Based upon an exploration of the versions of trademarks mainly from English into Chinese, this thesis illustrates some typical examples of inappropriateness for trademark translations and analyzes some factors that wo...Based upon an exploration of the versions of trademarks mainly from English into Chinese, this thesis illustrates some typical examples of inappropriateness for trademark translations and analyzes some factors that would influence the way a trademark is rendered. In addition, certain tactics for improvement are recommended.展开更多
Purpose:This study aims to evaluate the accuracy of authorship attributions in scientific publications,focusing on the fairness and precision of individual contributions within academic works.Design/methodology/approa...Purpose:This study aims to evaluate the accuracy of authorship attributions in scientific publications,focusing on the fairness and precision of individual contributions within academic works.Design/methodology/approach:The study analyzes 81,823 publications from the journal PLOS ONE,covering the period from January 2018 to June 2023.It examines the authorship attributions within these publications to try and determine the prevalence of inappropriate authorship.It also investigates the demographic and professional profiles of affected authors,exploring trends and potential factors contributing to inaccuracies in authorship.Findings:Surprisingly,9.14%of articles feature at least one author with inappropriate authorship,affecting over 14,000 individuals(2.56%of the sample).Inappropriate authorship is more concentrated in Asia,Africa,and specific European countries like Italy.Established researchers with significant publication records and those affiliated with companies or nonprofits show higher instances of potential monetary authorship.Research limitations:Our findings are based on contributions as declared by the authors,which implies a degree of trust in their transparency.However,this reliance on self-reporting may introduce biases or inaccuracies into the dataset.Further research could employ additional verification methods to enhance the reliability of the findings.Practical implications:These findings have significant implications for journal publishers,Beyond authorship:Analyzing contributions in PLOS ONE and Maddi,A.,&the challenges of appropriate attribution highlighting the necessity for robust control mechanisms to ensure the integrity of authorship attributions.Moreover,researchers must exercise discernment in determining when to acknowledge a contributor and when to include them in the author list.Addressing these issues is crucial for maintaining the credibility and fairness of academic publications.Originality/value:This study contributes to an understanding of critical issues within academic authorship,shedding light on the prevalence and impact of inappropriate authorship attributions.By calling for a nuanced approach to ensure accurate credit is given where it is due,the study underscores the importance of upholding ethical standards in scholarly publishing.展开更多
BACKGROUND Holoprosencephaly(HPE)is a congenital malformation with various degrees of incomplete separation of the cerebral hemispheres due to differentiation disorders of the forebrain.Although HPE with diabetes insi...BACKGROUND Holoprosencephaly(HPE)is a congenital malformation with various degrees of incomplete separation of the cerebral hemispheres due to differentiation disorders of the forebrain.Although HPE with diabetes insipidus due to associated pituitary dysfunction has been reported,HPE with the syndrome of inappropriate antidiuretic hormone secretion(SIADH)is very rare.Tolvaptan,a vasopressin V2 receptor antagonist,is effective in adults with SIADH.However,there is no report of its efficacy in infants with SIADH.The purpose of this report is to demonstrate that tolvaptan is effective for SIADH in infants and that administration of tolvaptan eliminates the need for restriction of water intake and sodium administration.CASE SUMMARY A 2414-g female infant was born at 38 wk by normal vaginal delivery.Facial anomalies and head magnetic resonance imaging indicated semilobar HPE.After birth,she had hyponatremia due to SIADH and was treated using water and sodium restriction.However,she developed an exaggerated response to the fluid restrictions,resulting in large fluctuations in serum sodium levels.Subsequent administration of tolvaptan improved the fluctuations in serum sodium levels without the need for adjustment of water or sodium administration.Serum sodium was maintained within the normal range after discontinuation of tolvaptan at 80 d of life.There were no side effects,such as hypernatremia or liver dysfunction,during the administration of tolvaptan.CONCLUSION This is the first report on the safety and efficacy of tolvaptan in an infant with SIADH associated with HPE.展开更多
English teachers are commonly confronted with the dilemma in the EFL classroom.However,Ellis(2009)mentioned thatless attention has been paid to this domain.The aim of this paper is to examine sources of demotivation a...English teachers are commonly confronted with the dilemma in the EFL classroom.However,Ellis(2009)mentioned thatless attention has been paid to this domain.The aim of this paper is to examine sources of demotivation among 17 English teachersin a vocational technical institute in China.The findings indicated that teacher demotivation is mainly attributed to six factors:thediscordance among the polarization of student language proficiency level,big class size and inappropriate course book,inhibitedteacher self-efficacy,government-mandated policy,inadequate school facilities and low student self-autonomy/self-efficacy.展开更多
The health mobility is a right of the citizens that they can turn to any structure, without territorial restrictions, to look for an answer to their needs. Often produces inappropriateness and increases costs without ...The health mobility is a right of the citizens that they can turn to any structure, without territorial restrictions, to look for an answer to their needs. Often produces inappropriateness and increases costs without affecting the quality of care. The purpose of this work is to study in depth the phenomenon of passive hospital mobility of Calabrian citizens through detailed and comparative analysis relating to the years 2014 and 2015, and the analysis of inappropriateness.展开更多
Colonoscopic screening has been reported to reduce deaths from colorectal cancer.Adequate bowel preparation is essential for this and safety is an important issue in choosing the methods.Polyethylene glycol(PEG)is reg...Colonoscopic screening has been reported to reduce deaths from colorectal cancer.Adequate bowel preparation is essential for this and safety is an important issue in choosing the methods.Polyethylene glycol(PEG)is regarded as a safe method for cleansing,especially compared with oral sodium phosphate.Here,we present a case of hyponatremia caused by the syndrome of inappropriate antidiuretic hormone(ADH)syndrome after PEG precolonoscopic cleansing resulting in generalized tonic-clonic seizures.A 62-year-old women had ingested PEG for precolonoscopic bowel cleansing.While waiting for the colonoscopy,she developed a stuporous mentality and generalized tonic-clonic seizures,which did not correlate with brain magnetic resonance imaging.Her serum sodium level was 113 mEq per liter and laboratory analyses were consistent with inappropriate ADH syndrome.Her thyroid and adrenal functions were normal.There were no malignancies,infections,respiratory disorders or central nervous disorders and she had no history of taking either diuretics or other medications,which might have caused inappropriate ADH syndrome.She was treated with 3%hypertonic saline and showed a complete neurological recovery as her sodium levels recovered.Follow-up visits showed the patient to have a normal sodium level without neurologic deficits.This case shows that inappropriate ADH syndrome can be caused by PEG preparation,which implies that physicians have to be aware of the possible side effects of this colonic cleansing approach and mindful of the possible ensuing symptoms.展开更多
BACKGROUND Implantable cardioverter defibrillators(ICDs)and cardiac resynchronisation therapy with defibrillators(CRT-D)reduce mortality in certain cardiac patient populations.However,inappropriate shocks pose a probl...BACKGROUND Implantable cardioverter defibrillators(ICDs)and cardiac resynchronisation therapy with defibrillators(CRT-D)reduce mortality in certain cardiac patient populations.However,inappropriate shocks pose a problem,having both adverse physical and psychological effects on the patient.The advances in device technology now allow remote monitoring(RM)of devices to replace clinic follow up appointments.This allows real time data to be analysed and actioned and this may improve patient care.AIM To determine if RM in patients with an ICD is associated with fewer inappropriate shocks and reduced time to medical assessment.METHODS This was a single centre,retrospective observational study,involving 156 patients implanted with an ICD or CRT-D,followed up for 2 years post implant.Both appropriate and inappropriate shocks were recorded along with cause for inappropriate shocks and time to medical assessment.RESULTS RM was associated with fewer inappropriate shocks(13.6%clinic vs 3.9%RM;P=0.030)and a reduced time to medical assessment(15.1±6.8 vs 1.0±0.0 d;P<0.001).CONCLUSION RM in patients with an ICD is associated with improved patient outcomes.展开更多
Advances in medical therapeutics have undoubtedly contributed to health gains and increases in life expectancy over the last century. However, there is growing evidence to suggest that therapeutic decisions in older p...Advances in medical therapeutics have undoubtedly contributed to health gains and increases in life expectancy over the last century. However, there is growing evidence to suggest that therapeutic decisions in older patients are frequently suboptimal or potentially inappropriate and often result in negative outcomes such as adverse drug events, hospitalisation and increased healthcare resource utilisation. Several factors influence the appropriateness of medication selectionin older patients including age-related changes in pharmacokinetics and pharmacodynamics, high numbers of concurrent medications, functional status and burden of co-morbid illness. With ever-increasing therapeutic options, escalating proportions of older patients worldwide, and varying degrees of prescriber education in geriatric pharmacotherapy, strategies to assist physicians in choosing appropriate pharmacotherapy for older patients may be helpful. In this paper, we describe important age-related pharmacological changes as well as the principal domains of prescribing appropriateness in older people. We highlight common examples of drugdrug and drug-disease interactions in older people. We present a clinical case in which the appropriateness of prescription medications is reviewed and corrective strategies suggested. We also discuss various approaches to optimising prescribing appropriateness in this population including the use of explicit and implicit prescribing appropriateness criteria, comprehensive geriatric assessment, clinical pharmacist review, prescriber education and computerized decision support tools.展开更多
The subcutaneous implantable cardioverter defibrillators (SICD) is an altemative to the transvenous ICD for the prevention of sudden cardiac death (SCD). Multiple studies have shown that the SICD is safe and effec...The subcutaneous implantable cardioverter defibrillators (SICD) is an altemative to the transvenous ICD for the prevention of sudden cardiac death (SCD). Multiple studies have shown that the SICD is safe and effective in treating ventricular arrhythmias. While earlier stud- ies mainly enrolled younger patients with channelopathies, more recent reports included patients with "typical" indications for ICD therapy for the prevention of SCD. In this review we summarize the data available to date on the SICD while highlighting its pros and cons.展开更多
BACKGROUND Syndrome of inappropriate secretion of antidiuretic hormone(SIADH)is relatively common in several cancers,such as small cell lung cancer.However,nedaplatin-induced SIADH is rare.We describe a case of SIADH ...BACKGROUND Syndrome of inappropriate secretion of antidiuretic hormone(SIADH)is relatively common in several cancers,such as small cell lung cancer.However,nedaplatin-induced SIADH is rare.We describe a case of SIADH mediated by nedaplatin.CASE SUMMARY A 54-year-old female with nasopharyngeal carcinoma was treated with nedaplatin and developed severe hyponatremia due to SIADH.The side effects were successfully treated by fluid restriction and sodium supplementation.CONCLUSION This case report highlights the importance of cautiously treating life-threatening hyponatremia in patients treated with nedaplatin.展开更多
Neuroinflammation following immune activation in the central nervous system(CNS)leads to neuronal loss in specific areas of the CNS resulting in neurodegenerative disorders.Thus,fine tuning the immune responses with...Neuroinflammation following immune activation in the central nervous system(CNS)leads to neuronal loss in specific areas of the CNS resulting in neurodegenerative disorders.Thus,fine tuning the immune responses within the brain is essential,because most of the brain diseases are associated with chronic inflammation,展开更多
70 clinical Mycobacterium tuberculosis strains isolated from AIDS patients in two HIV/AIDS referral hospitals in Beijing were used in this study.M.tuberculosis and non-tuberculosis mycobacterium(NTM)were identified ...70 clinical Mycobacterium tuberculosis strains isolated from AIDS patients in two HIV/AIDS referral hospitals in Beijing were used in this study.M.tuberculosis and non-tuberculosis mycobacterium(NTM)were identified by using multi-locus PCR.M.tuberculosis was genotyped by using 15-locus MIRU-VNTR technique and spoligotyping afterwards.Meanwhile,the drug susceptibilities of the strains to the four first-line anti TB drugs(rifampin,isoniazid,streptomycin, and ethambutol) and the four second-line anti-TB drugs (capreomycin, kanamycin, ofloxacin, and ethionanide) were tested with proportional method. In this study, M. tuberculosis and NTM strains isolated from AIDS patients with TB-like symptoms were identified and genotyping analysis indicated that Beijing genotype was the predominant genotype. In addition, the prevalence of drug-resistant TB, especially the prevalence of XDR-TB, was higher than that in TB patients without HIV infection.展开更多
Thailand officials are set to release a two-minute animated video2 in Chinese to discourage tourists from taking their clothes off in inappropriate places when on holiday.The move follows a public outcry after an imag...Thailand officials are set to release a two-minute animated video2 in Chinese to discourage tourists from taking their clothes off in inappropriate places when on holiday.The move follows a public outcry after an image of a woman going topless3 in展开更多
About the Journal Medical Journal of Chinese People’s Liberation Army(Med J Chin PL A,ISSN 0577-7402,CN 11-1056/R,http://www.plamj.org)is an Open Access monthly journal in Chinese and English,published by the Peo...About the Journal Medical Journal of Chinese People’s Liberation Army(Med J Chin PL A,ISSN 0577-7402,CN 11-1056/R,http://www.plamj.org)is an Open Access monthly journal in Chinese and English,published by the People’s Military Medical Press,under the auspice of Department of Health,General Logistics Department of PLA,and it is issued domestically and abroad.Med J Chin PLA aims to publish the most exciting basic and clinical research especially those addressing the importance of military medicine,展开更多
Hyponatremia related to ectopic secretion of cancer cells of arginine vasopressin(AVP)or atrial natriuretic peptide(ANP)is most commonly caused by small cell lung cancer.The ideal treatment would be one that not only ...Hyponatremia related to ectopic secretion of cancer cells of arginine vasopressin(AVP)or atrial natriuretic peptide(ANP)is most commonly caused by small cell lung cancer.The ideal treatment would be one that not only corrects the hyponatremia,especially if it is life threatening,but at the same time causes regression of the cancer,and thus improves both quality and length of life.As one is waiting for chemotherapy,surgery,or radiotherapy to decrease the cancer burden,tolvaptan has been used to correct the hyponatremia to improve symptoms or prevent death.Mifepristone,a progesterone receptor modulator/antagonist has been used to treat various cancers.The oral 200mg tablet was given to an 80-year-old woman who developed sudden extensive lung cancer with a serum sodium of 118 mmol/L.She refused chemotherapy but agreed to take mifepristone.The hyponatremia was completely corrected(145 mmol/L)within one month of treatment.She was in complete remission for 5 years and died not from lung cancer,but an acute myocardial infarction.Mifepristone may serve the purpose to not only quickly correct hyponatremia when it is related to an endocrine paraneoplastic syndrome,but also to provide improved quality and length of life.展开更多
We report a case of natural killer(NK)/T-cell lymphoma with concomitant syndrome of inappropriate antidiuretic hormone secretion(SIADH).The patient was a 64-yearold woman with a history of nasopharyngeal carcinoma of ...We report a case of natural killer(NK)/T-cell lymphoma with concomitant syndrome of inappropriate antidiuretic hormone secretion(SIADH).The patient was a 64-yearold woman with a history of nasopharyngeal carcinoma of over 30 years.She was admitted with a chief complaint of intermittent fever for 2 mo.Palpation after admission indicated a swollen lymph node below the left jaw.Multiple imaging examinations on admission indicated multiple enlarged lymph nodes throughout the body.We performed a left submandibular lymph node biopsy,and the results revealed NK/T-cell lymphoma.A biochemical examination indicated Epstein-Barr virus positivity.At the same time,the patient developed hyponatremia.Based on her laboratory examination and clinical manifestation,decreased plasma osmolality,urine osmolality greater than plasma osmolality,lack of skin swelling,normal blood pressure,normal renal function,no adrenal function detected on serology,and no abnormalities in imaging examination of the adrenal glands,the likelihood of SIADH in the patient was high.After fluid restriction and administration of sodium chloride,the patient’s blood sodium level gradually increased.Subsequently,the immune function of the patient declined,there were severe symptoms of infection,and she died of respiratory failure.NK/T-cell lymphoma associated with SIADH has not,to our knowledge,been previously reported in PubMed.This case emphasizes the importance of monitoring serum ion levels,especially serum sodium,in patients with NK/T-cell lymphoma.展开更多
BACKGROUND: The syndrome of inappropriate secretion of antidiuretic hormone (SIADH) as a dilutional hyponatremia is due to a pathological increase of antidiuretic hormone (ADH). It is characterized by hyponatremia and...BACKGROUND: The syndrome of inappropriate secretion of antidiuretic hormone (SIADH) as a dilutional hyponatremia is due to a pathological increase of antidiuretic hormone (ADH). It is characterized by hyponatremia and decreased serum osmolarity as well as an increase in urinary osmolarity. The most common etiological factors of this syndrome include diseases or trauma of the central nervous system and malignant tumor or inflammation of the lung. SIADH following abdominal surgery is rare. METHODS: We report the case of a 68-year-old woman who developed, 24 hours after common bile duct exploration and stone removal, continuous hyponatremia for 20 days and clinical manifestations of nausea, vomiting, and lethargy without focal neurological signs. RESULT: Laboratory examinations supported the diagnosis of SIADH. After therapy with fluid restriction, the patient recovered. CONCLUSION: There are diverse causes for SIADH. It is important to have kept this clinical possibility in mind in the differential diagnosis of refractory hyponatremia under any circumstances.展开更多
Background: Sodium imbalances are among the most common electrolyte abnormalities encountered in the acute care setting. The syndrome of inappropriate anti-diuretic hormone (SIADH) and cerebral salt wasting (CSW) are ...Background: Sodium imbalances are among the most common electrolyte abnormalities encountered in the acute care setting. The syndrome of inappropriate anti-diuretic hormone (SIADH) and cerebral salt wasting (CSW) are characterized by hyponatremia and can be difficult to differentiate. Failure to accurately diagnose these conditions and implement the correct treatment results in an increased mortality risk, a longer length of stay in the hospital, and an increase in the cost of hospitalization. Objective: The purpose of this review is to summarize the key diagnostic findings in each disorder and to review the use of the fractional excretion of uric acid (FeUA) and the fractional excretion of phosphate as additional diagnostic measures to differentiate between SIADH and CSW. Observation: Publications from MEDLINE, CINAHL, and Google Scholar from 2009 through 2017 were reviewed. Articles were included if original data was presented and diagnosed either SIADH or CSW. Articles were excluded if they did not discuss diagnostic measures or were review articles. Results: Thirteen out of 51 publications met the inclusion criteria;four (31%) were clinica trials, seven (54%) were case reports, one (7.5%) was a prospective study and one (7.5%) was a retrospective-observational study. The populations studied, the etiologies causing hyponatremia, and diagnostic criteria used to distinguish between SIADH and CSW varied. Conclusion and Relevance: There is a need for consistent diagnostic criteria for SIADH and CSW. Based on current evidence, the use of FeUA and the fractional excretion of phosphate have consistently and accurately differentiated between SIADH and CSW.展开更多
文摘Based upon an exploration of the versions of trademarks mainly from English into Chinese, this thesis illustrates some typical examples of inappropriateness for trademark translations and analyzes some factors that would influence the way a trademark is rendered. In addition, certain tactics for improvement are recommended.
文摘Purpose:This study aims to evaluate the accuracy of authorship attributions in scientific publications,focusing on the fairness and precision of individual contributions within academic works.Design/methodology/approach:The study analyzes 81,823 publications from the journal PLOS ONE,covering the period from January 2018 to June 2023.It examines the authorship attributions within these publications to try and determine the prevalence of inappropriate authorship.It also investigates the demographic and professional profiles of affected authors,exploring trends and potential factors contributing to inaccuracies in authorship.Findings:Surprisingly,9.14%of articles feature at least one author with inappropriate authorship,affecting over 14,000 individuals(2.56%of the sample).Inappropriate authorship is more concentrated in Asia,Africa,and specific European countries like Italy.Established researchers with significant publication records and those affiliated with companies or nonprofits show higher instances of potential monetary authorship.Research limitations:Our findings are based on contributions as declared by the authors,which implies a degree of trust in their transparency.However,this reliance on self-reporting may introduce biases or inaccuracies into the dataset.Further research could employ additional verification methods to enhance the reliability of the findings.Practical implications:These findings have significant implications for journal publishers,Beyond authorship:Analyzing contributions in PLOS ONE and Maddi,A.,&the challenges of appropriate attribution highlighting the necessity for robust control mechanisms to ensure the integrity of authorship attributions.Moreover,researchers must exercise discernment in determining when to acknowledge a contributor and when to include them in the author list.Addressing these issues is crucial for maintaining the credibility and fairness of academic publications.Originality/value:This study contributes to an understanding of critical issues within academic authorship,shedding light on the prevalence and impact of inappropriate authorship attributions.By calling for a nuanced approach to ensure accurate credit is given where it is due,the study underscores the importance of upholding ethical standards in scholarly publishing.
文摘BACKGROUND Holoprosencephaly(HPE)is a congenital malformation with various degrees of incomplete separation of the cerebral hemispheres due to differentiation disorders of the forebrain.Although HPE with diabetes insipidus due to associated pituitary dysfunction has been reported,HPE with the syndrome of inappropriate antidiuretic hormone secretion(SIADH)is very rare.Tolvaptan,a vasopressin V2 receptor antagonist,is effective in adults with SIADH.However,there is no report of its efficacy in infants with SIADH.The purpose of this report is to demonstrate that tolvaptan is effective for SIADH in infants and that administration of tolvaptan eliminates the need for restriction of water intake and sodium administration.CASE SUMMARY A 2414-g female infant was born at 38 wk by normal vaginal delivery.Facial anomalies and head magnetic resonance imaging indicated semilobar HPE.After birth,she had hyponatremia due to SIADH and was treated using water and sodium restriction.However,she developed an exaggerated response to the fluid restrictions,resulting in large fluctuations in serum sodium levels.Subsequent administration of tolvaptan improved the fluctuations in serum sodium levels without the need for adjustment of water or sodium administration.Serum sodium was maintained within the normal range after discontinuation of tolvaptan at 80 d of life.There were no side effects,such as hypernatremia or liver dysfunction,during the administration of tolvaptan.CONCLUSION This is the first report on the safety and efficacy of tolvaptan in an infant with SIADH associated with HPE.
文摘English teachers are commonly confronted with the dilemma in the EFL classroom.However,Ellis(2009)mentioned thatless attention has been paid to this domain.The aim of this paper is to examine sources of demotivation among 17 English teachersin a vocational technical institute in China.The findings indicated that teacher demotivation is mainly attributed to six factors:thediscordance among the polarization of student language proficiency level,big class size and inappropriate course book,inhibitedteacher self-efficacy,government-mandated policy,inadequate school facilities and low student self-autonomy/self-efficacy.
文摘The health mobility is a right of the citizens that they can turn to any structure, without territorial restrictions, to look for an answer to their needs. Often produces inappropriateness and increases costs without affecting the quality of care. The purpose of this work is to study in depth the phenomenon of passive hospital mobility of Calabrian citizens through detailed and comparative analysis relating to the years 2014 and 2015, and the analysis of inappropriateness.
文摘Colonoscopic screening has been reported to reduce deaths from colorectal cancer.Adequate bowel preparation is essential for this and safety is an important issue in choosing the methods.Polyethylene glycol(PEG)is regarded as a safe method for cleansing,especially compared with oral sodium phosphate.Here,we present a case of hyponatremia caused by the syndrome of inappropriate antidiuretic hormone(ADH)syndrome after PEG precolonoscopic cleansing resulting in generalized tonic-clonic seizures.A 62-year-old women had ingested PEG for precolonoscopic bowel cleansing.While waiting for the colonoscopy,she developed a stuporous mentality and generalized tonic-clonic seizures,which did not correlate with brain magnetic resonance imaging.Her serum sodium level was 113 mEq per liter and laboratory analyses were consistent with inappropriate ADH syndrome.Her thyroid and adrenal functions were normal.There were no malignancies,infections,respiratory disorders or central nervous disorders and she had no history of taking either diuretics or other medications,which might have caused inappropriate ADH syndrome.She was treated with 3%hypertonic saline and showed a complete neurological recovery as her sodium levels recovered.Follow-up visits showed the patient to have a normal sodium level without neurologic deficits.This case shows that inappropriate ADH syndrome can be caused by PEG preparation,which implies that physicians have to be aware of the possible side effects of this colonic cleansing approach and mindful of the possible ensuing symptoms.
文摘BACKGROUND Implantable cardioverter defibrillators(ICDs)and cardiac resynchronisation therapy with defibrillators(CRT-D)reduce mortality in certain cardiac patient populations.However,inappropriate shocks pose a problem,having both adverse physical and psychological effects on the patient.The advances in device technology now allow remote monitoring(RM)of devices to replace clinic follow up appointments.This allows real time data to be analysed and actioned and this may improve patient care.AIM To determine if RM in patients with an ICD is associated with fewer inappropriate shocks and reduced time to medical assessment.METHODS This was a single centre,retrospective observational study,involving 156 patients implanted with an ICD or CRT-D,followed up for 2 years post implant.Both appropriate and inappropriate shocks were recorded along with cause for inappropriate shocks and time to medical assessment.RESULTS RM was associated with fewer inappropriate shocks(13.6%clinic vs 3.9%RM;P=0.030)and a reduced time to medical assessment(15.1±6.8 vs 1.0±0.0 d;P<0.001).CONCLUSION RM in patients with an ICD is associated with improved patient outcomes.
文摘Advances in medical therapeutics have undoubtedly contributed to health gains and increases in life expectancy over the last century. However, there is growing evidence to suggest that therapeutic decisions in older patients are frequently suboptimal or potentially inappropriate and often result in negative outcomes such as adverse drug events, hospitalisation and increased healthcare resource utilisation. Several factors influence the appropriateness of medication selectionin older patients including age-related changes in pharmacokinetics and pharmacodynamics, high numbers of concurrent medications, functional status and burden of co-morbid illness. With ever-increasing therapeutic options, escalating proportions of older patients worldwide, and varying degrees of prescriber education in geriatric pharmacotherapy, strategies to assist physicians in choosing appropriate pharmacotherapy for older patients may be helpful. In this paper, we describe important age-related pharmacological changes as well as the principal domains of prescribing appropriateness in older people. We highlight common examples of drugdrug and drug-disease interactions in older people. We present a clinical case in which the appropriateness of prescription medications is reviewed and corrective strategies suggested. We also discuss various approaches to optimising prescribing appropriateness in this population including the use of explicit and implicit prescribing appropriateness criteria, comprehensive geriatric assessment, clinical pharmacist review, prescriber education and computerized decision support tools.
文摘The subcutaneous implantable cardioverter defibrillators (SICD) is an altemative to the transvenous ICD for the prevention of sudden cardiac death (SCD). Multiple studies have shown that the SICD is safe and effective in treating ventricular arrhythmias. While earlier stud- ies mainly enrolled younger patients with channelopathies, more recent reports included patients with "typical" indications for ICD therapy for the prevention of SCD. In this review we summarize the data available to date on the SICD while highlighting its pros and cons.
文摘BACKGROUND Syndrome of inappropriate secretion of antidiuretic hormone(SIADH)is relatively common in several cancers,such as small cell lung cancer.However,nedaplatin-induced SIADH is rare.We describe a case of SIADH mediated by nedaplatin.CASE SUMMARY A 54-year-old female with nasopharyngeal carcinoma was treated with nedaplatin and developed severe hyponatremia due to SIADH.The side effects were successfully treated by fluid restriction and sodium supplementation.CONCLUSION This case report highlights the importance of cautiously treating life-threatening hyponatremia in patients treated with nedaplatin.
基金funded by Department of Science and Technology,Government of India (Grant No.SR/CSI/59/2011(G)Gujarat State Biotechnology Mission (Grant No.GSBTM/MD/PROJECTS/.SSA/3385/2012/2013)
文摘Neuroinflammation following immune activation in the central nervous system(CNS)leads to neuronal loss in specific areas of the CNS resulting in neurodegenerative disorders.Thus,fine tuning the immune responses within the brain is essential,because most of the brain diseases are associated with chronic inflammation,
基金funded by(2013ZX10003006-002-001 and 2011ZX10004-001)National Key Program of Mega Infectious DiseaseNational Natural Science Foundation(30973388)Capital Medical Development Scientific Research Fund(2009-1057)
文摘70 clinical Mycobacterium tuberculosis strains isolated from AIDS patients in two HIV/AIDS referral hospitals in Beijing were used in this study.M.tuberculosis and non-tuberculosis mycobacterium(NTM)were identified by using multi-locus PCR.M.tuberculosis was genotyped by using 15-locus MIRU-VNTR technique and spoligotyping afterwards.Meanwhile,the drug susceptibilities of the strains to the four first-line anti TB drugs(rifampin,isoniazid,streptomycin, and ethambutol) and the four second-line anti-TB drugs (capreomycin, kanamycin, ofloxacin, and ethionanide) were tested with proportional method. In this study, M. tuberculosis and NTM strains isolated from AIDS patients with TB-like symptoms were identified and genotyping analysis indicated that Beijing genotype was the predominant genotype. In addition, the prevalence of drug-resistant TB, especially the prevalence of XDR-TB, was higher than that in TB patients without HIV infection.
文摘Thailand officials are set to release a two-minute animated video2 in Chinese to discourage tourists from taking their clothes off in inappropriate places when on holiday.The move follows a public outcry after an image of a woman going topless3 in
文摘About the Journal Medical Journal of Chinese People’s Liberation Army(Med J Chin PL A,ISSN 0577-7402,CN 11-1056/R,http://www.plamj.org)is an Open Access monthly journal in Chinese and English,published by the People’s Military Medical Press,under the auspice of Department of Health,General Logistics Department of PLA,and it is issued domestically and abroad.Med J Chin PLA aims to publish the most exciting basic and clinical research especially those addressing the importance of military medicine,
文摘Hyponatremia related to ectopic secretion of cancer cells of arginine vasopressin(AVP)or atrial natriuretic peptide(ANP)is most commonly caused by small cell lung cancer.The ideal treatment would be one that not only corrects the hyponatremia,especially if it is life threatening,but at the same time causes regression of the cancer,and thus improves both quality and length of life.As one is waiting for chemotherapy,surgery,or radiotherapy to decrease the cancer burden,tolvaptan has been used to correct the hyponatremia to improve symptoms or prevent death.Mifepristone,a progesterone receptor modulator/antagonist has been used to treat various cancers.The oral 200mg tablet was given to an 80-year-old woman who developed sudden extensive lung cancer with a serum sodium of 118 mmol/L.She refused chemotherapy but agreed to take mifepristone.The hyponatremia was completely corrected(145 mmol/L)within one month of treatment.She was in complete remission for 5 years and died not from lung cancer,but an acute myocardial infarction.Mifepristone may serve the purpose to not only quickly correct hyponatremia when it is related to an endocrine paraneoplastic syndrome,but also to provide improved quality and length of life.
文摘We report a case of natural killer(NK)/T-cell lymphoma with concomitant syndrome of inappropriate antidiuretic hormone secretion(SIADH).The patient was a 64-yearold woman with a history of nasopharyngeal carcinoma of over 30 years.She was admitted with a chief complaint of intermittent fever for 2 mo.Palpation after admission indicated a swollen lymph node below the left jaw.Multiple imaging examinations on admission indicated multiple enlarged lymph nodes throughout the body.We performed a left submandibular lymph node biopsy,and the results revealed NK/T-cell lymphoma.A biochemical examination indicated Epstein-Barr virus positivity.At the same time,the patient developed hyponatremia.Based on her laboratory examination and clinical manifestation,decreased plasma osmolality,urine osmolality greater than plasma osmolality,lack of skin swelling,normal blood pressure,normal renal function,no adrenal function detected on serology,and no abnormalities in imaging examination of the adrenal glands,the likelihood of SIADH in the patient was high.After fluid restriction and administration of sodium chloride,the patient’s blood sodium level gradually increased.Subsequently,the immune function of the patient declined,there were severe symptoms of infection,and she died of respiratory failure.NK/T-cell lymphoma associated with SIADH has not,to our knowledge,been previously reported in PubMed.This case emphasizes the importance of monitoring serum ion levels,especially serum sodium,in patients with NK/T-cell lymphoma.
基金supported by Excellent Youth Talents Foundation of Health Bureau of Zhejiang Province of China(No.2008QNO15)
文摘BACKGROUND: The syndrome of inappropriate secretion of antidiuretic hormone (SIADH) as a dilutional hyponatremia is due to a pathological increase of antidiuretic hormone (ADH). It is characterized by hyponatremia and decreased serum osmolarity as well as an increase in urinary osmolarity. The most common etiological factors of this syndrome include diseases or trauma of the central nervous system and malignant tumor or inflammation of the lung. SIADH following abdominal surgery is rare. METHODS: We report the case of a 68-year-old woman who developed, 24 hours after common bile duct exploration and stone removal, continuous hyponatremia for 20 days and clinical manifestations of nausea, vomiting, and lethargy without focal neurological signs. RESULT: Laboratory examinations supported the diagnosis of SIADH. After therapy with fluid restriction, the patient recovered. CONCLUSION: There are diverse causes for SIADH. It is important to have kept this clinical possibility in mind in the differential diagnosis of refractory hyponatremia under any circumstances.
文摘Background: Sodium imbalances are among the most common electrolyte abnormalities encountered in the acute care setting. The syndrome of inappropriate anti-diuretic hormone (SIADH) and cerebral salt wasting (CSW) are characterized by hyponatremia and can be difficult to differentiate. Failure to accurately diagnose these conditions and implement the correct treatment results in an increased mortality risk, a longer length of stay in the hospital, and an increase in the cost of hospitalization. Objective: The purpose of this review is to summarize the key diagnostic findings in each disorder and to review the use of the fractional excretion of uric acid (FeUA) and the fractional excretion of phosphate as additional diagnostic measures to differentiate between SIADH and CSW. Observation: Publications from MEDLINE, CINAHL, and Google Scholar from 2009 through 2017 were reviewed. Articles were included if original data was presented and diagnosed either SIADH or CSW. Articles were excluded if they did not discuss diagnostic measures or were review articles. Results: Thirteen out of 51 publications met the inclusion criteria;four (31%) were clinica trials, seven (54%) were case reports, one (7.5%) was a prospective study and one (7.5%) was a retrospective-observational study. The populations studied, the etiologies causing hyponatremia, and diagnostic criteria used to distinguish between SIADH and CSW varied. Conclusion and Relevance: There is a need for consistent diagnostic criteria for SIADH and CSW. Based on current evidence, the use of FeUA and the fractional excretion of phosphate have consistently and accurately differentiated between SIADH and CSW.