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Laparoscopic Surgery of Incisional Hernia: Technique and Short-Term Results in Three Surgical Units in Cameroon

Surgical Science 2024年第4期15卷 232-243页

作者： Guy Aristide Bang eric Patrick Savom Achille Aimé Bekolo Otiti Fred Dikongue Dikongue mahamat Yannick Ekani Boukar Richard II mbele Cédric Paterson Atangana Daniel Biwole Biwole Arthur Essomba Yaoundé Teaching Hospital Yaound&#233 Cameroon Faculty of medicine and Biomedical Sciences of the University of Yaoundé I Yaound&#233 Cameroon Yaoundé General Hospital Yaound&#233 Cameroon Faculty of medicine and Biomedical Sciences of the University of Dschang Dschang Cameroon Faculty of Health Sciences University of Buea Buea Cameroon Yaoundé Central Hospital Yaound&#233 Cameroon

Introduction: Incisional hernia is a common medical situation and its treatment has always been a challenge for general surgeons. If laparoscopic repair has become a gold standard elsewhere, it is increasingly done in our milieu, but no data has been found. The aim of this study was to review this surgery done in our country so far, to describe the operative technique and to evaluate the postoperative outcomes. Patients and methods: We conducted an observational descriptive study with retrospective collection of data from the 1st of July 2018 to 30th of June 2022, in three hospitals in Cameroon. Data on socio-demographic and clinical characteristics, surgical technique and postoperative outcomes of patients who had a laparoscopic repair of their incisional hernia were collected. Results: We reviewed 20 files. There were 14 women with an average age of 54.6 years. The average BmI was 32.8 kg/m2. Thirteen patients had a moderate size hernia and the hernia was localized at the midline in 18 cases. Only composite biface meshes were used with dimensions chosen to obtain at least 5 cm overlap. Spiral tacks were the only fixation means used. We registered 3 complications. One case of generalized peritonitis secondary to missed digestive perforation, one case of seroma and one case of postoperative ileus. We registered no death. Conclusion: Laparoscopic repair of incisional hernias is feasible in a resource-limited setting like ours. Compliance with the operative technique and recommendations is important to obtain short-term results closed to that put forward by literature.

关键词： Incisional Hernia Laparoscopy Repair Composite Biface mesh Postoperative Outcomes

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Traditional Healer’s medicinal Practice Survey and Clinical Evidence Assessment of “YIKI”: An Antimalarial Phytomedicine Recipe from Bobo-Dioulasso, Burkina Faso

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Pharmacology & Pharmacy 2024年第7期15卷 248-267页

作者： Zachari Kabre Rakiswende Serge Yerbanga Aminata Fofana Roland Nâg-Tiero meda Anyirekun Fabrice Some Alassane Haro Natacha A. J. A. Boro Fazhira B. Ye Benjamin Kouliga Koama Sami eric Kam Eliasse Zongo Hadidjatou Belèm Windmi Kagambèga Florence Fournet Georges A. Ouedraogo Jean-Bosco Ouedraogo Institut de Recherche en Sciences de la Sant Direction Rgionale de lOuest Bobo-Dioulasso Burkina Faso Laboratoire de Recherche et dEnseignement en Sant et Biotechnologies Animales Universit Nazi BONI Bobo-Dioulasso Burkina Faso Institut des Sciences et Techniques Bobo-Dioulasso Burkina Faso Laboratoire de Recherche en Bactriologie INSP/Centre MURAZ Bobo-Dioulasso Burkina Faso maladies Infectueuses et Vecteurs: Ecologie Gntique Evolution et Contrle (MIVEGEC) Institut de Recherche pour le Dveloppement Universit de Monpellier Montpellier France

YIKI is an antimalarial phytomedicine used by a traditional healer to treat malaria in Bobo-Dioulasso. However, there is no scientific evidence to support its use by local populations. The aim of this study was to identify the medicinal practices of the healer holder of YIKI and assess the clinical evidence of its phytomedicine in the uncomplicated malaria treatment. Ethnomedical survey based on a semi-structured and open questionnaire was conducted from October to December 2019 with the healer. malaria knowledge and diagnosis methods, patient treatment and monitoring, and recipe formulation steps were surveyed. moreover, thick and thin blood smears were taken, haemoglobin levels and temperature of consenting patients were measured before treatment, mid-treatment and at the end of treatment. The survey revealed that the healer has a good knowledge of malaria symptoms and his diagnosis is based on observation and physical examination of patients. The healer’s malaria diagnosis was rudimentary and had accuracy problems, with only 62.79% of malaria cases confirmed by microscopy. The formulation of YIKI and its use to treat malaria follow a standard process for plant harvesting, powder quantities and posology, but do not use any reproducible parameters for dose adjustment. Forty-three patients diagnosed and treated by the healer participated in the study. Laboratory results revealed 27 Plasmodium falciparum infection cases, including 2 with parasitaemia ≥ 200,000 p/µl blood. 25 patients were selected for therapeutic evidence assessment. There was a 48% elimination of parasites, a 28% parasitaemia decrease without complete cure, with gametocytogenesis in some patients, and a 24% parasitaemia increase. Haemoglobin and temperature results suggested that YIKI was not cytotoxic and reduced fever. Encouraging preliminary results have been obtained, but in view of the low number of patients, further YIKI efficacy and toxicity studies will be necessary for patient safety.

关键词： Antimalarial-Phytomedicine Efficacy Traditional Practices Bobo-Dioulasso

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Autoimmune liver disease and the Canadian First Nations Aboriginal Communities of British Columbia's Pacific Northwest

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World Journal of Gastroenterology 2006年第23期12卷 3625-3627页

作者： eric m Yoshida mark Riley Laura T Arbour Department of medicine University of British ColumbiaVancouverBCCanada Department of Pediatrics University of British Columbia Vancouver BC Canada Department of medical Genetics the University of British Columbia. Vancouver BC Canada

Primary biliary cirrhosis (PBC) is a well-known but uncommon chronic liver disease that is presumed to be of autoimmune etiology. Recently, investigations in British Columbia (BC), a province of Canada situated along the Pacific North-West of North America, have suggested that PBC is not a rare disease amongst BC's Aboriginal (i.e. First Nations) communities. Geographically, BC is adjacent to South East Alaska, an American state that has also reported an increased prevalence of PBC amongst its Aboriginal communities. In this article, the medical evidence supporting a hypothesis of increased risk of PBC amongst BC's First Nations communities is reviewed. Evidence suggesting that autoimmune hepatitis is also more likely amongst BC's First Nations communities is also presented.

关键词： Primary biliary cirrhosis Aboriginal FirstNations British Columbia

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Long noncoding RNA lncKdm2b: A critical player in the maintenance of group 3 innate lymphoid cells

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Cellular & molecular Immunology 2018年第1期15卷 5-7页

作者： Can-Jie Guo Weici Zhang m eric Gershwin Division of Gastroenterology and Hepatology Key Laboratory of Gastroenterology and HepatologyMinistry of HealthRenji HospitalSchool of MedicineShanghai Jiao Tong UniversityShanghai Institute of Digestive Disease Shanghai Institute of Digestive Disease Shanghai200001China Division of Rheumatology Allergy and Clinical ImmunologySchool of MedicineUniversity of CaliforniaDavis95616CAUSA

Innate lymphoid cells(ILCs)represent a heterogeneous population,including both effectors and regulators of innate immunity,inflammation and tissue modeling.1 ILCs are categorized into three subgroups,ILC1s,ILC2s and ILC3s,based on similarities in phenotypic,ontogenetic and functional characteristics.2 ILC3s intrinsically require the transcription factor retinoic acid receptor-related orphan receptorγt(RORγt)for their development and function.3 In response to specific stimuli,ILC3s produce IL-17 and IL-22 and play a critical role in intestinal mucosal protection,inflammation and innate responses 4 accompanied by a series of pathophysiological changes involving large-scale genetic upregulation and downregulation.5,6 However,a key challenge remains in understanding the molecular mechanisms underlying the development and maintenance of ILC3s.

关键词： lymphoid inflammation immunity

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The long and latent road to autoimmunity

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Cellular & molecular Immunology 2018年第6期15卷 543-546页

作者： Carlo Selmi Bin Gao m.eric Gershwin Division of Rheumatology and Clinical Immunology Humanitas Research HospitalRozzanoMilanItaly Department BIOmETRA University of MilanMilanItaly Laboratory of Liver Diseases National Institute for Alcohol Abuse and AlcoholismNational Institutes of HealthBethesdaMDUSA Division of Rheumatology Allergyand Clinical ImmunologyUniversity of CaliforniaDavisCAUSA

Autoimmune diseases affect nearly 5%of the general population,yet etiology remains poorly *** factors are clearly necessary but remain insufficient to explain the loss of tolerance;environmental and stochastic factors fill this *** paradigm is indicated by the concordance rates(ranging between 4 and 63%)for autoimmune diseases among monozygotic twins,who share an identical genome,compared to the invariably lower rates in dizygotic *** term“exposome”cumulatively refers to the non-hereditary(i.e.,environmental)factors that account for the remaining susceptibility and include endogenous factors such as *** evidence suggests that exposure to infections,drugs,vaccines,and chemicals may contribute to the loss of *** mechanisms by which environmental factors can shape the immune system to generate autoimmunity include molecular mimicry,self-antigen modification,bystander activation,and immune reactivity *** all cases,we should first consider the prolonged time between an environmental trigger and the appearance of autoreactivity and subsequent clinical *** this special issue,several excellent reviews discuss the potential mechanisms linking environmental factors and autoimmunity.

关键词： endogenous latent reactivity

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Retrospective analysis of hepatitis C infected patients treated through an integrated care model

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World Journal of Gastroenterology 2016年第38期22卷 8558-8567页

作者： James m Levin Shabnam Dabirshahsahebi mindy Bauer eric Huckins Department of Infectious Disease Dean Clinic

AIm To determine if our health system's integrated model reflects sustained virologic response(SVR) outcomes similar to those in clinical trial data, maximizes adherence, and averts drug *** Subjects with chronic hepatitis C had their medical records reviewed from November 1st, 2014 through march 1st, 2016. Patients eligible for treatment were entered into an integrated care model therapy algorithm. The primary outcome was SVR12 based on intention to treat(ITT) analysis. Inclusion criteria consisted of both treatment na?ve and experienced patients over the age of 18 who were at least twelve weeks post-therapy completion with any genotype(GT) or mETAVIR score. Secondary outcomes included adherence, adverse events, and number of drug interaction *** At the time of analysis, 133 patients had reached twelve weeks post therapy with ITT. In the ITT analysis 70 patients were GT 1a, 26 GT 1b, 23 could not be differentiated between GT 1a or 1b, 8 GT 2, 4 GT 3, and 2 patients with multiple genotypes. The ITT treatment regimens consisted of 97 sofosbuvir(SOF)/ledipasvir(LDV), 8 SOF/LDV and ribavirin(RBV), 7 SOFand Simeprevir(SmV), 6 3D and RBV, 1 3D, 11 SOF and RBV, and 1 SOF, peg interferon alpha, and RBV. The overall SVR12 rate was 93% in the ITT analysis with a total of 6 patients relapsing. In patients with cirrhosis, 89% obtained SVR12. All 33 patients who were previous treatment failures achieved SVR12. Drug-drug interactions were identified in 56.4% of our patient population, 69 of which required interventions made by the pharmacist. The most common side effects were fatigue(41.4%), headache(28.6%), nausea(18.1%), and diarrhea(8.3%). No serious adverse effects were *** Dean Health System's integrated care model successfully managed patients being treated for hepatitis C virus(HCV). The integrated care model demonstrates high SVR rates amongst patients with different levels of fibrosis, genotypes, and HCV treatment histo

关键词： Hepatitis C medication adherance Direct acting antiviral Sustained viral response Integrated care model

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Hepatoid adenocarcinoma of the colon in a patient with inflammatory bowel disease

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World Journal of Gastroenterology 2014年第35期20卷 12657-12661页

作者： Yuanyuan Chen David F Schaeffer eric m Yoshida Division of Gastroenterology University of British Columbia Department of Pathology and Laboratory medicine University of British Columbia

A case is presented of a 36-year-old male with primary sclerosing cholangitis-associated inflammatory bowel disease(PSC-IBD) and two synchronous stage 1 adenocarcinomata of the colon,who was initially treated with a subtotal colectomy with *** year later,the patient presented with extensive intra-abdominal lymphadenopathy and peritoneal carcinomatosis,as well as a markedly elevated serum level of alpha-fetoprotein(AFP).Fine needle aspiration biopsy of a porta hepatis lymph node revealed a metastatic hepatoid *** review of the previous colectomy specimen showed that one of the previously identified adenocarcinomata had features suggestive of a hepatoid colonic *** patient was subsequently treated with a cytotoxic regimen of FOLFOX(oxaliplatin,leucovorin,5-fluorouracil) and bevacizumab,with stable results being achieved after six *** case presents the first known report of PSC-IBD associated with synchronous typical and hepatoid adenocarcinomata of the colon and highlights the importance of considering hepatoid adenocarcinoma as a differential diagnosis in patients with an increasing serum AFP level.

关键词： Hepatoid adenocarcinoma Inflammatory bowel disease Colon cancer Alpha-fetoprotein Ulcerative colitis Primary sclerosing cholangitis Recurrence metastasis

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AIm associated with the Igm pentamer: attackers on stand-by at aircraft carrier

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Cellular & molecular Immunology 2018年第6期15卷 563-574页

作者： Toru miyazaki Tomoko Yamazaki Ryoichi Sugisawa m eric Gershwin Satoko Arai Laboratory of molecular Biomedicine for Pathogenesis Center for Disease Biology and Integrative MedicineFaculty of MedicineThe University of TokyoTokyo 113-0033Japan CREST Japan Agency for Medical Research and DevelopmentTokyo 113-0033Japan max Planck-The University of Tokyo Center for Integrative Inflammology Tokyo 113-0033Japan Division of Rheumatology Allergy and Clinical Immunology The University of California School of MedicineDavisCA 95616USA

Circulating immunoglobulin m(Igm)exists in a pentameric form,possessing a polyreactive nature that responds not only to foreign antigens but also to autoantigens;thus,it is involved in both beneficial and detrimental immune responses,including protection from infection and the progression of *** the other hand,Igm also behaves as a carrier of the apoptosis inhibitor of macrophage(AIm)protein,storing a large amount of the inactivated form of AIm in the blood through this *** different disease conditions,AIm can dissociate from Igm locally or systemically to exert its function,inducing the removal of various biological debris such as excess fat,bacteria,cancer cells or dead cell *** typically,upon induction of acute kidney injury(AKI),Igm-free AIm is filtered by the glomerulus in the kidney,which stimulates the clearance of intraluminal dead cells debris at the obstructed proximal tubules,thereby facilitating the repair of kidney ***,cats exhibit a deficiency in AIm release from Igm,which may increase their susceptibility to renal ***,association with AIm inhibits Igm binding to the Fcα/μreceptor on follicular dendritic cells at the splenic germinal center,thereby protecting the Igm immune complex from Fcα/μreceptor-mediated internalization,which supports Igm-dependent antigen presentation to B cells and stimulates high-affinity IgG antibody *** regulation of AIm–Igm binding,resulting from the discovery of reciprocal actions between AIm and Igm,could lead to the development of novel therapies against different diseases.

关键词： apoptosis inhibitor of macrophage(AIm) immunoglobulin m(Igm) acute kidney injury(AKI) hepatocellular carcinoma(HCC) cat renal failure

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Biomechanics associated with tibial stress fracture in runners:A systematic review and meta-analysis

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Journal of Sport and Health Science 2023年第3期12卷 333-342页

作者： Clare E.milner eric Foch Joseph m.Gonzales Drew Petersen Department of Physical Therapy and Rehabilitation Sciences Drexel UniversityPhiladelphiaPA 19102USA Department of Health Sciences Central Washington UniversityEllensburgWA 98926USA

Background:Tibial stress fracture(TSF)is an overuse running injury with a long recovery *** many running studies refer to biomechanical risk factors for TSF,only a few have compared biomechanics in runners with TSF to *** aim of this systematic review and meta-analysis was to evaluate biomechanics in runners with TSF compared to ***:Electronic databases Pubmed,Web of Science,SPORTDiscus,Scopus,Cochrane,and CINAHL were *** of bias was assessed and meta-analysis conducted for variables reported in 3 or more ***:The search retrieved 359 unique records,but only the 14 that compared runners with TSF to controls were included in the *** studies were retrospective,2 were prospective,and most had a small sample size(5-30 per group).many variables were not significantly different between ***-analysis of peak impact,active,and braking ground reaction forces found no significant differences between *** studies found larger tibial peak anterior tensile stress,peak posterior compressive stress,peak axial acceleration,peak rearfoot eversion,and hip adduction in the TSF ***:meta-analysis indicated that discrete ground reaction force variables were not statistically significantly different in runners with TSF compared to *** individual included studies,many biomechanical variables were not statistically significantly different between ***,many were reported by only a single study,and sample sizes were *** encourage additional studies with larger sample sizes of runners with TSF and controls and adequate statistical power to confirm or refute these findings.

关键词： Bone stress injury Gait Kinematics Kinetics Tibial acceleration

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Organizational Changes Needed in Disasters and Public Health Emergencies:A Qualitative Study among managers at a major Hospital

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International Journal of Disaster Risk Science 2022年第4期13卷 481-494页

作者： Ingela Wennman Catharina Jacobson eric Carlström Anders Hyltander Amir Khorram‑manesh Institute of Health and Care Sciences Sahlgrenska AcademyGothenburg University41346GothenburgSweden Preparedness Unit Sahlgrenska University Hospital41305 GothenburgSweden Institute of Clinical Sciences Department of SurgerySahlgrenska AcademyGothenburg University41345GothenburgSweden

most hospitals have a contingency plan,based on all-risks and all-hazards assessment ***,emerging threats and risks often necessitate a flexible approach to emergency management at several levels of a disaster response system,for example,in ***,and possibly other countries,has limited possibilities of surge capacity in the management of large-scale disasters and emergencies,which necessitates a local/national partnership and a flexible local disaster and contingency *** study evaluates the opinions of a selected managerial group,both at operative and strategic levels,regarding possible changes in a major hospital's contingency plan during the ongoing COVID-19 *** interviews were conducted to explore the elements of surge capacity and an operational tool,consisting of command and control,safety,communication,assessment,triage,treatment,and *** results show a need to create feasible management methods that can be evaluated,establish clear leadership,put preparedness as a constant point on the highest managerial agenda,improve external monitoring,and create a regional coordinating ***,the results emphasize the significant role played by the incident command system and qualified leadership to facilitate competent and crucial medical decision making,as well as to provide reliable communication,collaboration,and coordination in a multi-agency response system during dynamic and unexpected *** steps enable a constant connection between reactive contingency plans and the proactivity in continuous risk assessment and enhance the flexibility of the contingency plans.

关键词： Disaster risks Organizational changes Public health emergencies Sweden

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