The European Journal of Case Reports in Internal Medicine – The First Two Years

The European Journal of Case Reports in Internal Medicine (EJCRIM) is just over two years old. To date 400 reports have been submitted and just under half have been accepted for publication. In order to keep costs down our initial policy was to charge a small fee for all submissions, and a further small publication fee for papers that were accepted. However, we have now abolished the submission charge and replaced it with a single, slightly increased, publication charge for all accepted papers

Editorial: European Journal of Case Reports in Internal Medicine

Modern medicine began in the last half of the nineteenth century when doctors started practising the scientific method at the bedside. However, in his presidential address to the Association of American Physicians in 1979 James Wyngaarden postulated that the clinical scientist was an endangered species. Several reasons for this have been suggested, including “the seductive incomes that now derive from procedure-based specialty medicine”. Others have suggested that it is simply because the things left to be discovered at bedside have become exhausted, and that all the big medical advances will now be made by high-powered institutions

Characteristics and Subjective Evaluation of an Intelligent Empowering Agent for Health Person Empowerment

Empowerment is a process through which people acquire the necessary knowledge and self-awareness to understand their health conditions and treatment options, self-manage them, and make informed choices. Currently, few stand-alone applications for patient empowerment exist and people/patients often go on the Web to search for health information. Such information is mainly obtained through generic search engines and it is often overwhelming, too generic, and of poor quality. Intelligent Empowering Agents (IEA) can filter such information and assist the user in the understanding of health information about specific complaints or health in general. We have designed and developed a first prototype of an IEA that dialogues with the user in simple language, collects health information from the Web, and provides tailored, easily understood, and trusted information. It empowers users to create their own comprehensive and objective opinion on health matters that concern them. The paper describes the IEA main characteristics and presents the results of subjective tests carried out to assess the effectiveness of the IEA. Twenty-eight Master students in Digital Health filled an online survey presenting questions on usability, user experience and perceived value. Most respondents found the IEA easy to use and helpful. They also felt that it would improve communication with their doctors

Mapping the DNA Damaging Effects of Polypyridyl Copper Complexes with DNA Electrochemical Biosensors

Several classes of copper complexes are known to induce oxidative DNA damage that mediates cell death. These compounds are potentially useful anticancer agents and detailed investigation can reveal the mode of DNA interaction, binding strength, and type of oxidative lesion formed. We recently reported the development of a DNA electrochemical biosensor employed to quantify the DNA cleavage activity of the well-studied [Cu(phen)2]2+ chemical nuclease. However, to validate the broader compatibility of this sensor for use with more diverse—and biologically compatible—copper complexes, and to probe its use from a drug discovery perspective, analysis involving new compound libraries is required. Here, we report on the DNA binding and quantitative cleavage activity of the [Cu(TPMA)(N,N)]2+ class (where TPMA = tris-2-pyridylmethylamine) using a DNA electrochemical biosensor. TPMA is a tripodal copper caging ligand, while N,N represents a bidentate planar phenanthrene ligand capable of enhancing DNA interactions through intercalation. All complexes exhibited electroactivity and interact with DNA through partial (or semi-) intercalation but predominantly through electrostatic attraction. Although TPMA provides excellent solution stability, the bulky ligand enforces a non-planar geometry on the complex, which sterically impedes full interaction. [Cu(TPMA)(phen)]2+ and [Cu(TPMA)(DPQ)]2+ cleaved 39% and 48% of the DNA strands from the biosensor surface, respectively, while complexes [Cu(TPMA)(bipy)]2+ and [Cu(TPMA)(PD)]2+ exhibit comparatively moderate nuclease efficacy (ca. 26%). Comparing the nuclease activities of [Cu(TPMA)(phen)] 2+ and [Cu(phen)2]2+ (ca. 23%) confirms the presence of TPMA significantly enhances chemical nuclease activity. Therefore, the use of this DNA electrochemical biosensor is compatible with copper(II) polypyridyl complexes and reveals TPMA complexes as a promising class of DNA damaging agent with tuneable activity due to coordinated ancillary phenanthrene ligands

A medical study on wireless inertial measurement technology as a tool for identifying patients at risk of death or imminent clinical deterioration

This paper provides a system description and preliminary results for an ongoing clinical study currently being carried out at the Mid-Western Regional Hospital, Nenagh, Ireland. The goal of the trial is to determine if wireless inertial measurement technology can be employed to identify elderly patients at risk of death or imminent clinical deterioration. The system measures cumulative movement and provides a score that will help provide a robust early warning to clinical staff of clinical deterioration. In addition the study examines some of the logistical barriers to the adoption of wearable wireless technology in front-line medical care

Early warning scores generated in developed healthcare settings are not sufficient at predicting early mortality in Blantyre, Malawi : a prospective cohort study

Early warning scores (EWS) are widely used in well-resourced healthcare settings to identify patients at risk of mortality. The Modified Early Warning Score (MEWS) is a well-known EWS used comprehensively in the United Kingdom. The HOTEL score (Hypotension, Oxygen saturation, Temperature, ECG abnormality, Loss of independence) was developed and tested in a European cohort; however, its validity is unknown in resource limited settings. This study compared the performance of both scores and suggested modifications to enhance accuracy

An Examination of the Persistence of Socialist Institutions within Australian 20th Century Capitalism: With a Case Study of NSW Education until 1955

As a system to satisfy society's needs, capitalism has some utility, the more so if all classes and individuals have some capital. As the ABS contends, "the economic wellbeing of individuals is largely determined by their command over economic resources." In spite of any trickle down of wealth from the dominant capitalist structures and institutions, certain basic impediments to the satisfaction of needs exist for those within society without command over economic resources. That capital and/or wealth are asymmetrically distributed in Australia is demonstrated by the ABS's statistical exposition, such that in 2009-10 the wealthiest 20% owned 66% of the total household wealth, while the poorest 20% owned 1% of total household wealth. The middle cohort, 60% of all households, possessed the residual of around 33%. Moreover, the wealthiest cohort experienced a 15% increase in wealth since 2005-6, while the lowest cohort increased their wealth by only 4% in the same period. It is the lacuna in the satisfaction of social needs that arises from the unequal distribution of income and wealth and the persistence of certain socialistic counter measures that sets the context for this thesis. It is argued that the inequality of satisfaction of needs in an unequal society such as Australia (and many other similar advanced countries) can be and has been remedied by institutionalised 'socialist process systems', to the extent that they have become part of the structure of Australian society

Periodontal regeneration capacity of human periodontal ligament-derived stromal cells

Restoring periodontal defect is still one of the clinical challenges; this is due to the complex structure and diversity of cell types in this joint. The advancement in tissue engineering and cell therapy, make it possible to recruit these approaches to overcome this challenge. This study aims to investigate the capacity of HPDLSCs to differentiation into the main periodontal cell types and enhance the regeneration process. The isolated HPDLSCs were cultured to be characterised for the presence progenitor cell using colony forming unit method. Flow cytometry was used to measure the expression of mesenchymal and hematopoietic cell markers. Furthermore, multilineage cells differentiation was induced. Cells then were seeded on silk scaffold and incubated both in vitro and in vivo in nude mice to examine cellular growth and differentiation. The isolated cells expressed a higher level of MSCs markers in comparison to Hematopoietic markers. Also, these cells showed the ability to proliferate and differentiate into osteogenic, fibrogenic, chondrogenic and adipogenic cues. In Vitro and In Vivo experiments demonstrated the ability of those cells to attach and spread on silk scaffold; In addition to the cellular activities that became evident through the formation of collagen fibres along with the deposition of extracellular minerals. In conclusion, HPDLSCs possess the essential progenitor cells that could differentiate into the primary periodontal cells; Thus, enhancing the periodontal regeneration process