their approval is negatively impacting prevention and treatment of COVID-19 in minors. This review reveals the necessity for redefining pediatric age groups to rapidly establish recommendations for optimal prevention and treatment in minors.

儿童感染2019冠状病毒病(COVID-19)的频率与成年人一样高,但症状较少。在COVID-19大流行的第一波期间,在COVID-19检测呈阳性的年轻未成年人中发现了症状与川崎综合征相似的儿童多系统炎症综合征(MIS- c)。美国疾病控制和预防中心(CDC)将misc定义为发生在
{"title":"COVID-19 and Treatment and Immunization of Children-The Time to Redefine Pediatric Age Groups is Here.","authors":"Klaus Rose,&nbsp;Jane M Grant-Kels,&nbsp;Earl B Ettienne,&nbsp;Oishi Tanjinatus,&nbsp;Pasquale Striano,&nbsp;David Neubauer","doi":"10.5041/RMMJ.10433","DOIUrl":"https://doi.org/10.5041/RMMJ.10433","url":null,"abstract":"<p><p>Children are infected with coronavirus disease 2019 (COVID-19) as often as adults, but with fewer symptoms. During the first wave of the COVID-19 pandemic, multisystem inflammatory syndrome (MIS) in children (MIS-C), with symptoms similar to Kawasaki syndrome, was described in young minors testing positive for COVID-19. The United States (US) Centers for Disease Control and Prevention (CDC) defined MIS-C as occurring in <21-year-olds, triggering hundreds of PubMed-listed papers. However, postpubertal adolescents are no longer children biologically; the term MIS-C is misleading. Furthermore, MIS also occurs in adults, termed MIS-A by the CDC. Acute and delayed inflammations can be triggered by COVID-19. The 18th birthday is an administrative not a biological age limit, whereas the body matures slowly during puberty. This blur in defining children leads to confusion regarding MIS-C/MIS-A. United States and European Union (EU) drug approval is handled separately for children, defined as <18-year-olds, ascribing non-existent physical characteristics up to the 18th birthday. This blur between the administrative and the physiological meanings for the term child is causing flawed demands for pediatric studies in all drugs and vaccines, including those against COVID-19. Effective treatment of all conditions, including COVID-19, should be based on actual physiological need. Now, the flawed definition for children in the development of drugs and vaccines and their approval is negatively impacting prevention and treatment of COVID-19 in minors. This review reveals the necessity for redefining pediatric age groups to rapidly establish recommendations for optimal prevention and treatment in minors.</p>","PeriodicalId":46408,"journal":{"name":"Rambam Maimonides Medical Journal","volume":"12 2","pages":""},"PeriodicalIF":1.5,"publicationDate":"2021-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8092959/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25529990","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 5
Correlation of Mast Cell and Angiogenesis in Oral Lichen Planus, Dysplasia (Leukoplakia), and Oral Squamous Cell Carcinoma. 肥大细胞和血管生成在口腔扁平苔藓、发育不良(白斑)和口腔鳞状细胞癌中的相关性。
IF 1.5 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2021-04-29 DOI: 10.5041/RMMJ.10438
Amutha Sundararajan, Rajmohan Muthusamy, Kumar Gopal Siva, Prasad Harikrishnan, Sri Chinthu Kenniyan Kumar, Selva Kumar Rathinasamy

Objective: The aim of this study was to compare and correlate mast cell density (MCD) and microvessel density (MVD) between normal oral mucosa, oral lichen planus, various grades of dysplasia, and oral squamous cell carcinoma (OSCC).

Materials and methods: The study comprised a total of 75 samples, of which 65 were archival tissue blocks of histopathologically confirmed cases, which included 10 cases of oral lichen planus, 25 cases of dysplasia (mild [n=10], moderate [n=10], and severe [n=5]), and 30 cases of OSCC (well differentiated [n=10], moderately differentiated [n=10], and poorly differentiated [n=10]), and 10 samples of normal oral mucosa. All the sections were immunohistochemically stained with anti-CD34 and counterstained with toluidine blue stain. Mean MCD and MVD were determined and analyzed using ANOVA test and compared between the lesions using Tukey HSD test. Pearson's correlation coefficient test was used to correlate these two factors between various lesions.

Results: Mean MCD and mean MVD were found to be increased in all the lesions compared to normal oral mucosa, and the values were statically significant. Overall, MCD and MVD showed a significant positive correlation (r=0.640).

Conclusion: Increase of MCD and MVD and their positive correlation in all the lesions have emphasized their role in the pathogenesis and disease progression.

目的:本研究的目的是比较正常口腔黏膜、口腔扁平苔藓、不同程度的不典型增生和口腔鳞状细胞癌(OSCC)之间肥大细胞密度(MCD)和微血管密度(MVD)的相关性。材料与方法:本研究共纳入75份样本,其中65份为组织病理学确诊病例的档案组织块,其中口腔扁平苔藓10例,发育不良(轻度[n=10]、中度[n=10]、重度[n=5]) 25例,OSCC(高分化[n=10]、中分化[n=10]、低分化[n=10]) 30例,口腔正常黏膜10例。所有切片均采用抗cd34免疫组织化学染色,甲苯胺蓝反染色。平均MCD和MVD采用方差分析,病变间比较采用Tukey HSD检验。使用Pearson相关系数检验将这两个因素在不同病变之间进行相关性分析。结果:与正常口腔黏膜相比,所有病变的平均MCD和平均MVD均升高,且具有统计学意义。总体而言,MCD与MVD呈显著正相关(r=0.640)。结论:MCD和MVD的升高及其在所有病变中的正相关关系强调了它们在疾病发生和进展中的作用。
{"title":"Correlation of Mast Cell and Angiogenesis in Oral Lichen Planus, Dysplasia (Leukoplakia), and Oral Squamous Cell Carcinoma.","authors":"Amutha Sundararajan,&nbsp;Rajmohan Muthusamy,&nbsp;Kumar Gopal Siva,&nbsp;Prasad Harikrishnan,&nbsp;Sri Chinthu Kenniyan Kumar,&nbsp;Selva Kumar Rathinasamy","doi":"10.5041/RMMJ.10438","DOIUrl":"https://doi.org/10.5041/RMMJ.10438","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to compare and correlate mast cell density (MCD) and microvessel density (MVD) between normal oral mucosa, oral lichen planus, various grades of dysplasia, and oral squamous cell carcinoma (OSCC).</p><p><strong>Materials and methods: </strong>The study comprised a total of 75 samples, of which 65 were archival tissue blocks of histopathologically confirmed cases, which included 10 cases of oral lichen planus, 25 cases of dysplasia (mild [n=10], moderate [n=10], and severe [n=5]), and 30 cases of OSCC (well differentiated [n=10], moderately differentiated [n=10], and poorly differentiated [n=10]), and 10 samples of normal oral mucosa. All the sections were immunohistochemically stained with anti-CD34 and counterstained with toluidine blue stain. Mean MCD and MVD were determined and analyzed using ANOVA test and compared between the lesions using Tukey HSD test. Pearson's correlation coefficient test was used to correlate these two factors between various lesions.</p><p><strong>Results: </strong>Mean MCD and mean MVD were found to be increased in all the lesions compared to normal oral mucosa, and the values were statically significant. Overall, MCD and MVD showed a significant positive correlation (r=0.640).</p><p><strong>Conclusion: </strong>Increase of MCD and MVD and their positive correlation in all the lesions have emphasized their role in the pathogenesis and disease progression.</p>","PeriodicalId":46408,"journal":{"name":"Rambam Maimonides Medical Journal","volume":"12 2","pages":""},"PeriodicalIF":1.5,"publicationDate":"2021-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8092953/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38862323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 6
Career Trajectory of Physicians Following a Fellowship Program: A Descriptive Study. 医师进修计划后的职业轨迹:一项描述性研究。
IF 1.5 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2021-04-29 DOI: 10.5041/RMMJ.10432
Gidon Berger, Danny Epstein, Galit Kobi, Eyal Braun, Zaher S Azzam, Michael Halberthal

Introduction: A clinical and/or research fellowship abroad has become a prevalent choice among Israeli physicians. However, the influence of fellowship programs on the career path is unclear. We evaluated the role of physicians returning from fellowship in the organizational hierarchy and their professional and academic status.

Methods: This was a retrospective, descriptive, cross-sectional study of physicians who completed a survey after accomplishing a fellowship. The survey included questions about the physicians' attitudes toward the program, programs' details, and the physicians' current academic, professional, and administrative status. Information about scientific publications was also collected.

Results: Of the 106 physicians receiving the questionnaire, 101 responded. The majority completed a two-year fellowship in North America. Forty percent participated in an integrated program (research and clinical), and 40% participated in clinical programs. Subjectively, the physicians attributed a significant value to the fellowship and positively recommend it. Most of the physicians held managerial positions, academic appointments, and had generated significant research.

Discussion: The subjective perspective of all physicians participating in the study was that attending a fellowship program had a positive impact on their careers. Objectively, the accomplishment of a fellowship program empowered the studied physicians to become scholars, senior executives, and opinion leaders in their professional field.

简介:临床和/或研究奖学金出国已成为以色列医生的普遍选择。然而,奖学金项目对职业道路的影响尚不清楚。我们评估了从奖学金归来的医生在组织层级中的作用以及他们的专业和学术地位。方法:这是一项回顾性、描述性、横断面研究,研究对象是在获得奖学金后完成调查的医生。调查的问题包括医生对项目的态度、项目的细节、医生目前的学术、专业和管理状况。还收集了有关科学出版物的信息。结果:106名接受问卷调查的医生中,有101人回复了问卷。其中大多数人在北美完成了为期两年的研究。40%的人参加了综合项目(研究和临床),40%的人参加了临床项目。主观上,医生认为该奖学金具有重要价值,并积极推荐。大多数医生担任管理职位,学术任命,并产生了重要的研究。讨论:所有参与研究的医生的主观观点是,参加奖学金项目对他们的职业生涯有积极的影响。客观地说,奖学金项目的完成使学习的医生成为他们专业领域的学者、高级管理人员和意见领袖。
{"title":"Career Trajectory of Physicians Following a Fellowship Program: A Descriptive Study.","authors":"Gidon Berger,&nbsp;Danny Epstein,&nbsp;Galit Kobi,&nbsp;Eyal Braun,&nbsp;Zaher S Azzam,&nbsp;Michael Halberthal","doi":"10.5041/RMMJ.10432","DOIUrl":"https://doi.org/10.5041/RMMJ.10432","url":null,"abstract":"<p><strong>Introduction: </strong>A clinical and/or research fellowship abroad has become a prevalent choice among Israeli physicians. However, the influence of fellowship programs on the career path is unclear. We evaluated the role of physicians returning from fellowship in the organizational hierarchy and their professional and academic status.</p><p><strong>Methods: </strong>This was a retrospective, descriptive, cross-sectional study of physicians who completed a survey after accomplishing a fellowship. The survey included questions about the physicians' attitudes toward the program, programs' details, and the physicians' current academic, professional, and administrative status. Information about scientific publications was also collected.</p><p><strong>Results: </strong>Of the 106 physicians receiving the questionnaire, 101 responded. The majority completed a two-year fellowship in North America. Forty percent participated in an integrated program (research and clinical), and 40% participated in clinical programs. Subjectively, the physicians attributed a significant value to the fellowship and positively recommend it. Most of the physicians held managerial positions, academic appointments, and had generated significant research.</p><p><strong>Discussion: </strong>The subjective perspective of all physicians participating in the study was that attending a fellowship program had a positive impact on their careers. Objectively, the accomplishment of a fellowship program empowered the studied physicians to become scholars, senior executives, and opinion leaders in their professional field.</p>","PeriodicalId":46408,"journal":{"name":"Rambam Maimonides Medical Journal","volume":"12 2","pages":""},"PeriodicalIF":1.5,"publicationDate":"2021-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8092956/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25361356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Coping with the Challenges of COVID-19 Using the Sociotype Framework: A Rehearsal for the Next Pandemic. 利用社会类型框架应对COVID-19的挑战:下一次大流行的预演。
IF 1.5 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2021-01-19 DOI: 10.5041/RMMJ.10425
Wen Peng, Elliot M Berry

The world, as a global village, is currently taking part in a real-time public health, medical, socio-cultural, and economic experiment on how best to combat the COVID-19 pandemic. Extraordinary times demand extraordinary measures. Depending on the time from the outbreak, strategies have ranged from minimal intervention to mitigation by quarantine for high-risk groups (elderly with chronic illnesses) to containment and lockdown. Adherence to such restrictions have depended on the individual and national psyche and culture. One can understand and forgive governments for being over-cautious, but not for being ill-prepared. It seems that Singapore after SARS (2003) and South Korea after MERS (2015) learnt from their experiences and have fared relatively well with minimal disruption to daily routines. Coping with the challenge of COVID-19 is an urgent global task. We use the Sociotype ecological framework to analyze different coping responses at three levels: Context (government and leadership, social context, health services, and media); Relationships; and the Individual. We describe the many negative outcomes (e.g. mortality [obviously], unemployment, economic damage, food insecurity, threat to democracy, claustrophobia) and the positive ones (e.g. new, remote teaching, working, and medical routines; social bonding and solidarity; redefining existential values and priorities) of this surreal situation, which is still evolving. We highlight the importance of humor in stress reduction. Regular and reliable communication to the public has to be improved, acknowledging incomplete data, and learning to deal with fake news, misinformation, and conspiracy theories. Excess mortality is the preferred statistic to follow and compare outcomes. When the health risks are over, the economic recovery responses will vary according to the financial state of countries. If world order is to be reshaped, then a massive economic aid plan should be launched by the rich countries-akin to the Marshall plan after the Second World War. It should be led preferably by the USA and China. The results of the tradeoffs between health and economic lockdowns will only become apparent in the months to come. The experiences and lessons learned from this emergency should be used as a rehearsal for the next epi-/pandemic, which will surely take place in the foreseeable future.

作为一个地球村,世界目前正在参与一场关于如何最好地抗击COVID-19大流行的实时公共卫生、医疗、社会文化和经济实验。非常时期需要非常措施。根据疫情爆发的时间,采取的策略包括从最低限度的干预到通过隔离高危人群(患有慢性病的老年人)来缓解疫情,再到遏制和封锁。遵守这些限制取决于个人和国家的心理和文化。人们可以理解并原谅政府的过度谨慎,但不能原谅政府的准备不足。非典(2003)后的新加坡和MERS(2015)后的韩国似乎吸取了经验教训,并在日常生活受到最小干扰的情况下表现得相对较好。应对新冠肺炎疫情挑战是一项紧迫的全球性任务。我们使用社会类型生态框架从三个层面分析不同的应对反应:环境(政府和领导、社会环境、卫生服务和媒体);关系;和个人。我们描述了许多消极的结果(例如死亡率[显然],失业,经济损失,粮食不安全,对民主的威胁,幽闭恐惧症)和积极的结果(例如新的,远程教学,工作和医疗程序;社会联系和团结;重新定义存在的价值和优先事项),这种超现实的情况仍在演变。我们强调幽默在减压中的重要性。必须改善与公众定期和可靠的沟通,承认数据不完整,并学会处理假新闻、错误信息和阴谋论。超额死亡率是跟踪和比较结果的首选统计数据。当健康风险结束后,经济复苏对策将根据各国的财政状况而有所不同。如果要重塑世界秩序,那么富国就应该启动一项大规模的经济援助计划——类似于二战后的马歇尔计划。最好由美国和中国领导。在健康和经济封锁之间权衡的结果只会在未来几个月显现出来。从这次紧急情况中吸取的经验和教训应被用作下一次扩大/大流行的预演,而下一次大流行肯定会在可预见的将来发生。
{"title":"Coping with the Challenges of COVID-19 Using the Sociotype Framework: A Rehearsal for the Next Pandemic.","authors":"Wen Peng, Elliot M Berry","doi":"10.5041/RMMJ.10425","DOIUrl":"10.5041/RMMJ.10425","url":null,"abstract":"<p><p>The world, as a global village, is currently taking part in a real-time public health, medical, socio-cultural, and economic experiment on how best to combat the COVID-19 pandemic. Extraordinary times demand extraordinary measures. Depending on the time from the outbreak, strategies have ranged from minimal intervention to mitigation by quarantine for high-risk groups (elderly with chronic illnesses) to containment and lockdown. Adherence to such restrictions have depended on the individual and national psyche and culture. One can understand and forgive governments for being over-cautious, but not for being ill-prepared. It seems that Singapore after SARS (2003) and South Korea after MERS (2015) learnt from their experiences and have fared relatively well with minimal disruption to daily routines. Coping with the challenge of COVID-19 is an urgent global task. We use the Sociotype ecological framework to analyze different coping responses at three levels: Context (government and leadership, social context, health services, and media); Relationships; and the Individual. We describe the many negative outcomes (e.g. mortality [obviously], unemployment, economic damage, food insecurity, threat to democracy, claustrophobia) and the positive ones (e.g. new, remote teaching, working, and medical routines; social bonding and solidarity; redefining existential values and priorities) of this surreal situation, which is still evolving. We highlight the importance of humor in stress reduction. Regular and reliable communication to the public has to be improved, acknowledging incomplete data, and learning to deal with fake news, misinformation, and conspiracy theories. Excess mortality is the preferred statistic to follow and compare outcomes. When the health risks are over, the economic recovery responses will vary according to the financial state of countries. If world order is to be reshaped, then a massive economic aid plan should be launched by the rich countries-akin to the Marshall plan after the Second World War. It should be led preferably by the USA and China. The results of the tradeoffs between health and economic lockdowns will only become apparent in the months to come. The experiences and lessons learned from this emergency should be used as a rehearsal for the next epi-/pandemic, which will surely take place in the foreseeable future.</p>","PeriodicalId":46408,"journal":{"name":"Rambam Maimonides Medical Journal","volume":"12 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2021-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7835120/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38627413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 9
Is There a Role for Bismuth in Diarrhea Management? 铋在腹泻治疗中有作用吗?
IF 1.5 Q2 MEDICINE, GENERAL & INTERNAL Pub Date : 2021-01-19 DOI: 10.5041/RMMJ.10422
Helen Senderovich, Megan Vierhout

Diarrhea, an illness of both the developed and developing world, involves the burdensome characteristics of frequent bowel movements, loose stools, and abdominal discomfort. Diarrhea is a long-standing challenge in palliative care and can have a myriad of causes, making symptomatic treatment pertinent when illness evaluation is ongoing, when there is no definitive treatment approach, or when effective treatment cannot be attained. Symptomatic therapy is a common approach in palliative care settings. Bismuth is a suitable agent for symptomatic therapy and can be effectively employed for management of chronic diarrhea. The objective of this narrative review is to examine the role of bismuth in management of diarrheal symptoms. To explore this, PubMed (including Medline) and Embase were used to search the existing literature on bismuth and diarrhea published from 1980 to 2019. It was found that bismuth has potential utility for diarrheal relief in multiple settings, including microscopic colitis, traveler's diarrhea, gastrointestinal infection, cancer, and chemotherapy. It also has great potential for use in palliative care patients, due to its minimal side effects. Overall, the antisecretory, anti-inflammatory, and antibacterial properties of bismuth make it a suitable therapy for symptomatic treatment of diarrhea. The limited range of adverse side effects makes it an appealing option for patients with numerous comorbidities. Healthcare providers can explore bismuth as an adjunct therapy for diarrhea management in an array of conditions, especially in the palliative care setting.

腹泻是一种发达国家和发展中国家都有的疾病,其特点是排便频繁、稀便和腹部不适。腹泻是姑息治疗中的一个长期挑战,可能有多种原因,因此在进行疾病评估、没有明确的治疗方法或无法获得有效治疗时,对症治疗是有必要的。对症治疗是姑息治疗设置的常见方法。铋是一种适合对症治疗的药物,可以有效地用于慢性腹泻的治疗。这篇叙述性综述的目的是研究铋在腹泻症状治疗中的作用。为了探讨这一点,我们使用PubMed(包括Medline)和Embase检索了1980 - 2019年发表的关于铋与腹泻的现有文献。研究发现,铋对多种情况下的腹泻有潜在的缓解作用,包括显微镜下的结肠炎、旅行者腹泻、胃肠道感染、癌症和化疗。由于副作用很小,它在姑息治疗患者中也有很大的潜力。总的来说,铋的抗分泌、抗炎和抗菌特性使其成为对症治疗腹泻的合适疗法。有限的不良副作用使其成为许多合并症患者的一个有吸引力的选择。医疗保健提供者可以探索铋作为一种辅助治疗腹泻管理在一系列条件下,特别是在姑息治疗设置。
{"title":"Is There a Role for Bismuth in Diarrhea Management?","authors":"Helen Senderovich, Megan Vierhout","doi":"10.5041/RMMJ.10422","DOIUrl":"10.5041/RMMJ.10422","url":null,"abstract":"<p><p>Diarrhea, an illness of both the developed and developing world, involves the burdensome characteristics of frequent bowel movements, loose stools, and abdominal discomfort. Diarrhea is a long-standing challenge in palliative care and can have a myriad of causes, making symptomatic treatment pertinent when illness evaluation is ongoing, when there is no definitive treatment approach, or when effective treatment cannot be attained. Symptomatic therapy is a common approach in palliative care settings. Bismuth is a suitable agent for symptomatic therapy and can be effectively employed for management of chronic diarrhea. The objective of this narrative review is to examine the role of bismuth in management of diarrheal symptoms. To explore this, PubMed (including Medline) and Embase were used to search the existing literature on bismuth and diarrhea published from 1980 to 2019. It was found that bismuth has potential utility for diarrheal relief in multiple settings, including microscopic colitis, traveler's diarrhea, gastrointestinal infection, cancer, and chemotherapy. It also has great potential for use in palliative care patients, due to its minimal side effects. Overall, the antisecretory, anti-inflammatory, and antibacterial properties of bismuth make it a suitable therapy for symptomatic treatment of diarrhea. The limited range of adverse side effects makes it an appealing option for patients with numerous comorbidities. Healthcare providers can explore bismuth as an adjunct therapy for diarrhea management in an array of conditions, especially in the palliative care setting.</p>","PeriodicalId":46408,"journal":{"name":"Rambam Maimonides Medical Journal","volume":"12 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2021-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7835118/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38495175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
期刊
Rambam Maimonides Medical Journal
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1