Clinical Medicine Research

ISSN Online: 2326-9057 ISSN Print: 2326-9049

Archive Home / Archive

Volume 8, Issue 5, September 2019

  • Authors: Daniel Lopez-Hernandez, Nadhyieli Orozco-Campos, Leticia Brito-Aranda, Maria de la Luz Lopez-Hernandez, Aurora Bautista-Marquez, Vesta Richardson

    Abstract: There has been a limited evaluation of the efficacy of administered vitamin-D3 and bisphosphonate in a single pill (once-weekly) on changes of Bone Mineral Density (BMD), speciality in elderly people. To evaluate the changes in BMD, using Risedronate and vitamin D3, in patients from the first level of primary care after a period of more than 2 years of follow-up. An observational and retrospective cohort study, in a non-controlled, real-life setting nested to a database was designed. Records of participants between March-04-2008 and June-27-2012. Mexican patients from 21 Clinics of Family Medicine. The database is characterized by all patients received Risedronate (35 mg) and vitamin-D3 (2800 IU) combined in a single pill, administered once-weekly. BMD was determined in the distal portion of the radius bone using an Omnisense-7000S bone densitometer. The Kaplan-Meier method was used to estimate cumulative probabilities. Hazard ratios (HRs) were estimated using Cox-proportional hazard-models. A total of 14,721 women were included. The mean time of treatment was 27.06 months (interquartile-range=26.00-29.00); the crude HR in patients with osteoporosis was 2.483 (95%CI 1.806-3.414) times higher than their counterparts with osteopenia. In relation to age, the increase in BMD was 26% higher (HR=0.739; 95%CI 0.712-0.766) in patients with 60 or more age than their counterparts aged ≤59 years. The duration of treatment with risedronate/vitamin D3 once-weekly depends on the target population and need strict monitoring of BMD particularly for those patients who have a treatment for more of 18 months due to the risk of decreased BMD.

    Received: Aug. 10, 2019 Accepted: Sep. 10, 2019 Published: Sep. 30, 2019

    DOI: 10.11648/j.cmr.20190805.11 View: Downloads:

  • Authors: Omolola Abike Akintola, Samuel Ademola Adegoke, Adanze Onyenonachi Asinobi, Temilade Aderounmu, Victor Oluwatimilehin Adebayo, Peter Adebayo Idowu

    Abstract: This study identifies the risk factors of recurrent tonsillitis in pediatric patient which in turn are the variables used in developing a predictive model for predicting the risk of recurrent tonsillitis. This is achieved by eliciting knowledge on the risk factors of recurrent tonsillitis, formulating the model using the variables and simulating the model using MATLAB tool. Interviews were conducted with the pediatrician and existing literature was studied on the knowledge of study in order to identify the variables for recurrent tonsillitis. Seven (7) data from tonsillitis patients were collected from Wesley Guild Hospital, Ilesha. Predictive model was formulated using the fuzzy logic model and simulated on MATLAB R2016a. Fuzzy logic was used as the predictive model to determine the risk of recurrent tonsillitis. The stages involved in the process are four (4) which includes: fuzzification, rule production, aggregation and defuzzification. The identified variables were given crisp values and within a membership function of 0 and 1. The simulated result of the fuzzy logic model was done using MATLAB which involved formulation of the fuzzy logic inference system (FIS) which was carried out by the MATLAB tool. The variables which are the risk factors were used to build the fuzzy logic inference system (FIS) to determine the risk of recurrent tonsillitis. Possible combinations of rules were given for the variables and the rules were used in the inference engine to predict the output of the model whether it is no, low, moderate or high risk of recurrent tonsillitis. The validation was done on the data gotten from Wesley Guild Hospital Ilesha from 7 patients. In conclusion, out of the seven (7) patients test data provided, five (5) patients have low risk, two (2) patients have moderate risk, no patients have no low risk and no patients have high risk of recurrent tonsillitis with 100% test accuracy.

    Received: Jul. 14, 2019 Accepted: Aug. 5, 2019 Published: Oct. 12, 2019

    DOI: 10.11648/j.cmr.20190805.13 View: Downloads:

  • Authors: Cotelli Maria Sofia, Manelli Filippo, Tosana Elisa, Turla Marinella

    Abstract: Transient global amnesia (TGA) is a clinical syndrome characterized by the sudden onset of anterograde amnesia, accompanied by repetitive questioning, sometimes with a retrograde component, lasting up to 24 hours, without compromise of other neurologic functions. Although various factors, such as migraine, focal ischemia, venous flow abnormalities, and epileptic phenomena, can be considered as involved in the pathophysiology and differential diagnosis of TGA, the factors triggering the emergence of these lesions are still elusive. Recent data suggest that the vulnerability of CA1 neurons to metabolic stress plays a pivotal part in the pathophysiological cascade, leading to an impairment of hippocampal function during TGA. We report three cases on neurodegenerative disorders presenting with transitory global amnesia, all evaluated at the department of emergency of Esine Hospital (Brescia), who developed all neurodegenerative disorders. It is important, when performing neurological evaluation in the department of emergency, to consider the possible presence of underlying cognitive impairment or behavioral symptoms especially in older people. Neurological evaluation should take into consideration the presence of piramidal, extrapiramidal or frontal sign release positivity or the presence of higher cortical functions impairment. It should be important to refer these patients to appropriate neurological evaluation in appropriate Centers for Neurodegenerative Disorders.

    Received: Sep. 15, 2019 Accepted: Oct. 8, 2019 Published: Oct. 17, 2019

    DOI: 10.11648/j.cmr.20190805.14 View: Downloads:

  • Authors: Liu Ji, Fang Weiwu, Jia Fukong, Song Haifeng, Lou Xiaotong, Li Lu, Yang x Rong, Tan Rong, Shi Tiejun, Wu Jie, Zhou Li, Wang Yuan, Gu Jianwen

    Abstract: To analyze the characteristics and basic principles of the medical support and anesthesia for the Shenzhou eleven astronaut landing field, and to summarize the experience of the medical care and anesthesia in the main landing field of our country, and to ensure the security tasks in the special environment such as the emergency return of manned space flight. To review the reports on the medical care and anesthesia of the astronauts at landing field, and summarize the experience of the medical care and anesthesia of the Shenzhou five to the Shenzhou ten astronaut medical support landing field, and put forward a series of organizations and prepositions on the environment characteristics of the "Shenzhou eleven" in the long time and the cold weather in the main landing field of the scheduled return time. Case, equipment and effective treatment plan, and be tested in actual combat. On the basis of the original first aid, the first aid equipment was adjusted, the first aid procedure was optimized, the heat preservation heating device was added, the laryngeal mask, the anti fog visible laryngoscope and the portable ultrasonic device were introduced, and the anesthesia and medical care plan for the manned space landing field was formulated, which was the astronaut stay in the space and the cold and complicated weather conditions. The treatment and medical care provided a strong guarantee. The first aid support scheme of the Shenzhou eleven spacecraft's main landing field was improved and optimized, and it fully met the medical security task of the special environment such as the astronaut emergency return and so on in the cold weather.

    Received: Sep. 9, 2019 Accepted: Oct. 14, 2019 Published: Oct. 23, 2019

    DOI: 10.11648/j.cmr.20190805.15 View: Downloads:

  • Authors: Ke Lin, Hongwei Cai, Jing Bai, Siyu Liu, Qi Fan, Qintai Zhang, Li Tang

    Abstract: This study aimed to explore the practical effect and reasonable evaluation methods of specialized high quality nursing care in operating room. Stratified random sampling was used to select 93 nurses from the operating rooms of two affiliated hospitals of Kunming Medical University in Yunnan Province. A set of “Specialized High Quality Nursing Care Items in Operating Room” was implemented in the operating rooms of the two hospitals simultaneously. The “Task Performance and Contextual Performance Scale” was used to measure and collect data of nurses in operating room before and after the implementation of the items. After the “Specialized High Quality Nursing Care Items in Operating Room” was implemented, the task performance total score and dimension scores of patient care, nursing information provision and specialized nursing skills were (58.59±1.77), (19.27±1.16), (19.50±1.11), (19.80±0.70), respectively, higher than the respective scores (37.21±1.92), (5.55±0.70), (13.78±1.12), (17.87±0.98) before the implementation, and the differences were statistically significant (t=−82.48 to −15.15, P<0.01). After the “Specialized High Quality Nursing Care Items in Operating Room” was implemented, the contextual performance total score and dimension scores of mutual support among colleagues, extra burden outside work tasks, and support to the organization were (70.43±2.94), (28.23±1.21), (18.52±1.29), (23.67±1.86), respectively, higher than the respective scores (36.20±1.79), (15.52±1.94), (7.33±1.11), (13.34±0.87) before the implementation, and the differences were statistically significant (t=−91.99 to −46.68, P<0.01). In conclusion, the “Specialized High Quality Nursing Care Items in Operating Room” is a series of nursing care that can improve task performance and contextual performance of nurses in operating room and promote the quality of high-quality nursing in operating room. The task performance and contextual performance can also comprehensively and effectively evaluate the implementation effect of specialized high quality nursing care in operating room.

    Received: Sep. 16, 2019 Accepted: Oct. 4, 2019 Published: Oct. 23, 2019

    DOI: 10.11648/j.cmr.20190805.16 View: Downloads:

All Issues