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Interest of Transcranial Doppler (TCD) in Emergency in Traumatic Brain Injury Patients at Gabriel Touré University Hospital, bamako, Mali

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Open Journal of Emergency Medicine 2024年第3期12卷 114-121页

作者： Abdoulhamidou Almeimoune Moustapha Mangane Madane Thierno diop Mahamadoun Coulibaly Amadou Gamby Dramane Sanogo Alfousseini Soumare Adama Coulibaly Ababacar Salaha Harouna Sangaré Diango Djibo Mahamane Department of Intensive Care Anesthesia and Emergency Medicine CHU Gabriel Toure Bamako Mali Faculty of Medicine and Odontostomatology University of Sciences Techniques and Technology of Bamako Bamako Mali Department of Intensive Care Anesthesia CHU Luxembourg Luxembourg City Luxembourg

Introduction: Transcranial Doppler is a simple, non-invasive and inexpensive examination which allows the assessment of cerebral perfusion. In countries with limited resources, which do not have a means of monitoring intracranial pressure, this examination offers hope of survival for patients with traumatic brain injury. This study was designed to investigate the incidence of early cerebral circulation abnormalities after traumatic brain injury using transcranial Doppler (TCD). Methodology: A descriptive and analytical study was conducted over one year, including patients with traumatic brain injury and an initial Glasgow Coma Scale (GCS) score of less than 15. Non-inclusion criteria: Stroke, brain tumor, cerebral abscess. Exclusion criteria: Inadequate insonation window. Results: Out of 854 traumatic brain injury patients admitted to the emergency department, 112 were included in the study. The average age was 30.14 years, with a sex ratio of 4.1. Initially, 83.5% had moderate traumatic brain injury, and 12.1% had severe traumatic brain injury. Brain CT scans were performed in 95.7% of the patients. Edematous-hemorrhagic contusion was observed in 95% of the patients. On initial TCD, the pulsatility index in the middle cerebral artery was greater than 1.3 in 49.4% of the patients. Diastolic velocity was less than 20 cm/s in 46.4% of cases, and mean velocity was greater than 150 cm/s in 8.7% of cases. In this group, low diastolic velocity indicated cerebral hypoperfusion suggestive of intracranial hypertension. When the pulsatility index was greater than 1.9, no patient had a normal diastolic velocity. Among patients with severe traumatic brain injury, 61.5% had an abnormal pulsatility index compared to 42.3% of patients with moderate traumatic brain injury. Conclusion: TCD is a simple tool for analyzing intracerebral hemodynamics.

关键词： Traumatic Brain Injury TCD Neuroresuscitation Sub-Saharan Africa

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中国新型消费发展水平测度与影响因素

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经济问题探索 2024年第10期 102-114页

作者：郑重巴殿君吉林大学东北亚研究院长春130012

本文基于30个省(区、市)的面板数据,采用熵值法测度2012—2022年中国新型消费发展水平,并借助计量模型探究其影响因素。研究结果表明,样本期内中国新型消费发展水平整体呈现稳步上升态势;新型消费内容在中国新型消费发展水平各子系统中... 详细信息

本文基于30个省(区、市)的面板数据,采用熵值法测度2012—2022年中国新型消费发展水平,并借助计量模型探究其影响因素。研究结果表明,样本期内中国新型消费发展水平整体呈现稳步上升态势;新型消费内容在中国新型消费发展水平各子系统中位列第一,其次为新型消费环境,再次为新型消费潜力,最后为新型消费方式;各地区中国新型消费发展水平存在较大差异,呈现出东部地区>中部地区>西部地区的趋势。影响因素方面,经济发展水平、对外贸易强度、就业发展水平、科技发展水平和固定资产投资均对中国新型消费发展水平具有显著促进作用,且就业发展水平对中国新型消费发展水平的促进作用最强,而对外贸易强度的促进作用相对较弱。对此,要持续壮大新型消费发展规模、差异化推动新型消费发展、纵深推动高质量充分就业,推动中国新型消费发展。

关键词：新型消费发展水平熵值法经济发展水平就业发展水平

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Infection in Multiple Myeloma: Microbiological Profile and Prognosis in Senegalese Patients

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Open Journal of Blood Diseases 2024年第2期14卷 47-58页

作者： Seynabou Fall El Hadj Daouda Niang Khadim Sarr Lolita Mariéme Camara-Tall Modou Moustapha Ciss Amy Thiam Aminata Dakono awa Ndiaye Fatou Samba Diago Ndiaye Clinical Hematology Department of Dalal Jamm Hospital Gudiawaye Dakar Sngal Hematology Clinic Unit of Aristide Le Dantec Hospital Dakar Sngal

Introduction: Infections are additional factors of morbidity and mortality in multiple myeloma (MM), and the current recommendation is antibiotic prophylaxis. In sub-Saharan Africa, few data on infectious complications of MM are available. We aim to describe the microbiological features of infections in MM, and their impact on survival in Senegalese patients. Methods: A retrospective (January 2005-January 2022), analytic, multicenter study on infections in patients followed for MM (IMWG criteria) in Senegalese clinical hematology services. The socio-epidemiological, diagnostic, microbiological, evolutionary and survival aspects were analyzed. Results: The study included 106 patients with multiple myeloma who had an infection at admission or during the treatment. Ten patients have the comorbidity (hypertension, lupus, type 2 diabetes). These patients had 136 infectious events identified at diagnosis (79.2%) or during chemotherapy (20.8%). The sites of infection are lung (42.6%), urinary (29.4%), dermatological (6.6%), digestive (5.2%), osteoarticular (4.4%), ear, nose and throat (3.7%), central nervous system (1.5%), or without site. We recorded 26.4% of patients with multi-site infections. The causal pathogens are bacteria (Gram-negative bacilli: 22.1%;Gram positive bacilli: 9.5%, Mycobacterium tuberculosis: 13.3%), parasitique (plasmodium falciparum 6.6%), viruses (SARS-COV2: 2.9%, VZV: 2.2%) and fungal (2.9%). Survival was reduced in patients who had an infection at the time of multiple myeloma diagnosis (p: 0.189) and those who had multiple infectious foci (p: 0.011). Conclusion: Infections in multiple myeloma are more frequent at diagnosis. The germs are varied and mostly bacteria, particularly gram-negative bacteria, and Kochs bacillus. Our study reveals that multiple infectious foci are a poor prognosis factor. It is necessary to evaluate the infectious risk early, and to adopt an antibiotic prophylaxis based on our tropical environment.

关键词： Multiple Myeloma Infections Tuberculosis Senegal

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Thrombolysis in Pulmonary Embolia at the Cardiology Department of Aristide le Dantec Cardiology Department

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World Journal of Cardiovascular Diseases 2024年第9期14卷 521-538页

作者： Joseph Salvador Mingou Marguerite Téning Diouf Fatou Aw Simon Antoine Sarr Khadim Rassoul diop Malick Bodian Mouhamadou bamba Ndiaye Maboury Diao Abdoul Kane Cardiology Department Aristide le Dantec Hospital Dakar Senegal Cardiology Department Dalal Jam Hospital Dakar Senegal

Introduction: Venous thromboembolic disease is the 3rd most common cardiovascular pathology. Acute pulmonary embolism constitutes its most serious presentation and a major cause of mortality, morbidity and hospitalization in Africa and Senegal. The objectives of this work were to study the epidemiological profile of pulmonary embolisms and to evaluate the practice of thrombolysis in patients in a cardiological setting. Methodology: A retrospective, descriptive study was carried out in the Cardiology department of the Aristide le Dantec Hospital (HALD) over the period from August 2011 to December 2019 in patients hospitalized in the cardiology department for pulmonary embolism confirmed by CT angiography and/or with thrombi on cardiac ultrasound and who had also benefited from thrombolysis. Results: Thirty-one patients with pulmonary embolism were thrombolyzed. There was a predominance of the female gender with an average age of 45.97 years. Risk factors were dominated by age (61.29%) followed by obesity (32.26%) and prolonged immobilization (22.5%). The functional signs were dominated by dyspnea (77.42%) followed by chest pain (51.62%) and cough (35.48%). The physical signs were dominated by right heart failure in 22.5% of cases, pulmonary condensation syndrome in 19.35%, and inflammatory large leg in 12.9% of cases. Echocardiography and chest CT angiography were the means of diagnosis. Nine of our patients presented with an intracardiac mass. Thrombotic treatment was administered in all patients. The average length of hospitalization was 12.32 days and in-hospital mortality was 32.26%. Conclusion: Pulmonary embolism does exist in our regions and is responsible for heavy mortality. Rapid and efficient support is essential. Prevention remains the corner-stone in the fight against this pathology.

关键词： Pulmonary Embolism Thrombolysis Senegal

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Immunoprophylaxis failure and vaccine response in infants born to mothers with chronic hepatitis B infection in Djibouti

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World Journal of Hepatology 2024年第7期16卷 1039-1050页

作者： Sahal Darar Dirir Ambroise D Ahouidi Aboubacry Drame Warsama Osman Abdi Guelleh Youssouf Kayad Mohamed Houmed Aboubakar Makhtar Camara Coumba Toure Kane Halimatou diop Ndiaye Laboratoire Medical de la Caisse National de SécuritéSocial de Djibouti Caisse National de SécuritéSocial de DjiboutiDjibouti BP 696Senegal Parasitology Institut de Recherche en santéde Surveillanceépidémiologique et de FormationDakar 7325Senegal Ecole Doctoral UniversitéAlioune Diop de BambeyDakar 7325Senegal Department of Des Soins Caisse National de Securite SocialDjibouti 696Senegal Centre de Soin Caisse National de Securite SocialDjibouti 696Senegal Laboratoire Medical Mer Rouge Djibouti 99399Senegal Centre Hospitalier Universitaire Aristide le Dantec Laboratoire Bactériologie-Virologie-Hôpital Aristide le DantecDakar 7325Senegal Department of Virology Institut de Recherche en Santéde Surveillanceépidémiologique et de FormationDakar 7325Senegal bacteriology and Virology Laboratory Le Dantec University Teaching HospitalDakar BP 7325Senegal

baCKGROUND In endemic areas,vertical transmission of hepatitis B virus(HBV)remains a major source of the global reservoir of infected *** mother-to-child transmission(MTCT)of HBV is at the heart of World Health Organization’s goal of reducing the incidence of HBV in children to less than 0.1%by *** screening for hepatitis B during pregnancy and neonatal vaccination are the main preventive *** To evaluate the efficacy of HBV vaccination combined with one dose of immunoglobulin in children born to hepatitis B surface antigen(HBsAg)-positive mothers in Djibouti *** We conducted a study in a prospective cohort of HBsAg-positive pregnant women and their *** study ran from January 2021 to May 2022,and infants were followed up to 7 mo of *** serological markers and viral load in pregnant women were measured using aVidas microparticle enzyme-linked immunosorbent assay(Biomérieux,Paris,France)and the automated Amplix platform(Biosynex,Strasbourg,France).All infants received hepatitis B immunoglobulin and were vaccinated against HBV at *** infants were closely monitored to assess their seroprotective response and for failure of *** logistic regression was also used to identify risk factors associated with immunoprophylaxis failure and poor vaccine *** statistical analyses were performed with version 4.0.1 of the R *** Of the 50 pregnant women recruited,the median age was 31 years,ranging from 18 years to 41 *** MTCT rate in this cohort was 4%(2/50)in HBsAg-positive women and 67%(2/3)in hepatitis B e antigen-positive women with a viral load>200000 IU/*** the 48 infants who did not fail immunoprophylaxis,8(16%)became poor responders(anti-HB100 mIU/mL).Factors associated with this failure of immunoprophylaxis were maternal HBV DNA lev

关键词： Hepatitis B surface antigen Infants Hepatitis B immunoglobulin Hepatitis vaccine Djibouti

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Button Cell Ingestion in Infants: A Report of Five Cases

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Journal of Biosciences and Medicines 2024年第8期12卷 199-209页

作者： Mbène Fall Aminata diop Nakoulima Khadija Fall Alice Ingabiré Goumba Mame Aïta Seck Tagouthie Niang Madawase Mboup Mame Diarra Mbacké Ibrahima Diallo Meissa Ndew Seye Department of Pediatrics Dakar Principal Hospital Dakar Senegal Department of Surgery Dakar Principal Hospital Dakar Senegal Department of Medecine Dakar Principal Hospital Dakar Senegal

Button cell ingestion is a common household accident among infants, often leading to serious complications that require immediate diagnosis and urgent removal. We report five cases of button cell ingestion involving infants aged between 9 and 32 months, including four boys and one girl. The ingestion was accidentally discovered in two infants, while in the other three, it was suspected during play. In three cases, mothers attempted to induce vomiting by giving fluids, but the batteries remained in the digestive tract for 38 hours to 5 days. After confirming the diagnosis, the batteries were removed within 4 to 36 hours. The locations of the cells were the esophagus in two cases, the cardia in one, the stomach in one, and the bowel in one. One case involved a large cell in the esophagus, while the others involved smaller cells. Complications occurred in four cases, including esotracheal fistula, esophageal ulceration, and perforation of the jejunum and caecum. In one case, the digestive mucosa appeared normal upon endoscopy. One patient died.

关键词： Button Cell Domestic Accident Infant

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MXene的红外特性及其应用研究展望

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无机材料学报 2024年第2期39卷 162-170页

作者：巴坤王建禄韩美康复旦大学芯片与系统前沿技术研究院上海200433 复旦大学光电研究院和上海市智能光电与感知前沿科学研究基地上海200433

MXene是一大类二维过渡金属碳氮化合物,其丰富的组分、二维原子层结构、金属电导和活性表面等特性使其与不同波段的电磁波(可见光、红外、太赫兹、微波波段等)产生独特的相互作用,并衍生了多种电磁功能应用。在红外波段,MXene具有宽域... 详细信息

MXene是一大类二维过渡金属碳氮化合物,其丰富的组分、二维原子层结构、金属电导和活性表面等特性使其与不同波段的电磁波(可见光、红外、太赫兹、微波波段等)产生独特的相互作用,并衍生了多种电磁功能应用。在红外波段,MXene具有宽域的红外辐射特性,活性表面使其具备可调的红外吸收。近年来,MXene的上述性质引起了广泛研究兴趣。本文首先对不同MXene组分的本征红外辐射特性及调控策略进行了系统总结,并简要介绍其代表性红外应用,重点讨论MXene在这些应用中的贡献和作用机制,包括红外识别/伪装、表面等离激元、光热转换、红外光电探测等。最后,对MXene红外功能应用的未来发展方向进行了展望。

关键词： MXene 红外辐射光热转换热管理红外识别专题评述

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Multi-aspect analysis of ureteral access sheath usage in retrograde intrarenal surgery: A RIRSearch group study

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Asian Journal of Urology 2024年第1期11卷 80-85页

作者： Oktay Özman Hacı M.Akgül Cem başataç Önder Çınar Eyüp B.Sancak Cenk M.Yazıcı Bülent Önal Haluk Akpınar Gaziosmanpasa Training and Research Hospital Urology ClinicİstanbulTurkey TekirdağNamık Kemal University School of MedicineDepartment of UrologyTekirdağTurkey Group Florence Nightingale Hospitals Department of UrologyİstanbulTurkey Zonguldak Bulent Ecevit University School of MedicineDepartment of UrologyZonguldakTurkey Çanakkale Onsekiz Mart University School of MedicineDepartment of UrologyÇanakkaleTurkey İstanbul University-Cerrahpaşa Cerrahpaşa Medical FacultyDepartment of UrologyİstanbulTurkey

Objective:To evaluate the effect of ureteral access sheath(UAS)use and calibration change on stone-free rate and complications of retrograde intrarenal surgery(RIRS).Methods:Data from 568 patients undergoing RIRS for kidney or upper ureteral stones were retrospectively ***,patients were compared after 1:1 propensity score matching,according to UAS usage during RIRS(UAS used[+]87 and UAS non-used[−]87 patients).Then all UAS+patients(n=481)were subdivided according to UAS calibration:9.5-11.5 Fr,10-12 Fr,11-13 Fr,and 13-15 *** outcomes of the study were the success and complications of ***:Stone-free rate of UAS+patients(86.2%)was significantly higher than UAS−patients(70.1%)after propensity score matching(p=0.01).Stone-free rate increased with higher caliber UAS(9.5-11.5 Fr:66.7%;10-12 Fr:87.0%;11-13 Fr:90.6%;13-15 Fr:100%;p<0.001).Postoperative complications of UAS+patients(11.5%)were significantly lower than UAS−patients(27.6%)(p=0.01).Complications(8.7%)with 9.5-11.5 Fr UAS was lower than thicker UAS(17.2%)but was not statistically significant(p=0.09).UAS usage was an independent factor predicting stone-free status or peri-and post-operative complications(odds ratio[OR]3.654,95%confidence interval[CI]1.314-10.162;OR 4.443,95%CI 1.350-14.552;OR 4.107,95%CI 1.366-12.344,respectively).Conclusion:Use of UAS in RIRS may increase stone-free rates,which also increase with higher caliber *** usage may reduce complications;however,complications seemingly increase with higher UAS calibration.

关键词： Stone Retrograde intrarenal surgery Ureteral access sheath Urolithiasis Kidney

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Diabetic Macroangioapathy at the Internal Medicine Department of the Abass Ndao Hospital Center (About 359 Cases)

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Journal of Diabetes Mellitus 2024年第1期14卷 1-12页

作者： Sow Djiby Djiba Boundia Ndour Michel Assane Diedhiou Demba Dieng Mouhamed Diallo Ibrahima Mané Fall Ndiouga Gueye Khoudia Gadji Fatou Kiné Sarr Anna diop Said Nourou Ndour Mbaye Maimouna Department of Internal Medicine and Medical Specialties H&#244pital Abass Ndao Dakar Senegal

Introduction: Macroangiopathy plays an important role, with a high prevalence of morbidity and mortality in diabetic patients. The aim was to study the epidemiological, clinical, paraclinical, therapeutic and evolutionary profile of macroangiopathy in diabetic patients in the internal medicine department of the Abass Ndao hospital. Patients and methods: This was a descriptive and analytical cross-sectional study. Our investigations were recruited over a 7-year period (January 1, 2016 to December 31, 2022). Results: Three hundred and fifty-nine (359) patients (10.22%) were enrolled. The mean age was 62.83 years, with extremes ranging from 17 to 98 years. The [60 - 69] age group was more representative (37.32%). Women accounted for 180 cases (50.1%), with a sex ratio (m/f) of 0.99. The average duration of diabetes was 11.86 years. Average consultation time was 38.07 days, with extremes ranging from 1 to 368 days. Average hospital stay was 7.65 days. Inaugural diabetes was noted in 12 cases (3.34%). Type 2 diabetes accounted for 95.82% (n = 344) of patients. Hypertension was present in 150 patients (41.8%). Patients with 2 risk factors accounted for 173 cases (48.18%). Nineteen patients had already had a stroke (5.29% of cases). Fourteen (14) patients (4.2%) were amputees. Obliterative arteriopathy of the lower limbs (AOMI) was noted in 193 patients (54%). Stroke was noted in 101 patients (28%). Ischemic heart disease (IHD) was noted in 38 patients (11%). AOMI was more common in males (110 patients, 57%) than in females (43%). Seventy-three (73) patients (20.3%) died. Predictors of death were age over 60 and the existence of more than two cardiovascular risk factors. Conclusion: Diabetic macroangiopathy is a major cause of morbidity and mortality. The development and implementation of a prevention and management program is essential.

关键词： Macroangiopathy Diabetes Risk Factors Senegal

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翼缘连接板削弱型上焊下栓钢梁柱节点抗震性能有限元分析

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地震工程学报 2024年第5期46卷 1118-1125页

作者：巴金璐董锦坤辽宁工业大学土木建筑工程学院辽宁锦州121001

分析不同参数对节点抗震性能的影响,为梁柱翼缘连接板削弱型上焊下栓钢结构梁柱节点的设计提供参考。通过改变下翼缘连接板削弱区长度和框架梁截面形状,设计7组算例,利用有限元软件AbaQUS对翼缘连接板削弱型上焊下栓钢梁柱节点进行有限... 详细信息

分析不同参数对节点抗震性能的影响,为梁柱翼缘连接板削弱型上焊下栓钢结构梁柱节点的设计提供参考。通过改变下翼缘连接板削弱区长度和框架梁截面形状,设计7组算例,利用有限元软件AbaQUS对翼缘连接板削弱型上焊下栓钢梁柱节点进行有限元分析,研究其破坏模式、滞回曲线、骨架曲线、最大承载力和螺栓孔径变化率。有限元分析结果表明:下翼缘连接板削弱长度过短无法达到塑性铰外移的目的,削弱长度过长则会导致严重的平面外屈曲;梁全截面削弱组的抗震性能优于半截面削弱组与无变化组。翼缘连接板削弱型上焊下栓钢梁柱节点能有效利用翼缘连接板削弱区的塑性变形、拼接区螺栓的滑移、螺栓杆与孔壁的挤压,以及板件的摩擦来实现耗能。

关键词：钢结构梁柱节点抗震性能有限元分析

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