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Positive health:An integrated quantitative approach in patients with chronic gastrointestinal and hepato-pancreatico-biliary disorders

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World Journal of Gastroenterology 2024年第28期30卷 3418-3427页

作者： Anja H W M Lemlijn-Slenter Karolina AP Wijnands Gijs van der Hamsvoort Luuk P van Iperen Nico Wolter Angelique E de Rijk ad am masclee Department of Social Medicine Faculty of HealthMedicine and Life sciencesCare and Public Health Research Institute Maastricht UniversityMaastricht 6200 MDLimburgNetherlands Division of Gastroenterology and Hepatology Department of Internal MedicineSchool of Nutrition and Translational Research in MetabolismMaastricht 6200 MDLimburgNetherlands Social Medical Affairs Employee Insurance Agency(UWV)Heerlen 6400 ACLimburgNetherlands Department of Research Academic Knowledge Center Work and Health South-East Netherlands(AKAG-ZON)Heerlen 6400 ACLimburgNetherlands

BACKGROUND The concept of positive health(PH)supports an integrated approach for patients by taking into account six dimensions of *** approach is especially relevant for patients with chronic *** gastrointestinal and hepatopancreatico-biliary(GI-HPB)disorders are among the top-6 of the most prevalent chronically affected organ *** impact of chronic GI-HPB disorders on individuals may be disproportionally high because:(1)The affected organ system frequently contributes to a malnourished state;and(2)persons with chronic GIHPB disorders are often younger than persons with chronic diseases in other organ *** To describe and quantify the dimensions of PH in patients with chronic GI-HPB *** Prospective,observational questionnaire study performed between 2019 and 2021 in 235 patients with a chronic GIHPB disorder attending the Outpatient Department of the Maastricht University Medical *** questionnaires and data from patient files were used to quantify the six dimensions of *** consistency was tested with McDonald’s ***-order Pearson correlations and t-tests were used to assess associations and differences.A P valueame range as patients with chronic disorders in other organ systems,but depressive symptoms(in 35%)and malnutrition(in 45%)were more frequent in patients with chronic GI-HPB *** scores between the six dimensions were only very weak to weak,forcing us to quantify each domain *** All six dimensions of PH are impaired in the GI-HPB *** and depressive symptoms are more prevalent compared to patients with chronic disorders in other organ systems.

关键词： Positive health Chronic gut disorders Gastrointestinal disorders Hepato-pancreatico-biliary disorders Integrated care

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Optical diagnosis of colorectal polyps using high-definition i-scan: An educational experience

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World Journal of Gastroenterology 2013年第27期19卷 4334-4343页

作者： Mariёlle WE Bouwens Rogier de Ridder ad am masclee Ann Driessen Robert G Riedl Bjorn Winkens Silvia Sanduleanu Division of Gastroenterology and Hepatology Department of Internal MedicineMaastricht University Medical Center NUTRIM School for NutritionToxicology and MetabolismMaastricht University Medical Center Department of Pathology Maastricht University Medical Center Department of Methodology and Statistics Maastricht University Medical Center GROW School for Oncology and Developmental BiologyMaastricht University Medical Center

AIM:To examine performances regarding prediction of polyp histology using high-definition (HD) i-scan in a group of endoscopists with varying levels of experience. METHODS:We used a digital library of HD i-scan still images, comprising twin pictures (surface enhancement and tone enhancement), collected at our university hospital. We defined endoscopic features of adenomatous and non-adenomatous polyps, according to the following parameters:color, surface pattern and vascular pattern. We familiarized the participating endoscopists on optical diagnosis of colorectal polyps using a 20-min didactic training session. All endoscopists were asked to evaluate an image set of 50 colorectal polyps with regard to polyp histology. We classified the diagnoses into high confidence (i.e., cases in which the endoscopist could assign a diagnosis with certainty) and low confidence diagnoses (i.e., cases in which the endoscopist preferred to send the polyp for formal histology). Mean sensitivity, specificity and accuracy per endoscopist/image were computed and differences between groups tested using independent-samples t tests. High vs low confidence diagnoses were compared using the pairedsamples t test. RESULTS:Eleven endoscopists without previous experience on optical diagnosis evaluated a total of 550 images (396 adenomatous, 154 non-adenomatous). Mean sensitivity, specificity and accuracy for diagnosing adenomas were 79.3%, 85.7% and 81.1%, respectively. No significant differences were found between gastroenterologists and trainees regarding performances of optical diagnosis (mean accuracy 78.0%vs 82.9%,P = 0.098). Diminutive lesions were predicted with a lower mean accuracy as compared to non-diminutive lesions (74.2% vs 93.1%, P = 0.008). A total of 446 (81.1%) diagnoses were made with high confidence. High confidence diagnoses corresponded to a significantly higher mean accuracy than low confidence diagnoses (84.0% vs 64.3%, P = 0.008). A total of 319 (58.0%) images were evalu

关键词： Colonoscopy High-definition i-scan Optical diagnosis Colorectal polyps Training

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Routine utilization of machine perfusion in liver transplantation:Ready for prime time?

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World Journal of Gastroenterology 2024年第11期30卷 1488-1493页

作者： Alessandro Parente Keyue Sun Philipp Dutkowski am James Shapiro Andrea Schlegel Department of Surgery Division of TransplantationUniversity of Alberta HospitalEdmonton T6G 2B7Canada Immunity and Inflammation Lerner Research InstituteClevelandOH 44195United States Swiss Hepato-Pancreato-Biliary Center Department of Visceral and Transplantation SurgeryUniversity Hospital ZurichZurich 8091Switzerland Immunity and Inflammation Digestive Disease and Surgery InstituteClevelandOH 44195United States

The last decade has been notable for increasing high-quality research and dramatic improvement in outcomes with dynamic liver *** evidence from numerous randomized controlled trials has been pooled by meta-analyses,providing the highest available evidence on the protective effect of machine perfusion(MP)over static cold storage in liver transplantation(LT).Based on a protective effect with less complications and improved graft survival,the field has seen a paradigm shift in organ *** editorial focuses on the role of MP in LT and how it could become the new“gold standard”.Strong collaborative efforts are needed to explore its effects on long-term outcomes.

关键词： Liver transplantation Machine perfusion Viability assessment Hypothermic oxygenated perfusion Normothermic machine perfusion

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The Role of Secondary School Teacher Training in Their Teaching Practices-A Secondary Publication

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Journal of Contemporary Educational Research 2024年第4期8卷 328-345页

作者： amélie Duguet Sophie Morlaix Institute for Research on Education(IREDU) University of Burgundy Franche-ComtéFrance

This work aims to analyze the effect exerted by the initial and continuous training of secondary school teachers in France on their teaching *** this,we carried out a secondary analysis of data from the TALIS survey(Teaching and Learning International Survey),conducted in 2013 in 34 countries,including *** particular,we focus on practices related to the teaching methods used,classroom management,how to communicate,and the evaluative practices of *** support of binary logistic regression models,we showed that the variables related to initial training play a weak role,and even exert a negative effect on certain pedagogic practices,leading to a reflection on the renovation of this *** the other hand,our analyses highlighted the greater weight played by certain continuing education actions.

关键词： Teacher training Pedagogy methods and tools Analysis of professional practice

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Gifted Students’Special Educational Programs in France:An Analysis of Students’Needs as Perceived by Headmasters-A Secondary Publication

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Journal of Contemporary Educational Research 2024年第4期8卷 316-327页

作者： Karine Buard Minna Puustinen amélie Courtinat-Camps Research Group on Disability AccessibilityEducational and School Practices(GRHAPES)INSHEAFrance Developmental and Educational Psychology “Psychology of Socialisation-Development and Work”Laboratory(LPS-DT)Toulouse Jean Jaurès UniversityFrance

Some French public middle schools offer gifted students the opportunity to pursue their education in general classes,while benefiting from specific facilities within the framework of a dedicated educational *** this study,we sought to identify and analyze the needs of these students as perceived by the headmaster of each middle school *** results highlight two main student needs,common to all these programs(uneasiness and difficulties in peer relationships)as well as needs specifically mentioned by some headmasters(non-adaptive behavior).

关键词： Learning difficulties Students in difficulty Education policies

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Unravelling COVID-19 waves in Rio de Janeiro city:Qualitative insights from nonlinear dynamic analysis

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Infectious Disease Modelling 2024年第2期9卷 314-328页

作者： adriane S.Reis Laurita dos Santos américo Cunha Jr Thaís C.R.O.Konstantyner Elbert E.N.Macao Institute of Science and Technology Federal University of São PauloSão Josédos CamposSPBrazil Physics Institute University of São PauloSão PauloSPBrazil Scientific and Technological Institute Universidade BrasilSão PauloSPBrazil Department of Applied Mathematics Rio de Janeiro State UniversityRio de JaneiroRJBrazil Paulista School of Medicine Federal University of São PauloSão PauloSPBrazil

Since the COVID-19 pandemic was first reported in 2019,it has rapidly spread around the *** countries implemented several measures to try to control the virus *** healthcare system and consequently the general quality of life population in the cities have all been significantly impacted by the Coronavirus *** different waves of contagious were responsible for the increase in the number of cases that,unfortunately,many times lead to *** this paper,we aim to characterize the dynamics of the six waves of cases and deaths caused by COVID-19 in Rio de Janeiro city using techniques such as the Poincaréplot,approximate entropy,second-order difference plot,and central tendency *** results reveal that by examining the structure and patterns of the time series,using a set of non-linear techniques we can gain a better understanding of the role of multiple waves of COVID-19,also,we can identify underlying dynamics of disease spreading and extract meaningful information about the dynamical behavior of epidemiological time *** findings can help to closely approximate the dynamics of virus spread and obtain a correlation between the different stages of the disease,allowing us to identify and categorize the stages due to different virus variants that are reflected in the time series.

关键词： COVID-19 Nonlinear analysis Poincaréplot Central tendency measure

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Prognostic Factors for Mortality in Severe Traumatic Brain Injury at HGZ 46, Villahermosa, Tabasco, Period from March 1, 2021 to December 31, 2022

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Open Journal of Emergency Medicine 2024年第1期12卷 1-9页

作者： américa del Carmen Flores Jiménez Eduardo Guillermo Aguilar López Rafael Blanco De La Vega Pérez Juan Manuel Hernández Vázquez Emergency Room at General Zone Hospital #46 (HGZ46) “Dr. Bartolomé Reynés Berezaluce” from Mexican Institute of Social Security Tabasco Mexico Intensive Care Unit at General Zone Hospital #46 (HGZ46) “Dr. Bartolomé Reynés Berezaluce” from Mexican Institute of Social Security Tabasco Mexico

Introduction: A traumatic brain injury (TBI) is caused by a forceful bump, blow, or jolt to the head or body, or by an object that pierces the skull and interrupts the normal function of the brain. Severe TBI is estimated at 73 cases per 100,000 people. The mortality of severe TBI can be reduced if a timely diagnosis and treatment of the injuries are made through prognostic factors. Objective: To determine the prognostic factors related to mortality in severe traumatic brain injury at the Hospital General de Zona No. 46. Material and Methods: Retrospective, cross-sectional and descriptive study in beneficiaries admitted to the Hospital General de Zona (HGZ) No. 46 of the Mexican Institute of Social Security (IMSS by its acronym in Spanish), with a diagnosis of severe TBI;the possible prognostic factors related to mortality of severe TBI were obtained from their records. Measures of central tendency and chi square were used for data analysis. Results: The study sample consisted of 60 subjects diagnosed with severe traumatic brain injury, of which 5 (8%) were women and 55 (92%) were men, and all 60 (100%) patients died. The average age of the sample was 26 with a standard deviation of 9 years. The variables that had a p value less than or equal to 0.05 were: Mydriasis, seizures, Hyperglycemia, Normoglycemia, Hypothermia and Hypotension. This means that these variables were associated with mortality. Conclusion: Statistical significance is demonstrated in prognostic factors of mortality in severe traumatic brain injury with p < 0.05 in the case of mydriasis, seizures, hyperglycemia, normoglycemia, hypothermia and hypotension.

关键词： Traumatic Brain Injury Prognostic Factors Mortality Severity

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Obstetric References in Disadvantaged Environments: Case of References to the University Hospital Center of Kara, in Northern Togo

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Open Journal of Obstetrics and Gynecology 2024年第2期14卷 267-277页

作者： Kossi Edem Logbo-Akey Bassowa Akila Kofi Mawoulé améwouho Ketevi Tina Yendoubé Pierre Kambote Dédé Régine Diane Ajavon Baguilane Djoauguibe Abdoul-Samadou Aboubakari Koffi Akpadza Service de Gynécologie-Obstétrique CHU Kara Togo Service de Gynécologie-Obstétrique CHU Campus Lomé Togo Service de Gynécologie-Obstétrique CHU Sylvanus Olympio Lomé Togo Service de Gynécologie-Obstétrique CHR Tomdé Kara Togo

Introduction: References are frequent and most often carried out in emergency situations. The objective of this study was to describe the epidemiological and clinical profile of obstetric referrals to the CHU-Kara. Methodology: This was a retrospective cross-sectional descriptive study conducted from September 1, 2022, to February 28, 2023, at CHU-Kara, focusing on obstetric referrals to the Gynecology-Obstetrics department. Result: 828 patients were referred for obstetric reasons out of 1295 admissions, representing a frequency of 63.9%. The average age was 25.04 years. They were primigravida (38.3%), unemployed (62.7%). Motorcycles were the main means of transportation, accounting for 53.1% of cases. The average distance to reach the referral center was 31.6 km, covered in an average of 71 minutes. In 40.7% of cases, patients had less than 4 prenatal consultations and were referred in peripartum (56.6%) for pre-eclampsia (14%), post-term pregnancy (11.8%), dystocia (10.5%). Eighty-six point nine percent (86.9%) of the referred patients were able to deliver during their stay in the department, of which 61.7% had vaginal deliveries. The maternal and perinatal mortality rates were 0.7% and 14.9%, respectively. Conclusion: Obstetric referrals to Kara University Hospital are frequent during the perpartum period and are often carried out by motorbike.

关键词： Obstetric Referral Epidemiology Prognosis CHU-Kara

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Female Contraception: Comparative Study of Biometrics and Vascularization of the Uterus at Sylvanus Olympio University Hospital (Togo)

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Open Journal of Obstetrics and Gynecology 2024年第1期14卷 162-174页

作者： Dédé Régine Diane Ajavon Metoukam Andrée Josiane Douaguibe Baguilane Ketevi améyo Ayoko Logbo Akey Kossi Edem Kambote Yendoube M’bortche Bingo amadou Abdoulatif Aboubakari Abdoul Samadou Faculty of Health Sciences University of Kara Kara Togo Faculty of Health Sciences University of Lomé Lomé Togo Service de gynécologie obstétrique du CHU Sylvanus Olympio Lomé Togo

Female contraception uses both hormonal and non-hormonal methods. The aim of the study is to determine the impact of female contraception on uterine vascularisation and the endometrium. Method: It was a descriptive comparative study with an analytical aim. It took place at the University Clinic of Obstetrics Gynaecology and the Radiology and Medical imaging Department of Sylvanus Olympio University Hospital in Lomé over a two-month period from May 15, 2023 to July 15, 2023. Group 1 included women using a modern contraceptive method and group 2 women not using a modern contraceptive method. Epidata 3.1 and R 4.0.4 software were used to process the data. Results: Each group included 50 women. There were no significant differences in uterine and endometrial biometrics. All women on contraception had their zone 1 vascularized, without vascularisation of zone 2, without significant difference with women without contraception The pulsatility index was greater than 3 in 51% (n = 51) of women, including 62.7% (n = 32) of women without contraception and 37.3% (n = 19) of women on contraception, with a statistically significant difference (p = 0.009). Conclusion: Contraceptive methods do not influence the biometry of the uterus. However, uterine artery Doppler indices can predict abnormal uterine bleeding.

关键词： Contraception Endometrium Uterine Artery Doppler

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Is the DHEAS/cortisol ratio a potential filter for non-operable constipated cases?

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World Journal of Gastroenterology 2010年第6期16卷 659-662页

作者： am El-Tawil Department of Surgery East CorridorGround FloorUniversity Hospital of Birmingham

Constipation is a significant manifestation of a number of psychological *** papers recommend using self-assessment questionnaires for discriminating psychological from non-psychological constipated patients before operating on them but reports from major surveys revealed that general practitioners failed to diagnose 70%of depressed patients using self-assessment *** circulating concentrations of progesterone,17-hydroxyprogesterone,cortisol,testosterone,androstenedione,and dehydroepiandrostenedione sulfate(DHEAS) during the follicular phase in constipated young women compared with respective controls were found during the follicular phase of the menstrual cycles. During the luteal phase of the cycle,reductions were identified in estriol,cortisol and testosterone in the constipated ***,circulating concentrations of DHEAS were found to be lower in depressed patients than comparable healthy ***/cortisol ratios in morning serum and salivary samples were lower than those retrieved during other times of the day in depressed *** idea of recognizing major depression in constipated patients by measuring DHEAS/cortisol ratios in saliva and serum may be plausible but this possibility needs to be confirmed in well-designed studies.

关键词： Chronic constipation Gastrointestinal motility Colonic inertia Steroid hormones adrenal hormones Dehydroepiandrosterone Depression Anxiety

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