WikiJournal of Medicine
WikiJournal of Medicine
Open access • Publication charge free • Public peer review • Wikipedia-integrated
The WikiJournal of Medicine is an open access, free-to-publish Wikipedia-integrated journal devoted to medicine and biomedicine. It is part of the larger WikiJournal publishing group. Its function is to put articles through academic peer review for stable, citable versions, whose content can potentially benefit Wikipedia and other Wikimedia projects.
VOLUME 10 (2023)
ISSUE 1Current issue
Extract of Laurus nobilis attenuates inflammation and epithelial ulcerations in an experimental model of inflammatory bowel disease
Authors: Robert A. Orlando, Natalie S. Correa
Inflammatory bowel diseases (IBD), including Crohn's disease and ulcerative colitis, are classified as chronic inflammatory disorders and typically require anti-inflammatory drug therapies, such as glucocorticoid regimens, non-steroidal anti-inflammatory drugs, and biologics, aimed at reducing inflammation in the bowel wall. However, each of these therapies is accompanied by a list of possible serious side effects. Because of this, there remains an urgent need to identify new pharmacologic options to reduce or prevent the pro-inflammatory events of IBD while minimizing adverse side effects, and to make available more cost-effective treatment modalities. We have previously identified several herbal extracts that demonstrate potent bio-inhibitory activity of the innate immune response. In particular, Laurus nobilis (LN), or more commonly called bay laurel, demonstrated significant anti-inflammatory function by inhibiting nuclear factor-κB activation. Based upon our original in vitro findings, we have now examined the effects of this herbal extract on a murine dextran sodium sulfate (DSS) model of IBD. Hematoxylin and eosin-stained paraffin sections prepared from DSS treated animals show clear epithelial damage, including ulcerations, extensive neutrophil infiltration into the mucosal layer, and granuloma formation. Tissue from DSS treated animals that also received LN extract showed improved tissue morphology more closely resembling that from control animals. In addition, DSS treated mice with co-administration of LN extract showed a significant reduction in CD4+ antibody staining within the mucosal layer in colonic sections indicating reduced lymphocyte infiltration. Based on these findings, we believe that administration of LN extracts may be effective in reducing the intestinal epithelial damage seen in human IBD and warrants further investigation through clinical trials. [...]
Lay Summary: Inflammatory bowel diseases (IBD), such as Crohn's disease (CD) and ulcerative colitis (UC), manifest as chronic inflammation and ulceration of tissues lining the digestive tract. CD involves inflammation of the deeper layers of the digestive tract, including both the small and large intestines, and less commonly, the upper digestive tract. UC involves inflammation along the lining of the colon and rectum. Steroid or biologic treatments for IBD are common, however, are limited due to significant side effects and/or prohibitive cost. In the present study, we provide evidence for use of the natural product, Laurus nobilis (bay leaf), as a safe and effective anti-inflammatory therapy for IBD.
Authors: Emily Pender, Liana Kostak, Kelsey Sutton, Cody Naccarato, Angelina Tsai, Tammy Chung, Stacey Daughters
Substance Use Disorder (SUD) is understood as the persistent use of substances to the detriment of the individual's livelihood and wellness. SUD can have serious mental, physical, and social ramifications if not properly addressed. Though SUD can develop at any age, it is especially important to address in adolescents, given rising prevalence of certain substances (e.g. cannabis) in that age group and poor prognosis associated with early-onset SUD. Data from the National Survey on Drug Use and Health show the lifetime use of illicit drugs in people ages 12-17 is 20.9%. The same survey found the rate of Substance Use Disorder in the past year for people ages 12-17 who used illicit drugs or alcohol to be 6.3% in 2020. [...]
This paper is intended for clinicians and lay people to gain a deeper understanding of SUD in adolescents, particularly relating to alcohol, cannabis, nicotine, and opioids. Though alcohol, cannabis, and nicotine are the substances most commonly used by this age demographic nationally, opioid use – and resulting deaths – have been on the rise. According to the Centers for Disease Control and Prevention (CDC), opioids were connected to about 75% of the nearly 92,000 drug deaths in 2020. Beyond significant death rates in the general population, recent spikes in adolescent death rate tied to the synthetic opioid fentanyl – which held a relatively stable death rate from 2010 to 2019 until seeing a 94% increase from 2019 to 2020 and additional 20% increase to 2021 - warrants inquiry into opioids for this population. Each of these substances can have adverse, long-lasting effects on health if not managed properly, resulting in seriously compromised lifelong wellbeing. This article explores SUD prevalence and reviews diagnostic criteria in relation to adolescence, including a synopsis of changes in SUD classification between the DSM-IV and DSM-5 and discussion of ICD-11 and the Research Domain Criteria (RDoC) as a basis for research related to substance use. Effective assessment and consideration of co-occurring disorders are covered as well. Although the prognosis of SUD varies by an individual's environment and circumstances, a modal developmental course for SUD is discussed. Finally, a curated list of nationally recognized resources including hotlines, treatment locators, informational sites, and support groups is provided, along with tools to compile local resources. By addressing these aspects of adolescent SUD, the research team offers a broader view of its prevalence in the United States, key warning signs and comorbidities, and possible assessments and treatments for adolescents with SUD.
VOLUME 9 (2022)
ISSUE 1Current issue
Author: Joseph Cusimano
Rabeprazole is a proton pump inhibitor that suppresses gastric acid production in the stomach. Available under different brand name products as well as in a variety of combination products, rabeprazole has several medical uses concerning the management of problems of pathological gastric acid. Rabeprazole's adverse effects tend to be mild but can be serious, including deficiencies in essential nutrients, rare incidences of liver damage, and immune-mediated reactions. As a class effect, rabeprazole can increase the risk for osteoporosis, serious infections (including Clostridium difficile infections), and kidney damage. Rabeprazole can theoretically contribute to numerous drug interactions, mediated both through its metabolic properties and its direct effect on acid in the stomach, though its potential for clinically meaningful drug interactions is low. Like other medications in the proton pump inhibitor class, rabeprazole's mechanism of action involves the irreversible inhibition of proton pumps in the stomach, which are responsible for gastric acid production. Rabeprazole has a number of chemical metabolites, though it is primarily degraded by non-enzymatic metabolism and excreted in the urine. Genetic differences in a person's drug-metabolizing enzymes may theoretically affect individual responses to rabeprazole therapy, though the clinical significance of this interaction is unlikely in comparison to other proton pump inhibitors. The purpose of this review is to provide an up-to-date monograph on rabeprazole.
Author: Kholhring Lalchhandama
The history of coronaviruses is an account of the discovery of coronaviruses and the diseases they cause. It starts with a report of a new type of upper-respiratory tract disease among chickens in North Dakota, US, in 1931. The causative agent was identified as a virus in 1933. By 1936, the disease and the virus were recognised as unique from other viral diseases. The virus became known as infectious bronchitis virus (IBV), but later officially renamed as Avian coronavirus. A new brain disease of mice (murine encephalomyelitis) was discovered in 1947 at Harvard Medical School in Boston. The virus was called JHM (after Harvard pathologist John Howard Mueller). Three years later a new mouse hepatitis was reported from the National Institute for Medical Research in London. The causative virus was identified as mouse hepatitis virus (MHV), later renamed Murine coronavirus. In 1961, a virus was obtained from a school boy in Epsom, England, who was suffering from common cold. The sample, designated B814, was confirmed as novel virus in 1965. New common cold viruses (assigned 229E) collected from medical students at the University of Chicago were also reported in 1966. Structural analyses of IBV, MHV, B18 and 229E using transmission electron microscopy revealed that they all belong to the same group of viruses. Making a crucial comparison in 1967, June Almeida and David Tyrrell invented the collective name coronavirus, as all those viruses were characterised by solar corona-like projections (called spikes) on their surfaces. Other coronaviruses have been discovered from pigs, dogs, cats, rodents, cows, horses, camels, Beluga whales, birds and bats. As of 2022, 52 species are described. Bats are found to be the richest source of different species of coronaviruses. All coronaviruses originated from a common ancestor about 293 million years ago. Zoonotic species such as Severe acute respiratory syndrome-related coronavirus (SARS-CoV), Middle East respiratory syndrome-related coronavirus (MERS-CoV) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a variant of SARS-CoV, emerged during the past two decades and caused the first pandemics of the 21st century.
Author: Siang Ching Raymond Chieng
This review article is written to give a comprehensive and yet straightforward overview regarding a tropical disease named melioidosis. Besides that, this article also aims to promote awareness and research in the disease. Melioidosis is an infectious disease that ravages the tropical regions around the world. However, the awareness of this disease is lacking in developing countries. It is not even included in the WHO list of Neglected Tropical Disease. The ability of this disease to spread through air by inhalation makes it a potential agent for bioweapons, although there is no documented evidence of its use in biological warfare. There are also various gaps of research in melioidosis. A search into PubMed and Google Scholar was done by using keywords "melioidosis", "melioidosis biological agent", "Burkholderia pseudomallei", "human melioidosis", and "melioidosis review" while writing this review. Allocation of resources into the study and prevention of melioidosis will help to improve the disease burden in developing countries.
Authors: Richard Abidin, Logan Smith, Hannah Kim, Eric Youngstrom
Parenting Stress relates to stressors that are a function of being in and executing the parenting role. It is a construct that relates to both psychological phenomena and to the human body’s physiological state as a parent or caretaker of a child. This article serves as a brief narrative review of the construct.
Author: Siang Ching Raymond Chieng
This article aims to provide a comprehensive overview of the infectious zoonotic disease Leptospirosis in tropical countries. Warm blooded animals such as mice, dogs, and cows can be infected by this disease and carry the disease to humans. Although cold blooded animals such as reptiles may have Leptospira bacteria in them, their role in causing diseases in humans are unknown. Once infected, symptoms can range from mild disease to life-threatening ones. The pathogenesis of the leptospirosis infection is not completely understood. Therefore, more researches are required to understand the disease. Searches into PubMed and Google Scholar were done by using keywords "leptospirosis", "human leptospirosis", "animal leptospirosis", "Leptospira", and "leptospirosis review" while writing this article. In conclusion, leptospirosis is a common disease in the tropics and the public should know the effective ways of avoiding or treating the disease.
Author: Osmin Anis
The Kivu Ebola epidemic began on 1 August 2018, when four cases of Ebola virus disease (EVD) were confirmed in the eastern region of Kivu in the Democratic Republic of the Congo (DRC). The disease affected the DRC, Uganda, and is suspected to have also affected Tanzania, though the Ministry of Health there never shared information with the WHO. The outbreak was declared ended on 25 June 2020, with a total of 3,470 cases and 2,280 deaths. [...]
Other locations in the DRC affected included the Ituri Province, where the first case was confirmed on 13 August 2018. In November 2018, it became the biggest Ebola outbreak in the DRC's history, and by November, it had become the second-largest Ebola outbreak in recorded history, behind only the 2013–2016 Western Africa epidemic. On 3 May 2019, 9 months into the outbreak, the DRC death toll surpassed 1,000. In June 2019, the virus reached Uganda, having infected a 5-year-old Congolese boy who entered with his family, but this was contained. Since January 2015, the affected province and general area have been experiencing a military conflict, which hindered treatment and prevention efforts. The World Health Organization (WHO) has described the combination of military conflict and civilian distress as a potential "perfect storm" that could lead to a rapid worsening of the situation. In May 2019, the WHO reported that, since January of that year, there had been 42 attacks on health facilities and 85 health workers had been wounded or killed. In some areas, aid organizations have had to stop their work due to violence. Health workers also had to deal with misinformation spread by opposing politicians. Due to the deteriorating security situation in North Kivu and surrounding areas, the WHO raised the risk assessment at the national and regional level from "high" to "very high" in September 2018. In October, the United Nations Security Council stressed that all armed hostility in the DRC should come to a stop to address the ongoing outbreak better. A confirmed case in Goma triggered the decision by the WHO to convene an emergency committee for the fourth time, and on 17 July 2019, the WHO announced a Public Health Emergency of International Concern (PHEIC), the highest level of alarm the WHO can sound. On 15 September 2019, some slowdown of cases was noted in the DRC. However, contact tracing continued to be less than 100%; at the time, it was at 89%. In mid-October the transmission of the virus had significantly reduced; by then it was confined to the Mandima region near where the outbreak began, and was only affecting 27 health zones in the DRC (down from a peak of 207). New cases decreased to zero by 17 February 2020, but after 52 days without a case, surveillance and response teams confirmed three new cases in mid-April. As a new and separate outbreak, was reported on 1 June 2020 in Équateur Province in north-western DRC, described as the eleventh Ebola outbreak since records began; after almost two years the tenth outbreak was declared ended on 25 June 2020, with a total of 3,470 cases and 2,280 deaths.
VOLUME 8 (2021)
ISSUE 1Current issue
Authors: Joana Azeredo, Jean-Paul Pirnay, Diana Priscila Pires, Mzia Kutateladze, Krystyna Dabrowska, Rob Lavigne, Bob G Blasdel
Phage therapy refers to the use of bacteriophages (phages - bacterial viruses) as therapeutic agents against infectious bacterial diseases. This therapeutic approach emerged in the beginning of the 20th century but was progressively replaced by the use of antibiotics in most parts of the world after the second world war. More recently however, the alarming rise of multidrug-resistant bacteria and the consequent need for antibiotic alternatives has renewed interest in phages as antimicrobial agents. Several scientific, technological and regulatory advances have supported the credibility of a second revolution in phage therapy. Nevertheless, phage therapy still faces many challenges that include: i) the need to increase phage collections from reference phage banks; ii) the development of efficient phage screening methods for the fast identification of the therapeutic phage(s); iii) the establishment of efficient phage therapy strategies to tackle infectious biofilms; iv) the validation of feasible phage production protocols that assure quality and safety of phage preparations; and (v) the guarantee of stability of phage preparations during manufacturing, storage and transport. Moreover, current maladapted regulatory structures represent a significant hurdle for potential commercialization of phage therapeutics. This article describes the past and current status of phage therapy and presents the most recent advances in this domain.
Author: Kholhring Lalchhandama
The history of penicillin was shaped by the contributions of numerous scientists. The ultimate result was the discovery of the mould Penicillium's antibacterial activity and the subsequent development of penicillins, the most widely used antibiotics. Following an accidental discovery of the mould, later identified as Penicillium rubens, as the source of the antibacterial principle (1928) and the production of a pure compound (1942), penicillin became the first naturally derived antibiotic. There is anecdotal evidence of ancient societies using moulds to treat infections and of awareness that various moulds inhibited bacterial growth. However, it is not clear if Penicillium species were the species traditionally used or if the antimicrobial substances produced were penicillin. In 1928, Alexander Fleming was the first to discover the antibacterial substance secreted by the Penicillium mould and concentrate the active substance involved, giving it the name penicillin. His success in treating Harry Lambert's streptococcal meningitis, an infection until then fatal, proved to be a critical moment in the medical use of penicillin. Many later scientists were involved in the stabilisation and mass production of penicillin and in the search for more productive strains of Penicillium. Among the most important were Ernst Chain and Howard Florey, who shared with Fleming the 1945 Nobel Prize in Physiology or Medicine.
Authors: Sofia M. Ramos, Reinhardt G. Dreyer, Thandi E. Buthelezi
Bilateral persistent sciatic artery (PSA) is a rare vascular anomaly. We report an exceptionally rare case of complete bilateral PSAs, diagnosed on computed tomography angiography (CTA) in a patient who sustained a gunshot wound to the lower limb. Incidental PSAs are unlikely to have clinical significance, however, the unusual anatomy and higher incidence of complications requires accurate reporting of such variants. In this case, the anomaly paradoxically proved beneficial given the proximity of the gunshot wound to the femoral vessels. The embryology, clinical and imaging findings, potential complications, and treatment options regarding PSA are discussed.
Does the packaging of health information affect the assessment of its reliability? A randomized controlled trial protocol
Authors: Denise Smith, James Heilman, Leela Raj
Background: Wikipedia is frequently used as a source of health information. However, the quality of its content varies widely across articles. The DISCERN tool is a brief questionnaire developed in 1996 by the Division of Public Health and Primary Health Care of the Institute of Health Sciences of the University of Oxford. They claim it provides users with a valid and reliable way of assessing the quality of written information. However, the DISCERN instrument’s reliability in measuring the quality of online health information, particularly whether or not its scores are affected by reader biases about specific publication sources, has not yet been explored. [...]
Methods: This study is a double-blind randomized assessment of a Wikipedia article versus a BMJ literature review using a modified version of the DISCERN tool. Participants will include physicians and medical residents from four university campuses in Ontario and British Columbia and will be randomized into one of four study arms. Inferential statistics tests (paired t-test, multi-level ordinal regression, and one-way ANOVA) will be conducted with the data collected from the study. Outcomes: The primary outcome of this study will be to determine whether a statistically significant difference in DISCERN scores exists, which could suggest whether or not how health information is packaged influences how it is assessed for quality.
VOLUME 7 (2020)
ISSUE 1Previous issue
Authors: Ankita Gupta, Kate V Meriwether, Sara Petruska, Sydni Fazenbaker-Crowell, Collin M McKenzie, Adam L Goble, J Ryan Stewart
Objective: We aim to evaluate hysterectomy-recovery related videos on YouTube. [...]
Methods: This cross-sectional study analyzed videos available through the YouTube interface. We calculated the views-per-day and interactions (comments, “thumbs up or down”) per 1,000 views for relevant videos. The publishers were categorized into patients, physicians, hospitals, media, industry, nonprofit, government and “other”. Video characteristics were compared between these categories using non-parametric tests. Results: We analyzed 2,092 YouTube videos related to hysterectomy recovery; 959 relevant videos published from August 30, 2006 to June 16, 2017 were included. The largest number of relevant videos were published by patients (48.6%), followed by physicians (15.8%), hospitals (12.7%), media (7.8%), and industry (7.6%). Views per day were similar between videos published by patients and physicians (median 2.1, vs median 2.6, p = 0.31). Videos published by patients had more interaction in the form of “thumbs up” votes (median 8.6/1,000 views, p<0.01) and comments (median 2.7/1,000 views, p<0.01) as compared to other categories. Conclusion: Almost half of the hysterectomy videos on YouTube are posted by patients and have more viewer interaction than other categories. Physicians should consider partnering with patient advocates to improve viewer interaction.
Authors: Jack Nunn, Steven Chang
Systematic reviews are a type of review that uses repeatable analytical methods to collect secondary data and analyse it. Systematic reviews are a type of evidence synthesis which formulate research questions that are broad or narrow in scope, and identify and synthesize data that directly relate to the systematic review question. While some people might associate ‘systematic review’ with 'meta-analysis', there are multiple kinds of review which can be defined as ‘systematic’ which do not involve a meta-analysis. Some systematic reviews critically appraise research studies, and synthesize findings qualitatively or quantitatively. Systematic reviews are often designed to provide an exhaustive summary of current evidence relevant to a research question. For example, systematic reviews of randomized controlled trials are an important way of informing evidence-based medicine, and a review of existing studies is often quicker and cheaper than embarking on a new study. [...]
While systematic reviews are often applied in the biomedical or healthcare context, they can be used in other areas where an assessment of a precisely defined subject would be helpful. Systematic reviews may examine clinical tests, public health interventions, environmental interventions, social interventions, adverse effects, qualitative evidence syntheses, methodological reviews, policy reviews, and economic evaluations. An understanding of systematic reviews and how to implement them in practice is highly recommended for professionals involved in the delivery of health care, public health and public policy.
Authors: Eric Youngstrom, Stephen Hinshaw, Alberto Stefana, Jun Chen, Kurt Michael, Anna Van Meter, Victoria Maxwell, Erin Michalak, Emma Grace Choplin, Logan Smith, Caroline Vincent, Avery Loeb, Eduard Vieta
Beyond public health and economic costs, the COVID-19 pandemic adds strain, disrupts daily routines, and complicates mental health and medical service delivery for those with mental health and medical conditions. Bipolar disorder can increase vulnerability to infection; it can also enhance stress, complicate treatment, and heighten interpersonal stigma. Yet there are successes when people proactively improve social connections, prioritize self-care, and learn to effectively use mobile and telehealth.
Emotional and Psychological Impact of Interpreting for Clients with Traumatic Histories on interpreters: a review of qualitative articles
Authors: Salma Rehman, Parveen Ali, Aasia Rajpoot
Interpreters play an important role in the health and social care system. The aim of this review is to synthesize available qualitative studies exploring experiences of interpreters when working with individuals and groups who have experienced domestic violence and abuse or other traumatic situations. A comprehensive literature search of databases helped identify 18 studies including 3 quantitative and 15 qualitative studies published between 2003-2017. The studies were conducted in various countries and data analysis resulted in the development of 5 themes which included: ‘role and impact of interpreter’; ‘psychological and emotional impact of interpreting’; ‘workplace challenges faced by interpreters’; ‘coping strategies used by interpreters’; and ‘interpreters’ support needs’. Themes are discussed in relation to the available literature and gaps in the literature are identified.
Comparison between the Lund-Browder chart and the BurnCase 3D® for consistency in estimating total body surface area burned
Authors: Kyung tak Yoo, Gowoon Woo, Tae Young Jang, Jae Seok Song
Objective: Measure time required to determine total body surface area (TBSA) burned (%TBSA) using the Lund-Browder chart and BurnCase 3D®, and calculate discrepancy between the two methods' %TBSA estimates. [...]
Methods: We asked 3 burn experts with 7 to 9 years of experience to participate in our experiment by estimating TBSA burned (%TBSA) for 26 subjects with a total of 262 photos, based on the Lund-Browder chart and the BurnCase 3D. We also measured time required for each estimation. Results: Estimations via the Lund-Browder chart and the BurnCase 3D showed statistically significant differences for Observers 1 and 2 (p < 0.05), but not for Observer 3 (p = 0.11). Inter-observer variability was insignificant among the observers (p = 0.31). When using the BurnCase 3D, burn estimation was consistent across the 3 participants (p = 0.31), yet the time spent for each method was significantly different (p < 0.05) from using the Lund-Browder chart and the time spent for estimation did not statistically vary (p = 0.20). Time spent on burn estimation varied when using either the Lund-Browder chart or the BurnCase 3D for all participants (p < 0.05). Conclusion: Using the BurnCase 3D over the Lund-Browder chart produced slightly different estimations for TBSA burned but estimation results stayed stable across inspectors. Due to the small sample size however, further investigation is necessary.
Author: Mario Rizzetto
Hepatitis D is a globally occurring liver disease. It afflicts those who have been infected by both the Hepatitis B virus (HBV) and also the Hepatitis D virus (HDV), since HDV needs the hepatitis B surface antigen (HBsAg) to replicate. It is therefore most prevalent in countries where HBV infection is also common, currently the Amazon basin and low income regions of Asia and Africa. Improved measures to control HBV in industrialised countries (such as by vaccination) have also reduced the prevalence of HDV, with the main remaining at-risk populations in those countries being injection drug users and immigrants from endemic HDV areas.
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