Journal of Translational Internal Medicine

Open Access Published by De Gruyter Open Access

Volume 7 Issue 3

September 2019

Issue of Journal of Translational Internal Medicine

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Contents
Journal Overview

Editorial

Open Access October 12, 2019

Application of wearable technology in clinical walking and dual task testing

Bin Hu

Page range: 87-89

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Commentary

Open Access October 12, 2019

A hypothetical approach on gender differences in cancer diagnosis

Katrin Sak

Page range: 90-92

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Review Article

Open Access October 12, 2019

Endoscopic Ultrasound-guided Gastroenterostomy: A Promising Alternative to Surgery

Guoxin Wang, Xiang Liu, Sheng Wang, Nan Ge, Jintao Guo, Siyu Sun

Page range: 93-99

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Abstract

Recently, with the advancement of techniques, endoscopic ultrasound-guided therapies have shown distinct advantages, especially in relieving benign and malignant gastric outlet obstruction (GOO), as well as in postoperative pancreaticobiliary diseases. Herein, we present five currently used approaches in endoscopic ultrasound-guided gastroenterostomy (EUS-GE) using lumenapposing biflanged metal stents (LAMS), along with several examples of LAMS-based EUS treatment of pancreaticobiliary diseases. Compared with traditional treatment methods, EUS-guided procedures have – to some degree – shown higher success rates, both technical and clinical. Moreover, EUS-guided therapies reduce the risk of multiple surgical adverse events, including delayed gastric emptying, prolonged hospital stay, increased costs, and delay in cancer treatment. Particularly in terms of postoperative pancreaticobiliary diseases, EUS-guided therapy has assumed an essential role as a treatment option in cases where traditional methods are difficult to perform. Nevertheless, EUS-guided gastrointestinal procedures are still relatively new, with some clinical failures, and additional prospective clinical trials are warranted.

Original Article

Open Access October 12, 2019

Treatment of ventilator-associated pneumonia with high-dose colistin under continuous veno-venous hemofiltration

Herbert Spapen, Johan van Laethem, Maya Hites, An Verdoodt, Marc Diltoer, Patrick M. Honoré

Page range: 100-105

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Abstract

Background and Objectives High-dose colistin (COL) ensures adequate treatment of pneumonia caused by multidrug resistant gram-negative bacteria (MDR-GNB) but must be weighed against a higher risk of nephrotoxicity. Continuous veno-venous hemofiltration (CVVH) clears COL by filtering and membrane adsorption that permits to avoid dose accumulation and excessively high peak concentrations. We evaluated clinical/microbiological efficacy of the high-dose COL treatment under CVVH in patients with newly diagnosed MDR-GNB ventilator-associated pneumonia (VAP). Methods Observational cohort study in critically ill adult patients with MDR-GNB VAP. Colistimethate sodium (CMS) was administered as a 9 million international units (MIU) of loading dose followed by 3 × 4.5 MIU daily. CVVH was performed over a highly adsorptive membrane. Clinical and microbiological efficacies were assessed at the end of therapy. In survivors, serum creatinine level was evaluated before and at the end of therapy. Results Fourteen patients (8 male patients, aged 57 ± 14 years) were consecutively included. Isolated pathogens were Pseudomonas aeruginosa in 7, Klebsiella pneumoniae in 5, and other Enterobacteriaceae in 2 patients. A favorable clinical response was observed in 9 patients (64%). Full and presumed microbiological eradication was observed in 12 patients (86%). Two patients were diagnosed with Stage 1 acute kidney injury. Conclusions In patients with MDR-GNB VAP, CVVH may represent an interesting option to enable effective high-dose COL treatment.

Open Access October 12, 2019

Effect of weight reduction on histological activity and fibrosis of lean nonalcoholic steatohepatitis patient

Shahinul Alam, Mohammad Jahid Hasan, Md. Abdullah Saeed Khan, Mahabubul Alam, Nazmul Hasan

Page range: 106-114

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Abstract

Background and Objectives Weight reduction has evidenced benefit on attenuation of histological activity and fibrosis of nonalcoholic steatohepatitis (NASH), but there is scarcity of data for lean NASH subgroup. We have designed this study to compare the effects of weight reduction on histological activity and fibrosis of lean and non-lean NASH. Methods We have included 20 lean and 20 non-lean histologically proven NASH patients. BMI < 25 kg/m2 was defined as non-lean. Informed consent was taken from each subject. All methods were carried out in accordance with the Declaration of Helsinki. Moderate exercise along with dietary restriction was advised for both groups for weight reduction. After 1 year, 16 non-lean and 15 lean had completed second liver biopsy. Results Age, sex, alanine transaminase (ALT), aspartate aminotransferase (AST), gamma-glutamyltrasferase (GGT), Homeostasis model assessment insulin resistance (HOMA-IR), triglyceride and high density lipoprotein (HDL) was similar in both groups. Steatosis, ballooning, lobular inflammation, nonalcoholic fatty liver disease activity score (NAS) and fibrosis was similar in the two groups. In lean/non-lean group, any amount of weight reduction, ≥ 5% weight reduction and ≥ 7% weight reduction was found in respectively 8/11, 5/6 and 2/6 patients. In both lean and non-lean groups, weight reduction of any amount was associated with significant reduction of steatosis, ballooning and NAS, except lobular inflammation and fibrosis. In both groups, weight reduction of ≥ 5% was associated with significant reduction in NAS only. However, significant improvement in NAS was noted with ≥ 7% weight reduction in non-lean group only. Conclusion Smaller amount of weight reduction had the good benefit of improvement in all the segments of histological activity in both lean and non-lean NASH.

Case Report

Open Access October 12, 2019

Elevated lactic acid during ketoacidosis: pathophysiology and management

Hamda Houssein Ahmed, David De Bels, Rachid Attou, Patrick M. Honore, Sebastien Redant

Page range: 115-117

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Abstract

Lactic acidosis results from an acid-base balance disorder of the body due to an excess of lactic acid. It is frequently found in critically ill patients admitted to the intensive care. The most common cause is type A, found in pathologies such as cardiogenic, septic and hypovolemic shock, trauma and severe hypoxemia. The type B is less common and arises without evidence of tissue hypoperfusion or shock. Divers etiologies have been described for this type of hyperlactatemia: Grand Mal seizures, liver failure, hematologic malignancies, congenital enzyme deficiencies, thiamine deficiencies and diabetes mellitus and also alcohol abuse, which may induce a lactic acid under-use or an increased production. The authors describe a rare complication of type 1 Diabetes Mellitus (T1DM), leading to a major and persistent expression of a type B lactic acidosis during ketoacidosis.

Open Access August 6, 2019

Intrahepatic portosystemic shunt in a young female: Views from a developing country

Zain Majid, Muhammad Manzoor ul Haque, Muhammad Danish Ashraf, Nasir Hassan Luck, Ameet Kumar Lalwani

Page range: 118-120

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Abstract

A young female presented to us with abdominal distension along with pedal edema. She had no prior medical or surgical history apart from a caesarean section done a few years prior. Initial workup showed low hemoglobin, low serum albumin and slight raised ESR. Her LFTs were slightly deranged. Ultrasound abdomen had evidence of portal hypertension along with splenomegaly. While ultrasound hepatic Doppler revealed a portosystemic shunt between the portal vein and the left hepatic vein, with a shunt ratio of 7.1%. CT scan abdomen confirmed these findings and a diagnosis of Type III intrahepatic portosystemic shunt and spleno-renal shunt was made. Since the patient was currently asymptomatic, she was advised regular follow-ups and was managed conservatively.

Letter to the Editor

Open Access August 6, 2019

Vitamin C dosing during continuous renal replacement therapy: The last word is not said!

Patrick M. Honore, David De Bels, Luc Kugener, Sebastien Redant, Rachid Attou, Andrea Gallerani, Herbert D. Spapen

Page range: 121-122

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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.