Journal of International Medical Research

Journal Information
ISSN / EISSN: 03000605 / 14732300
Published by: SAGE Publications
Total articles ≅ 9,255

Latest articles in this journal

Fábio Barlem Hohmann, Renato Carneiro De Freitas Chaves, Guilherme Benfatti Olivato, Guilherme Martins de Souza, Vinicius Barbosa Galindo, Moacyr Silva Jr, Marines Dalla Valle Martino, Fernando Gatti de Menezes, Thiago Domingos Corrêa
Published: 19 January 2023
Journal of International Medical Research, Volume 51; https://doi.org/10.1177/03000605221131122

Abstract:
Objective: The main objective was to assess the clinical characteristics, associated factors, and outcomes of patients admitted to the ICU for candidemia. The secondary objective was to examine the relationship of candidemia with the length of stay and mortality. Methods: The analysis was a retrospective single-center cohort study addressing the effect of invasive candidemia on outcomes. This study was performed in a medical-surgical ICU located in a tertiary private hospital in São Paulo, Brazil. Data was collected through the review of the hospital database. Results: In total, 18,442 patients were included in our study, including 22 patients with candidemia. The median age was similar in patients with and without candidemia [67 (56–84) vs. 67 (51–80)]. Most patients were male, and the proportion of men was higher among patients with candidemia (77% vs. 55.3%). The rates of renal replacement therapy (40.9% vs. 3.3%), mechanical ventilation (63.6% vs. 29.6%), and parenteral nutrition (40.9% vs. 4.8%) were higher in patients with candidemia than in those without candidemia. The mortality rate (77.3% vs. 11.9%) and length of hospital stay [42 days (23.0–78.8) vs. 8 days (5.0–17.0)] were significantly higher in patients with candidemia. Conclusions: Patients with candidemia are prone to longer hospital stay and mortality. In addition, we found associations of candidemia with the use of invasive mechanical ventilation, renal replacement therapy, and parenteral nutrition.
Nicole Bompani, Laura Bertella, Valentina Barbieri, Luca Scarabel, , Laura Perucca, Paolo Rossi
Published: 17 January 2023
Journal of International Medical Research, Volume 51; https://doi.org/10.1177/03000605221148435

Abstract:
Objective: To verify the impact of altered cognitive functioning and higher levels of mental fatigue, both reported after coronavirus disease 2019 (COVID-19), on rehabilitation treatment outcomes. Methods: In this real-practice retrospective pre–post intervention cohort study, cognitive functioning, measured through standardized neuropsychological measures, and individual levels of fatigue, depression and anxiety symptoms, were evaluated at admission to a rehabilitation program in individuals who had been hospitalized for COVID-19. The rehabilitation program effectiveness was measured through the Functional Independence Measure. Results: Among the patient sample ( n = 66), 87.88% reported experiencing high levels of fatigue at admission, while 16.67% reported depressive symptoms, and 22.73% reported anxiety symptoms. After rehabilitation, the sample displayed a significant decrease in the level of disability, in both the motor and cognitive subscales. Neuropsychological and psychological functioning did not play a predictive role. The 45 patients who received mechanical ventilation during intensive care, representing 68.18% of the sample, benefited more from rehabilitation treatment. Conclusions: The results support the importance of an early rehabilitation program after COVID-19 infection, independent of the initial neuropsychological and psychological functioning. Respiratory assistance may represent a crucial factor for short-term neuropsychological disease after-effects. Future studies on the long-term neuropsychological effect of COVID-19 infection on individual levels of disability are necessary.
Dalia Mohamed Gaber, Marwa Mostafa Ahmed, Amal Mohamed Sayed, Yasmine Samy Elkholy, Mai Diaa Sarhan
Published: 17 January 2023
Journal of International Medical Research, Volume 51; https://doi.org/10.1177/03000605221148833

Abstract:
Objectives: The current study explores the level of perceived social stigma and associated psychological challenges among healthcare workers during the second wave of the COVID-19 pandemic in Egypt. Methods: This was a cross-sectional study of 150 healthcare workers at Cairo University hospitals that were confirmed positive for COVID-19 infection. Participants were interviewed for assessment of perceived COVID-19-related stigma and associated psychological symptoms using the Patient Health Questionnaire for depression, the Generalized Anxiety Disorder Assessment for anxiety, and the Post-Traumatic Stress Disorder Checklist for post-traumatic stress symptoms. Results: Two-thirds of participants perceived moderate-to-severe COVID-19-related stigma. Depression, anxiety, and post-traumatic stress symptoms were observed at varying levels in 58.0%, 38.0%, and 11.3% of participants, respectively. Female sex and occupation as a nurse were significantly associated with the total perceived COVID-19-related stigma score. COVID-19-related stigma perception significantly correlated with depression, anxiety, and post-traumatic stress. Conclusion: Perceived social stigma prevails among healthcare workers and is associated with numerous psychological disturbances.
Jing Wei, Hui Deng, Lihua Wu, Jianbo Song, Junping Zhang, Wenhui Yang, Mengxian Zhang, Hongtao Zhen
Published: 17 January 2023
Journal of International Medical Research, Volume 51; https://doi.org/10.1177/03000605221148895

Abstract:
Objective: To explore the epidemiological characteristics of patients with lymphoepithelial carcinoma (LEC) of the head and neck and the prognostic factors. Methods: We conducted a retrospective cohort study of cases of head and neck LEC retrieved from the Surveillance, Epidemiology and End Results database. Kaplan–Meier survival analysis and the log-rank test were employed to assess overall survival (OS) and cancer-specific survival (CSS). Univariate and multivariate analyses were used to construct Cox regression models. We established nomograms to predict OS and CSS among patients with nasopharyngeal LEC, who were divided into high- and low-risk groups based on the OS nomograms to compare the effects of treatment using the restricted mean survival time (RMST). Results: The 5-year OS and CSS rates of the cohort were 70.8% and 74.8%, respectively. Advanced age, unmarried status, black race, distant metastasis, and the absence of surgical treatment were significantly associated with decreased survival rates. RMST did not differ between the combined treatment (radiotherapy and chemotherapy) and radiotherapy monotherapy groups, but chemotherapy alone displayed poor efficacy. Conclusions: Head and neck LEC is associated with a favorable prognosis. Radiotherapy plays a significant role in managing patients with nasopharyngeal LEC, which is influenced by multiple prognostic factors.
Huanhuan Zhang, Jinhua He, Yanru Du, Meinv Liu,
Published: 17 January 2023
Journal of International Medical Research, Volume 51; https://doi.org/10.1177/03000605221148618

Abstract:
Trigeminocardiac reflex (TCR) can result in bradycardia and even cardiac arrest, and is reversible with elimination of the stimulus. Here, we report the case of a 68-year-old man who experienced cardiac arrest during percutaneous balloon compression for the treatment of trigeminal neuralgia. In this patient, sinus rhythm did not recover after stimulation removal, causing us to successfully perform cardiopulmonary resuscitation (CPR). The patient regained a sinus rhythm and was pretreated with atropine 0.5 mg, allowing the operation to be started again. The operation was completed successfully and the patient experienced no complications. Subsequent heart rate variability (HRV) analysis showed that parasympathetic activity predominated before anesthesia induction and after tracheal intubation. It further elevated during foramen ovale puncture, leading to prolonged asystole. Fortunately, sympathetic activity predominated after atropine was administered, which manifested as an increase in sympathetic activity and a decrease in parasympathetic activity. This could be beneficial for patients with TCR. This case indicates that TCR-related cardiac arrest might not be reversed with stimulus cessation, and atropine played a key role in preventing TCR. Moreover, HRV analysis might be essential for preoperative screening for high-risk patients. We also reviewed the literature for cases of TCR with prolonged asystole.
Xiaojing Li, Wenwei Zhu, Jizhang Bao, Jiekai Li, Yongming Zhou
Published: 17 January 2023
Journal of International Medical Research, Volume 51; https://doi.org/10.1177/03000605221149870

Abstract:
Objective: To conduct a meta-analysis assessing the efficacy and safety of cyclosporine-based combinations for primary immune thrombocytopenia (ITP). Methods: Randomized controlled clinical trials were collected by systematically searching databases (PubMed®, MEDLINE®, EMBASE, The Cochrane Library, China National Knowledge Infrastructure) from inception to June 2022. All studies included patients with ITP who received cyclosporine-based regimens. We performed comprehensive analyses of the overall response rate (ORR), complete response (CR) rate, partial response (PR) rate, relapse rate, platelet count, and adverse drug reaction (ADR) rate. Results: Seven studies (n = 418) were ultimately included. According to a fixed-effects model, cyclosporine-based combinations improved the ORR and CR rate and reduced the relapse rate. The ADR rate was not increased in the cyclosporine-based combination group. Cyclosporine-based regimens effectively increased the platelet count. Subgroup analysis illustrated that cyclosporine-based combinations were linked to higher ORRs in both children (odds ratio [OR] = 5.74, 95% confidence interval [CI] = 1.79–18.41) and adults (OR = 5.46, 95% CI = 2.48–12.02) and a higher CR rate in adults (OR = 2.97, 95% CI = 1.56–5.63). Conclusion: Cyclosporine exhibited efficacy in the treatment of ITP without increasing the risk of ADRs.
, Ikechukwu O Igbokwe, Celestine O Njoku, Mohammed Y Fatihu, Ussa D Tizhe, Najume Dg Ibrahim, Essienifiok S Unanam, Rachel M Korzerzer
Published: 12 January 2023
Journal of International Medical Research, Volume 51; https://doi.org/10.1177/03000605221147188

Abstract:
Objectives: To evaluate the effect of zinc supplementation on immunotoxicity induced by subchronic oral exposure to glyphosate-based herbicide (GBH). Methods: Sixty adult male Wistar rats randomly divided equally into six groups were exposed to GBH by gavage daily for 16 weeks with or without zinc pretreatment. Group DW rats received distilled water (2 mL/kg), group Z rats received zinc (50 mg/kg), and group G1 and G2 rats received 187.5 and 375 mg/kg GBH, respectively. Group ZG1 and ZG2 rats were pretreated with 50 mg/kg zinc before exposure to 187.5 and 375 mg/kg GBH, respectively. Tumor necrosis factor alpha (TNF-α) and immunoglobulin (IgG, IgM, IgE) levels were measured by enzyme-linked immunosorbent assay. Spleen, submandibular lymph node, and thymus samples were processed for histopathology. Results: Exposure to GBH (G1 and G2) significantly increased serum TNF-α concentrations and significantly decreased serum IgG and IgM concentrations compared with the control levels. Moderate-to-severe lymphocyte depletion occurred in the spleen, lymph nodes, and thymus in the GBH-exposed groups. Zinc supplementation mitigated the immunotoxic effects of GBH exposure. Conclusions: GBH exposure increased pro-inflammatory cytokine responses, decreased immunoglobulin production, and depleted lymphocytes in lymphoid organs in rats, but zinc supplementation mitigated this immunotoxicity.
Wenlu Xing, Shan Wang, Xinyun Liu, Jicheng Jiang, Qiuping Zhao, Yuming Wang, You Zhang, Chuanyu Gao
Published: 12 January 2023
Journal of International Medical Research, Volume 51; https://doi.org/10.1177/03000605221148905

Abstract:
Objective: We aimed to assess hypertension prevalence and management in Central China. Methods: In this cross-sectional study conducted from February 2019 to February 2020, we applied stratified multistage random sampling to investigate residents aged 35 to 75 years in Dancheng county of Zhoukou city and Xincai county of Zhumadian city, both in Central China. Results: We enrolled 63,940 participants in this survey. A total of 43.6% (95% confidence interval [CI]: 43.2–44.0) of participants had hypertension. Of these, 49.3% (95% CI: 48.7–49.9) were aware of their diagnosis, 36.5% (95% CI: 35.9–37.1) took antihypertensive medication, and 14.3% (95% CI: 13.9–14.7) had their blood pressure under control. Only 31.4% of hypertensive people receiving antihypertensive treatment had achieved control. The hypertension prevalence was lower in urban areas than in rural areas, with higher rates of awareness, treatment, and control. Among subgroups, rural men had the highest prevalence of hypertension. Prevalence, awareness, and treatment rates all increased with age, except for control rates, which declined in the 65- to 75-year-old group. Conclusions: People in Central China have a high hypertension prevalence but low rates of awareness, treatment, and control. Great effort is needed to improve the prevention and management of hypertension in this region.
Hong-Bo Zeng, Jun-Di Jiang, Rong Li, Jian Li, Wen-Juan Zeng, Xiong-Kai Li, Bin Hu, Fei Zhou, Hai-Ying Yu, Jian-Guo Xie, et al.
Published: 11 January 2023
Journal of International Medical Research, Volume 51; https://doi.org/10.1177/03000605221147434

Abstract:
Objective: To investigate the pathogenesis of primary angle-closure disease (PACG) by measuring the anatomical structures of the anterior and posterior segments of the eye and inflammatory markers in the peripheral blood. Methods: This case–control study enrolled patients diagnosed with acute PACG (APACG) and chronic PACG (CPACG). It also enrolled control subjects without PACG. The anterior and posterior anatomical features were measured in all study participants. The levels of interleukin (IL)-6, tumour necrosis factor-α and the neutrophil-to-lymphocyte ratio (NLR) in the peripheral blood were measured. Results: This study analysed a total of 99 eyes: 34 eyes from 34 patients with APACG, 28 eyes from 28 patients with CPACG and 37 eyes from 37 control patients with senile cataract. The axis length, corneal diameter, anterior chamber depth and anterior chamber volume were significantly smaller in the APACG and CPACG groups compared with the controls. The level of IL-6 in the peripheral blood of patients with PACG was significantly lower than that of the controls. The NLR in the peripheral blood of patients with PACG was significantly greater than that of the controls. Conclusions: Changes in the ocular anatomy and some inflammatory markers might be involved in the pathogenesis of PACG.
Xuebing Li, Chunxia Wang, Heng Yang, Dongxu Pei, Yuchun Liu, Sha Yan, Yongwei Li
Published: 10 January 2023
Journal of International Medical Research, Volume 51; https://doi.org/10.1177/03000605221147444

Abstract:
Objective: To identify key genes involved in occurrence and development of polycystic ovary syndrome (PCOS). Methods: By downloading the GSE85932 dataset from the GEO database, we used bioinformatical analysis to analyse differentially expressed genes (DEGs) from blood samples of eight women with PCOS and eight matched controls. Following bioinformatic analysis, we performed a cross-sectional study of serum samples taken from 79 women with PCOS and 36 healthy controls. Results: From the 178 DEGs identified by bioinformatical analysis, 15 genes were identified as significant, and of these, ORM1 and ORM2 were selected for further verification as potential biomarkers for PCOS. Serum ORM1 and ORM2 levels were significantly increased in women with PCOS, and had a high diagnostic value. ORM1 and ORM2 were positively correlated with testosterone, cholesterol, and triglycerides. ORM1 levels were negatively correlated with high density lipoprotein (HDL) while ORM2 levels showed no significant correlation. Conclusions: ORM may be an effective biomarker for the diagnosis of PCOS and its monitoring may be a useful therapeutic strategy.
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