Scurvy is Back Callus, Claire Ann; Vella, Samantha; Ferry, Peter
Nutrition and metabolic insights,
2018, Letnik:
11
Journal Article
Recenzirano
Odprti dostop
Background and objective:
Scurvy, caused by vitamin C deficiency, first described by Hippocrates, is known to many as ‘The Pirates’ Disease’. Although a disease rarely acknowledged in modern ...medicine, we present 2 cases of elderly gentlemen found to have scurvy, who improved significantly on treatment.
Methods:
This study presents a case report of 2 patients undergoing rehabilitation at Karin Grech Hospital in Malta, noted to have signs and symptoms of vitamin C deficiency. Vitamin C levels were found to be low and thus supplementation was administered.
Results:
After a few weeks, a significant improvement was noted in level of frailty, mood, bleeding tendency, and gum health.
Conclusions:
The modern doctor must keep this ancient disease in mind, as it presents insidiously with debilitating repercussions, particularly in older people who are at a higher risk. It is easily treatable once detected.
This study assessed the differences in swabbing rates, vaccine uptake, COVID-19 infection, hospitalization rates and outcomes in patients suffering from inflammatory bowel disease (IBD) on ...immunomodulation and patients diagnosed with irritable bowel syndrome (IBS).
A population consisting of 250 IBD and 250 IBS patients was randomly selected from the local database. Apart from demographic data, the following data was collected: number of COVID-19 swabs taken, vaccination rates, type of vaccine administered, infection secondary to COVID-19, hospitalization and outcomes.
IBD patients performed significantly more swabs tests for SARS-CoV-2 detection compared with IBS patients in both phases of the study. Whilst the IBS cohort recorded a larger number of COVID-19 infection and less hospitalisations whilst infected, IBD patients had a better outcome whilst infected since hospitalisation reason in the latter was not related to COVID-19 infection. IBD patients had a larger uptake of COVID-19 vaccines.
This study was the first of its nature locally and internationally as it compared two unrelated cohorts of patients followed up in gastroenterology. Vaccination rates in both cohorts were higher than those reported internationally. In concordance with international studies, IBD patients are not at an increased risk of worse outcomes from COVID-19 infection compared to non-IBD cohorts.
Mesenchymal stem cell (MSC) derived extracellular vesicles (EVs) have been proposed as an alternative to cell therapy, creating new possible delivery modalities such as nebulisation. We wished to ...investigate the therapeutic potential of directly nebulised MSC-EVs in the mitigation of Escherichia coli-induced pneumonia.
EV size, surface markers and miRNA content were assessed pre- and post-nebulisation. BEAS2B and A459 lung cells were exposed to lipopolysaccharide (LPS) and treated with nebulised bone marrow (BM) or umbilical cord (UC) MSC-EVs. Viability assays (MTT) and inflammatory cytokine assays were performed. THP-1 monocytes were stimulated with LPS and nebulised BM- or UC-EVs and phagocytosis activity was measured. For in vivo experiments, mice received LPS intratracheally (IT) followed by BM- or UC-EVs intravenously (IV) and injury markers assessed at 24 h. Rats were instilled with E. coli bacteria IT and BM- or UC-EVs delivered IV or by direct nebulisation. At 48 h, lung damage was assessed by physiological parameters, histology and inflammatory marker presence.
MSC-EVs retained their immunomodulatory and wound healing capacity after nebulisation in vitro. EV integrity and content were also preserved. Therapy with IV or nebulised MSC-EVs reduced the severity of LPS-induced lung injury and E. coli-induced pneumonia by reducing bacterial load and oedema, increasing blood oxygenation and improving lung histological scores. MSC-EV treated animals also showed lower levels of inflammatory cytokines and inflammatory-related markers.
MSC-EVs given IV attenuated LPS-induced lung injury, and nebulisation of MSC-EVs did not affect their capacity to attenuate lung injury caused by E. coli pneumonia, as evidenced by reduction in bacterial load and improved lung physiology.
Hyperglycaemia and inpatient mortality and morbidity Farrugia, Yvette; Mangion, Jessica; Fava, Marie Claire ...
Clinical medicine (London, England),
July 2022, 2022-07-00, 20220701, Letnik:
22, Številka:
4
Journal Article
Recenzirano
Odprti dostop
By reviewing hospital admissions during different seasons, we studied seasonal variation in the relationship of hyperglycaemia to mortality in view of the known seasonal variation in blood glucose ...levels.3,4 Material and methods We retrospectively examined the records of 1,132 hospital admissions. Assessing the relationship between admission glucose levels, subsequent length of hospital stay, readmission and mortality. 3 Kershenbaum A, Tarabeia J, Stein N, Lavi I, Rennert G. Unraveling seasonality in population averages: an examination of seasonal variation in glucose levels in diabetes patients using a large population-based data set.
Background
Whilst there has been significant improvement in mortality outcomes after emergency laparotomy, there is little information on longer term outcomes in the year after discharge. The main ...aim of the study was to assess the impact that an emergency laparotomy has on patients’ and employment and health status 1 year after surgery.
Methods
This study was a questionnaire study conducted in a single centre district general hospital of patients who had undergone an emergency laparotomy between October 2015 and December 2016. Patients were included according to the National Emergency Laparotomy Audit criteria. At screening, patients who were alive at 1 year and had the capacity to consent were approached between January and December 2017. Patients underwent a researcher-led telephone interview using a semi-structured questionnaire to assess the impact of emergency laparotomy on overall, general and physical health (Glasgow Benefit Inventory) as well as employment status. The symptoms that patients experienced and their impact were also recorded.
Results
Forty-two patients responded to and completed the questionnaire. Just over one-third of patients experienced a deterioration in their general or physical health and 21% of patients experienced a change in employment. Factors which significantly impacted on health status were stoma issues, postoperative morbidity and a change in employment (
p
< 0.05). The main symptoms which patients identified as being troublesome were altered bowel habit and stoma issues with a resultant social and psychological impact.
Conclusions
One-third of patients experienced a deterioration in their psychosocial and physical health status as well as a change in employment during the first-year postsurgery. Larger research studies are required to define the impact of emergency laparotomy on patients in the longer term and more research is needed to improve perioperative rehabilitation in the postoperative period to ensure optimal functional gain after technically successful surgery.
Sacro-iliitis: A rare complication post caesarian section Farrugia, Marie Claire; Vella, Chantal; Consiglio, Helga ...
European journal of obstetrics & gynecology and reproductive biology,
March 2019, 2019-03-00, Letnik:
234
Journal Article
We aim to identify the preoperative and perioperative risk factors associated with post-surgical Staphylococcus aureus prosthetic joint infections (PJI), and to develop and validate risk-scoring ...systems, to allow a better identification of high-risk patients for more efficient targeted interventions.
We performed a multicenter matched case-control study of patients who underwent a primary hip and knee arthroplasty from 2014 to 2016. Two multivariable models by logistic regression were performed, one for the preoperative and one for perioperative variables; also, predictive scores were developed and validated in an external cohort.
In total, 130 cases and 386 controls were included. The variables independently associated with S. aureus-PJI in the preoperative period were (adjusted OR; 95% CI): BMI >30 kg/m2 (3.0; 1.9-4.8), resident in a long-term care facility (2.8; 1.05-7.5), fracture as reason for arthroplasty (2.7; 1.4-5.03), skin disorders (2.5; 0.9-7.04), previous surgery in the index joint (2.4; 1.3-4.4), male sex (1.9; 1.2-2.9) and ASA score 3-4 (1.8; 1.2-2.9). The AUROC curve was 0.73 (95% CI 0.68-0.78). In perioperative model, the risk factors were the previous ones plus surgical antibiotic prophylaxis administered out of the first 60 minutes before incision (5.9; 2.1-16.2), wound drainage for >72h after arthroplasty (4.5; 1.9-19.4) and use of metal bearing material vs. ceramic (1.9; 1.1-3.3). The AUROC curve was 0.78 (95% CI 0.72-0.83). The predictive scores developed were validated in the external cohort.
Predictive scores for S. aureus-PJI were developed and validated; this information would be useful for implementation of specific preventive measures.
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