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Clinical Significance of Color Doppler Ultrasound Applied in Patients with Peripherally Inserted Central Venous Catheters before Extubation: A Retrospective Analysis of Real-World Data 彩色多普勒超声在中心静脉导管拔管前应用的临床意义:真实世界数据的回顾性分析
Pub Date : 2022-06-30 DOI: 10.47363/jmhc/2022(4)201
Ran An, Wen-feng Chen, Qiaomiao Zeng
Aims and Objectives: By comparing peripherally inserted central venous catheter (PICC)-related complications in real-life patients, we aimed to analyze the significance of color Doppler ultrasound (CDU) applied routinely or once with symptoms of thrombosis before extubation. Methods: For this retrospective study, patient data from January to December 2020 were collected from an intelligent safe platform for infusion, which was embedded in the hospital information system (HIS). After screening by the inclusion and exclusion criteria, venous therapy liaisons were interviewed regarding the PICC procedures and complications of the enrolled patients. Then, the patient medical records were checked to verify the CDU usage and collect the CDU results. Difficulties in extubation and serious complications, including catheter fracture or pulmonary embolism during or after extubation, were also collected. This paper adheres to the RECORD checklist of EQUATOR guidelines. Results: Of the 1455 patients, 489 underwent CDU examination before extubation. Among these, thrombosis was detected in 37 (7.6%) patients and only 1 (0.2%) patient without thrombosis experienced difficulties in extubation. No serious complications were observed in the CDU group. Meanwhile, among the 966 patients in the non-CDU group, three (0.3%) faced difficulties and one patient developed symptoms of pulmonary embolism. Furthermore, among patients with thrombosis in the CDU group, the duration of catheter retention was significantly shorter than that in patients without thrombosis (76.65±42.55 vs. 121.04±45.99 days, P <0.001). Conclusions: After evaluation of their clinical symptoms, patients without symptoms could be directly removed according to conventional procedures, while patients with symptoms should undergo CDU examination before extubation. Relevance to Clinical Practice: When removing the catheter for PICC carriers, it is assessed that the patients have no discomfort symptoms and can be directly extubated without B-ultrasound examination.
目的与目的:通过比较现实患者外周血管中心静脉导管(PICC)相关并发症,分析常规或一次彩色多普勒超声(CDU)对拔管前血栓形成症状的意义。方法:本回顾性研究从嵌入医院信息系统(HIS)的输液安全智能平台收集2020年1月至12月的患者数据。通过纳入和排除标准筛选后,对静脉治疗联络员进行了关于PICC手术和入组患者并发症的访谈。然后,检查患者医疗记录以验证CDU使用情况并收集CDU结果。还收集了拔管困难和严重并发症,包括拔管期间或拔管后导管断裂或肺栓塞。本文遵循赤道准则的RECORD清单。结果:1455例患者中,489例在拔管前行CDU检查。其中,37例(7.6%)患者检测到血栓形成,无血栓形成的患者仅1例(0.2%)拔管困难。CDU组未见严重并发症。同时,在非cdu组的966例患者中,3例(0.3%)面临困难,1例出现肺栓塞症状。CDU组有血栓患者留置导管时间明显短于无血栓患者(76.65±42.55天vs. 121.04±45.99天,P <0.001)。结论:对临床症状进行评估后,无症状者可按常规程序直接拔除,有症状者应在拔管前行CDU检查。与临床实践的相关性:对PICC携带者拔管时,评估患者无不适症状,无需b超检查即可直接拔管。
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引用次数: 0
Successful Management of an Oligometastatic Nsclc Patient with Multimodal Therapy 多模式治疗成功治疗一例少转移性Nsclc患者
Pub Date : 2022-06-30 DOI: 10.47363/jmhc/2022(4)199
N. Ismaili
Non-small cell lung cancer (NSCLC) is more often diagnosed at an advanced stage and carries a poor prognosis. Recently, according to the new version of AJCC staging system published in 2018, oligometastatic disease has been integrated as an intermediate stage between non-metastatic and metastatic forms. The prognosis of oligometastatic NSCLC was significantly improved by the use of multimodal therapy, including chemotherapy, targeted therapies, immunotherapy, surgery and stereotactic radiotherapy. However, there is little evidence regarding the optimal sequence of these modalities in the management of patients with oligometastatic disease. We describe here a case study of a patient diagnosed with metachronous oligometastatic NSCLC, successfully managed by multimodal therapy based on stereotactic radiotherapy, chemotherapy, immunotherapy and standard radiotherapy for local control. Furthermore, randomized prospective studies would be of capital interest, including multi-centre patient studies and evaluation of several treatment strategies.
癌症(NSCLC)通常诊断为晚期,预后较差。最近,根据2018年发布的新版AJCC分期系统,少转移性疾病已被整合为非转移性和转移性之间的中间阶段。通过多模式治疗,包括化疗、靶向治疗、免疫治疗、手术和立体定向放疗,可显著改善少转移性NSCLC的预后。然而,很少有证据表明这些模式在治疗少转移性疾病患者中的最佳顺序。我们在这里描述了一个诊断为异时性少转移NSCLC的患者的病例研究,该患者通过基于立体定向放疗、化疗、免疫疗法和标准放疗的多模式治疗成功地进行了局部控制。此外,随机前瞻性研究将具有重大意义,包括多中心患者研究和几种治疗策略的评估。
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引用次数: 0
Possible Role of Ppar-Alpha Agonist in Attenuated Cardioprotective Effects of Ischemic Postconditioning in Diabetic Rat Heart ppar - α激动剂在降低糖尿病大鼠心脏缺血后适应的保护作用中的可能作用
Pub Date : 2022-06-30 DOI: 10.47363/jmhc/2022(4)197
S. Shivangi
Background: It has been accounted for that infarct size reduction and cardioprotective effects of Ischemic Postconditioning (IPOC) have been abrogated in few pathological conditions including diabetes. Peroxisome Proliferator-Activated Receptor-Alpha (PPAR-Alpha) agonist is known to have cardioprotective effect. Therefore, the current examination researched the possible role of PPAR-Alpha Agonist in Attenuated Cardioprotective Effects of Ischemic Postconditioning in Diabetic Rat Heart. Materials and Methods: Rats were injected Alloxan Monohydrate (150/mg/kg/i.p) single dose to produced diabetes. Isolated Langendorff ’s perfused normal and diabetic rat hearts were subjected to global ischemia for 30 min followed by reperfusion for 120 min. Coronary effluent was analyzed for Lactatedehydogenase (LDH) and Creatine Kinase (CK) release to evaluate the extent of cardiac injury. The oxidative stress in heart was evaluated by measuring Thiobarbituric Acid Reactive Substances (TBARS), superoxide dismutase (SOD) generation and reduced form of glutathione. Result: In the current investigation, Ischemia-reperfusion (I/R) induced oxidative stress by increasing TBARS, superoxide anion generation and the decreased form of glutathione in normal and diabetic rat heart. Moreover, I/R induced myocardial injury, was evaluated in terms of increase in, LDH and CK release in coronary effluent, and reduction in coronary flow rate in normal and diabetic rat heart. The diabetic rat heart showed enhanced I/R induced myocardial injury with high extent of oxidative stress as compared with normal rat heart subjected to I/R Six episodes of IPOC afforded cardioprotection against I/R induced myocardial injury in normal rat heart as assessed in terms of improvement of coronary flow rate and decrease of LDH, CK and oxidative stress. On other hand, IPOC mediated myocardial protection against I/R injury was nullified in diabetic rat heart. Fenofibrate (5µM), a selective agonist of PPAR alpha, its administration markedly restored the Cardioprotective potential of IPOC in diabetic rat heart. Conclusion: The current investigation presumed that, the high degree of oxidative stress produced in diabetic rat heart during reperfusion and resulting inactivation of PPAR alpha receptor might be responsible for abolishing the Cardioprotective potential of IPOC against I/R induced myocardial injury
背景:在包括糖尿病在内的少数病理条件下,缺血性后处理(IPOC)的梗死面积减小和心脏保护作用已被认为是无效的。已知过氧化物酶体增殖物激活受体- α (ppar - α)激动剂具有心脏保护作用。因此,本实验研究ppar - α激动剂在糖尿病大鼠心脏缺血后适应的保护作用减弱中的可能作用。材料与方法:大鼠单次注射四氧嘧啶(150/mg/kg/i.p)致糖尿病。取离体Langendorff灌注正常和糖尿病大鼠心脏局部缺血30 min,再灌注120 min,分析冠状动脉流出液乳酸脱氢酶(LDH)和肌酸激酶(CK)释放情况,评价心脏损伤程度。通过测定硫代巴比妥酸活性物质(TBARS)、超氧化物歧化酶(SOD)的生成和谷胱甘肽的还原形式来评价心脏氧化应激。结果:缺血再灌注(I/R)通过增加TBARS、超氧阴离子生成和谷胱甘肽形式减少诱导正常和糖尿病大鼠心脏氧化应激。此外,通过观察正常和糖尿病大鼠冠状动脉流出液中LDH和CK释放量的增加以及冠状动脉血流速率的降低来评价I/R诱导的心肌损伤。与I/R诱导的正常大鼠心脏相比,糖尿病大鼠心脏表现出I/R诱导的心肌损伤增强和高度氧化应激,6次IPOC对正常大鼠心脏I/R诱导的心肌损伤具有心脏保护作用,可改善冠状动脉血流速率,降低LDH、CK和氧化应激。另一方面,IPOC对糖尿病大鼠心肌I/R损伤的保护作用无效。非诺贝特(5µM)是PPAR α的选择性激动剂,其给药可显著恢复糖尿病大鼠心脏IPOC的心脏保护潜能。结论:本研究推测,糖尿病大鼠心脏在再灌注过程中产生的高度氧化应激和由此导致的PPAR α受体失活可能是IPOC对I/R诱导心肌损伤的心脏保护潜力丧失的原因
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引用次数: 0
Chronic Inflammatory Demyelinating Polyneuropathy Incidence in Covid-19 and Covid-19 Vaccines 慢性炎症性脱髓鞘多神经病变在Covid-19和Covid-19疫苗中的发病率
Pub Date : 2022-06-30 DOI: 10.47363/jmhc/2022(4)193
Simranjit Singh
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引用次数: 0
Acute Pancreatitis in Children 儿童急性胰腺炎
Pub Date : 2022-06-30 DOI: 10.47363/jmhc/2022(4)190
R. Muthiah
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引用次数: 0
Investigating the Multidimensional Comorbidity of ObsessiveCompulsive Disorder, Body Dysmorphic Disorders, and Eating Disorders: Theoretical and Practical Approaches to Treatment 调查强迫症,身体畸形障碍和饮食失调的多维共病:理论和实践的治疗方法
Pub Date : 2022-06-30 DOI: 10.47363/jmhc/2022(4)200
E. Gorbis
Research on obsessive-compulsive disorder (OCD), body dysmorphic disorder (BDD), and eating disorders (EDs), including anorexia and bulimia, has shown appreciable two-way comorbidity between these conditions, especially OCD and BDD. There are few, if any, however, assessments of the multidimensional comorbidity of OCD, BDD, and EDs. Here, we review the literature on prevalence and comorbidity of these disorders and estimate their three-way comorbidity. We calculate that multidimensional comorbidity of OCD, BDD, and EDs is present in about 1.5% of cases of primary OCD, 3.7% of cases of primary BDD and 9.8% of cases of primary EDs. We further provide recommendations for treatment of cases in which all three disorders appear together, beginning with the advice to treat that disorder first which poses the highest danger to the patient upon check in. for LVM.
对强迫症(OCD)、身体畸形障碍(BDD)和饮食失调(EDs)的研究,包括厌食症和贪食症,已经显示出这些疾病之间明显的双向共病,尤其是强迫症和BDD。然而,对强迫症、BDD和ed的多维共病的评估很少,如果有的话。在这里,我们回顾了这些疾病的患病率和合并症的文献,并估计他们的三重合并症。我们计算出强迫症、BDD和ed的多维共病存在于约1.5%的原发性强迫症、3.7%的原发性BDD和9.8%的原发性ed中。我们进一步为所有三种疾病同时出现的病例提供治疗建议,首先建议在检查时首先治疗对患者构成最大危险的疾病。LVM。
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引用次数: 0
Distinction between Guillain-Barre Syndrome and Chronic Inflammatory Demyelinating Polyneuropathy 格林-巴利综合征与慢性炎症性脱髓鞘性多神经病的鉴别
Pub Date : 2022-06-30 DOI: 10.47363/jmhc/2022(4)194
Simranjit Singh
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引用次数: 0
Cell Communication in Brain for Memory and Cognition 记忆和认知的大脑细胞通讯
Pub Date : 2022-06-30 DOI: 10.47363/jmhc/2022(4)191
S. Phadnis
Memory retention is the important topic of study in terms of Neurobiology. Cellular circuits involved in the nervous system is seen to be cordially communicating and establishing a network to transfer and store the data. The most extraordinary property of this cellular community is its ability to undergo adaptive modifications in response to environment, originating from inside or outside the body. Such ability, known as neuronal plasticity, allows long-lasting modifications of the strength, composition and efficacy of the connections between neurons, which constitutes the biochemical base for learning and memory. Neuronal and Non- neuronal cells both are involved in the process of memory. Cellular communication can be through release of chemical or a component or by releasing some biological structures like Extracellular vesicles. Also certain hormones are released by cells as a mean of communication and these hormones or cytokine like factors also assist in memory building process. We will further also see the action of these non- neuronal cells when implanted into a mice to check its memory retention.
记忆保留是神经生物学研究的重要课题。神经系统中涉及的细胞回路被认为是真诚的通信,并建立了一个传输和存储数据的网络。这种细胞群落最非凡的特性是它能够对来自体内或体外的环境做出适应性改变。这种能力被称为神经元可塑性,可以长期改变神经元之间连接的强度、组成和功效,这构成了学习和记忆的生化基础。神经元和非神经元细胞都参与记忆过程。细胞通讯可以通过释放化学物质或成分,也可以通过释放一些生物结构,如细胞外小泡。细胞也会释放某些激素作为交流的手段,这些激素或细胞因子样因子也有助于记忆的建立过程。我们还将进一步观察这些非神经元细胞在植入小鼠体内以检查其记忆保留时的作用。
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引用次数: 0
Chronic Inflammatory Demyelinating Polyneuropathy [CIDP] 慢性炎症性脱髓鞘性多神经病变
Pub Date : 2022-06-30 DOI: 10.47363/jmhc/2022(4)196
Simranjit Singh
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引用次数: 0
The Prevalence of Work Related Wound and Associated Risk Factors in Working Equines 工作马工伤的患病率及相关危险因素
Pub Date : 2022-06-30 DOI: 10.47363/jmhc/2022(4)192
Alamne Hunegnaw Mekete
Across-sectional study was conducted in Hawasssa town, the capital city of Southern Nations and Nationalities People Regional state; to estimate the prevalence of work related wound and associated risk factors in working equines. The study animals were selected randomly. A total of 309 equines were included in the study comprising 164 (53.1%) of donkey, 95(30.74%) of horses, and 50(16.18%) of mules. The risk factors sex, age, body condition scores, purpose of the animals were assessed through questionnaire survey and physical clinical examination of animals. The study shows that an overall prevalence of external injuries in working equines was 84.1%. The prevalence of external injuries by the species was 25.89%, 45.95% and 12.3% for horse, donkey and mule respectively. Statistically significant difference (p<0.05) in the occurrence of external injuries was noted among working equines of different sex groups, different functions, and different causes. Higher prevalence of external injuries was recorded in male animals (79.93%) than female (4.6%). Moreover, the occurrence of external injuries was higher in equines used for cart pool (40.77%) than those used for fetching of water (14.28%). In addition to this the distribution rate of external injuries between animals of different body condition showed that the highest rate was recorded in animals with medium body condition (31.39%) followed by those with good condition (27.18%).The major causes of external injury was inappropriate use of harness materials (33.7%) followed by over load and falling (12.3%). The prevalence of distribution of wounds on various body parts, was (23.46%) on the back which was relatively highest than shoulder, multiple body parts and wither which represent 11.5%, 10.77% and 8.1% respectively. The occurrence of external injuries in horses were 18.75% multiple wounds, 17.5% on the back and 15% on the shoulder while 23.24% on the back, 9.86 on wither and 8.45% multiple wounds, were found in donkeys. The occurrence of 36.86% of external injuries in the back of mule was observed in the study which was higher than other parts of the body. The study showed that working equine owners practice different approaches (70.4%) to manage wounds while 29.6% owners left their animals without any follow up. Hence, greater proportion of the owners (40%) have taken their animals to nearby health centers, while treated with medicine purchased from local markets 11.5% and 9.6% with medical plants. Relatively horse owners seek veterinarian services (43.5%).
横断面研究在南方民族和民族地区州首府哈瓦萨镇进行;评估工作马中与工作有关的伤口的患病率和相关的危险因素。研究动物是随机选择的。研究共纳入309匹马,其中驴164匹(53.1%),马95匹(30.74%),骡50匹(16.18%)。通过问卷调查和动物体格临床检查,评估危险因素性别、年龄、体质评分、目的。研究表明,工作马的总体外伤率为84.1%。马、驴、骡外伤发生率分别为25.89%、45.95%和12.3%。不同性别、不同功能、不同原因的工作马外伤发生率差异有统计学意义(p<0.05)。雄性动物的外伤发生率(79.93%)高于雌性动物(4.6%)。此外,用于车池的马(40.77%)外伤发生率高于用于取水的马(14.28%)。此外,不同体型动物的外伤发生率分布情况显示,体型中等的动物外伤发生率最高(31.39%),其次是体型较好的动物外伤发生率(27.18%)。外伤的主要原因是安全带材料使用不当(33.7%),其次是超载和坠落(12.3%)。伤发部位分布以背部(23.46%)、多处(11.5%)和四肢(10.77%)为最高,分别为8.1%。马外伤发生率为多发伤18.75%、背部伤17.5%、肩部伤15%;驴外伤发生率为背部伤23.24%、颈部伤9.86%、多发伤8.45%。本研究中,骡子背部外伤发生率为36.86%,高于身体其他部位。研究表明,工作马的主人采用不同的方法(70.4%)来处理伤口,而29.6%的主人没有对他们的动物进行任何随访。因此,更大比例的业主(40%)将他们的动物带到附近的保健中心,11.5%的人用从当地市场购买的药物治疗,9.6%的人用药用植物治疗。相对而言,马主寻求兽医服务(43.5%)。
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Journal of medicine and healthcare
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