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Inhaled volatile anesthetics in the intensive care unit

World Journal of Critical Care Medicine 2024年第1期13卷 28-39页

作者： Erin D Wieruszewski mariam elsaban Patrick M Wieruszewski Nathan J Smischney Department of Pharmacy Mayo ClinicRochesterMN 55905United States Anesthesiology and Perioperative Medicine Mayo ClinicRochesterMN 55905United States Department of Anesthesiology&Perioperative Medicine Mayo ClinicRochesterMN 55905United States

The discovery and utilization of volatile anesthetics has significantly transformed surgical practices since their inception in the mid-19th century.Recently,a paradigm shift is observed as volatile anesthetics extend beyond traditional confines of the operating theatres,finding diverse applications in intensive care settings.In the dynamic landscape of intensive care,volatile anesthetics emerge as a promising avenue for addressing complex sedation requirements,managing refractory lung pathologies including acute respiratory distress syndrome and status asthmaticus,conditions of high sedative requirements including burns,high opioid or alcohol use and neurological conditions such as status epilepticus.Volatile anesthetics can be administered through either inhaled route via anesthetic machines/devices or through extracorporeal membrane oxygenation circuitry,providing intensivists with multiple options to tailor therapy.Furthermore,their unique pharmacokinetic profiles render them titratable and empower clinicians to individualize management with heightened accuracy,mitigating risks associated with conventional sedation modalities.Despite the amounting enthusiasm for the use of these therapies,barriers to widespread utilization include expanding equipment availability,staff familiarity and training of safe use.This article delves into the realm of applying inhaled volatile anesthetics in the intensive care unit through discussing their pharmacology,administration considerations in intensive care settings,complication considerations,and listing indications and evidence of the use of volatile anesthetics in the critically ill patient population.

关键词： Anesthesia Critical care Mechanical ventilation Sedation Volatile anesthetics Sedative

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Endoscopic treatment of scarred polyps with a non-thermal device(Endorotor):A review of the literature

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World Journal of Gastroenterology 2024年第12期30卷 1706-1713页

作者： mariam Zaghloul Hameed Rehman Stefano Sansone Konstantinos Argyriou Adolfo Parra-Blanco Department of Hepatology Gastroenterology and Infectious DiseasesKafrelsheikh UniversitKafr-Elshikh 33516Egypt Department of Gastroenterology Service Nottingham City Hospital CampusNottingham University Hospitals NHS TrustNottingham NG51PBUnited Kingdom Department of Gastroenterology University Hospital of LarissaLarissa 41334Greece NIHR Nottingham Biomedical Research Centre Nottingham University Hospitals NHS Trust and University of NottinghamNottingham NG72UHUnited Kingdom

Endoscopic resection(ER)of colorectal polyps has become a daily practice in most endoscopic units providing a colorectal cancer screening program and requires the availability of local experts and high-end endoscopic devices.ER procedures have evolved over the past few years from endoscopic mucosal resection(EMR)to more advanced techniques,such as endoscopic submucosal dissection and endo-scopic full-thickness resection.Complete resection and disease eradication are the ultimate goals of ER-based techniques,and novel devices have been developed to achieve these goals.The EndoRotor®Endoscopic Powered Resection System(Interscope Medical,Inc.,Northbridge,Massachusetts,United States)is one such device.The EndoRotor is a powered resection tool for the removal of alimentary tract mucosa,including post-EMR persistent lesions with scarring,and has both CE Mark and FDA clearance.This review covers available published evidence documenting the usefulness of EndoRotor for the management of recurrent colorectal polyps.

关键词： EndoRotor Scarred polyps Recurrent polyps Colorectal cancer Colorectal polyps

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Optimizing wind farm layout for enhanced electricity extraction using a new hybrid PSO-ANN method

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Global Energy Interconnection 2024年第3期7卷 254-269页

作者： mariam El Jaadi Touria Haidi Abdelaziz Belfqih Mounia Farah Atar Dialmy LAGES Laboratory Hassania School of Public Works(EHTP)Casablanca 20230Morocco LESE Laboratory National School of Electricity and Mechanics(ENSEM)Casablanca 20100Morocco LAGCET Laboratory Hassania School of Public Works(EHTP)Casablanca 20230Morocco

With the growing need for renewable energy,wind farms are playing an important role in generating clean power from wind resources.The best wind turbine architecture in a wind farm has a major influence on the energy extraction efficiency.This paper describes a unique strategy for optimizing wind turbine locations on a wind farm that combines the capabilities of particle swarm optimization(PSO)and artificial neural networks(ANNs).The PSO method was used to explore the solution space and develop preliminary turbine layouts,and the ANN model was used to fine-tune the placements based on the predicted energy generation.The proposed hybrid technique seeks to increase energy output while considering site-specific wind patterns and topographical limits.The efficacy and superiority of the hybrid PSO-ANN methodology are proved through comprehensive simulations and comparisons with existing approaches,giving exciting prospects for developing more efficient and sustainable wind farms.The integration of ANNs and PSO in our methodology is of paramount importance because it leverages the complementary strengths of both techniques.Furthermore,this novel methodology harnesses historical data through ANNs to identify optimal turbine positions that align with the wind speed and direction and enhance energy extraction efficiency.A notable increase in power generation is observed across various scenarios.The percentage increase in the power generation ranged from approximately 7.7%to 11.1%.Owing to its versatility and adaptability to site-specific conditions,the hybrid model offers promising prospects for advancing the field of wind farm layout optimization and contributing to a greener and more sustainable energy future.

关键词： Layout optimization Turbine placement Wind energy Hybrid optimization Particle swarm optimization Artificial neural networks Renewable energy Energy efficiency

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Symmetries,optimal system,exact and soliton solutions of(3+1)-dimensional Gardner-KP equation

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Journal of Ocean Engineering and Science 2024年第2期9卷 178-190页

作者： Amjad Hussain Ashreen Anjum M.Junaid-U-Rehman Ilyas Khan mariam A.Sameh Amnah S.Al-Johani Department of Mathematics Quaid-I-Azam University 45320Islamabad 44000Pakistan Department of Mathematics College of Science Al-ZulfiMajmaah UniversityAl-MajmaahP.O Box 66Majmaah 11952Saudi Arabia Electrical Engineering Department Faculty of Engineering and TechnologyFuture University in EgyptNew Cairo 11845Egypt Mathematics Department Faculty of ScienceUniversity of TabukTabukSaudi Arabia

In this research article,the(3+1)-dimensional nonlinear Gardner-Kadomtsov-Petviashvili(Gardner-KP)equation which depicts the nonlinear modulation of periodic waves,is analyzed through the Lie group-theoretic technique.Considering the Lie invariance condition,we find the symmetry generators.The pro-posed model yields eight-dimensional Lie algebra.Moreover,an optimal system of sub-algebras is com-puted,and similarity reductions are made.The considered nonlinear partial differential equation is re-duced into ordinary differential equations(ODEs)by utilizing the similarity transformation method(STM),which has the benefit of yielding a large number of accurate traveling wave solutions.These ODEs are further solved to get closed-form solutions of the Gardner-KP equation in some cases,while in other cases,we use the new auxiliary equation method to get its soliton solutions.The evolution profiles of the obtained solutions are examined graphically under the appropriate selection of arbitrary parameters.

关键词： Gardner-KP equation Lie symmetry analysis Optimal system New auxiliary equation method Solitary wave solutions

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Assessing intersectional gender analysis in Nepal’s health management information system: a case study on tuberculosis for inclusive health systems

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贫困所致传染病(英文) 2024年第2期13卷 1-11页

作者： Parajuli Ayuska Kakchapati Sampurna Arjyal Abriti Joshi Deepak Kharel Chandani del Barrio mariam Otmani Baral Sushil C HERD International Saibu Awas Cr-Marga Bhaisepati Lalitpur Nepal UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases (TDR) World Health Organization Geneva Switzerland

Background Tuberculosis (TB) remains a major public health problem in Nepal, high in settings marked by prevalent gender and social inequities. Various social stratifiers intersect, either privileging or oppressing individuals based on their characteristics and contexts, thereby increasing risks, vulnerabilities and marganilisation associated with TB. This study aimed to assess the inclusiveness of gender and other social stratifiers in key health related national policies and the Health Management Information System (HMIS) of National Tuberculosis Programme (NTP) by conducting an intersectional analysis of TB cases recorded via HMIS.Methods A desk review of key policies and the NTP’s HMIS was conducted. Retrospective intersectional analysis utilized two secondary data sources: annual NTP report (2017–2021) and records of 628 TB cases via HMIS 6.5 from two TB centres (2017/18–2018/19). Chi-square test and multi-variate analysis was used to assess the association between social stratifers and types of TB, registration category and treatment outcome.Results Gender, social inclusion and concept of intersectionality are incorporated into various health policies and strategies but lack effective implementation. NTP has initiated the collection of age, sex, ethnicity and location data since 2014/15 through the HMIS. However, only age and sex disaggregated data are routinely reported, leaving recorded social stratifiers of TB patients static without analysis and dissemination. Furthermore, findings from the intersectional analysis using TB secondary data, showed that male more than 25 years exhibited higher odds [adjusted odds ratio (aOR) = 4.95, 95% confidence interval (CI): 1.60–19.06,P = 0.01)] of successful outcome compared to male TB patients less than 25 years. Similarly, sex was significantly associated with types of TB (P < 0.05) whereas both age (P < 0.05) and sex (P < 0.05) were significantly associated with patient registration category (old/new cases).Conclusions The results highlight inadequacy in the avail

关键词： Tuberculosis Intersectional gender analysis Gender and social inequities Social determinant Health Management Information System National Tuberculosis Programme Social inclusion Gender

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Peritoneo-Vaginal Leaks in Peritoneal Dialysis: A Report of 3 Cases

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Open Journal of Nephrology 2024年第2期14卷 176-184页

作者： mariam Jdidou Sara Elmakkoul Nabil Hmaidouch Naima Ouzeddoun Loubna Benamar Department of Nephrology Dialysis and Renal Transplantation Ibn Sina University Hospital Rabat Morocco

Introduction: Peritoneal dialysis (PD) is an extra-renal purification technique indicated for patients with end-stage kidney disease (ESKD). Although it has many advantages, it also has a number of complications, such as peritoneo-vaginal leakage of dialysate. Cases Reports: Three male patients, aged 70, 50 and 77 respectively, with ESKD were placed on PD. All three patients presented with inadequate drainage and the progressive appearance of bilateral hydrocele, which occurred one year (late leakage), two and four days (early leakage) respectively after the initiation of exchanges. The etiological investigation led to the conclusion of a peritoneo-vaginal leak associated with an inguinal hernia in only one case. The two cases of early leakage were treated by temporary suspension of PD, with a good response in one case and failure in the second, leading to hisdefinitive transfer to hemodialysis (HD);however, the hernia repair enabled immediate resumption of PD in the third patient. Discussion and Conclusion: Peritoneo-vaginal leakage is a rare mechanical complication in PD. The clinical examination plays an essential role in confirming the diagnosis and in the therapeutic decision. If the diagnosis is uncertain, or if there is a clinical need to show the anatomy of the leak, an imaging approach becomes desirable. This complication should not prevent the progression of PD in the management of patients with ESKD.

关键词： Peritoneal Dialysis Peritoneal Leakage Hernia-Peritoneal Scintigraphy

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Resistant Pulmonary TB-HIV Co-Infection in an Infant: About a Case

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Open Journal of Pediatrics 2024年第2期14卷 420-425页

作者： mariam Maiga Pierre Togo Tati Simaga mariam Traoré Moussa Konaté Mamadou Diallo Alou Samaké Mamadou Keïta Korotoumou Wélé Diallo Djibril Kassogué Pediatrics Department Distric VI Reference Health Center Bamako Mali Paediatrics Department Gabriel Touré Teaching Hospital Bamako Mali Pediatrics Department Mali Hospital Bamako Mali Paediatrics Department Timbuktu Regional Hospital Bamako Mali

Diagnosis of childhood tuberculosis (TB) is difficult, especially in resource-limited countries where the number of reported cases of TB-HIV co-infection continues to rise. This co-infection poses a diagnostic and therapeutic problem for caregivers. We report a case of rifampicin-resistant HIV-TB pulmonary coinfection in a 19-month-old infant.

关键词： Tuberculosis Rifampicin Resistance HIV Infants

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Ruptured Ectopic Pregnancy: Epidemiology and Management in the General Surgery Department of the Ignace Deen National Hospital, Conakry University Hospital

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Open Journal of Obstetrics and Gynecology 2024年第4期14卷 503-508页

作者： Barry Mamadou Sakoba Barry Boubacar Guirassy mariam Touré Aboubacar Diallo Aissatou Taran Department of General Surgery Ignace Deen National Hospital/Conakry University Hospital Conakry Guinea Faculty of Health Sciences and Technology Gamal Abdel Nasser University of Conakry Conakry Guinea

Introduction: The aim of this study was to contribute to improving the quality of GEUR management in the general surgery department and in the maternity ward of the Ignace Deen national hospital, Conakry University Hospital. Methodology: This was a retrospective, descriptive study lasting two years (January 1, 2020 to December 31, 2022), carried out in the general surgery and gyneco-obstetrics departments of the Ignace Deen national hospital, Conakry University Hospital. We included all patients with a ruptured ectopic pregnancy who received surgical treatment during the study period. Results: We collected 13,524 cases of surgical interventions in the two services, among them, we recorded 89 cases or 0.66% GEUR. The average age of the patients was 24.26 years. Brides were the most represented with 80.96% of cases. Women practicing a liberal profession were 51.69% (n = 46) and housewives 26.97% (n = 24). Clinically, amenorrhea was noted in all patients, i.e. 100%, abdominal-pelvic pain in 95.2% (n = 85) of cases, metrorrhagia in 94.08% (n = 84), abdominal-pelvic sensitivity in 97.44% (n = 87) of cases and anemia in 85.39% of cases. The GEUR was ampullary in 69.66% (n = 62) cases. Salpingectomy was performed in 90.72% (n = 81). The surgical outcomes were satisfactory in 98.87% (n = 88) of cases. We recorded one case of surgical site infection. We have not recorded any deaths. The average length of hospitalization was 4 days. Conclusion: GEUR is relatively high in our context. A good understanding of the prognostic factors of GEUR, awareness and family planning could reduce GEUR.

关键词： Ruptured Ectopic Pregnancy Epidemiology and Management

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Pyomyoma as a Complication of Uterine Artery Embolization (A Case Report)

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Open Journal of Obstetrics and Gynecology 2024年第1期14卷 29-35页

作者： Abrar Tooq Layla Rafeei Nusrat Kazi Safa Hussain Mohamed Al-Tabban mariam Mahmood Salmanyia Medical Complex Manama Bahrain

Pyomoyoma is a rare complication of Uterine Artery Embolization (UAE). This case report reflects on this condition. A 45-year-old female, a known case of adenomyosis, presented with intermittent fever and foul vaginal discharge. These symptoms occurred shortly after the patient underwent UAE for menorrhagia secondary to adenomyosis. Computed tomography scan of the abdomen and pelvis aided in the diagnosis of Pyomyoma secondary to UAE. After a trial of broad spectrum antibiotics and Suction and Evacuation of the uterus had little to no help in the patient’s condition, she underwent Total Abdominal Hysterectomy in which a big, organized pus collection was removed from the uterus. Conclusion: Pyomyoma should be considered in the differentials for patients presenting with fever and vaginal discharge post UAE.

关键词： Pyomyoma Uterine Artery Embolization Adenomyosis

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Promotion of structural plasticity in area V2 of visual cortex prevents against object recognition memory deficits in aging and Alzheimer's disease rodents

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Neural Regeneration Research 2024年第8期19卷 1835-1841页

作者： Irene Navarro-Lobato mariam Masmudi-Martín Manuel F.López-Aranda Juan F.López-Téllez Gloria Delgado Pablo Granados-Durán Celia Gaona-Romero Marta Carretero-Rey Sinforiano Posadas María E.Quiros-Ortega Zafar U.Khan Laboratory of Neurobiology Centro de Investigaciones Médico Sanitarias(CIMES)University of MalagaMalagaSpain Department of Medicine Faculty of MedicineUniversity of MalagaMalagaSpain Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas(CIBERNED) Institute of Health Carlos IIIMadridSpain the Donders Institute for Brain Cognition and Behaviour Radboud UniversityNijmegenThe Netherlands the Brain Metastasis Group National Cancer Research Centre(CNIO)MadridSpain the Department of Neurobiology University of California-Los AngelesLos AngelesCAUSA

Memory deficit,which is often associated with aging and many psychiatric,neurological,and neurodegenerative diseases,has been a challenging issue for treatment.Up till now,all potential drug candidates have failed to produce satisfa ctory effects.Therefore,in the search for a solution,we found that a treatment with the gene corresponding to the RGS14414protein in visual area V2,a brain area connected with brain circuits of the ventral stream and the medial temporal lobe,which is crucial for object recognition memory(ORM),can induce enhancement of ORM.In this study,we demonstrated that the same treatment with RGS14414in visual area V2,which is relatively unaffected in neurodegenerative diseases such as Alzheimer s disease,produced longlasting enhancement of ORM in young animals and prevent ORM deficits in rodent models of aging and Alzheimer’s disease.Furthermore,we found that the prevention of memory deficits was mediated through the upregulation of neuronal arbo rization and spine density,as well as an increase in brain-derived neurotrophic factor(BDNF).A knockdown of BDNF gene in RGS14414-treated aging rats and Alzheimer s disease model mice caused complete loss in the upregulation of neuronal structural plasticity and in the prevention of ORM deficits.These findings suggest that BDNF-mediated neuronal structural plasticity in area V2 is crucial in the prevention of memory deficits in RGS14414-treated rodent models of aging and Alzheimer’s disease.Therefore,our findings of RGS14414gene-mediated activation of neuronal circuits in visual area V2 have therapeutic relevance in the treatment of memory deficits.

关键词： behavioral performance brain-derived neurotrophic factor cognitive dysfunction episodic memory memory circuit activation memory deficits memory enhancement object recognition memory prevention of memory loss regulator of G protein signaling

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