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Evaluation of hand infections in the emergency department using point-of-care ultrasound

World Journal of Emergency medicine 2024年第4期15卷 283-288页

作者： David Ahmad Haidar David mintz bra.don m wubben Omar Rizvi Srikar Adhikari Department of Emergency medicine Michigan MedicineAnn Arbor 48109-1382USA University of Arizona College of medicine Tucson 85724USA Department of Emergency medicine University of IowaIowa City 52242-1009USA Department of Surgery University of Arizona College of MedicineTucson 85724USA Department of Emergency medicine University of Arizona College of MedicineTucson 85724USA

BACKGROUND:We aimed to evaluate the utility of point-of-care ultrasound(POCUS)in the assessment of hand infections that present to the emergency department(ED)and its impact on medical decision making and patient ***:We conducted a retrospective review of patients who presented to two urban academic EDs with clinical presentations concerning for skin and soft tissue infections(SSTI)of the hand between December 2015 and December *** trained POCUS fellowship physicians reviewed an ED POCUS database for POCUS examinations of the *** then reviewed patients’electronic health records(EHR)for demographic characteristics,history,physical examination findings,ED course,additional imaging studies,consultations,impact of POCUS on patient care and final ***:We included a total of 50 cases(28 male,22 female)in the final *** most common presenting symptoms and exam findings were pain(100%),swelling(90%),and erythema(74%).The most common sonographic findings were edema(76%),soft tissue swelling(78%),and fluid surrounding the tendon(57%).POCUS was used in medical decision making 68%of the time(n=34),with the use of POCUS leading to changes in management 38%of the time(n=19).POCUS use led to early antibiotic use(11/19),early consultation(10/19),and led to the performance of a required procedure(8/19).The POCUS diagnosis was consistent with the discharge diagnosis of flexor tenosynovitis 8/12 times,abscess 12/16 times,and cellulitis 14/20 ***:POCUS is beneficial for evaluating of hand infections that present to the ED and can be used as an important part of medical decision making to expedite patient care.

关键词： Ultrasound Point-of-care ultrasound Cellulitis Abscess Flexor tenosynovitis

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Surgical Site Infections in Trauma and Orthopaedics at Bouaké Teaching Hospital (Côte d’Ivoire)

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Open Journal of Orthopedics 2024年第9期14卷 381-390页

作者： Loukou Blaise Yao Koffi Léopold Krah Aya Adelaïde Natacha Kouassi Kouamé Innocent m’bra Kouamé Jean-Eric Kouassi michel Kodo Department of Trauma and Orthopaedics Bouak Teaching Hospital Bouak Cte dIvoire

Background: Surgical site infections are serious healthcare problems. The aim was to describe the epidemiological, diagnostic, therapeutic, and prognostic aspects of surgical site infections in Trauma and Orthopaedics at Bouaké Teaching Hospital. method: This retrospective, descriptive, and analytical study was conducted from January 2019 to December 31, 2021. The data studied included prevalence, initial lesions, type of surgical intervention, type of SSI, bacteria involved, treatment, and outcomes. Results: Forty-four (11%) of the 399 patients included in the study developed a surgical site infection. The mean age was 27 years, with 36 male and 8 female. Initial lesions were predominantly open fractures (n = 31;70%), with a mean delay of 48 hours for surgical management. Emergency interventions accounted for 70% (n = 31) of cases. The NNISS infection risk score was 1 in 80% (n = 35) of cases. Superficial infections (n = 34;77%) appeared early, on a mean 6 days postoperatively. Bacteriological analysis primarily identified Pseudomonas aeruginosa (n = 10;23%), sensitive to Imipenem and Chloramphenicol but resistant to Amoxicillin-clavulanic acid, Ceftriaxone, Gentamicin, and Ciprofloxacin. multidrug-resistant bacteria were found in 89% (n = 8) of cases, with all bacteria resistant to Ceftriaxone. Surgical revision was performed in 10 patients (23%), primarily involving debridement with hardware retention (n = 7;70%). Chloramphenicol was the most commonly used antibiotic post-antibiogram (61%). Outcomes were favourable in 98% of cases. Identified risk factors included the type of lesion according to NRC classification, the delay in managing open fractures, and the NNISS score. Conclusion: The prevalence of surgical site infection was 11%, favoured by the delayed operation of open fractures.

关键词： Surgical Site Infection Open Fractures Pseudomonas aeruginosa Ceftriaxone

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Prevalence and Factors Associated with Dry Eyes Syndrome in Glaucomatous Patients on Anti-Glaucoma Eye Drops Followed up at the Garoua Regional Hospital-Northern Cameroon

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Open Journal of Ophthalmology 2024年第3期14卷 350-360页

作者： Josiane mare Njoya Dodo Balkissou Bimingo Noelle bra’ Eyatcha Viola Dohvoma Yannick Bilong Godefroy Koki Faculty of medicine and Biomedical Sciences University of Garoua Garoua Cameroon Faculty of medicine and Biomedical Sciences University of Yaounde I Yaounde Cameroon

Background: Dry eye and glaucoma are two common pathologies in the elderly, and are very often associated. This association suggests a link between them and between their treatments. Our purpose for this study is to determine the prevalence of dry eye in our glaucoma patients treated with eye drops and deduce the factors associated with it. Patients and methods: We conducted a cross-sectional, analytical study from October 2022 to September 2023 in the ophthalmology department of Garoua Regional Hospital in glaucoma patients aged over 15 years able to answer the Ocular Surface Disease Index (OSDI) questionnaires and treated with antiglaucoma eye drops for more than 3 months. These patients underwent a complete ophthalmological examination and a tear film break-up time test. Results: A total of 73 patients (146 eyes) were examined. The average age of the patients was 47.2 ± 16.5 years, with a male predominance of 54.8%. The prevalence of dry eye syndrome in our patients according to the OSDI score was 56.2% (95% CI) (44.8;67.6). The prevalence of dry eye syndrome on clinical examination of the BUT in the right eye was 83.7% (95% CI) (75.1;92.1) and 79.4% (70.2;88.7) in the left eye. The duration of antiglaucoma treatment was the factor associated with dry eye syndrome (p ma patients in our setting. Conclusion: Dry Eye Syndrome is common in glaucoma patients on drops in our setting. Treatment duration of more than 1 year seems to be associated with dry eyes.

关键词： Dry Eyes Glaucoma Conservative Eye Drops médications Garoua-Cameroon

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Honey Dressing of Cutaneous Wounds on Limbs in the Traumatology Orthopaedics Department of Bouaké University Hospital

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Open Journal of Orthopedics 2024年第9期14卷 411-420页

作者： Achié Jean-Régis Akobe Aya Adélaide Natacha Kouassi Ibrahim Soumahoro Zolopégué marcel Soro Sedy Louess De Randolphe Akpro Bakary Traoré Almamy Kamate Axel Fabrice Essehin Yao Aboh Ganyn Robert Arnaud Assere Lanciné Kaba Kouamé Innocent m’bra Loukou Blaise Yao Bada Justin Léopold Niaoré Sery Koffi Léopold Krah michel Kodo Orthopaedics-Traumatology Department of the University Hospital of Bouak Bouak Ivory Coast Plastic and Reconstructive Surgery Department of the University Hospital of Bouak Bouak Ivory Coast

The study evaluated the effectiveness of honey dressings in healing recent skin wounds with soft tissue loss on limbs. Conducted over a year with 60 patients, results showed a significant reduction in wound size and early healing, with complete recovery on average within 29 days. The study supports honey as a viable wound treatment.

关键词： Healing Honey Limbs Loss of Substances

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Endoscopic ultrasound-guided portal pressure gradient identifies patients with previously undiagnosed clinically significant portal hypertension

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Portal Hypertension & Cirrhosis 2024年第2期3卷 67-74页

作者： Jerome C.Edelson Scott F.D.Edelson John G.Quiles Cyrus V.Edelson Eric m.montminy Christian L.Horn John P.magulick don C.Rockey Department of Gastroenterology and Hepatology Brooke Army Medical CenterFort Sam HoustonTexasUSA Department of medicine Uniformed Services University of the Health SciencesBethesdaMarylandUSA Department of medicine Brooke Army Medical CenterFort Sam HoustonTexasUSA John H.Stroger Jr.Hospital of Cook County ChicagoIllinoisUSA Digestive Disease Research Center Medical University of South CarolinaCharlestonSouth CarolinaUSA

Aims:Portal hypertension(PH)is a complication of cirrhosis that leads to hepatic *** the portal pressure gradient(PPG)provides valuable information for disease assessment,staging,and *** this study,we aimed to report the utilization of endoscopic ultrasound(EUS)-guided PPG(EUS-PPG)measurements in a real-world ***:This retrospective analysis included patients at a tertiary care center who underwent EUS-PPG between February 2021 and may *** most common indication was to establish or exclude the diagnosis of cirrhosis,followed by an assessment of surgical risk in the setting of suspected *** demographic and clinical data were collected,and statistical analysis was performed using the Student's t ***:Eighteen patients underwent *** success was achieved in 17 of the 18 *** complications were *** mean scores of Child-Pugh,model for End-Stage Liver Disease-Sodium,and Fibrosis-4 scores were 5.1±0.5,9.0±3.0,and 3.7±4.5,*** the 18 patients,two presented with esophageal varices and six with portal hypertensive *** mean PPG was 5.8±4.5 mmHg,and five patients exhibited clinically significant PH(CSPH).Of the 18 patients,15 underwent concurrent EUS-liver biopsy,which was 100%successful and provided diagnostic histology for all *** PPG data led to changes in the clinical management of 17 ***:EUS-PPG is safe and technically *** Child-Pugh score did not correlate well with the presence of CSPH;however,PPG measurements resulted in changes in the management of almost all *** studies correlating EUS-PPG with other assessments of liver diseases are required.

关键词： EUS portal hypertension portal pressure gradient

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Osteoarticular Lesions of the Shoulder Girdle by Hippopotamus Bite: Highly Septic Lesion

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Open Journal of Orthopedics 2024年第2期14卷 114-121页

作者： Jr Pierre Germain Ochou Achié Jean Régis Akobe Yao Aboh Ganyn Robert Arnaud Assere Kouamé Jean-Eric Kouassi Adelaïde Aya Natacha Kouassi Ibrahim Soumahoro Zolopégué marcel Soro Sédi Loues De Randolphe Akpro Gbalé Yannick Blé Kouamé Innocent m’bra Loukou Blaise Yao Bada Juste Léopold NiaoréSery Koffi Léopold Krah michel Kodo Department of Orthopaedic and Traumatological Surgery Bouaké University Hospital Bouaké Ivory Coast Raoul Follereau Institute Manikro Centre Bouaké Ivory Coast

Hippopotamus bites are rare in medical consultations, despite several studies exposing their aggressive character. A case of a hippopotamus bite on the shoulder of a fisherman has been reported. In addition to the osteoarticular aspect representing a therapeutic problem, the infectious aspect was marked by sepsis, with a death in less than 48 hours. Based on this observation, a protocol for the initial management of large animal bites was submitted.

关键词： Bite Hippopotamus Septic Shock

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Investigation of Quantitative Relationship between Adsorbed Amount of Solute and Solvent Concentration at Relatively High Solute Concentration by Frontal Analysis in RPLC

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Chinese Journal of Chemistry 2003年第10期21卷 1339-1343页

作者：王彦耿信笃 ZEBOLSKY don m. Institute of modern Separation Science Department of Chemistry

In previous paper a new adsorption isotherm which relates the amount of solute absorbed to the solvent concentration is proposed and simplified, and it only can be used at lower solute concentration. In this article the scope of the new adsorption isotherm is extended and the expressions with three and four parameters are obtained. The equations with multi parameters are valid when the adsorbed amounts are larger and show non linear logarithmic relationships. Tests with a homologue of aromatic alcohols by frontal analysis in reversed phase liquid chromatography demonstrate that the experimental results fit those equations well. In addition, the predicted values by the multi parameters were found to fit the experimental values well also. The parameters have physical meaning only for the two parameter equation for the aromatic alcohols.

关键词： solid liquid adsorption solvent concentration stoichiometric displacement adsorption isotherm reversed phase liquid chromatography frontal analysis phenyl alcohol

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Predisposing factors’effects on mortality of oak (Quercus) and hickory (Carya) species in mature forests undergoing mesophication in Appalachian Ohio

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Forest Ecosystems 2021年第1期8卷 81-94页

作者： don C.Radcliffe David m.Hix Stephen N.matthews School of Environment and Natural Resources The Ohio State University2021 Coffey RoadColumbus OH 43210USA School of Environmental and Forest Sciences University of WashingtonBox 352100Seattle WA 98195-2100USA

Background:mature oak(Quercus spp.)and hickory(Carya spp.)trees are gradually being replaced by more shadetolerant tree species across the eastern U.S.,likely due to fire suppression and increased *** and hickories are highly valuable to wildlife;therefore,studying their mortality patterns can provide information on the longevity of habitat quality for many animal *** mortality has most often been studied following large oak decline events,but background mortality rates in forests with aging oak and hickory canopies warrant equal attention,especially in the context of widespread oak and hickory regeneration ***:We studied background mortality rates of five oak and one hickory species over a 23–25 year time period(1993–1995 to 2018),using 821/20th hectare permanent plots on the marietta Unit of the Wayne National Forest in southeastern *** calculated mortality rates based on remeasurement of individual trees for white oak(Quercus alba),chestnut oak(Quercus montana),northern red oak(Quercus rubra),black oak(Quercus velutina),scarlet oak(Quercus coccinea),and pignut hickory(Carya glabra).For each of these species other than scarlet oak,we also modeled the relationships of mortality probability with a priori topographic,soil,stand structural,and individual tree covariates,using a mixed-effects logistic regression ***:The species with the highest mortality rate was scarlet oak(61.3%),followed by northern red oak(41.4%),black oak(26.7%),pignut hickory(23.9%),white oak(23.4%),and chestnut oak(19.1%).In our models,northern red oak mortality was associated with more mesic slope positions,shallower solums,more acidic soils,and older stand *** hickory and chestnut oak mortality rates were associated with higher basal areas on the plot,while white oak mortality showed the opposite ***:Our data suggest that red oak subgenus trees in mature forests of our area will become increasingly uncommon relative t

关键词： mortality Quercus Carya mesophication Wildlife habitat

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Theory of phonon-modulated electron spin relaxation time based on the projection reduction method

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Chinese Physics B 2014年第8期23卷 436-443页

作者： Nam Lyong Kang Sang don Choi Department of Applied Nanoscience Pusan National University Department of Physics Kyungpook National University

This paper introduces a new method for a formula for electron spin relaxation time of a system of electrons interacting with phonons through phonon-modulated spin-orbit coupling using the projection-reduction method. The phonon absorption and emission processes as well as the photon absorption and emission processes in all electron transition processes can be explained in an organized manner, and the result can be represented in a diagram that can provide intuition for the quantum dynamics of electrons in a solid. The temperature （T） dependence of electron spin relaxation times （T1） in silicon is T1 ∝ T-1.07 at low temperatures and T1 ∝ T-3.3 at high temperatures for acoustic deformation constant Pad = 1.4 × 10^7 eV and optical deformation constant Pod = 4.0 × 10^17 eV/m. This means that electrons are scattered by the acoustic deformation phonons at low temperatures and optical deformation phonons at high temperatures, respectively. The magnetic field （B） dependence of the relaxation times is T1 ∝ B-2.7 at 100 K and T1 ∝ B-2.3 at 150 K, which nearly agree with the result of Yafet, T1 ∝ B-3.0- B -2.5.

关键词： electron spin resonance spin-orbit coupling projection-reduction method phonon scattering

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Analysis of opto-thermal interaction of porcine stomach tissue with 808-nm laser for endoscopic submucosal dissection

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Journal of Innovative Optical Health Sciences 2015年第6期8卷 81-91页

作者： Seongjun Kim m.Tamim Hossain don Haeng Lee Jung Kyung Kim Department of mechanical Engineering Graduate School Kookmin University Seoul 136-702Republic of Korea Department of Integrative Biomedical Science and Engineering Graduate SchoolKookmin University Seoul 136-702Republic of Korea Division of Gastroenterology Department of Internal medicine Inha University School of medicine National Center of Efficacy Evaluation for the Development of Health Products Targeting Digestive Disorders Utah-Inha DDS&Advanced Therapeutics Research Center 27 Inhang-ro Jung-guIncheon 400-711Republic of Korea Department of mechanical Engineering Kookmin University Seoul 136-702 Republic of Korea

In endoscopic submucosal dissection(ESD),the narrow gastrointestinal space can cause difficulty in surgical *** ablation apparatuses with high-power CO_(2) lasers or Nd:YAG lasers have been developed to facilitate endoscopic surgical *** studied the interaction of 808-nm laser light with a porcine stomach tissue,with the aim of developing a therapeutic medical device that can remove lesions at the gastrointestinal wall by irradiating a near-infrared laser light incorporated in an endoscopic *** perforation depths at the porcine fillet and the stomach tissues linearly increased in the range of 2–8mm in proportion to the laser energy density of 63.7–382 kJ/cm^(2).Despite the distinct structural and compositional di®erence,the variation of the perforation depth between the stomach and the fillet was not found at 808-nm wavelength in our *** further studied the laser–tissue interaction by changing the concentration of the methyl blue solution used conventionally as a submucosal fluidic cushion(SFC)in ESD *** temperature of the mucosal layer increased more rapidly at higher concentration of the methyl blue solution,because of enhanced light absorption at the SFC *** insertion of the SFC would protect the muscle layer from thermal *** confirmed that more effective laser treatment should be enabled by tuning the opto-thermal properties of the *** study can contribute to the optimization of the driving parameters for laser incision techniques as an alternative to conventional surgical interventions.

关键词： Near-infrared laser surgical intervention laser-tissue interaction submucosal fluid cushion temperature distribution

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