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Impact of pre- and peri-operative risk factors on length of stay and hospital readmission following minimally-invasive partial nephrectomy

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Asian Journal of Urology 2024年第1期11卷 72-79页

作者： Vanessa A.Lukas Rahul Dutta Ashok K.Hemal Matvey Tsivian Timothy E.Craven Nicholas A.Deebel David D.Thiel Ram anil Pathak Brigham and Women's Hospital Division of UrologyDepartment of Surgery75 Francis StreetBostonMAUSA Atrium Health Wake Forest Baptist Medical Center Department of Urology1 Medical Center BlvdWinston-SalemNCUSA Mayo Clinic Florida Department of Urology4500 San Pablo RoadJacksonvilleFLUSA

Objective:We conducted an analysis of the American College of Surgeons National Surgical Quality Improvement Program database for minimally-invasive partial nephrectomy cases reported with the goal to identify pre-and peri-operative variables associated with length of stay(LOS)greater than 3 days and readmission within 30 ***:Records from 2008 to 2018 for“laparoscopy,surgical;partial nephrectomy”for prolonged LOS and readmission cohorts were *** analysis with Chi-square,t-tests,and multivariable logistic regression analysis with odds ratios(ORs),p-values,and 95%confidence intervals assessed statistical ***:Totally,20306 records for LOS greater than 3 days and 15854 for readmission within 30 days were *** and multivariable analysis exhibited similar *** LOS greater than 3 days,undergoing non-elective surgery(OR=5.247),transfusion of greater than four units within 72 h prior to surgery(OR=5.072),pre-operative renal failure or dialysis(OR=2.941),and poor pre-operative functional status(OR=2.540)exhibited the strongest statistically significant *** hospital readmission within 30 days,loss in body weight greater than 10%in 6 months prior to surgery(OR=2.227)and bleeding disorders(OR=2.081)exhibited strongest statistically significant ***:Multiple pre-and peri-operative risk factors are independently associated with prolonged LOS and hospital readmission within 30 days of surgery using the American College of Surgeons National Surgical Quality Improvement Program *** the risks factors that can potentially be improved prior to minimally-invasive partial nephrectomy is crucial to informing patient selection,optimization strategies,and patient education.

关键词： Minimally-invasive partial nephrectomy The American College of Surgeons National Surgical Quality Improvement Program Lengthof stay Hospital readmission

Spectrum of COVID-19 induced liver injury:A review report

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World Journal of Hepatology 2024年第4期16卷 517-536页

作者： Lokjan Singh anil Kumar Maya Rai Bibek Basnet Nishant Rai Pukar Khanal Kok-Song Lai Wan-Hee Cheng Ahmed Morad Asaad Shamshul Ansari Department of Microbiology Karnali Academy of Health ScienceTeaching HospitalJumla 21200KarnaliNepal Health Sciences Asian College of Advance StudiesPurbanchal UniversitySatdobato 24122LalitpurNepal Department of Biotechnology Graphic Era(Deemed to be University)Dehradun 248002UttarakhandIndia Department of Pharmacology&Toxicology KLE College of PharmacyBelagaviKLE Academy of Higher Education and ResearchBelagavi 590010KarnatakaIndia Division of Health Sciences Abu Dhabi Women's CollegeHigher Colleges of TechnologyAbu Dhabi 41012United Arab Emirates Health and Life Sciences INTI International UniversityNilai 71800Malaysia Department of Microbiology College of MedicineZagazig UniversityZagazig 44519Egypt

The coronavirus disease 2019(COVID-19)pandemic has caused changes in the global health system,causing significant setbacks in healthcare systems *** pandemic has also shown resilience,flexibility,and creativity in reacting to the *** severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection targets most of the respiratory tract,resulting in a severe sickness called acute respiratory distress syndrome that may be fatal in some *** the lung is the primary organ targeted by COVID-19 viruses,the clinical aspect of the disease is varied and ranges from asymptomatic to respiratory ***,due to an unorganized immune response and several affected mechanisms,the liver may also experience liver cell injury,ischemic liver dysfunction,and drug-induced liver injury,which can result in respiratory failure because of the immune system’s disordered response and other compromised processes that can end in multisystem organ *** with liver cirrhosis or those who have impaired immune systems may be more likely than other groups to experience worse results from the SARS-CoV-2 *** thus intend to examine the pathogenesis,current therapy,and consequences of liver damage concerning COVID-19.

关键词： Autoimmune liver disease COVID-19 Clinical manifestation of liver Drug-induced liver injury SARS-CoV-2

Echocardiographic predictors and associated outcomes of multiple vegetations in infective endocarditis:A pilot study

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World Journal of Cardiology 2024年第6期16卷 318-328页

作者： Ajay Kumar Mishra Kannu Bansal Ibragim Al-Seykal Pradnya B Bhattad Anu Anna George anil Jha Nitish Sharma Jennifer Sargent Mark J Kranis Division of Cardiology Saint Vincent HospitalWorcesterMA 01608United States Department of Internal Medicine Saint Vincent HospitalWorcesterMA 01608United States Department of Medicine Division of CardiologySaint Vincent HospitalWorcesterMA 01608United States Division of Cardiovascular Medicine Saint Vincent HospitalWorcesterMA 01608United States

BACKGROUND Infective endocarditis(IE)is a life-threatening infection with an annual mortality of 40%.Embolic events reported in up to 80%of *** of>10 mm size are associated with increased embolic events and poor *** is a paucity of literature on the association of multiple vegetations with *** To study the echocardiographic(ECHO)features and outcomes associated with the presence of multiple *** In this retrospective,single-center,cohort study patients diagnosed with IE were recruited from June 2017 to June 2019.A total of 84 patients were diagnosed to have IE,of whom 67 with vegetation were *** demographic,clinical,laboratory,and ECHO parameters were *** that were studied included recurrent admission,embolic phenomenon,and *** Twenty-three(34%)patients were noted to have multiple vegetations,13(56.5%)were male and 10(43.5%)were *** mean age of these patients was ***(35%)had a prior episode of *** features of moderate to severe valvular regurgitation[odds ratio(OR)=4],presence of pacemaker lead(OR=4.8),impaired left ventricle(LV)relaxation(OR=4),and elevated pulmonary artery systolic pressure(PASP)(OR=2.2)are associated with higher odds of multiple *** these moderate to severe valvular regurgitation(P=0.028),pacemaker lead(P=0.039)and impaired relaxation(P=0.028)were statistically *** patients were noted to have an increased association of recurrent admissions(OR=3.6),recurrent bacteremia(OR=2.4),embolic phenomenon(OR=2.5),intensive care unit stay(OR=2.8),hypotension(OR=2.1),surgical intervention(OR=2.8)and device removal(OR=4.8).Of this device removal(P=0.039)and recurrent admissions(P=0.017)were statistically *** This study highlights the associations of ECHO predictors and outcomes in patients with IE having multiple *** features of moderate to severe regurgitation,presence of pacemaker lead,impai

关键词： Endocarditis Echocardiography Vegetations Predictors Outcome

Efficacy and safety of abrocitinib in Chinese patients with moderate-to-severe atopic dermatitis: A post hoc analysis of the JADE REGIMEN phase 3 trial

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中华医学杂志(英文版) 2024年第16期137卷 2024 Jul 15页

作者： Li Hang Cheng Hao Lu Qianjin Lai Wei Tao Xiaohua Encinas Gerardo A. vyas Shefali Wang Bo Luo Xin Li Shiqi Department of Dermatology Peking University First Hospital National Clinical Research Center for Skin and Immune Diseases Beijing China Department of Dermatology Sir Run Run Shaw Hospital Zhejiang University School of Medicine Hangzhou Zhejiang China Department of Dermatology The Second Xiangya Hospital of Central South University Changsha Hunan China Department of Dermatology The Third Affiliated Hospital of Sun Yat-sen University Guangzhou Guangdong China Department of Dermatology Zhejiang Provincial People’s Hospital Hangzhou Medical College Hangzhou Zhejiang China Pfizer S.A. de C.V. Mexico City Mexico Pfizer Inc. New York NY USA Pfizer Investment Co. Ltd Beijing China Pfizer (China) R& D Co. Ltd Shanghai China Pfizer PBG Shanghai China

Evidence-based universal health coverage interventions delivery in infectious disease of poverty elimination and eradication

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Infectious Diseases of Poverty 2024年第1期13卷 90-90页

作者： Ernest Tambo Chidiebere E.Ugwu Amberbir Alemayehu anil Krishna Agnes Binagwaho Center for Leadership in Global Health Equity University of Global HealthEquityKigaliRwanda Africa Disease Intelligence Preparedness and Response(ADIPR)YaoundeCameroon Higher Institute of Health Sciences Faculty of MedicineBangangteCameroon Institute for Global Health Equity Research University of Global Health EquityKigaliRwanda Department of Human Biochemistry Nnamdi Azikiwe UniversityNnewiAnambraNigeria

The recent 78th United Nations General Assembly(UNGA)declaration relaunched a new health priority and political commitment in accelerating Universal Health Coverage(UHC),adopted by the United Nations(UN)in 2015 and are intended to be met by *** mid-way point of UHC implementation,we advocate for the much needed program-matic implementation research,evidence-based interventions(EBls)policies and strategies leadership and manage-ment capacity building to enable robust,resilient and sustainable multi-sectoral partnerships,integrated coordination and governance mechanisms capabilities in accelerating UHC package mainly infectious diseases of poverty elimina-tion and eradication agenda.

关键词： elimination enable poverty

Emerging Novel Therapeutic Approaches for the Treatment of Alzheimer’s Disease

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Advances in Alzheimer's Disease 2024年第3期13卷 65-94页

作者： Amit Panwar Mohd. Imran Khan Rajesh Kumar Rakesh Kumar Santosh Kumar Rai anil Kumar New Drug Discovery Research Mankind Research Centre Mankind Pharma Limited Gurugram India

Alzheimer’s disease (AD) is caused by synaptic failure and the excessive accumulation of misfolded proteins especially Aβ and tau, and associated with memory loss and cognitive impairment. Treatment of AD mainly consists of symptomatic therapy and disease-modifying therapy (DMT). Several monotherapies including small molecules or antibodies have been evaluated through multiple clinical trials, but a very few have been approved by the USFDA to intervene the disease’s pathogenesis. Past research has shown multifactorial nature of AD, therefore, multi-target drugs were proposed to target different pathways at the same time, however, currently no rationally designed multi-target directed ligand (MTDL) has been clinically approved. Different combinations and bispecific antibodies are also under development. Novel approaches like stem cell-based therapies, microRNAs, peptides, ADCs and vaccines cast a new hope for AD treatment, however, a number of questions remained to be answered prior to their safe and effective clinical translation. This review explores the small molecules, MTDL, and antibodies (monospecific and bispecific) for the treatment of AD. Finally, future perspectives (stem cell therapy, PROTAC approaches, microRNAs, ADC, peptides and vaccines) are also discussed with regard to their clinical applications and feasibility.

关键词： Alzheimer’s Disease (AD) Disease-Modifying Therapy (DMT) MicroRNAs PROTAC

Is it necessary to stop glucagon-like peptide-1 receptor agonists prior to endoscopic procedure? A retrospective study

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World Journal of Gastroenterology 2024年第26期30卷 3221-3228页

作者： Haider Ghazanfar Nismat Javed Abeer Qasim Franklin Sosa Faryal Altaf Shazia Khan Jaydeep Mahasamudram Abhilasha Jyala Sameer Datta Kandhi Dongmin Shin Nikhitha Mantri Haozhe Sun Siddarth Hanumanthu Harish Patel Jasbir Makker Bhavna Balar anil Dev Sridhar Chilimuri Division of Gastroenterology Department of Internal MedicineBronxCare Health SystemIcahn School of Medicine at Mount SinaiBronxNY 10457United States Department of Internal Medicine BronxCare Health SystemIcahn School of Medicine at Mount SinaiBronxNY 10457United States

BACKGROUND Glucagon-like peptide-1 receptor agonists(GLP-1 RA)are effective in diabetes and obesity,reducing hyperglycemia by increasing insulin release and delaying gastric ***,they can cause gastroparesis,raising concerns about aspiration during *** guidelines advise discontinuing GLP-1 RA before surgery to reduce the risk of pulmonary *** To evaluate the effect of GLP-1 RAs on gastric residual contents during endosco-pic *** A retrospective chart review at BronxCare Health System,New York,from January 2019 to October 2023,assessed gastric residue and aspiration in GLP-1 RA patients undergoing endoscopic *** groups were compared based on dietary status before the *** included demographics,symptoms of gastroparesis,opiate use,hemoglobin A1c,GLP-1 agonist indication,endo-scopic details,and aspiration *** SPSS was used for analysis,cal-culating means,standard deviations,and applying Pearson’s chi-square and t-tests for associations,with P<0.05 as being *** During the study,306 patients were included,with 41.2%on a clear liquid/low residue diet and 58.8%on a regular diet before *** patients(63.1%)were male,with a mean age of 60±12 *** majority(85.6%)were on GLP-1 RAs for diabetes,and 10.1%reported digestive symptoms before *** those on a clear liquid diet,1.5%had residual food at endoscopy compared to 10%on a regular diet,which was statistically significant(P=0.03).Out of 31 patients with digestive symptoms,13%had residual food,all from the regular diet group(P=0.130).No complications were reported during or after the *** The study reflects a significant rise in GLP-1 RA use for diabetes and obesity.A 24-hour liquid diet seems safe for endoscopic procedures without *** with upper gastrointestinal symptoms might have a higher residual food risk,though not statistically *** research is needed

关键词： Glucagon-like peptide-1 agonists Gastroparesis Endoscopic procedures Residual food Complications

Handgrip strength in type 2 diabetics and nondiabetics:A comparative cross-sectional study among adults in rural Mysore

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Journal of Integrative Nursing 2024年第3期6卷 150-154页

作者： Deepak anil M.RAKESH Shabeena AKBAR Vijaylakshmi Rao VADAGA D.Sunil KUMAR Department of Community Medicine JSS Medical CollegeJSS Academy of Higher Education and ResearchMysoreKarnatakaIndia

Objectives:The objective of this study is to assess the handgrip strength(HGS)in patients with type 2 diabetes,compare it with nondiabetes age-matched individuals,and assess the correlation between diabetic status and HGS among diabetic *** and Methods:A community-based cross-sectional study was conducted in rural Mysore,India,for 4 ***-eight clinically diagnosed type 2 diabetics and 58 nondiabetics participated in the *** handheld dynamometer was used to test the HGS of all subjects in their dominant *** t-test was used to analyze the differences in HGS between patients with and without ***:The mean dynamometer reading among diabetics was 19.08±7.51,whereas that in nondiabetics was 27.474±*** was a significant difference in HGSs between diabetics and nondiabetics(P<0.01).Conclusion:Decreased muscle strength and quality in the upper extremities are associated with type 2 diabetes and can lead to functional and physical *** patients’HGS should be evaluated promptly to identify any disabilities and plan for appropriate therapy.

关键词： Diabetics dynamometer handgrip muscle strength

Does the use of double hormone replacement therapy for trauma patient organ donors improve organ recovery for transplant

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World Journal of Transplantation 2024年第2期14卷 119-125页

作者： Eden M Gallegos Tanner Reed Paige Deville Blake Platt Claudia Leonardi Lillian Bellfi Jessica Dufrene Saad Chaudhary John Hunt Lance Stuke Patrick Greiffenstein Jonathan Schoen Alan Marr anil Paramesh Alison A Smith Department of Physiology Louisiana State University Health Sciences Center New OrleansNew OrleansLA 70124United States Department of Medicine Louisiana State University Health Sciences Center New OrleansNew OrleansLA 70112United States Department of Surgery Louisiana State University Health Sciences Center New OrleansNew OrleansLA 70112United States Department of Trauma Surgery Tacoma General HospitalTacoma 98405United States Department of Public Health Louisiana State University Health Sciences Center New OrleansNew OrleansLA 70112United States Department of Donation Services Louisiana Organ Procurement AgencyCovingtonLA 70433United States Department of Surgery Tulane Transplant InstituteTulane University School of MedicineNew OrleansLA 70112United States

BACKGROUND With an ongoing demand for transplantable organs,optimization of donor management protocols,specifically in trauma populations,is important for obta-ining a high yield of viable organs per *** management of brain-dead potential organ donors(BPODs)is controversial,leading to heterogeneous clinical management *** studies have shown that when levo-thyroxine was combined with other treatments,including steroids,vasopressin,and insulin,BPODs had better organ recovery and survival outcomes were increased for transplant *** To determine if levothyroxine use in combination with steroids in BPODs increased the number of organs donated in trauma *** A retrospective review of adult BPODs from a single level 1 trauma center over ten years was *** criteria included patients who were not solid organ donors,patients who were not declared brain dead(donation after circulatory death),and patients who did not receive steroids in their hospital *** and steroid administration,the number of organs donated,the types of organs donated,and demographic information were *** analyses were performed with P0.05).In the ST/LT group,68.1%(n=47)donated a high yield(3-5)of organ types per donor compared to 42.1%(n=8)in the ST group(P=0.038).There was no difference in the total number of organ types donated between the groups(P=0.068).CONCLUSION This study suggests that combining levothyroxine and steroid administration increases high-yield organ donation per donor in BPODs in the trauma patient *** to this study include

关键词： Organ donation Trauma Brain death Levothyroxine Hormone replacement therapy Steroids Organ donor Retrospective