Medicine
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Comparative Study Observational Study
Clinical implication of maximal voluntary ventilation in myotonic muscular dystrophy.
Patients with myotonic muscular dystrophy type 1 (DM1) tend to exhibit earlier respiratory insufficiency than patients with other neuromuscular diseases at similar or higher forced vital capacity (FVC). This study aimed to analyze several pulmonary function parameters to determine which factor contributes the most to early hypercapnia in patients with DM1. We analyzed ventilation status monitoring, pulmonary function tests (including FVC, maximal voluntary ventilation [MVV], and maximal inspiratory and expiratory pressure), and polysomnography in subjects with DM1 who were admitted to a single university hospital. ⋯ At the same partial pressure of carbon dioxide, the ratio to the predicted value was lowest for MVV, then FEV1, followed by FVC. Moreover, the P values for differences in MVV and its ratio to the predicted value between ventilator users and nonusers were the lowest. When screening ventilation failure in patients with DM1, MVV should be considered alongside other routinely measured parameters.
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Randomized Controlled Trial
The teaching order of using direct laryngoscopy first may improve the learning outcome of endotracheal incubation: A preliminary, randomized controlled trial.
Endotracheal intubation (ETI) is a life-saving procedure taught to medical students. We examined the influence of the order of teaching ETI through direct laryngoscopy (DL) and video laryngoscopy (VL) on learning by measuring the intubation time and learning curve of trainees, in order to explore ways to improve ETI performance. ⋯ ChiCTR-OOR-16008364.
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The current study aimed to investigate the relationship between the severity of gastroesophageal reflux disease (GERD) according to the Los Angeles (LA) classification and esophageal motility using high-resolution manometry (HRM) and 24-hour esophageal pH monitoring. We examined 124 patients with GERD from January 2016 to June 2018. The LA classification of each patient was determined by endoscopy. ⋯ Patients with severe esophagitis may have motor dysfunction not only in the LES but also in the esophageal body, with resulting increased esophageal acid exposure, which causes esophagitis. Low LES pressure might be the main reason that patients with HH develop esophagitis. GERD without HH may be due to a variety of motor dysfunctions.
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Mibyeongbogam (MBBG) is a mobile application developed for subhealth status self-management in the Republic of Korea. It aims to assess a user's subhealth status, and then to recommend relevant traditional Korean medicine (TKM)-based health-promoting strategies. The purpose of this study is to evaluate the feasibility and effectiveness of MBBG's employment for the subhealth management of general healthy adults. ⋯ The primary endpoint will be tested with a 2-sample t test, or a Wilcoxon rank sum test. Any other continuous variables will be tested via an analysis of covariance, while categorical variables will be tested by a Chi-squared or Fisher exact test. Repeated measure analysis of variance will be performed to explore any in-group differences. The results will be addressed with a 95% confidence interval. We expect that MBBG will be the 1st TKM-based mobile application to be feasible for primary care in subhealth management.
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This study aims to investigate urban-rural differences in characteristics and risk factors of ischemic stroke in northern China. The present cross-sectional study was based on the High-risk Population Screening and Intervention Project for Stroke. The cluster sampling method was used to select urban and rural screening sites in northern China. ⋯ In addition, the prevalence of alcoholism, dyslipidemia, diabetes, and obvious overweight/obesity was greater in urban areas, while high-salt diet and low education and income were more prevalent in rural regions. Moreover, the smoking index was higher in rural areas than in urban areas. The characteristics and risk factors of ischemic stroke differ between rural and urban areas, which could be used to design specific preventative measures.