| 1. |
- Al-Ahmad, M, et al.
(författare)
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ARIA 2019 Care Pathways for Allergic Rhinitis in the Kuwait Health Care System
- 2021
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Ingår i: Medical principles and practice : international journal of the Kuwait University, Health Science Centre. - : S. Karger AG. - 1423-0151. ; 30:4, s. 320-330
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Tidskriftsartikel (refereegranskat)abstract
- A worldwide increase in prevalence of allergic diseases has led to adaptations in national and international health care systems. ARIA (Allergic Rhinitis and Its Impact on Asthma) initiative develops internationally applicable guidelines for allergic respiratory diseases. In collaboration with international initiatives, ARIA offers updates of real-life integrated care pathways (ICPs) for digitally assisted, integrated, and individualized treatment of allergic rhinitis (AR). This article presents certain aspects of the health care system in Kuwait with reference to the management of AR and the objective of introducing ICPs and adopting the latest ARIA recommendations. Guidelines for ICPs include aspects of patients and health care providers and cover key areas of management of AR. This model of guidelines supports real-life health care better than traditional models. ARIA recommendations will be locally integrated in the health care system with the aim of improving both pharmacotherapy and allergy immunotherapy.
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| 2. |
- Al-Hussaini, M, et al.
(författare)
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Prokinetic effect of duodenal extract on ovine gallbladders
- 2000
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Ingår i: Medical principles and practice. - 1011-7571 .- 1423-0151. ; 9:1, s. 74-80
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Tidskriftsartikel (refereegranskat)abstract
- Objective: It is known that the macrolide antibiotic erythromycin stimulates gastrointestinal and gallbladder motility by an as yet unidentified mechanism. It was the objective of this study to investigate the mechanism of the gallbladder motility-stimulating effect of erythromycin. Methods: In our experiments we used strips of sheep gallbladders measuring isometric tension in organ baths. Since erythromycin itself did not induce contraction we examined the prokinetic effects of sheep duodenal extract, incubated with (DEX) or without (blank) erythromycin (10(-5) M). Results: Both DEX and blank elicited gallbladder contraction associated with heat-stable, water-soluble but not with lipid-soluble duodenal prokinetic factor. The factor is unrelated to motilin or cholecystokinin and is only partially (<20%) blocked by atropine (10(-6) M) and not affected by the pretreatment with dexamethasone or somatostatin. Conclusion: It was concluded that erythromycin indirectly stimulates contraction of ovine gallbladders through the endogenous release of a duodenal prokinetic factor. Copyright (C) 2000 S. Karger AG, Basel.
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| 3. |
- Ashrafian, Hutan, et al.
(författare)
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Metabolomics : The Stethoscope for the Twenty-First Century
- 2021
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Ingår i: Medical principles and practice. - : S. Karger. - 1011-7571 .- 1423-0151. ; 30:4, s. 301-310
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Tidskriftsartikel (refereegranskat)abstract
- Metabolomics encompasses the systematic identification and quantification of all metabolic products in the human body. This field could provide clinicians with novel sets of diagnostic biomarkers for disease states in addition to quantifying treatment response to medications at an individualized level. This literature review aims to highlight the technology underpinning metabolic profiling, identify potential applications of metabolomics in clinical practice, and discuss the translational challenges that the field faces. We searched PubMed, MEDLINE, and EMBASE for primary and secondary research articles regarding clinical applications of metabolomics. Metabolic profiling can be performed using mass spectrometry and nuclear magnetic resonance-based techniques using a variety of biological samples. This is carried out in vivo or in vitro following careful sample collection, preparation, and analysis. The potential clinical applications constitute disruptive innovations in their respective specialities, particularly oncology and metabolic medicine. Outstanding issues currently preventing widespread clinical use are scalability of data interpretation, standardization of sample handling practice, and e-infrastructure. Routine utilization of metabolomics at a patient and population level will constitute an integral part of future healthcare provision.
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| 4. |
- Ciorba, Andrea, et al.
(författare)
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Sudden bilateral sensorineural hearing loss as an unusual consequence of accidental ingestion of potassium hydroxide
- 2010
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Ingår i: Medical principles and practice. - Basel : S. Karger. - 1011-7571 .- 1423-0151. ; 19:5, s. 406-408
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To discuss the possible etiopathogenetic mechanism of inner ear damage induced by the ingestion of potassium hydroxide (KOH).Clinical presentation and intervention: We report the case of a 37-year-old patient with sudden bilateral sensorineural hearing loss after accidental ingestion of a KOH solution. The first ear, nose and throat examination disclosed only mild edema of the upper airways. He was treated in the intensive care unit and prescribed high-dose steroids, proton pump inhibitors and sucralfate for 2 weeks. Unfortunately, there was no recovery of the hearing loss, and no audiogram changes were noticed after 12 months of follow-up.Conclusion: After exploring the possible etiopathogenetic mechanism involved, the authors believe that in this case, a transient severe hemodynamic imbalance can actually be considered to be the most reliable explanation for the inner ear damage and subsequent onset of permanent bilateral sensorineural hearing loss.
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| 5. |
- Clos, E., et al.
(författare)
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ACTN3's R577X Single Nucleotide Polymorphism Allele Distribution Differs Significantly in Professional Football Players according to Their Field Position
- 2021
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Ingår i: Medical Principles and Practice. - : S. Karger AG. - 1011-7571 .- 1423-0151. ; 30:1, s. 92-97
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Football is characterised by intermittent high-intensity efforts varying according to the field position of a player. We aimed to ascertain whether polymorphisms in the ACTN3 gene are associated with different playing positions in elite professional football players. Subjects and Methods: Genotyping of the ACTN3 gene was conducted in 43 elite professional football players of a single team. Playing position was recorded based on the player's most frequent position. Results: The genotype distribution was not significant between positions (p = 0.057), while the allele distribution differed significantly (p = 0.035). Goalkeepers (p = 0.04, p = 0.03), central defenders (p = 0.03, p = 0.01), and central midfielders (p = 0.01, p = 0.00) had a significantly different allele distribution compared with wide midfielders and forward players. Conclusions: Genetic biomarkers may be important when analysing performance capability in elite professional football. Identifying the genetic characteristics of a player to adapt his playing position may lead to orientation of positions based on physical capabilities and tissue quality in young football players, and also to performance enhancement in those who are already playing in professional teams.
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| 6. |
- Dankl, D, et al.
(författare)
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Red Cell Distribution Width Is Independently Associated with Mortality in Sepsis
- 2022
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Ingår i: Medical principles and practice : international journal of the Kuwait University, Health Science Centre. - : S. Karger AG. - 1423-0151. ; 31:2, s. 187-194
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Tidskriftsartikel (refereegranskat)abstract
- <b><i>Background:</i></b> Mortality in sepsis remains high. Studies on small cohorts have shown that red cell distribution width (RDW) is associated with mortality. The aim of this study was to validate these findings in a large multicenter cohort. <b><i>Methods:</i></b> We conducted this retrospective analysis of the multicenter eICU Collaborative Research Database in 16,423 septic patients. We split the cohort in patients with low (≤15%; <i>n</i> = 7,129) and high (>15%; <i>n</i> = 9,294) RDW. Univariable and multivariable multilevel logistic regressions were used to fit regression models for the binary primary outcome of hospital mortality and the secondary outcome intensive care unit (ICU) mortality with hospital unit as random effect. Optimal cutoffs were calculated using the Youden index. <b><i>Results:</i></b> Patients with high RDW were more often older than 65 years (57% vs. 50%; <i>p</i> < 0.001) and had higher Acute Physiology and Chronic Health Evaluation (APACHE) IV scores (69 vs. 60 pts.; <i>p</i> < 0.001). Both hospital (adjusted odds ratios [aOR] 1.18; 95% CI: 1.16–1.20; <i>p</i> < 0.001) and ICU mortality (aOR 1.16; 95% CI: 1.14–1.18; <i>p</i> < 0.001) were associated with RDW as a continuous variable. Patients with high RDW had a higher hospital mortality (20 vs. 9%; aOR 2.63; 95% CI: 2.38–2.90; <i>p</i> < 0.001). This finding persisted after multivariable adjustment (aOR 2.14; 95% CI: 1.93–2.37; <i>p</i> < 0.001) in a multilevel logistic regression analysis. The optimal RDW cutoff for the prediction of hospital mortality was 16%. <b><i>Conclusion:</i></b> We found an association of RDW with mortality in septic patients and propose an optimal cutoff value for risk stratification. In a combined model with lactate, RDW shows equivalent diagnostic performance to Sequential Organ Failure Assessment (SOFA) score and APACHE IV score.
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| 7. |
- Fadeel, B, et al.
(författare)
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The potential role of apoptosis in human disease
- 2000
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Ingår i: MEDICAL PRINCIPLES AND PRACTICE. - : S. Karger AG. - 1011-7571 .- 1423-0151. ; 9:3, s. 151-163
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Programmed cell death or apoptosis is an evolutionarily conserved process which is essential for the maintenance of tissue homeostasis. Recent studies have indicated a role for apoptosis in a variety of human diseases. Hence, dysregulation of apoptosis has been implicated in, for instance, systemic and organ-specific autoimmune disease, acquired immune deficiency syndrome, neurodegenerative disorders, atherosclerosis and cancer. This presentation serves as an overview of pathological conditions, which are associated with defective or inadvertent apoptosis, with examples of disorders in which putative apoptosis defects have been elucidated at the molecular level. A critical assessment of apoptosis as a target for therapeutic intervention is also provided.
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| 8. |
- Halaweh, Hadeel, 1969, et al.
(författare)
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Cross-Cultural Adaptation, Validity and Reliability of the Arabic Version of the Falls Efficacy Scale-International (FES-I)
- 2016
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Ingår i: Medical principles and practice. - : S. Karger AG. - 1011-7571 .- 1423-0151. ; 25:1, s. 1-7
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The aim of this study was to evaluate the validity and reliability of an Arabic language version (Ar) of the Falls Efficacy Scale-International (FES-I) with respect to its use with Arabic-speaking elderly subjects. Subjects and Methods: For cross-cultural adaptation, the translation of the original English version of the scale was conducted based on the protocol of the Prevention of Falls Network Europe (ProFaNE). The FES-I (Ar) was administered via face-to-face interviews to 108 community-dwelling elderly Palestinians (61 women and 47 men, aged 60-84 years). Statistical analyses were used to determine group differences with respect to age, gender and fall history. To assess validity, Spearman's rank correlation coefficient was used to examine the correlation between the total scores of FES-I (Ar) and the Timed Up and Go (TUG) test, gait speed and balance. Test-retest reliability between the two test occasions was assessed in accordance with Svensson's method. Results: The FES-I (Ar) total scores were positively correlated with TUG (rs = 0.641, p < 0.001) and negatively correlated with gait speed (rs = -0.670, p < 0.001) and balance (rs = -0.592, p < 0.001). All items of the FES-I (Ar) indicated a high percentage agreement (from 88 to 93%), and the relative position ranged from 0.01 to 0.06. Conclusion: In this study, the FES-I (Ar) was shown to be a comprehensible, valid and reliable measure of the concern about falling among community-dwelling elderly subjects. In clinical practice and future research, the FES-I (Ar) instrument could be used to effectively assess concern about falling in Arabic-speaking elderly persons.
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| 9. |
- Kakavas, G, et al.
(författare)
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Periodization in Anterior Cruciate Ligament Rehabilitation: A Novel Framework
- 2021
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Ingår i: Medical principles and practice : international journal of the Kuwait University, Health Science Centre. - : S. Karger AG. - 1423-0151. ; 30:2, s. 101-108
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Tidskriftsartikel (refereegranskat)abstract
- More than 250,000 anterior cruciate ligament (ACL) injuries occur each year in the USA, and approximately 65% of these injuries undergo reconstructive surgery. Appropriate rehabilitation after ACL reconstruction can yield predictably good outcomes, with return to previous levels of activity and high knee function. At present, periodization is used at all levels of sports training. Whether conceptualized and directed by coaches, or by athletes themselves, competitors structure their training in a cyclic fashion, enabling athletes to best realize their performance goals. In practical application, sport physical therapists use periodization: postoperative “protocols” serve as rudimentary forms of periodization, albeit implemented over shorter time frames than that typically employed in preparation for competition. An ACL injury should not be considered a “simple” musculoskeletal pathology with only local mechanical or motor dysfunctions. Together with the psychological trauma and reduction in physical capacity, there is a cascade of events, including neurological insult to the central nervous system and reduction in afferences to the sensorimotor system. Rehabilitation should consider all these issues, and periodization would allow to better define and to plan aims and objectives to return athletes to their sport. Technological resources including advanced neuroimaging methods, virtual reality for injury risk screening and return to sport assessment, and interactive artificial reality-based neuromuscular training methods offer new approaches and tools to address this important biomedical problem. The cost and availability of many of these technologies will continue to decrease, providing greater availability, scientific rigor, and ultimately, utility for cost-effective and data-driven assessments.
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| 10. |
- Thulesius, Olav, 1930-
(författare)
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Thermal reactions of blood vessels in vascular stroke and heatstroke
- 2006
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Ingår i: Medical principles and practice. - : S. Karger AG. - 1011-7571 .- 1423-0151. ; 15:4, s. 316-321
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Tidskriftsartikel (refereegranskat)abstract
- Research on the pathophysiology and treatment of brain damage with special focus on thermal vascular responses is the subject of this minireview. Interruption of cerebral blood supply by vascular obstruction, temporary cardiac arrest or hyperthermia causes a sudden attack of vascular stroke or heatstroke with serious consequences. It may not induce immediate cell death, but can precipitate a complex biochemical cascade leading to a delayed neuronal loss. When testing thermal vasomotor responses by stepwise cooling of isolated carotid arteries, a temperature-proportional dilatation was observed while heating induced the opposite response: a marked vasoconstriction. General hyperthermia with an increased oxygen demand combined with a reduction of blood supply therefore is a serious consequence. At the cellular level an important mechanism involving hyperthermia is the temperature-dependent regulation of K+ channel tone of vascular smooth muscle. Further, their inhibition through temperature elevation causes vasoconstriction. In heatstroke, which can induce platelet aggregation and the release of the vasoconstrictor serotonin, arterial cooling attenuates this response. General hypothermia is induced to prevent or attenuate neurological damage in stroke. The procedure is not without serious side effects. Therefore, rapid institution of selective brain cooling has been considered in adults and in infants with postpartum encephalopathy. Copyright © 2006 S. Karger AG.
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| 11. |
- Yang, Liping, et al.
(författare)
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Effects of fat, beef and fiber in diets on activities of sphingomyelinase, ceramidase and caspase-3 in rat colonic mucosa
- 2002
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Ingår i: Medical Principles and Practice. - : S. Karger AG. - 1011-7571 .- 1423-0151. ; 11:3, s. 150-156
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The present study investigates the activity changes of sphingomyelinase (SMase), ceramidase and caspase-3 in colonic mucosa of rats induced by high fat and red meat diets. Method. For a period of 3 weeks, rats were fed protein without fat (control), high fat only, high fat with beef, and high fat with fiber (cellulose) diets. The fat content (22.4%) was constant in the three high fat diets. Then, the colonic mucosae were scraped and homogenized and the activities of SMase, ceramidase and caspase-3 determined. Results: Compared to the control diet, the fat diet and fat with beef diet reduced intestinal alkaline SMase by 80 and 84%, respectively; ceramidase activity by 60 and 92%, respectively, and caspase-3 activity by 40 and 75%, respectively. The activities of acid and neutral SMases were also decreased by fat and fat with beef diets but to a smaller extent than those of alkaline SMase. Supplement of fiber in the fat diet had no effect on the changes of alkaline SMase activity but prevented fat-induced decreases in acid and neutral SMase activities and partially prevented those of ceramidase and caspase-3 activities. The activity of intestinal alkaline phosphatase was not changed by any of the diets. Conclusion: Fat, beef and fiber significantly affect the enzymes responsible for sphingomyelin metabolism and apoptosis in the colon. The effects may have implications in colonic tumorigenesis related to dietary factors.
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