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Septic Shock Secondary to Spontaneous Bacterial Peritonitis Caused by Pasteurella multocida: A Case Report and Review of the Literature
Bianca Varda,
Zaid Ansari,
Syed Zaidi,
Layth Al-Jashaami
Issue:
Volume 7, Issue 1, January 2021
Pages:
1-4
Received:
18 December 2020
Accepted:
5 January 2021
Published:
12 January 2021
Abstract: Spontaneous bacterial peritonitis (SBP) is a bacterial infection in the peritoneum commonly seen in the setting of cirrhosis and ascites. SBP is typically caused by gram-negative bacteria. Pasteurella is an organism typically associated with skin and soft tissue infections secondary to bites or scratches from domestic animals. We performed a literature review of all cases of Pasteurella-associated SBP to date. Due to the rarity of this clinical finding, there are a limited number of reported SBP cases due to Pasteurella. Our review showed that most associated cases are secondary to an animal wound and often present with hemodynamic instability. Furthermore, Pasteurella SBP has a high mortality rate when compared to the typical causative organisms. Herein, we present a case of septic shock secondary to spontaneous bacterial peritonitis caused by Pasteurella multocida in a patient with no evidence of dog or cat wounds. The patient was treated with antibiotics, but unfortunately required multiple pressors while in the hospital and he ultimately succumbed to his disease. This case not only demonstrates the importance of avoiding risk factors associated with Pasteurella SBP due to its high mortality rate, but also to maintain a high clinical suspicion for the infection in patients with seemingly no risk factors to initiate prompt treatment.
Abstract: Spontaneous bacterial peritonitis (SBP) is a bacterial infection in the peritoneum commonly seen in the setting of cirrhosis and ascites. SBP is typically caused by gram-negative bacteria. Pasteurella is an organism typically associated with skin and soft tissue infections secondary to bites or scratches from domestic animals. We performed a litera...
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New Obesity Index Associated with Fitness Among Korean Adults
Issue:
Volume 7, Issue 1, January 2021
Pages:
5-12
Received:
21 December 2020
Accepted:
29 December 2020
Published:
15 January 2021
Abstract: Background: The aim of this paper was to introduce a new obesity index associated with fitness and determine effective exercises for reducing the obesity in common Korean adults using a new kind of waist-to-height ratio (WHT2R). Objectives: This cross-sectional study was performed using the public-use releases of the 2017 survey of national physical fitness by the Korea Institute of Sport Science of the Korea Sports Promotion Foundation. Method: The correlation coefficients were calculated by correlation analyses between the obesity indices and four fitness tests for comparison. The lump mean values (LMVs) were introduced to find the association between the WHT2R and fitness tests using a linear regression method and to use as an indicator for the effective control of obesity. Result: The WHT2R is more associated with the fitness than the other indices and the correlation with fitness tests was interpreted more simply using the LMV of the WHT2R rather than that of the body mass index. Setting the goal of exercise using the WHT2R was easier and more convenient than using the body mass index. Conclusion: The WHT2R can be used as a possible contender for predicting fitness and is an effective indicator for the reduction of abdominal obesity.
Abstract: Background: The aim of this paper was to introduce a new obesity index associated with fitness and determine effective exercises for reducing the obesity in common Korean adults using a new kind of waist-to-height ratio (WHT2R). Objectives: This cross-sectional study was performed using the public-use releases of the 2017 survey of national physica...
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Long Term Efficacy and Safety of Herring Roe Oil in the Treatment of Psoriasis, a 39-week Open-label Extension Study
Kaare Steinar Tveit,
Karl Albert Brokstad,
Rolf Kristian Berge,
Per Christian Saeboe,
Hogne Hallaraaker,
Stian Brekke,
Nils Meland,
Bodil Bjoerndal
Issue:
Volume 7, Issue 1, January 2021
Pages:
13-20
Received:
22 December 2020
Accepted:
6 January 2021
Published:
22 January 2021
Abstract: The effect of omega-3 poly-unsaturated fatty acid supplements in patients with Psoriasis vulgaris has previously been investigated, but interventions varied in source, composition, dose, administration route and duration of treatment. The observed beneficial effects in patients with Psoriasis vulgaris using herring roe oil (HRO) as a dietary supplement prompted the conduct of this investigation. We monitored the longer-term efficacy and safety of as oral treatment for patients with plaque psoriasis originally included with a Psoriasis Area Severity Index (PASI) < 10 in a 39-week open-label extension period following a 26 week double-blind randomised and placebo controlled study (ClinicalTrials.gov: NCT03359577, date: 02 December 2017). All patients in the randomised study who were still participating at week 26 were invited to continue on active treatment. Fifty-eight of 64 patients included in the randomised study, were all treated with HRO through the extension period; 28 subjects from the HRO group and 30 subjects from the placebo group. Change (mean ± standard deviation; SD) in the PASI score from baseline in the 26 week double-blind period was -2.13±2.57 in the HRO-HRO group and -0.63±1.87 in the placebo-HRO group, and the difference between the groups was statistically significant (p<0.05). At conclusion of the entire 65-week period (15 months), the change in PASI was -3.44±1.83 in the HRO-HRO group and -3.06±1.69 in the placebo-HRO group. The secondary variables showed decreasing disease symptoms and clinically meaningful patient reported outcomes as shown with a mean reduction in Dermatological Life Quality Index (DLQI) score of >4 points. The most commonly reported adverse events in both groups were gastrointestinal in nature. No serious adverse reactions were reported.
Abstract: The effect of omega-3 poly-unsaturated fatty acid supplements in patients with Psoriasis vulgaris has previously been investigated, but interventions varied in source, composition, dose, administration route and duration of treatment. The observed beneficial effects in patients with Psoriasis vulgaris using herring roe oil (HRO) as a dietary supple...
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Multiple Myeloma Treatments, Outcomes, and Costs of Health Care Resource Utilisation During 2009-2016, Based on Multiple Data Sources from a Hospital District in Finland
Saku Torvinen,
Ville Vihervaara,
Tatu Miettinen,
Jari Jokelainen,
Melissa Bauer,
Anu Marttila,
Klaus Tamminen,
Jonna Salonen
Issue:
Volume 7, Issue 1, January 2021
Pages:
21-30
Received:
31 December 2020
Accepted:
11 January 2021
Published:
28 January 2021
Abstract: Multiple myeloma (MM) is one of the most prevalent hematologic cancers. Treatments of MM have been improved by availability of novel therapies but require regular hospital visits and intense patient follow-up. In this real-world study, patient characteristics, first four treatment lines (1L–4L), and associated outcomes and costs were assessed among adults treated for active MM during 2009–2016 at Kymenlaakso Central Hospital, Kymsote hospital district, Finland. In addition, patient burden and travel costs were determined for the patients treated during 2015–2016. Ninety-seven patients fulfilled the inclusion criteria. Data were retrospectively collected from hospital’s database, medical charts, and from healthcare professionals. Treatment lines and responses were defined according to the general recommendations. The median age at diagnosis was 70.1 years. The median overall survival was 68 months. Proteasome inhibitors (PI) or immunomodulatory drugs (IM) were the most common regimen types while the utilisation of a more novel approach, the simultaneous use of PI and IM, was low across first four treatment lines. Overall response rate was 72–74% for 1L–2L and 50–56% for 3L–4L. Drug costs represented the greatest proportion of total healthcare costs and increased in the later treatment lines. Patients receiving infusion treatments had specialised health care visits twice as much the patients treated with oral treatments. Furthermore, travel costs related to infusion treatments were three to four times more compared to the respective costs for oral treatments. Increasing drug costs but poorer treatment outcomes in later treatment lines underline a need for more efficient and better tolerated treatment options. This study demonstrates that oral treatments may indeed reduce patient and hospital resource burden and thus, should be considered in future health economic evaluations in Finland.
Abstract: Multiple myeloma (MM) is one of the most prevalent hematologic cancers. Treatments of MM have been improved by availability of novel therapies but require regular hospital visits and intense patient follow-up. In this real-world study, patient characteristics, first four treatment lines (1L–4L), and associated outcomes and costs were assessed among...
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Hydroxychloroquine and Chloroquine Induced Cardiomyopathy: A Concise Review
Pramod Theetha Kariyanna,
Andrew Doodnauth,
Mrinali Shetty,
Benjamin Ramalanjaona,
Naseem Hossain,
Yuvraj Singh Chowdhury,
Nimrah Hossain,
Apoorva Jayarangaiah,
Adam Budzikowski
Issue:
Volume 7, Issue 1, January 2021
Pages:
31-36
Received:
14 May 2020
Accepted:
9 September 2020
Published:
9 February 2021
Abstract: Hydroxychloroquine and Chloroquine are commonly used for the treatment of malaria and autoimmune conditions. Most recently, hydroxychloroquine has been implicated in the treatment armamentarium of Severe acute respiratory syndrome (SARS) caused by SARS-associated coronavirus-2. A rare, underreported side effect of hydroxychloroquine and chloroquine is cardiotoxicity. The cardiomyopathy occurs as a result of inhibition of lysosomal enzymes causing lysosomal dysfunction and intra-cellular accumulation of metabolic byproducts in the myocardium, leading to hypertrophy with or without restrictive physiology and resultant conduction abnormalities. Based on our review of 57 reported cases of hydroxychloroquine or chloroquine induced cardiomyopathy, dyspnea was the most common associated symptom. The most common rhythms seen on EKG were as follows: complete heart block (18.75%), right bundle branch block (RBBB) (18.75%). The most common findings on echocardiography were left ventricular hypertrophy (LVH) (54%), systolic dysfunction (48%) and diastolic dysfunction (32%). A definitive diagnosis is established by endomyocardial biopsy which demonstrates the presence of curvilinear inclusion bodies. The outcome following cessation of the offending agent ranges from complete reversal in 45% of the cases to continued progression with need for cardiac transplantation or even death in 17.5% of the cases.
Abstract: Hydroxychloroquine and Chloroquine are commonly used for the treatment of malaria and autoimmune conditions. Most recently, hydroxychloroquine has been implicated in the treatment armamentarium of Severe acute respiratory syndrome (SARS) caused by SARS-associated coronavirus-2. A rare, underreported side effect of hydroxychloroquine and chloroquine...
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