Pub Date : 2020-09-15DOI: 10.21203/rs.3.rs-73562/v1
Bilisuma Mulatu, Y. Michael, S. Alemu, W. R. Demissie
Background: Thyroid cancer is the most common malignant disease of endocrine system and its incidence is rapidly increasing globally (about three to four times higher among females and accounts the sixth most common malignancy diagnosed in women). Among the four major types of thyroid cancer, papillary thyroid cancer (PTC) accounts 85-90% from all thyroid cases, followed by follicular thyroid cancer (FTC) which accounts for 5-10% of cases.Materials and Methods: A retrospective data of 260 patients who underwent thyroid surgery from 2015 to 2019 were included in the study and the status of the disease (clinical manifestations, laboratory/pathology findings (thyroid function tests (TFTs) and biopsy) were reviewed from patient cards. The pattern of thyroid cancer was discriminated based on histo-pathological biopsy result. Descriptive and analytical statistics were applied to express the finding and reported by tables, figures and narration. Cross tabulation and logistic regression was applied to determine the association between thyroid CA and predictors. A p-value of <0.05 was declared as statistically significant. Results: From the total sample of 260 patients underwent thyroid surgery, majority of them were females 219(84.2%), belong to age interval of 31-40 years (34.6%), dwellers of Oromia region (91.2%) and Jimma zone (83.8%). Colloid goiter was the most prevalent (74.6%) pattern of thyroid disease followed by follicular CA (4.2%), papillary CA (1.9%) and medullary CA (0.77%) while biopsy results of 48(18.46%) patients were not known. In general, about the 194(91.5%) of the thyroid lesion was identified as benign type and malignancy accounts for 18(8.5%) from the total conducted biopsy results of 212 patients. About six variables (duration of the disease, marital status, family history of the disease, nodularity, surface and border of the thyroid mass) were the candidate variables in binary logistic regression (p-value <0.25) and finally, three variables (duration of the disease (>10 years), surface (rough) and border (irregular) of the thyroid mass) were identified as the predictors of thyroid malignancy with AOR 0.05(0.004-0.60, P-v=0.016; 1.9(1.17-5.8), P-v=0.012 and 2.5(1.13-16.16), P-v<0.001 respectively.Conclusion and recommendation: The burden of malignancy was higher and alarming among thyroid diseases and warrants early screening and management.
{"title":"Pattern of Thyroid Cancer and Its Associated Factors Among Thyroid Patients Underwent Thyroidectomy at Jimma Medical Center, Southwest Ethiopia; A Four Years Retrospective Review","authors":"Bilisuma Mulatu, Y. Michael, S. Alemu, W. R. Demissie","doi":"10.21203/rs.3.rs-73562/v1","DOIUrl":"https://doi.org/10.21203/rs.3.rs-73562/v1","url":null,"abstract":"\u0000 Background: Thyroid cancer is the most common malignant disease of endocrine system and its incidence is rapidly increasing globally (about three to four times higher among females and accounts the sixth most common malignancy diagnosed in women). Among the four major types of thyroid cancer, papillary thyroid cancer (PTC) accounts 85-90% from all thyroid cases, followed by follicular thyroid cancer (FTC) which accounts for 5-10% of cases.Materials and Methods: A retrospective data of 260 patients who underwent thyroid surgery from 2015 to 2019 were included in the study and the status of the disease (clinical manifestations, laboratory/pathology findings (thyroid function tests (TFTs) and biopsy) were reviewed from patient cards. The pattern of thyroid cancer was discriminated based on histo-pathological biopsy result. Descriptive and analytical statistics were applied to express the finding and reported by tables, figures and narration. Cross tabulation and logistic regression was applied to determine the association between thyroid CA and predictors. A p-value of <0.05 was declared as statistically significant. Results: From the total sample of 260 patients underwent thyroid surgery, majority of them were females 219(84.2%), belong to age interval of 31-40 years (34.6%), dwellers of Oromia region (91.2%) and Jimma zone (83.8%). Colloid goiter was the most prevalent (74.6%) pattern of thyroid disease followed by follicular CA (4.2%), papillary CA (1.9%) and medullary CA (0.77%) while biopsy results of 48(18.46%) patients were not known. In general, about the 194(91.5%) of the thyroid lesion was identified as benign type and malignancy accounts for 18(8.5%) from the total conducted biopsy results of 212 patients. About six variables (duration of the disease, marital status, family history of the disease, nodularity, surface and border of the thyroid mass) were the candidate variables in binary logistic regression (p-value <0.25) and finally, three variables (duration of the disease (>10 years), surface (rough) and border (irregular) of the thyroid mass) were identified as the predictors of thyroid malignancy with AOR 0.05(0.004-0.60, P-v=0.016; 1.9(1.17-5.8), P-v=0.012 and 2.5(1.13-16.16), P-v<0.001 respectively.Conclusion and recommendation: The burden of malignancy was higher and alarming among thyroid diseases and warrants early screening and management.","PeriodicalId":91371,"journal":{"name":"Open medicine journal","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48709513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abernethy malformation is a kind of congenital malformation of the portal vein system caused by abnormal portacaval shunts. It can be in combination with many other congenital malformations. There has been a limited number of patients since the first patient was reported, leading to limited knowledge of this kind of disease. In August 2018, we treated a patient diagnosed with type II Abernethy malformation complicated with both congenital polydactyly and enlargement of all cardiac chambers, which is extremely rare and can be supplementary to the existing cases. According to a comprehensive and adequate assessment of patients' condition, we treated him with oral silybin (70 mg every time and 3 times a day) for 3 months, and advised him to make follow-up visits. At the latest follow-up, we knew the health condition of this patient was generally satisfactory, whether in terms of laboratory test results or his daily life experience. Although the major therapy for Abernethy malformation is surgery, this case suggests that simple conservative treatment with regular follow-up visits can be suitable for certain patients.
{"title":"A Case Report: Type II Abernethy Malformation Complicated with Congenital Polydactyly and Enlargement of all Cardiac Chambers","authors":"Cheng Zhu, Min Wang, Qian Hao","doi":"10.21203/rs.2.18514/v1","DOIUrl":"https://doi.org/10.21203/rs.2.18514/v1","url":null,"abstract":"\u0000 \u0000 Abernethy malformation is a kind of congenital malformation of the portal vein system caused by abnormal portacaval shunts. It can be in combination with many other congenital malformations. There has been a limited number of patients since the first patient was reported, leading to limited knowledge of this kind of disease.\u0000 \u0000 \u0000 \u0000 In August 2018, we treated a patient diagnosed with type II Abernethy malformation complicated with both congenital polydactyly and enlargement of all cardiac chambers, which is extremely rare and can be supplementary to the existing cases. According to a comprehensive and adequate assessment of patients' condition, we treated him with oral silybin (70 mg every time and 3 times a day) for 3 months, and advised him to make follow-up visits.\u0000 \u0000 \u0000 \u0000 At the latest follow-up, we knew the health condition of this patient was generally satisfactory, whether in terms of laboratory test results or his daily life experience.\u0000 \u0000 \u0000 \u0000 Although the major therapy for Abernethy malformation is surgery, this case suggests that simple conservative treatment with regular follow-up visits can be suitable for certain patients.\u0000","PeriodicalId":91371,"journal":{"name":"Open medicine journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45052363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-11-08DOI: 10.2174/1874220301603010083
Zeineb Tbini, M. Mars, M. Chelli
The purpose of this study was to compare T1 and T2 relaxation times of normal and pathologic Achilles Tendon (AT) in order to evaluate the ability of these methods to detect early Achilles tendon tendinosis. Forty-eight subjects were included in this study. Twenty-two subjects were classified as normal group and twenty-six subjects as patient group with tendinosis. MR examination was performed by 3 Tesla scanner using a 12 channel head coil. For relaxation times quantification, we used a sagittal 3D FLASH variable flip angle gradient echo UTE sequence (3D VFA-GE UTE) for T1 mapping and a sagittal Multi Echo Spin Echo sequence (MESE) for T2 mapping. Relaxation times were quantified using two different algorithms written in MATLAB. P value < 0.05 was considered statistically significant. Our results showed a statistically significant difference in T1 and T2 values for the normal group compared to the patient group (p<0.05). Mean values of T1 and T2 were 571.69 ms and 24.16 ms for the normal group and 818.10 ms and 32.43 ms for the patient group, respectively. Results reported no correlation (r=0.193) for T1 mapping and a positive significant moderate correlation (r=0.542, p=0.000) for T2 mapping between the normal and patient groups. T1 and T2 showed no correlation in the normal group (r= 0.091, p=0.489) and a positive significant weak correlation in the patient group (r=0.263, p=0.048). We concluded that T1 and T2 relaxation times are relatively sensitive to diagnosis degenerative changes in the AT and T1 is more sensitive to AT tendinosis compared to T2.
{"title":"T1 and T2 Mappings in the Early Diagnosis of Achilles Tendinosis","authors":"Zeineb Tbini, M. Mars, M. Chelli","doi":"10.2174/1874220301603010083","DOIUrl":"https://doi.org/10.2174/1874220301603010083","url":null,"abstract":"\u0000 \u0000 The purpose of this study was to compare T1 and T2 relaxation times of normal and pathologic Achilles Tendon (AT) in order to evaluate the ability of these methods to detect early Achilles tendon tendinosis.\u0000 \u0000 \u0000 \u0000 Forty-eight subjects were included in this study. Twenty-two subjects were classified as normal group and twenty-six subjects as patient group with tendinosis. MR examination was performed by 3 Tesla scanner using a 12 channel head coil. For relaxation times quantification, we used a sagittal 3D FLASH variable flip angle gradient echo UTE sequence (3D VFA-GE UTE) for T1 mapping and a sagittal Multi Echo Spin Echo sequence (MESE) for T2 mapping. Relaxation times were quantified using two different algorithms written in MATLAB. P value < 0.05 was considered statistically significant.\u0000 \u0000 \u0000 \u0000 Our results showed a statistically significant difference in T1 and T2 values for the normal group compared to the patient group (p<0.05). Mean values of T1 and T2 were 571.69 ms and 24.16 ms for the normal group and 818.10 ms and 32.43 ms for the patient group, respectively. Results reported no correlation (r=0.193) for T1 mapping and a positive significant moderate correlation (r=0.542, p=0.000) for T2 mapping between the normal and patient groups. T1 and T2 showed no correlation in the normal group (r= 0.091, p=0.489) and a positive significant weak correlation in the patient group (r=0.263, p=0.048).\u0000 \u0000 \u0000 \u0000 We concluded that T1 and T2 relaxation times are relatively sensitive to diagnosis degenerative changes in the AT and T1 is more sensitive to AT tendinosis compared to T2.\u0000","PeriodicalId":91371,"journal":{"name":"Open medicine journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43623218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-30DOI: 10.2174/1874220301906010064
P. Wal, Nikita Saraswat, R. Pal, A. Wal, Madhvi Chaubey
Curcumin is an active constituent ofCurcuma longa,which belongs to Zingiberaceae family. It is derived from the Rhizome of a perennial plant having molecular formula C21H20O6and chemically it is (1, 7- bis (4- hydroxy - 3 methoxyphenyl) -1, 6 - heptadine - 3, 5 - diene), also known as diferuloylmethane. Curcumin has been extensively used as a herbal constituent for curing several diseases and is scientifically proven to show major effects as an anti-inflammatory agent.Inflammation is an important factor for numerous diseases including diabetes neuropathy, cancer, asthma, arthritis, and other diseases. Prophylaxis of inflammatory diseases through synthetic medications tends to have major toxicity and side effects on a large number of population. The foremost aim of this review paper is to assess the natural anti-inflammatory effect of curcumin, source, and mechanism of action, potential therapeutic effect and models associated. Additionally, this paper aims to scrutinize inflammation, sources of reactive oxygen species, and pathways of reactive oxygen species generation and potential side effects of curcumin.Selection of data has been done by studying the combination of research and review papers from different databases like PubMed, Medline and Web of science from the year 1985- 2018 by using search keywords like “curcumin”, “anti-inflammatory”, “ROS”, “Curcuma longa”, “medicinal uses of curcumin”, “assessing parameters”, “inflammation”, “anti-oxidant”On the basis of our interpretation, we have concluded that curcumin has potential therapeutic effects in different inflammatory diseases, it inhibits the inflammatory mediators, oxidation processes, and oxidative stress and has no severe toxicity on animals and humans.Oxidative stress is a major cause of inflammation and curcumin has a good potential for blocking it. Curcumin is also easily accessible herbal source and should be consumed in the form of food, antioxidant, anti-inflammatory agents and further observation should be done on its therapeutic parameters, risk factors, and toxicity studies and oral viability.
姜黄素是姜科姜黄属植物姜黄的一种有效成分。它是从多年生植物的根茎中提取的，分子式为c21h20o6，化学上是(1,7 -二(4-羟基- 3甲氧基苯基)- 1,6 -庚啶- 3,5 -二烯)，也称为二苯基甲烷。姜黄素作为一种草药成分被广泛用于治疗多种疾病，并被科学证明是一种抗炎剂。炎症是许多疾病的重要因素，包括糖尿病、神经病变、癌症、哮喘、关节炎和其他疾病。通过合成药物预防炎症性疾病往往会对大量人群产生严重的毒副作用。本文就姜黄素的天然抗炎作用、来源、作用机制、潜在治疗效果及相关模型进行综述。此外，本文旨在探讨姜黄素的炎症、活性氧的来源、活性氧的产生途径和潜在的副作用。通过检索关键词“姜黄素”、“抗炎”、“活性氧”、“长姜黄”、“姜黄素的药用用途”、“评估参数”、“炎症”、“抗氧化”等，结合PubMed、Medline和Web of science等不同数据库1985- 2018年的研究和综述论文进行数据选择，得出姜黄素对不同炎症性疾病具有潜在治疗作用的结论。它能抑制炎症介质、氧化过程和氧化应激，对动物和人类没有严重的毒性。氧化应激是炎症的主要原因，而姜黄素有很好的阻止氧化应激的潜力。姜黄素也是一种很容易获得的草药来源，应该以食物，抗氧化剂，抗炎剂的形式食用，应该进一步观察其治疗参数，风险因素，毒性研究和口服可行性。
{"title":"A Detailed Insight of the Anti-inflammatory Effects of Curcumin with the Assessment of Parameters, Sources of ROS and Associated Mechanisms","authors":"P. Wal, Nikita Saraswat, R. Pal, A. Wal, Madhvi Chaubey","doi":"10.2174/1874220301906010064","DOIUrl":"https://doi.org/10.2174/1874220301906010064","url":null,"abstract":"Curcumin is an active constituent ofCurcuma longa,which belongs to Zingiberaceae family. It is derived from the Rhizome of a perennial plant having molecular formula C21H20O6and chemically it is (1, 7- bis (4- hydroxy - 3 methoxyphenyl) -1, 6 - heptadine - 3, 5 - diene), also known as diferuloylmethane. Curcumin has been extensively used as a herbal constituent for curing several diseases and is scientifically proven to show major effects as an anti-inflammatory agent.Inflammation is an important factor for numerous diseases including diabetes neuropathy, cancer, asthma, arthritis, and other diseases. Prophylaxis of inflammatory diseases through synthetic medications tends to have major toxicity and side effects on a large number of population. The foremost aim of this review paper is to assess the natural anti-inflammatory effect of curcumin, source, and mechanism of action, potential therapeutic effect and models associated. Additionally, this paper aims to scrutinize inflammation, sources of reactive oxygen species, and pathways of reactive oxygen species generation and potential side effects of curcumin.Selection of data has been done by studying the combination of research and review papers from different databases like PubMed, Medline and Web of science from the year 1985- 2018 by using search keywords like “curcumin”, “anti-inflammatory”, “ROS”, “Curcuma longa”, “medicinal uses of curcumin”, “assessing parameters”, “inflammation”, “anti-oxidant”On the basis of our interpretation, we have concluded that curcumin has potential therapeutic effects in different inflammatory diseases, it inhibits the inflammatory mediators, oxidation processes, and oxidative stress and has no severe toxicity on animals and humans.Oxidative stress is a major cause of inflammation and curcumin has a good potential for blocking it. Curcumin is also easily accessible herbal source and should be consumed in the form of food, antioxidant, anti-inflammatory agents and further observation should be done on its therapeutic parameters, risk factors, and toxicity studies and oral viability.","PeriodicalId":91371,"journal":{"name":"Open medicine journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43951670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-09-30DOI: 10.2174/1874220301603010077
S. Kheirouri, M. Alizadeh, P. Sarbakhsh
Preterm birth is an important contributor to the global burden of disease. Evidence indicating that maternal health, nutritional and socioeconomic status may contribute to preterm birth. This cross-sectional study was conducted to describe the contribution of prenatal maternal factors on low gestational age, and to assess newborns anthropometric measurements regarding gestational age. Data of mothers delivering a singleton live infant (n= 759) and their newborns (n= 755) during the two years up to August 2014 were collected. Data were collected from the data set of eight public health centers which were chosen from different administrative regions of Tabriz city and were analyzed. Differences between the groups were assessed by Student’s t-test or one- way analysis of variance (ANOVA). Multiple linear regression was used to estimate the association between gestational age and variables studied. Incidence of preterm birth was 2.1%. Percentage of infants with low birth weight and Head Circumference (HC) under 34 cm was significantly higher in the preterm group. Mean gestational age was lower in mothers with cesarean delivery, high education, high economic status, high BMI, pre-pregnancy weight ≥ 65 kg and medical problem. Gestational age was inversely associated with maternal pre-pregnancy weight ≥ 65 kg (B= -0.20, p= 0.02), high BMI (B= -0.33, p= 0.01), high education (B= -0.47, p= 0.002) and cesarean delivery (B= -0.74, p< 0.001). The results indicate that maternal anthropometric characteristics, education and type of delivery are associated with gestational age. Explorating potentially modifiable risk factors for unfavorable gestational age and integrating them into intervention efforts may ameliorate adverse birth outcomes.
{"title":"Maternal Prenatal Anthropometry, High Education and Cesarean Delivery as Risk Factors for Low Gestational Age in Iran","authors":"S. Kheirouri, M. Alizadeh, P. Sarbakhsh","doi":"10.2174/1874220301603010077","DOIUrl":"https://doi.org/10.2174/1874220301603010077","url":null,"abstract":"\u0000 \u0000 Preterm birth is an important contributor to the global burden of disease. Evidence indicating that maternal health, nutritional and socioeconomic status may contribute to preterm birth.\u0000 \u0000 \u0000 \u0000 This cross-sectional study was conducted to describe the contribution of prenatal maternal factors on low gestational age, and to assess newborns anthropometric measurements regarding gestational age.\u0000 \u0000 \u0000 \u0000 Data of mothers delivering a singleton live infant (n= 759) and their newborns (n= 755) during the two years up to August 2014 were collected. Data were collected from the data set of eight public health centers which were chosen from different administrative regions of Tabriz city and were analyzed. Differences between the groups were assessed by Student’s t-test or one- way analysis of variance (ANOVA). Multiple linear regression was used to estimate the association between gestational age and variables studied.\u0000 \u0000 \u0000 \u0000 Incidence of preterm birth was 2.1%. Percentage of infants with low birth weight and Head Circumference (HC) under 34 cm was significantly higher in the preterm group. Mean gestational age was lower in mothers with cesarean delivery, high education, high economic status, high BMI, pre-pregnancy weight ≥ 65 kg and medical problem. Gestational age was inversely associated with maternal pre-pregnancy weight ≥ 65 kg (B= -0.20, p= 0.02), high BMI (B= -0.33, p= 0.01), high education (B= -0.47, p= 0.002) and cesarean delivery (B= -0.74, p< 0.001).\u0000 \u0000 \u0000 \u0000 The results indicate that maternal anthropometric characteristics, education and type of delivery are associated with gestational age. Explorating potentially modifiable risk factors for unfavorable gestational age and integrating them into intervention efforts may ameliorate adverse birth outcomes.\u0000","PeriodicalId":91371,"journal":{"name":"Open medicine journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45003067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-08-30DOI: 10.2174/1874220301906010058
Augustė Ragelytė, Gabrielė Rudokaitė, D. Žaliaduonytė-Pekšienė, V. Zabiela
Atrial fibrillation (AF) is a major risk factor for ischemic stroke. It is important to verify the effect of AF on the outcomes of stroke. To compare stroke severity and outcomes regarding stroke victims with and without AF. Analysis of the medical data (including age, sex, stroke type, localization, treatment method, severity and outcomes of the stroke (according to the National Institutes of Health Stroke Scale (NIHSS) score, Barthel index score, death), antithrombotic treatment) of 200 stroke patients (100 with AF, 100 without AF). Patients with AF were older than non-AF patients (76.19 ± 9.4 vs. 66.99 ± 11.7, p<0.001), there were more women among them (63 vs. 39, p=0.01). 53 patients with AF had used anticoagulants (AC) before stroke (most of them were used ineffectively), 99 had had indications to use them. The distribution of the type of the stroke did not differ significantly between groups. AF patients had stroke in the area of the brain supplied by the carotid artery more often (95% vs. 78%, p<0.001). Initial stroke severity (p=0.006), NIHSS after thrombolysis (p=0.008), NIHSS 7 days after thrombolysis (p=0.01) was higher in AF patients; Barthel index score (p=0.194) and mortality (p=0.323) did not differ. Patients with AF experienced more severe strokes and presented higher neurologic deficits than patients without this condition. Nevertheless, the mortality and patients' final functional status did not differ. AC usage in patients with AF did not alleviate neurologic deficits and stroke outcomes possibly due to their insufficient usage.
{"title":"Stroke Severity and Outcomes in Patients with and without Atrial Fibrillation","authors":"Augustė Ragelytė, Gabrielė Rudokaitė, D. Žaliaduonytė-Pekšienė, V. Zabiela","doi":"10.2174/1874220301906010058","DOIUrl":"https://doi.org/10.2174/1874220301906010058","url":null,"abstract":"\u0000 \u0000 Atrial fibrillation (AF) is a major risk factor for ischemic stroke. It is important to verify the effect of AF on the outcomes of stroke.\u0000 \u0000 \u0000 \u0000 To compare stroke severity and outcomes regarding stroke victims with and without AF.\u0000 \u0000 \u0000 \u0000 Analysis of the medical data (including age, sex, stroke type, localization, treatment method, severity and outcomes of the stroke (according to the National Institutes of Health Stroke Scale (NIHSS) score, Barthel index score, death), antithrombotic treatment) of 200 stroke patients (100 with AF, 100 without AF).\u0000 \u0000 \u0000 \u0000 Patients with AF were older than non-AF patients (76.19 ± 9.4 vs. 66.99 ± 11.7, p<0.001), there were more women among them (63 vs. 39, p=0.01). 53 patients with AF had used anticoagulants (AC) before stroke (most of them were used ineffectively), 99 had had indications to use them. The distribution of the type of the stroke did not differ significantly between groups. AF patients had stroke in the area of the brain supplied by the carotid artery more often (95% vs. 78%, p<0.001). Initial stroke severity (p=0.006), NIHSS after thrombolysis (p=0.008), NIHSS 7 days after thrombolysis (p=0.01) was higher in AF patients; Barthel index score (p=0.194) and mortality (p=0.323) did not differ.\u0000 \u0000 \u0000 \u0000 Patients with AF experienced more severe strokes and presented higher neurologic deficits than patients without this condition. Nevertheless, the mortality and patients' final functional status did not differ. AC usage in patients with AF did not alleviate neurologic deficits and stroke outcomes possibly due to their insufficient usage.\u0000","PeriodicalId":91371,"journal":{"name":"Open medicine journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44653735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-08-23DOI: 10.2174/1874220301906010050
Raila Gediminas, L. Ida, J. Lina, L. Valius
Type 2 diabetes mellitus is one of the most common chronic conditions, which requires appropriate management and care at PHC level, which is described in guidelines. However, guideline adherence at the international arena is insufficient and little is known about the reasons for guideline non-adherence. The aim of the survey was to analyse to what extent the Lithuanian family practitioners adhere to diabetes guidelines in order to compare to international data and to discover the factors associated with better diabetes care. The present study is a part of EUPRIMECARE Project, which sets out to develop a framework aiming at the analysis of PHC across Europe. The sample strategy was based on an unequal probability sampling design. An audit of 4 public and 6 private PHC medical records of the year 2011 was carried out in Kaunas region, clinical records of 382 diabetes type 2 patients were reviewed. Demography, diseases and diabetes performance indicators data were collected using a uniform template. Binary and multivariable logistic regression analyses were used in the investigation of the factors related to better diabetes guideline adherence. Three guideline adherence levels were identified: high performance (performed in more than 90% cases) - BP measurement and HbA1c exam; good performance (performed in more than 50% cases) - ECG examination and serum creatinine check; insufficient performance (performed in less than 50% of cases) - annual endocrinologist consultation, eye fundus and foot examinations, LDL check and BMI calculation. Insufficient glycaemic control was positive associated with increased endocrinologist consultation and foot exam rates, elevated BP demonstrated the positive effect to creatinine check rate, multimorbidity had positive association to the annual eye, ECG, creatinine check rates; frequent FP attendance showed no positive effect on process indicators. Rural patients have a negative association to foot and ECG exam rates compared to urban patients. In a stepwise logistic regression model, 3 dependent variables had statistically significant impact on overall diabetes care indicator performance: negative - rural location of patients (OR 0.4, 95% CI 0.2-0.8), elevated mean BP (OR 0.6, 95% CI 0.4-0.9); positive - multimorbidity (OR 2.0, 95% CI 1.2-3.4). Guideline adherence for T2DM is not optimal in Lithuanian PHC. The best are BP and HbA1c checks. Suboptimal are BMI and LDL annual checks. The situation with these is almost the same as in other European countries. The better guideline adherence has been observed in urban (foot exam, ECG exam), multimorbidity (eye, ECG, creatinine exams), controlled by means of BP patients (serum creatinine test).
2型糖尿病是最常见的慢性疾病之一，需要在初级保健水平上进行适当的管理和护理，这在指南中有所描述。然而，国际上对指南的依从性不够充分，对指南不遵守的原因知之甚少。调查的目的是分析立陶宛家庭医生在多大程度上遵守糖尿病指南，以便与国际数据进行比较，并发现与更好的糖尿病护理相关的因素。目前的研究是EUPRIMECARE项目的一部分，该项目旨在开发一个旨在分析整个欧洲初级保健的框架。样本策略基于不等概率抽样设计。对考纳斯地区2011年的4个公立和6个私立初级保健医疗记录进行了审计，审查了382名2型糖尿病患者的临床记录。使用统一模板收集人口、疾病和糖尿病绩效指标数据。采用二元和多变量logistic回归分析对糖尿病指南依从性的相关因素进行调查。确定了三个指南依从性水平:高性能(超过90%的病例执行)-血压测量和HbA1c检查;良好的表现(50%以上病例)-心电图检查和血清肌酐检查;表现不佳(少于50%的病例)-每年咨询内分泌医生，眼底和足部检查，低密度脂蛋白检查和BMI计算。血糖控制不足与内分泌科会诊和足部检查率增加呈正相关，血压升高对肌酐检查率有积极影响，多发病与每年眼科、心电图、肌酐检查率呈正相关;频繁参加计划生育对工艺指标没有积极影响。与城市患者相比，农村患者与足部和心电图检查率呈负相关。在逐步logistic回归模型中，3个因变量对总体糖尿病护理指标的表现有统计学意义的影响:阴性-患者的农村位置(OR 0.4, 95% CI 0.2-0.8)，平均血压升高(OR 0.6, 95% CI 0.4-0.9);阳性-多病(OR 2.0, 95% CI 1.2-3.4)。在立陶宛PHC患者中，T2DM的指南依从性并不理想。最好是检查血压和糖化血红蛋白。不理想的是每年检查BMI和LDL。这些国家的情况与其他欧洲国家几乎相同。城市患者(足部检查、心电图检查)、多病患者(眼、心电图、肌酐检查)、以BP患者(血清肌酐检查)为控制手段的患者均有较好的依从性。
{"title":"Guideline Adherence and the Factors Associated with Better Care for Type 2 Diabetes Mellitus Patients in Lithuanian PHC: Diabetes Mellitus Guideline Adherence in Lithuania PHC","authors":"Raila Gediminas, L. Ida, J. Lina, L. Valius","doi":"10.2174/1874220301906010050","DOIUrl":"https://doi.org/10.2174/1874220301906010050","url":null,"abstract":"\u0000 \u0000 Type 2 diabetes mellitus is one of the most common chronic conditions, which requires appropriate management and care at PHC level, which is described in guidelines. However, guideline adherence at the international arena is insufficient and little is known about the reasons for guideline non-adherence.\u0000 \u0000 \u0000 \u0000 The aim of the survey was to analyse to what extent the Lithuanian family practitioners adhere to diabetes guidelines in order to compare to international data and to discover the factors associated with better diabetes care.\u0000 \u0000 \u0000 \u0000 The present study is a part of EUPRIMECARE Project, which sets out to develop a framework aiming at the analysis of PHC across Europe. The sample strategy was based on an unequal probability sampling design. An audit of 4 public and 6 private PHC medical records of the year 2011 was carried out in Kaunas region, clinical records of 382 diabetes type 2 patients were reviewed. Demography, diseases and diabetes performance indicators data were collected using a uniform template. Binary and multivariable logistic regression analyses were used in the investigation of the factors related to better diabetes guideline adherence.\u0000 \u0000 \u0000 \u0000 Three guideline adherence levels were identified: high performance (performed in more than 90% cases) - BP measurement and HbA1c exam; good performance (performed in more than 50% cases) - ECG examination and serum creatinine check; insufficient performance (performed in less than 50% of cases) - annual endocrinologist consultation, eye fundus and foot examinations, LDL check and BMI calculation. Insufficient glycaemic control was positive associated with increased endocrinologist consultation and foot exam rates, elevated BP demonstrated the positive effect to creatinine check rate, multimorbidity had positive association to the annual eye, ECG, creatinine check rates; frequent FP attendance showed no positive effect on process indicators. Rural patients have a negative association to foot and ECG exam rates compared to urban patients. In a stepwise logistic regression model, 3 dependent variables had statistically significant impact on overall diabetes care indicator performance: negative - rural location of patients (OR 0.4, 95% CI 0.2-0.8), elevated mean BP (OR 0.6, 95% CI 0.4-0.9); positive - multimorbidity (OR 2.0, 95% CI 1.2-3.4).\u0000 \u0000 \u0000 \u0000 Guideline adherence for T2DM is not optimal in Lithuanian PHC. The best are BP and HbA1c checks. Suboptimal are BMI and LDL annual checks. The situation with these is almost the same as in other European countries. The better guideline adherence has been observed in urban (foot exam, ECG exam), multimorbidity (eye, ECG, creatinine exams), controlled by means of BP patients (serum creatinine test).\u0000","PeriodicalId":91371,"journal":{"name":"Open medicine journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44656972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-05-31DOI: 10.2174/1874220301906010033
Moutaz El Kadri, N. Bazargani, M. Farghaly, R. Mohamed, Nancy Awad, Ashok Natarajan, P. Pathak, Ahmed S. Ghorab, Nader El Kakoun, M. Savone, S. A. Kherraf, J. Mardekian, M. D. Fusco
There is a dearth of real-world evidence regarding patient characteristics, Oral Anti-Coagulant (OAC) treatment, and International Normalized Ratio (INR) patterns in Dubai, United Arab Emirates (UAE). This was a retrospective observational study among newly diagnosed adult Non-valvular Atrial Fibrillation (NVAF) patients in the Dubai Real World Claims Database. Selected patients had at least one activity claim during the 12 months pre-index date (baseline period), and a pharmacy claim for apixaban, dabigatran, rivaroxaban, or warfarin from 01 JAN 2015-31 JUL 2017. Patients with valvular heart disease, cardiac surgery, venous thromboembolism, transient atrial fibrillation, pregnancy, or OAC claims during baseline were excluded. Comorbidities and treatment patterns related to OAC use, index dosing, baseline medications, and INR patterns were described. Among 5,072 NVAF patients, 468 met the study criteria. A minority of them (14.3%) were prescribed warfarin, and the most frequently prescribed non-vitamin K antagonist OACs (NOACs) were rivaroxaban (33.3%) and apixaban (31.4%), followed by dabigatran (20.9%). Patients’ mean age was 59 years and mean CHA2DS2-VASc score was 2.3, with most frequent comorbidities of diabetes mellitus, hypertension, coronary artery disease, and peripheral vascular disease. Additionally, 51% and 33% were on statins and aspirin, respectively, while 39% were on other anticoagulant agents. A large proportion of dabigatran patients were on a lower dose (57%). INR patterns revealed 13% of rivaroxaban, 12% of apixaban, and 7% of dabigatran patients had INR claims. This study provides relevant insights into the use of OACs in real-world clinical practice settings in Dubai, UAE.
{"title":"Profiling Clinical Characteristics and Treatment Patterns Among Non-Valvular Atrial Fibrillation Patients: A Real-World Analysis in Dubai, United Arab Emirates","authors":"Moutaz El Kadri, N. Bazargani, M. Farghaly, R. Mohamed, Nancy Awad, Ashok Natarajan, P. Pathak, Ahmed S. Ghorab, Nader El Kakoun, M. Savone, S. A. Kherraf, J. Mardekian, M. D. Fusco","doi":"10.2174/1874220301906010033","DOIUrl":"https://doi.org/10.2174/1874220301906010033","url":null,"abstract":"\u0000 \u0000 There is a dearth of real-world evidence regarding patient characteristics, Oral Anti-Coagulant (OAC) treatment, and International Normalized Ratio (INR) patterns in Dubai, United Arab Emirates (UAE).\u0000 \u0000 \u0000 \u0000 This was a retrospective observational study among newly diagnosed adult Non-valvular Atrial Fibrillation (NVAF) patients in the Dubai Real World Claims Database. Selected patients had at least one activity claim during the 12 months pre-index date (baseline period), and a pharmacy claim for apixaban, dabigatran, rivaroxaban, or warfarin from 01 JAN 2015-31 JUL 2017. Patients with valvular heart disease, cardiac surgery, venous thromboembolism, transient atrial fibrillation, pregnancy, or OAC claims during baseline were excluded. Comorbidities and treatment patterns related to OAC use, index dosing, baseline medications, and INR patterns were described.\u0000 \u0000 \u0000 \u0000 Among 5,072 NVAF patients, 468 met the study criteria. A minority of them (14.3%) were prescribed warfarin, and the most frequently prescribed non-vitamin K antagonist OACs (NOACs) were rivaroxaban (33.3%) and apixaban (31.4%), followed by dabigatran (20.9%). Patients’ mean age was 59 years and mean CHA2DS2-VASc score was 2.3, with most frequent comorbidities of diabetes mellitus, hypertension, coronary artery disease, and peripheral vascular disease. Additionally, 51% and 33% were on statins and aspirin, respectively, while 39% were on other anticoagulant agents. A large proportion of dabigatran patients were on a lower dose (57%). INR patterns revealed 13% of rivaroxaban, 12% of apixaban, and 7% of dabigatran patients had INR claims.\u0000 \u0000 \u0000 \u0000 This study provides relevant insights into the use of OACs in real-world clinical practice settings in Dubai, UAE.\u0000","PeriodicalId":91371,"journal":{"name":"Open medicine journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45644520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-05-31DOI: 10.2174/1874220301906010041
Sanaa Gadbaan Hama Almandlawi, Muhanad Salah Mawlood
No specific and sufficient diagnostic biomarkers are currently available for predicting diabetic retinopathy (DR). This study was conducted to investigate the validity of serum sorbitol and Vascular Endothelial Growth Factor A (VEGF-A) in diagnosing DR and differentiating it from diabetes without retinopathy (DNR). The study also investigated the diagnostic efficiency of these biomarkers when compared to optical coherence tomography OCT. A cross-sectional study included 164 diabetes mellitus patients: 30 patients with no retinopathy (the control group), 86 patients with non-proliferative diabetic retinopathy (NPDR), and 48 patients with Proliferative Diabetic Retinopathy (PDR). Patients were referred to the Layla Qasim Diabetic Center between November 2016 and October 2017 and an ophthalmologist established a DR diagnosis using OCT. Serum sorbitol and serum VEGF-A were measured for all patients. By using study biomarkers, the cut-off values of VEGF-A (124.7 ng/ml) and sorbitol (0.3112 mg/ml) were established, and their validity parameters. For sorbitol, the values were as follows: specificity was 75.4, the sensitivity was 80 and 68.3% of observed agreement with the results of the OCT technique. For VEGF-A, the specificity was 73.1 the sensitivity was 80 and 76.2% of the observed agreement. The combined parallel test was applied as negative if both the tests were negative or as positive if either of the tests was positive: a highly significant statistical agreement (Kappa test p <0.001) was found with the gold standard diagnosis (OCT), with 85.4% of observed agreement. A combination of serum sorbitol and VEGF-A for diagnosing DR and for differentiating DR from DNR patients exhibits a significant agreement with an OCT diagnosis.
{"title":"The Usefulness of Serum Sorbitol and Vascular Endothelial Growth Factor A in Predicting Diabetic Retinopathy as Compared to Optical Coherence Tomography","authors":"Sanaa Gadbaan Hama Almandlawi, Muhanad Salah Mawlood","doi":"10.2174/1874220301906010041","DOIUrl":"https://doi.org/10.2174/1874220301906010041","url":null,"abstract":"\u0000 \u0000 No specific and sufficient diagnostic biomarkers are currently available for predicting diabetic retinopathy (DR).\u0000 \u0000 \u0000 \u0000 This study was conducted to investigate the validity of serum sorbitol and Vascular Endothelial Growth Factor A (VEGF-A) in diagnosing DR and differentiating it from diabetes without retinopathy (DNR). The study also investigated the diagnostic efficiency of these biomarkers when compared to optical coherence tomography OCT.\u0000 \u0000 \u0000 \u0000 A cross-sectional study included 164 diabetes mellitus patients: 30 patients with no retinopathy (the control group), 86 patients with non-proliferative diabetic retinopathy (NPDR), and 48 patients with Proliferative Diabetic Retinopathy (PDR). Patients were referred to the Layla Qasim Diabetic Center between November 2016 and October 2017 and an ophthalmologist established a DR diagnosis using OCT. Serum sorbitol and serum VEGF-A were measured for all patients.\u0000 \u0000 \u0000 \u0000 By using study biomarkers, the cut-off values of VEGF-A (124.7 ng/ml) and sorbitol (0.3112 mg/ml) were established, and their validity parameters. For sorbitol, the values were as follows: specificity was 75.4, the sensitivity was 80 and 68.3% of observed agreement with the results of the OCT technique. For VEGF-A, the specificity was 73.1 the sensitivity was 80 and 76.2% of the observed agreement. The combined parallel test was applied as negative if both the tests were negative or as positive if either of the tests was positive: a highly significant statistical agreement (Kappa test p <0.001) was found with the gold standard diagnosis (OCT), with 85.4% of observed agreement.\u0000 \u0000 \u0000 \u0000 A combination of serum sorbitol and VEGF-A for diagnosing DR and for differentiating DR from DNR patients exhibits a significant agreement with an OCT diagnosis.\u0000","PeriodicalId":91371,"journal":{"name":"Open medicine journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47475975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-04-30DOI: 10.2174/1874220301906010019
R. Pal, Y. Pal, P. Wal, A. Wal
Chopchinyadi Churna is a powdered Ayurvedic churna, commonly used for treating insect bite, rheumatoid arthritis, gout arthritis. The current research is oriented for the evaluation of ingredients and other aspects of Churna. The Churna was standardized as per the parameters of Ayurvedic Formulary of India for the organoleptic characters, microscopy, physicochemical, chromatographic, rheological properties and phytochemical screening for the detection of major phytoconstituents. The parameters were found to be significant and offered future benefits for the advanced evaluation of Churṇa. Herbal based anti-arthritic medicine Chopchinyadi Churna has been evaluated on the basis of various parameters, which can serve as references for developing the pharmacopoeial standards.
{"title":"Standardization and Detailed Aspects of Chopchinyadi Churna: A Potent Anti-Arthritic Medicine","authors":"R. Pal, Y. Pal, P. Wal, A. Wal","doi":"10.2174/1874220301906010019","DOIUrl":"https://doi.org/10.2174/1874220301906010019","url":null,"abstract":"\u0000 \u0000 Chopchinyadi Churna is a powdered Ayurvedic churna, commonly used for treating insect bite, rheumatoid arthritis, gout arthritis.\u0000 \u0000 \u0000 \u0000 The current research is oriented for the evaluation of ingredients and other aspects of Churna.\u0000 \u0000 \u0000 \u0000 The Churna was standardized as per the parameters of Ayurvedic Formulary of India for the organoleptic characters, microscopy, physicochemical, chromatographic, rheological properties and phytochemical screening for the detection of major phytoconstituents.\u0000 \u0000 \u0000 \u0000 The parameters were found to be significant and offered future benefits for the advanced evaluation of Churṇa.\u0000 \u0000 \u0000 \u0000 Herbal based anti-arthritic medicine Chopchinyadi Churna has been evaluated on the basis of various parameters, which can serve as references for developing the pharmacopoeial standards.\u0000","PeriodicalId":91371,"journal":{"name":"Open medicine journal","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46063086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：