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  • 1.

    【2hr】Malaria, Typhoid Fever, and Their Coinfection among Febrile Patients at a Rural Health Center in Northwest Ethiopia: A Cross-Sectional Study

    包量

    机译 埃塞俄比亚西北部农村医疗中心的高热患者中的疟疾，伤寒及其共感染：一项跨部门研究
    摘要：Background. Malaria and typhoid fever are major public health problems in tropical and subtropical countries. People in endemic areas are at risk of contracting both infections concurrently. Objectives. The study was aimed at determining the prevalence and associated risk factors of malaria, typhoid, and their coinfection among febrile patients. Methods. A cross-sectional study was conducted on 200 febrile patients suspected for malaria and/or typhoid fever from April to May, 2013, at Ayinba Health Center, Northwest Ethiopia. Blood samples were collected for blood culture, Widal test, and blood film preparation. Data were analyzed using SPSS version 20 statistical software. Results. The prevalence of malaria was 36.5% (n = 73). Among these 32 (43.8%), 30 (41.1%) and 11 (15.1%) were positive for P. falciparum, P. vivax, and mixed infections, respectively. The seroprevalence of typhoid fever was 38 (19%), but 1 (0.5%) with blood culture. Malaria typhoid fever coinfection was 13 (6.5%). 2–5-year-old children and poor hand washing habit were significantly associated with malaria and typhoid infection, respectively (P < 0.05). Conclusions. The prevalence of malaria and typhoid fever was found high. Further studies should be done on the other determinants of malaria and typhoid fever coinfection in different seasons and different study areas.
  • 2.

    【2hr】Assessment of the Self-Perception of Dental Appearance, Its Comparison with Orthodontist's Assessment and Demand for Treatment in Eastern Nepalese Patients

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    机译 尼泊尔东部患者对牙齿外观自我感知的评估，与牙齿矫正医生的评估和治疗需求的比较
    摘要：Aims. The aim of this study was to assess the self-perception of dental appearance among Eastern Nepalese patients using aesthetic component (AC) of the index of orthodontic treatment need (IOTN) and to compare it with that of an orthodontist's assessment using the same scale and determine whether gender, area of residence, and level of education influence subject's self-perception and orthodontist's ratings. Methods. A total of 252 subjects (equal number of male and female) were conveniently selected. The average ages of subjects were 22.33 ± 2.114 years. The level of subject's perception and orthodontist's assessment was analyzed by nonparametric Chi square test. Kappa coefficient was done to verify its agreement. The Spearman's correlation test was used to check the association of educational level and age. Mann-Whitney test was used to check the associations of sex and areas of residence. Results. The demand for treatment was significantly associated with the perception of the subject and orthodontist's assessment. However, age, gender, and educational level were statistically insignificant in influencing subject perception and orthodontist's assessment. Conclusion. Patient's self-perception should be given equal importance while planning orthodontic treatment.
  • 3.

    【2hr】An Average Body Circumference Can Be a Substitute for Body Mass Index in Women

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    机译 平均体围可以代替女性体重指数
    摘要：Introduction. Significant correlations between BMI and some body circumferences have been previously reported. In this study we investigated if the average of the sum of eight body circumferences can be a substitute for BMI. Patients and Methods. BMI and eight body circumferences (neck, waist, hip, arm, forearm, wrist, thigh, and ankle) were measured in 193 apparently healthy women aged 20–83, and within a wide range of BMI. Women with BMI ≤ 24.9 were designated as normal, with BMI 25–29.9 as overweight and with BMI ≥ 30 as obese. The relationship of the average body circumference (ABC) of the sum of the eight circumferences, and of each individual circumference with BMI, was evaluated. Results. ABC had the strongest correlation with BMI (r = 0.95, P < 0.001) among all the circumferences tested. Hip circumference had the strongest correlation with BMI (r = 0.89, P < 0.001) among the circumferences of individual body sites. Receiver-Operator Characteristic analysis showed that women with ABC > 44.0 cm could be recognized as having BMI ≥ 25 with sensitivity 90.2% and specificity 88.5%, while women with ABC > 47.1 cm could be diagnosed as having BMI ≥ 30 with sensitivity 92.2% and specificity 91.5%. Conclusion. An average body circumference strongly correlated with BMI in women and can serve as a surrogate of BMI.
  • 4.

    【2hr】Quality of Life among Egyptian Patients with Upper and Lower Limb Amputation: Sex Differences

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    机译 埃及上肢和下肢截肢患者的生活质量：性别差异
    摘要：Background. Limb amputation is a life-changing event that can cause significant disruptions in many important areas of existence. Aim of this study. To evaluate the quality of life (QOL) of patients with limb amputation and identify the factors affecting the quality of life of patients with limb amputation among Egyptian patients. Research Design. It was a descriptive exploratory design. Setting. The study was conducted in Orthopedics and Surgical Department in Emergency Hospital at Mansoura University Hospitals. Sample. A sample of convenience of 100 adult male and female patients who met the inclusion criteria was included. Tools. (a) Structured interview questionnaire (SIQ) was used to collect personal data, (b) short form (36) health status questionnaires: this part was utilized to assess the quality of life among Egyptian patients with amputation. Results. The result of this study indicates that most participants experienced a change in the quality of life. There is a statistically significant difference between total QOL aspects and each of the following: age, gender, educational level, and type of work. Conclusion. Limb amputation tends to cause increased disability for those amputated patients. The age, gender, place of amputation, and marital status are found as statistically significant factors with physical component and psychological component.
  • 5.

    【2hr】A Study on the Association between Low Maternal Serum Magnesium Level and Preterm Labour

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    机译 孕妇血清低镁水平与早产的关系研究
    摘要：Objectives. The study was aimed to assess the association between low maternal serum magnesium levels and preterm labour. Methods. It is a cross-sectional case-control study in which eligible participants were pregnant women admitted in labour within the labour ward complex of a Lagos tertiary hospital. Relevant data were extracted from the case records of these women and blood samples were obtained from all participants and serum magnesium levels measured. Results. The study showed that 36% of the study patients had varying degrees of hypomagnesaemia. The relative risk indicates that preterm labour is 1.83 times higher among the patients with low serum magnesium (less than 1.6 mg/dL). The mean difference in serum magnesium levels in both groups was statistically significant (P<0.05). Conclusion. We can infer that low serum magnesium (hypomagnesaemia) is associated with preterm onset of labour. We can, also from this finding, formulate a proposition that would help in preventing preterm labour and birth with the use of prophylactic oral magnesium supplementation among patients with higher risk for development of preterm labour.
  • 6.

    【2hr】Evaluating the Reproducibility of Motion Analysis Scanning of the Spine during Walking

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    机译 评估行走过程中脊柱运动分析扫描的可重复性
    摘要：The Formetric 4D dynamic system (Diers International GmbH, Schlangenbad, Germany) is a rasterstereography based imaging system designed to evaluate spinal deformity, providing radiation-free imaging of the position, rotation, and shape of the spine during the gait cycle. Purpose. This study was designed to evaluate whether repeated measurements with the Formetric 4D dynamic system would be reproducible with a standard deviation of less than +/− 3 degrees. This study looked at real-time segmental motion, measuring kyphosis, lordosis, trunk length, pelvic, and T4 and L1 vertebral body rotation. Methods. Twenty healthy volunteers each underwent 3 consecutive scans. Measurements for kyphosis, lordosis, trunk length, and rotations of T4, L1, and the pelvis were recorded for each trial. Results. The average standard deviations of same-day repeat measurements were within +/− 3 degrees with a range of 0.51 degrees to 2.3 degrees. Conclusions. The surface topography system calculated reproducible measurements with error ranges comparable to the current gold standard in dynamic spinal motion analysis. Therefore, this technique should be considered of high clinical value for reliably evaluating segmental motion and spinal curvatures and should further be evaluated in the setting of adolescent idiopathic scoliosis.
  • 7.

    【2hr】Effects of Atorvastatin on Oxidative Stress Biomarkers and Mitochondrial Morphofunctionality in Hyperfibrinogenemia-Induced Atherogenesis

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    机译 阿托伐他汀对高纤维蛋白原血症诱导的动脉粥样硬化中氧化应激生物标志物和线粒体形态功能的影响
    摘要：Relationship between hyperfibrinogenemia (HF), oxidative stress, and atherogenesis was established. Effect of atorvastatin (Ator) was assessed. Wistar male (6 months) rats were studied: Ctr, control, without HF induction; Ctr-Ator, without HF treated with atorvastatin; AI, atherogenesis induced, and AI-Ator, atherogenesis induced and treated with atorvastatin. Atherogenesis was induced by daily adrenaline injection (0.1 mL/day/rat) for 90 days; treatment started 15 days after induction. Fibrinogen (mg/dL) and nitric oxide (NO) were measured in plasma (mM) and superoxide dismutase (SOD) (U/mL) in red cell lysate by spectrophotometry. Slices of aorta were analyzed by electron microscopy (EM). ANOVA and chi-square test were used; P < 0.05 was established. There were no significant differences between Ctr and Ctr-Atorv in fibrinogen, NO, and SOD values. Comparing Ctr with AI an increase of fibrinogen is observed (P < 0.001), but it decreased after administration of atorvastatin in AI-Ator (P < 0.001). NO diminished in AI relative to Ctr and increased in AI-Ator (P < 0.001). SOD showed an increase in AI and AI-Ator compared to Ctr (P < 0.001). EM revealed expansion of intermembrane space and disorganization of crests in AI. In AI-Ator mitochondrial areas and diameters were similar to control. Atorvastatin normalizes HF, stabilizes NO, increases SOD, and produces a partial regression of mitochondrial lesions.
  • 8.

    【2hr】Ivacaftor Therapy in CF Patients: Single Center Experience

    包量

    机译 CF患者的Ivacaftor治疗：单中心经验
    摘要：Ivacaftor is the first novel cystic fibrosis pharmaceutical that acts at the molecular level to potentiate cystic fibrosis transmembrane conductance regulator (CFTR) function and was first approved for clinical use in 2012. We are sharing our single center experience of five patients: four from pediatric age group and one adult patient. All patients had both subjective and objective improvements in their health. Despite established lung disease, our patients had significant improvement in both their FEV1 (forced expiratory volume in 1 second) and FEF25–75 and BMI (body mass index). Larger studies demonstrated only 6.7% improvement in mean FEV1 after starting Ivacaftor therapy but their patient population had normal lung function to begin with. In contrast our case series demonstrates that, in patients with established lung disease and diminished lung function, Ivacaftor can be expected to result in much higher recovery in lung function. Mean FEV1 improved by 35% in our case series. Ivacaftor is extremely expensive, costing $300,000 per patient per year requiring lifelong therapy, hence requiring prior authorizations from most third-party payers in the USA. The knowledge shared from our experience will be useful for other clinicians to petition healthcare policymakers on behalf of their patients.
  • 9.

    【2hr】Advances in Proteomic Technologies and Its Contribution to the Field of Cancer

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    机译 蛋白质组学技术的进展及其对癌症领域的贡献
    • 作者：Mehdi Mesri
    • 刊名：Advances in Medicine
    • 2014年第期
    摘要：Systematic studies of the cancer genome have generated a wealth of knowledge in recent years. These studies have uncovered a number of new cancer genes not previously known to be causal targets in cancer. Genetic markers can be used to determine predisposition to tumor development, but molecularly targeted treatment strategies are not widely available for most cancers. Precision care plans still must be developed by understanding and implementing basic science research into clinical treatment. Proteomics is continuing to make major strides in the discovery of fundamental biological processes as well as more recent transition into an assay platform capable of measuring hundreds of proteins in any biological system. As such, proteomics can translate basic science discoveries into the clinical practice of precision medicine. The proteomic field has progressed at a fast rate over the past five years in technology, breadth and depth of applications in all areas of the bioscience. Some of the previously experimental technical approaches are considered the gold standard today, and the community is now trying to come to terms with the volume and complexity of the data generated. Here I describe contribution of proteomics in general and biological mass spectrometry in particular to cancer research, as well as related major technical and conceptual developments in the field.
  • 10.

    【2hr】Comorbid Obsessive-Compulsive Symptoms in Schizophrenia: Insight into Pathomechanisms Facilitates Treatment

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    机译 精神分裂症合并强迫症的症状：深入了解机制有助于治疗
    • 作者：Mathias Zink
    • 刊名：Advances in Medicine
    • 2014年第期
    摘要：Insight into the biological pathomechanism of a clinical syndrome facilitates the development of effective interventions. This paper applies this perspective to the important clinical problem of obsessive-compulsive symptoms (OCS) occurring during the lifetime diagnosis of schizophrenia. Up to 25% of schizophrenia patients suffer from OCS and about 12% fulfil the diagnostic criteria of obsessive-compulsive disorder (OCD). This is accompanied by marked subjective burden of disease, high levels of anxiety, depression and suicidality, increased neurocognitive impairment, less favourable levels of social and vocational functioning, and greater service utilization. Comorbid patients can be assigned to heterogeneous subgroups. It is assumed that second generation antipsychotics (SGAs), most importantly clozapine, might aggravate or even induce second-onset OCS. Several epidemiological and pharmacological arguments support this assumption. Specific genetic risk factors seem to dispose patients with schizophrenia to develop OCS and risk-conferring polymorphisms has been defined in SLC1A1, BDNF, DLGAP3, and GRIN2B and in interactions between these individual genes. Further research is needed with detailed characterization of large samples. In particular interactions between genetic risk constellations, pharmacological and psychosocial factors should be analysed. Results will further define homogeneous subgroups, which are in need for differential causative interventions. In clinical practise, schizophrenia patients should be carefully monitored for OCS, starting with at-risk mental states of psychosis and longitudinal follow-ups, hopefully leading to the development of multimodal therapeutic interventions.
  • 11.

    【2hr】Stroke Recovery: Surprising Influences and Residual Consequences

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    机译 中风恢复：令人惊讶的影响和残余后果
    摘要：There is startling individual variability in the degree to which people recover from stroke and the duration of time over which recovery of some symptoms occurs. There are a variety of mechanisms of recovery from stroke which take place at distinct time points after stroke and are influenced by different variables. We review recent studies from our laboratory that unveil some surprising findings, such as the role of education in chronic recovery. We also report data showing that the consequences that most plague survivors of stroke and their caregivers are loss of high level cortical functions, such as empathy or written language. These results have implications for rehabilitation and management of stroke.
  • 12.

    【2hr】Transplantation of Encapsulated Pancreatic Islets as a Treatment for Patients with Type 1 Diabetes Mellitus

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    机译 囊化胰岛的移植治疗1型糖尿病患者
    • 作者：Meirigeng Qi
    • 刊名：Advances in Medicine
    • 2014年第期
    摘要：Encapsulation of pancreatic islets has been proposed and investigated for over three decades to improve islet transplantation outcomes and to eliminate the side effects of immunosuppressive medications. Of the numerous encapsulation systems developed in the past, microencapsulation have been studied most extensively so far. A wide variety of materials has been tested for microencapsulation in various animal models (including nonhuman primates or NHPs) and some materials were shown to induce immunoprotection to islet grafts without the need for chronic immunosuppression. Despite the initial success of microcapsules in NHP models, the combined use of islet transplantation (allograft) and microencapsulation has not yet been successful in clinical trials. This review consists of three sections: introduction to islet transplantation, transplantation of encapsulated pancreatic islets as a treatment for patients with type 1 diabetes mellitus (T1DM), and present challenges and future perspectives.
  • 13.

    【2hr】Percutaneous Septal Ablation in Hypertrophic Obstructive Cardiomyopathy: From Experiment to Standard of Care

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    机译 肥厚性梗阻性心肌病的经皮隔隔消融：从实验到护理标准
    • 作者：Lothar Faber
    • 刊名：Advances in Medicine
    • 2014年第期
    摘要：Hypertrophic cardiomyopathy (HCM) is one of the more common hereditary cardiac conditions. According to presence or absence of outflow obstruction at rest or with provocation, a more common (about 60–70%) obstructive type of the disease (HOCM) has to be distinguished from the less common (30–40%) nonobstructive phenotype (HNCM). Symptoms include exercise limitation due to dyspnea, angina pectoris, palpitations, or dizziness; occasionally syncope or sudden cardiac death occurs. Correct diagnosis and risk stratification with respect to prophylactic ICD implantation are essential in HCM patient management. Drug therapy in symptomatic patients can be characterized as treatment of heart failure with preserved ejection fraction (HFpEF) in HNCM, while symptoms and the obstructive gradient in HOCM can be addressed with beta-blockers, disopyramide, or verapamil. After a short overview on etiology, natural history, and diagnostics in hypertrophic cardiomyopathy, this paper reviews the current treatment options for HOCM with a special focus on percutaneous septal ablation. Literature data and the own series of about 600 cases are discussed, suggesting a largely comparable outcome with respect to procedural mortality, clinical efficacy, and long-term outcome.
  • 14.

    【2hr】Identifying a Framework for Hope in Order to Establish the Importance of Generalised Hopes for Individuals Who Have Suffered a Stroke

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    机译 确定希望的框架，以便确定遭受中风的人的普遍希望的重要性
    摘要：Hope and hopelessness are important psychological constructs that physiotherapists should consider when working with patients who have experienced a stroke. The view of hope in rehabilitation is often focused around the concept of goals and how hope works within this framework. However, the current paper proposes a broader framework for hope and the importance of a more generalised view of understanding why a certain hope exists or is identified by a patient. A narrative review using an a priori thematic analysis was undertaken to consider how more generalised hopes are expressed by individuals who have suffered a stroke. An electronic search of 4 databases from inception until April 2014 was undertaken. Qualitative articles were included if they considered the concept of hope for patients who had suffered a stroke. The results identified three themes which included (1) consideration of the patient's identity/identities, (2) meaningful activities, experiences, and interactions, and (3) the experience of suffering and need for relief. An awareness of patients' generalised hopes should be a priority for HCPs. Detailed implications for HCPs are identified within the discussion.
  • 15.

    【2hr】Mesenchymal Conversion of Mesothelial Cells Is a Key Event in the Pathophysiology of the Peritoneum during Peritoneal Dialysis

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    机译 间皮细胞间质转化是腹膜透析过程中腹膜病理生理学中的关键事件
    摘要：Peritoneal dialysis (PD) is a therapeutic option for the treatment of end-stage renal disease and is based on the use of the peritoneum as a semipermeable membrane for the exchange of toxic solutes and water. Long-term exposure of the peritoneal membrane to hyperosmotic PD fluids causes inflammation, loss of the mesothelial cells monolayer, fibrosis, vasculopathy, and angiogenesis, which may lead to peritoneal functional decline. Peritonitis may further exacerbate the injury of the peritoneal membrane. In parallel with these peritoneal alterations, mesothelial cells undergo an epithelial to mesenchymal transition (EMT), which has been associated with peritoneal deterioration. Factors contributing to the bioincompatibility of classical PD fluids include the high content of glucose/glucose degradation products (GDPs) and their acidic pH. New generation low-GDPs-neutral pH fluids have improved biocompatibility resulting in better preservation of the peritoneum. However, standard glucose-based fluids are still needed, as biocompatible solutions are expensive for many potential users. An alternative approach to preserve the peritoneal membrane, complementary to the efforts to improve fluid biocompatibility, is the use of pharmacological agents protecting the mesothelium. This paper provides a comprehensive review of recent advances that point to the EMT of mesothelial cells as a potential therapeutic target to preserve membrane function.
  • 16.

    【2hr】Treatment Alternatives to Negotiate Peri-Implantitis

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    机译 谈判周围植入物炎的治疗选择
    摘要：Peri-implant diseases are becoming a major health issue in dentistry. Despite the magnitude of this problem and the potential grave consequences, commonly acceptable treatment protocols are missing. Hence, the present paper reviews the literature treatment of peri-implantitis in order to explore their benefits and limitations. Treatment of peri-implantitis may include surgical and nonsurgical approaches, either individually or combined. Nonsurgical therapy is aimed at removing local irritants from the implants' surface with or without surface decontamination and possibly some additional adjunctive therapies agents or devices. Systemic antibiotics may also be incorporated. Surgical therapy is aimed at removing any residual subgingival deposits and additionally reducing the peri-implant pockets depth. This can be done alone or in conjunction with either osseous respective approach or regenerative approach. Finally, if all fails, explantation might be the best alternative in order to arrest the destruction of the osseous structure around the implant, thus preserving whatever is left in this site for future reconstruction. The available literature is still lacking with large heterogeneity in the clinical response thus suggesting possible underlying predisposing conditions that are not all clear to us. Therefore, at present time treatment of peri-implantitis should be considered possible but not necessarily predictable.
  • 17.

    【2hr】Ensuring Confidentiality of Geocoded Health Data: Assessing Geographic Masking Strategies for Individual-Level Data

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    机译 确保经过地理编码的健康数据的机密性：评估个人级别数据的地理掩盖策略
    摘要：Public health datasets increasingly use geographic identifiers such as an individual's address. Geocoding these addresses often provides new insights since it becomes possible to examine spatial patterns and associations. Address information is typically considered confidential and is therefore not released or shared with others. Publishing maps with the locations of individuals, however, may also breach confidentiality since addresses and associated identities can be discovered through reverse geocoding. One commonly used technique to protect confidentiality when releasing individual-level geocoded data is geographic masking. This typically consists of applying a certain amount of random perturbation in a systematic manner to reduce the risk of reidentification. A number of geographic masking techniques have been developed as well as methods to quantity the risk of reidentification associated with a particular masking method. This paper presents a review of the current state-of-the-art in geographic masking, summarizing the various methods and their strengths and weaknesses. Despite recent progress, no universally accepted or endorsed geographic masking technique has emerged. Researchers on the other hand are publishing maps using geographic masking of confidential locations. Any researcher publishing such maps is advised to become familiar with the different masking techniques available and their associated reidentification risks.
  • 18.

    【2hr】Current Options for Determining Fracture Union

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    机译 确定断裂结合的当前选择
    • 作者：Saam Morshed
    • 刊名：Advances in Medicine
    • 2014年第期
    摘要：Determining whether a bone fracture is healed is one of the most important and fundamental clinical determinations made in orthopaedics. However, there are currently no standardized methods of assessing fracture union, which in turn has created significant disagreement among orthopaedic surgeons in both clinical and research settings. An extensive amount of research has been dedicated to finding novel and reliable ways of determining healing with some promising results. Recent advancements in imaging techniques and introduction of new radiographic scores have helped decrease the amount of disagreement on this topic among physicians. The knowledge gained from biomechanical studies of bone healing has helped us refine our tools and create more efficient and practical research instruments. Additionally, a deeper understanding of the molecular pathways involved in the bone healing process has led to emergence of serologic markers as possible candidates in assessment of fracture union. In addition to our current physician centered methods, patient-centered approaches assessing quality of life and function are gaining popularity in assessment of fracture union. Despite these advances, assessment of union remains an imperfect practice in the clinical setting. Therefore, clinicians need to draw on multiple modalities that directly and indirectly measure or correlate with bone healing when counseling patients.
  • 19.

    【2hr】Sepsis Associated Encephalopathy

    包量

    机译 败血症相关性脑病
    摘要：Sepsis associated encephalopathy (SAE) is a common but poorly understood neurological complication of sepsis. It is characterized by diffuse brain dysfunction secondary to infection elsewhere in the body without overt CNS infection. The pathophysiology of SAE is complex and multifactorial including a number of intertwined mechanisms such as vascular damage, endothelial activation, breakdown of the blood brain barrier, altered brain signaling, brain inflammation, and apoptosis. Clinical presentation of SAE may range from mild symptoms such as malaise and concentration deficits to deep coma. The evaluation of cognitive dysfunction is made difficult by the absence of any specific investigations or biomarkers and the common use of sedation in critically ill patients. SAE thus remains diagnosis of exclusion which can only be made after ruling out other causes of altered mentation in a febrile, critically ill patient by appropriate investigations. In spite of high mortality rate, management of SAE is limited to treatment of the underlying infection and symptomatic treatment for delirium and seizures. It is important to be aware of this condition because SAE may present in early stages of sepsis, even before the diagnostic criteria for sepsis can be met. This review discusses the diagnostic approach to patients with SAE along with its epidemiology, pathophysiology, clinical presentation, and differential diagnosis.
  • 20.

    【2hr】Reconstructive Surgery for Head and Neck Cancer Patients

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    机译 头颈癌患者的重建手术
    摘要：The field of head and neck surgery has gone through numerous changes in the past two decades. Microvascular free flap reconstructions largely replaced other techniques. More importantly, there has been a paradigm shift toward seeking not only to achieve reliable wound closure to protect vital structures, but also to reestablish normal function and appearance. The present paper will present an algorithmic approach to head and neck reconstruction of various subsites, using an evidence-based approach wherever possible.
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