Journal of Translational Internal Medicine

Open Access Published by De Gruyter Open Access

Volume 3 Issue 3

September 2015

Issue of Journal of Translational Internal Medicine

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Contents
Journal Overview

Open Access September 30, 2015

Current status and inspiration on macrolides in the treatment of chronic obstructive pulmonary disease

Shi-lin Qiu, Xiao-ning Zhong

Page range: 85-88

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Open Access September 30, 2015

Clinical significance of airway mucus hypersecretion in chronic obstructive pulmonary disease

Pan-wen Tian, Fu-qiang Wen

Page range: 89-92

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Abstract

Airway mucus hypersecretion is one of the most important features of chronic obstructive pulmonary disease (COPD). Airway mucus hypersecretion in COPD patients results in outcomes such as rapid decline of lung function, poor quality of life, and high rate of acute exacerbation, hospitalization and mortality. Nonpharmacologic treatments for airway mucus hypersecretion in COPD include smoking cessation and physical rehabilitation. Pharmacologic therapies include expectorants, mucolytics, methylxanthines, beta-adrenergic receptor agonists, anticholinergics, glucocorticoids, phosphodiesterase-4 inhibitors, antioxidants, and antibiotics. Novel drugs with promising prospects are currently under clinical trials.

Open Access September 30, 2015

Viral hepatitis in hemodialysis: An update

Bassam Bernieh

Page range: 93-105

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Abstract

Hepatitis outbreaks in hemodialysis (HD) patients and staff were reported in the late 1960s, and a number of hepatotropic viruses transmitted by blood and other body fluids have been identified. Hepatitis B virus (HBV) was the first significant hepatotropic virus to be identified in HD centers. HBV infection has been effectively controlled by active vaccination, screening of blood donors, the use of erythropoietin and segregation of HBV carriers. Hepatitis delta virus is a defective virus that can only infect HBV-positive individuals. Hepatitis C virus (HCV) is the most significant cause of non-A, non-B hepatitis and is mainly transmitted by blood transfusion. The introduction in 1990 of routine screening of blood donors for HCV contributed significantly to the control of HCV transmission. An effective HCV vaccine remains an unsolved challenge; however, pegylation of interferon-alfa has made it possible to treat HCV-positive dialysis patients. Unexplained sporadic outbreaks of hepatitis by the mid-1990s prompted the discovery of hepatitis G virus, hepatitis GB virus C and the TT virus. The vigilant observation of guidelines on universal precaution and regular virologic testing are the cornerstones of the effective control of chronic hepatitis in the setting of HD. Major recent advances in the viral diagnosis technology and the development of new oral, direct-acting antiviral agents allow early diagnosis and better therapeutic response. The current update will review the recent developments, controversies and new treatment of viral hepatitis in HD patients.

Open Access September 30, 2015

Clinical conundrums in management of sepsis in the elderly

Vishal Sehgal, Sukhminder Jit Singh Bajwa, John A. Consalvo, Anurag Bajaj

Page range: 106-112

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Abstract

In 2012, surviving sepsis campaign came out with updated international guidelines for management of severe sepsis and septic shock. Paradoxically, there are no specific guidelines for management of sepsis in the elderly, although the elderly are more predisposed to sepsis, and morbidity and mortality related to sepsis. Sepsis in the elderly is, more often than not, complicated by clinical conundrums such as congestive heart failure (CHF), atrial fibrillation (AF), chronic kidney disease (CKD), acute kidney injury (AKI), delirium, dementia, ambulatory dysfunction, polypharmacy, malglycemia, nutritional deficiencies, and antibiotic resistance. Also, with recurrent admissions to the hospital and widespread use of antibiotics, the elderly are more susceptible to Clostridium difficile colitis.

Open Access September 30, 2015

A historical perspective: Are inhaled corticoids sufficient to control asthma?

Renaud Louis, Sophie Demarche, Florence Schleich

Page range: 113-115

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Abstract

Inhaled corticoids (ICS) made a dramatic breakthrough in the management of asthma in the late eighties resulting in a sharp reduction in morbidity and mortality in the following decades. Soon after, the association between ICS and long acting β2 agonists (LABA) soon became the gold standard of maintenance asthma treatment. With the advent of sputum induction it has become clear that asthma could not be considered as a unique entity but rather a display of several inflammatory phenotypes. Eosinophilic phenotype shows good response to ICS while non-eosinophilic, and in particular the neutrophilic phenotype, seems to be more resistant. Severe asthmatics show insufficient asthma control despite ICS/LABA. Those who are allergic and eosinophilic may benefit from add-on treatment with anti-IgE or anti-IL-5. Severe neutrophilic asthma could benefit from maintenance treatment with macrolides while thermoplasty offers some promise to those in whom airway smooth muscle hypertrophy contributes to disease instability

Open Access September 30, 2015

Ascorbic acid improves renal microcirculatory oxygenation in a rat model of renal I/R injury

Bulent Ergin, Coert J. Zuurbier, Rick Bezemer, Asli Kandil, Emre Almac, Cihan Demirci, Can Ince

Page range: 116-125

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Abstract

Background and objectives: Acute kidney injury (AKI) is a clinical condition associated with a degree of morbidity and mortality despite supportive care, and ischemia/reperfusion injury (I/R) is one of the main causes of AKI. The pathophysiology of I/R injury is a complex cascade of events including the release of free oxygen radicals followed by damage to proteins, lipids, mitochondria, and deranged tissue oxygenation. In this study, we investigated whether the antioxidant ascorbic acid would be able to largely prevent oxidative stress and consequently, reduce I/R-related injury to the kidneys in terms of oxygenation, inflammation, and renal failure. Materials and methods: Rats were divided into three groups (n = 6/group): (1) a time control group; (2) a group subjected to renal ischemia for 60 min by high aortic occlusion followed by 2 h of reperfusion (I/R); and (3) a group subjected to I/R and treated with an i.v. 100 mg/kg bolus ascorbic acid 15 min before ischemia and continuous infusion of 50 mg/kg/hour for 2 h during reperfusion (I/R + AA). We measured renal tissue oxidative stress, microvascular oxygenation, renal oxygen delivery and consumption, and renal expression of inflammatory and injury markers. Results: We demonstrated that aortic clamping and release resulted in increased oxidative stress and inflammation that was associated with a significant fall in systemic and renal hemodynamics and oxygenation parameters. The treatment of ascorbic acid completely abrogated oxidative stress and inflammatory parameters. However, it only partly improved microcirculatory oxygenation and was without any effect on anuria. Conclusion: The ascorbic acid treatment partly improves microcirculatory oxygenation and prevents oxidative stress without restoring urine output in a severe I/R model of AKI.

Open Access September 30, 2015

Clinical characteristics of tobacco smoke-induced versus biomass fuelinduced chronic obstructive pulmonary disease

Lin-ling Cheng, Ya-ya Liu, Zhu-quan Su, Jun Liu, Rong-chang Chen, Pi-xin Ran

Page range: 126-129

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Abstract

Objective: To investigate differences in clinical features between tobacco smoke-induced and biomass fuel-induced chronic obstructive pulmonary disease (COPD). Methods: We retrospectively analyzed 206 patients with COPD caused by exposure to tobacco smoke and 81 cases of COPD caused by exposure to biomass fuels who received treatment in our hospital between 2011 March and 2014 March. Difference in general health status, clinical symptoms, the dyspnea score, and comorbidities between the two groups were compared. In addition, pulmonary function, grading, and acute exacerbations were also compared. Results: (1) Difference in general health status: Male and female patients with COPD caused by exposure to tobacco smoke were 83.5 and 16.5%, respectively. Male and female patients with COPD caused by exposure to smoke from biomass fuels were 14.8 and 85.2% (χ 2 = 27.2, P < 0.05), respectively. Tobacco smoke-induced COPD was more prevalent in men, and COPD caused by exposure to smoke from biomass fuels was more prevalent in women. After gender adjustment, body mass index (BMI) was lower in women with COPD caused by exposure to smoke from biomass fuels than those by tobacco smoke. There was no statistically significant difference in other indicators, such as age. (2): Difference in clinical symptoms: No statistically significant difference in the modified British Medical Research Counsel (mMRC) Questionnaire, a measure of breathlessness, was observed between the two groups. Dyspnea was more common in COPD patients that was caused by exposure to biomass fuels (38.3%) than by tobacco smoke (11.1%) (χ 2 = 17.9, P < 0.05). The comorbidities of allergic diseases (such as allergic rhinitis, bronchial asthma) were more prevalent in COPD patients that was caused by exposure to smoke from biomass fuels (43.2%) than by tobacco smoke (18%) (χ 2 = 16.1, P < 0.05). However, COPD comorbid with lung cancer was more prevalent in those cases that were caused by exposure to tobacco smoke (7.77%) than in cases caused by exposure to smoke from biomass fuels (3.7%) (χ 2 = 9.7, P < 0.05). (3) Differences in grading of pulmonary function: After gender adjustment, patients with COPD caused by exposure to biomass fuels were mostly in grade B or D. (4) Exacerbations: No significant difference in exacerbations per year was noted between the two groups. Conclusions: Marked differences exist between patients with COPD caused by exposure to tobacco smoke and smoke from biomass fuels. Patients with COPD caused by exposure to biofuels are mostly females with lower BMI and often with many clinical symptoms and complications, such as allergic rhinitis and bronchial asthma. Such patients are often in stage B or D. Tobacco smoke-induced COPD is more prevalent in male patients, often with complications in the form of lung cancer.

Open Access September 30, 2015

Seroprevalence of human immunodeficiency virus infection among tuberculosis patients at tertiary care combined hospital

Rakesh Basavareddy, Asha Basavareddy, Shimoga Laxman Ravi, Bilagumba Ramu Kiran, Gadwalkar R. Srikant

Page range: 130-135

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Abstract

Background and Objectives: Tuberculosis (TB) and the human immunodeficiency virus (HIV) infection have reached epidemic proportions in our country. This study was undertaken to know the seroprevalence of HIV infection among TB patients and to evaluate the various clinical features of TB in seropositive and seronegative patients. This study was undertaken in Vijayanagara Institute of Medical Sciences, Bellary. It was cross-sectional comparative observational study conducted from December 2010 to May 2012. Materials and Methods: A total of 100 consecutive patients diagnosed with TB satisfying inclusion criteria were selected for the study. All patients went through a detailed evaluation along with testing for HIV seroprevalence. Chi-square and Student’s t-tests used to find the significance between two groups. Results: The overall HIV seroprevalence among TB patients was 8%. Seroprevalence was highest in the age group between 31 and 40 years at 29.41% (odds ratio [OR] = 11.11, P = 0.003). It was found that seropositive TB patients were more likely to present with significant weight loss (OR = 19.25, P= 0.000), and have lymphadenopathy OR = 13.24, P = 0.002) and oral candidiasis (OR = 49.44, P = 0.000) on examination. Bilateral chest radiographic involvement (OR = 57.40, P = 0.000) and the disseminated variety of the disease (OR = 29.67, P = 0.001) are also more probable. Conclusions: Human immunodeficiency virus seroprevalence is quite high among TB patients in Bellary. During the evaluation of TB patients, the possibility of HIV co-infection should be kept in mind, and thus adequate knowledge of the likely clinical features is absolutely necessary.

About this journal

Print ISSN 2450-131X
Online ISSN 2224-4018

Journal of Translational Internal Medicine (JTIM), launched in Dec 2013, is an open access journal publishing articles in all areas of translational internal medicine. The journal focuses on information derived from human disease-related experimentations so as to optimize the communication between basic scientific research and clinical science. It has a cycling nature, namely from basic research to clinical practice and then from clinical practice back to basic research.

Aims and Scope

Journal of Translational Internal Medicine (JTIM) is devoted to promoting science and practice in translational medicine and internal medicine in the world. To this end, JTIM publishes articles from all areas of internal medicine. The journal publishes original articles, rapid communications, editorials, reviews, highlights, perspective and other information closed relevant to translational medicine, internal medicine and related fields. Other types of articles include advanced experience, ideological highlights, and Q&A from scholars and scientists in related fields. JTIM will also launch Special Issues in rapid response to the newest development directions of scientific research fields.

JTIM has the ambition to and will become the EXCELLENT international platform for the publication of outstanding studies from all over the world. JTIM is designed to report research progress and the most recent findings in Translational Internal Medicine field, accelerating successful transformation from basic research results to clinically practical theories，diagnosis and treatment techniques, methodologies and drug discovery. With the aims of health care delivery and policy making, JTIM will help to best balance benefits, qualities and costs of medications. At JTIM, we have a challenging mission: to improve the quality of human life and enable people live longer by facilitating disease prevention, treatment and eventually the CURE.

Journal of Translational Internal Medicine is academically supported by:

International Society of Translational Sciences,
Infectious Diseases Society of China,
Chinese Hypertension Committee of Chinese Medical Doctors Association,
China Alliance of COPD, China RTI Optimal Treatment Committee,
Drug Clinical Assessment Committee of Chinese Pharmaceutical Association.