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A case series of precipitous cardiac tamponade from suspected perimyocarditis in COVID-19 patients

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Journal of Geriatric Cardiology 2021年第5期18卷 403-406,I0002-I0004页

作者： William Kogler michael omar Naji Maaliki Shaorinkumar Patel Sam Foldy Jose Ruiz Department of Internal Medicine University of Florida JacksonvilleJacksonvilleFLUSA Department of Cardiology University of Florida JacksonvilleFLUSA

A 71yearold well controlled hypertensive female presented on day 4 of acute COVID19 illness with atypical chest pain and worsening exertional dyspnea.On examination,heart rate was 110 beats/min,blood pressure was 125/82 mmHg and there were decreased heart sounds with visible jugular venous distention.She was not in respiratory distress at rest and was not requiring supplemental oxygen.Chest radiography showed bilateral diffuse opacities(Figure 1).transthoracic echocardiography(TTE)confirmed a moderate pericardial effusion with right ventricular systolic compression,paradoxical right ventricular septal motion,enddiastolic right atrial collapse,and a plethoric inferior vena cava(IVC)with no respiratory variation.Her ejection fraction(EF)was 55%.Initial workup revealed mildly elevated troponin T levels of 0.14 ng/mL,NTPro BNP of 2500 pg/mL.

关键词： hypertensive distress elevated

Left ventricular non-compaction presenting as cardio-embolic stroke

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Journal of Geriatric Cardiology 2020年第10期17卷 645-646页

作者： Andres Martinez michael omar Fadi Kandah Jose Ruiz Ahsan Niazi Department of Internal Medicine University of Florida College of Medicine-JacksonvilleFloridaUSA Department of Cardiology University of Florida College of Medicine-JacksonvilleFloridaUSA Department of Neurology University of Florida College of Medicine-JacksonvilleFloridaUSA

A 39-year-old male with no known comorbidities presented with sudden onset right-sided weakness.On examination,blood pressure was 128/79 mmHg,National Institutes of Health Stroke Scale score was 4 and there were no signs of heart failure.Emergent computerized tomography demonstrated an ischemic infarct of the left middle cerebral artery distribution and brain magnetic resonance imaging later confirmed it(Figure 1).

关键词： Cardio-embolic Cardiomyopathy Non-compaction Trabeculae

Disparate outcomes in Hispanic patients with metabolic dysfunctionassociated steatotic liver disease/steatohepatitis and type 2 diabetes: Large cohort study

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World Journal of Diabetes 2024年第5期15卷 886-897页

作者： Joseph Matthew Gosnell George Golovko Esteban Arroyave Akshata Moghe michael L Kueht omar AbdulSaldarriaga Kevin H McKinney Heather L Stevenson Monique R Ferguson Department of Pathology University of Texas Medical BranchGalvestonTX 77555United States Department of Pharmacology&Toxicology University of Texas Medical BranchGalvestonTX 77555United States Department of Medicine University of Texas Health Science Center at HoustonHoustonTX 77030United States Department of Surgery University of Texas Medical BranchGalvestonTX 77555United States Center for Tropical Diseases Department of Internal MedicineUniversity of Texas Medical BranchGalvestonTX 77555United States Department of Internal Medicine University of Texas Medical BranchGalvestonTX 77555United States

BACKGROUND Metabolic dysfunction-associated steatotic liver disease(MASLD)and metabolic dysfunction-associated steatohepatitis(MASH)are a growing health burden across a significant portion of the global patient population.However,these conditions seem to have disparate rates and outcomes between different ethnic populations.The combination of MASLD/MASH and type 2 diabetes increases the risk of hepatocellular carcinoma(HCC),and Hispanic patients experience the greatest burden,particularly those in South Texas.AIM To compare outcomes between Hispanic and non-Hispanic patients in the United States,while further focusing on the Hispanic population within Southeast Texas to determine whether the documented disparity in outcomes is a function of geographical circumstance or if there is a more widespread reason that all clinicians must account for in prognostic consideration.METHODS This cohort analysis was conducted with data obtained from TriNetX,LLC(“TriNetX”),a global federated health research network that provides access to deidentified medical records from healthcare organizations worldwide.Two cohort networks were used:University of Texas Medical Branch(UTMB)hospital and the United States national database collective to determine whether disparities were related to geographic regions,like Southeast Texas.RESULTS This study findings revealed Hispanics/Latinos have a statistically significant higher occurrence of HCC,type 2 diabetes mellitus,and liver fibrosis/cirrhosis in both the United States and the UTMB Hispanic/Latino groups.Allcause mortality in Hispanics/Latinos was lower within the United States group and not statistically elevated in the UTMB cohort.CONCLUSION This would appear to support that Hispanic patients in Southeast Texas are not uniquely affected compared to the national Hispanic population.

关键词： Metabolic dysfunction-associated steatotic liver disease Metabolic dysfunction-associated steatohepatitis Hispanic Diabetes mellitus TriNetX Non-alcoholic fatty liver disease Non-alcoholic steatohepatitis Steatotic liver disease Hepatocellular carcinoma

Collaborative Efforts and Strategies for Cholera Outbreak Control in Garissa County, Kenya: Implementation of Water Quality Monitoring Interventions

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Journal of Water Resource and Protection 2024年第2期16卷 123-139页

作者： michael Habtu Mark Nanyingi Ali A. Hassan Abdiwahid M. Noor Joel Mutyandia Muli Alan Mwika Julius Wekesa Ahmed Fidhow Diba Dulacha Landry Kabego Ishata Nannie Conteh Andre Arsene Bita Fouda Sonia Chene Aden H. Ibrahim Ahmed Nadhir omar Martins C. Livinus Abdourahmane Diallo World Health Organization Nairobi Kenya Department of Health Garissa County Government Garissa Kenya Water Resources Authority Garissa Kenya World Health Organization Regional Office for Africa Brazzaville Congo Regional Agency for Health Dijon France

A multi-faceted Case Area Targeted Intervention (CATI) approach emphasizing the integration of Water, Sanitation and Hygiene (WASH) interventions and Oral Cholera Vaccine (OCV) campaign was employed to respond to the outbreak of cholera in Garissa County. Drinking water sources in areas heavily impacted by cholera were systematically mapped and tested for microbiological quality. The quality assessment was carried out in April 2023 during an ongoing cholera outbreak in the county. A total of 109 samples were collected and tested for thermotolerant coliforms and other in situ parameters. The finding revealed that more than 87% of the samples did not meet the World Health Organization (WHO) standard for thermotolerant coliforms;and 30% had turbidity values above the recommended threshold values. None of the 109 samples had any traceable residual chlorine. Following these findings, the county government implemented the targeted interventions which resulted in a positive impact in the fight against cholera. The WHO supported key interventions which included capacity building in water quality monitoring and prepositioning of critical WASH commodities to the cholera affected areas.

关键词： Cholera Drinking Water Household Water Treatment Kenya

Practical approach to linear endoscopic ultrasound examination of the gallbladder

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World Journal of Radiology 2024年第6期16卷 184-195页

作者： Hussein Hassan Okasha Eyad Gadour Hassan Atalla omar AbdAllah AbdEl-Hameed Reem Ezzat Ahmed Elsayed Alzamzamy Elsayed Ghoneem Rasha Ahmad Matar Zeinab Hassan Bogdan Miutescu Ayman Qawasmi Katarzyna M Pawlak Ahmed Elmeligui Department of Internal Medicine Division of Gastroenterology and HepatologyKasr Al-Aini School of MedicineCairo UniversityCairo 11562Egypt Department of Gastroenterology and Hepatology King Abdulaziz Hospital-National GuardAhsa 31982Saudi Arabia Department of Medicine School of MedicineZamzam University CollegeKhartoum 11113Sudan Department of Internal Medicine Hepatology and Gastroenterology UnitFaculty of MedicineMansoura UniversityMansoura 35516Egypt Department of Internal Medicine Faculty of MedicineAssiut UniversityAssiut 71511Egypt Department of Gastroenterology and Heptology Maadi Armed Forces Medical ComplexMilitary Medical AcademyCairo 11728Egypt Department of Gastroenterology and Advance Endoscopy Sultant Qaboos Comprehensive Cancer Care and Research CentreMuscat 0961Oman Department of Internal Medicine Stockport Hospitals NHS Foundation TrustManchester SK27JEUnited Kingdom Department of Gastroenterology and Hepatology Victor Babes University of Medicine and PharmacyTimisoara 300041Romania Advanced Regional Research Centre in Gastroenterology and Hepatology Victor Babes University of Medicine and PharmacyTimisoara 30041Romania Department of Gastroenterology Al-Makassed Islamic Charitable Society HospitalCairo 11124Egypt Division of Gastroenterology St.Michael’s HospitalUniversity of TorontoToronto M5B 1W8Canada Department of Gastroenterology Southend University HospitalEssex SS26XTUnited Kingdom

The gallbladder(GB)is a susceptible organ,prone to various pathologies that can be identified using different imaging techniques.Transabdominal ultrasound(TUS)is typically the initial diagnostic method due to its numerous well-established advantages.However,in cases of uncertainty or when a definitive diagnosis cannot be established,computed tomography(CT)or magnetic resonance imaging may be employed to provide more detailed information.Nevertheless,CT scans may sometimes offer inadequate spatial resolution,which can limit the differentiation of GB lesions,particularly when smaller yet clinically relevant abnormalities are involved.Conversely,endoscopic ultrasound(EUS)provides higher frequency compared to TUS,superior spatial resolution,and the option for contrast-enhanced harmonic imaging,enabling a more comprehensive examination.Thus,EUS can serve as a supplementary tool when conventional imaging methods are insufficient.This review will describe the standard EUS examination of the GB,focusing on its endosonographic characteristics in various GB path-ologies.

关键词： Endoscopic ultrasound Linear endoscopic ultrasound Gallbladder anatomy Gallbladder pathologies Therapeutic endoscopic ultrasound

Systemic inflammatory markers in elderly patients undergoing transcatheter aortic valve replacement

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Journal of Geriatric Cardiology 2022年第11期19卷 811-821页

作者： Haitham Abu Khadija Mechael Welt Gera Gendelman Ahamd Hamode Lion Poles michael Jonas Mustafa Jaber Gal Sella omar Ayyad Sagi Tshori Alex Blatt Jacob George Kaplan Heart Center Kaplan Medical CenterRehovotaffiliated with the Hebrew UniversityJerusalemIsrael

BACKGROUND Transcatheter aortic valve replacement(TAVR)provokes an early injury response,partially represented by dynamic changes in inflammatory markers.TAVR greatly benefits the elderly and we aimed to determine whether increased inflammatory markers post-TAVR in octagenerians were different than their younger counterparts and whether it was associated with adverse clinical outcomes.METHODS Patients with severe symptomatic aortic stenosis who underwent transfemoral TAVR from January 2010 to December 2021 were enrolled.Total white blood cells(WBC)count and subpopulation dynamics were evaluated.RESULTS Five-hundred and seven patients were finally included in the study,65%of these patients were 80 or more years old(54%female,median age 84[82-87])years,with severe symptomatic aortic stenosis.In patients aged above 80 years(patients≥80),we noticed significant kinetic changes in the WBC and their differential cellular subpopulations(P<0.0001)between admission and early days post-procedure.This was evident by a significant increase in total WBC(median 7.1 to 9.4)and absolute neutrophil count(median 4.7 to 7.4),neutrophil-lymphocyte(NL)ratio(median 2.82 to 7.21),and a meaningful decrease in absolute lymphocyte count(median 1.5 to 1.0).Implantation of self-expandable valves(SEVs)was associated with a more pronounced inflammatory response than balloon-expandable valves(BEVs).Higher WBC and neutrophil counts were associated with higher mortality and major vascular complications at 30 days,in addition,higher neutrophil counts and NL ratios were found to be correlated to arrhythmia at 30 days with P values of 0.04 and 0.028,respectively.CONCLUSION This is the first description of a differential age-related inflammatory response in patients after TAVR,which shows an association between inflammatory markers post procedure and clinical outcome.Nevertheless,survival rates were similar in the elderly population and in younger patients,despite the presence of comorbid conditions.

关键词： patients younger absolute

Incidence and risk factors for the development of anemia following gastric bypass surgery

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World Journal of Gastroenterology 2010年第15期16卷 1867-1870页

作者： Dimitrios V Avgerinos omar H Llaguna Matthew Seigerman Amanda J Lefkowitz I michael Leitman Department of Surgery Beth Israel Medical Center Albert Einstein College of Medicine

AIM:To evaluate the incidence and risk factors for the development of anemia after RouxenY gastric bypass (RYGB).METHODS: A retrospective analysis of patients undergoing RYGB from January 2003 to November 2007 was performed. All patients had a preoperative body mass index > 40 kg/m2. A total of 206 patients were evaluated. All patients were given daily supplements of ferrous sulfate tablets for 2 wk following their operation. Hematological and metabolic indices were routinely evaluated following surgery. Patients were followed for a minimum of 86 wk.RESULTS: There were 41 males and 165 females with an average age of 40.8 years. 21 patients (10.2%) developed postoperative anemia and 185 patients (89.8%) did not. Anemia was due to iron deficiency in all cases. The groups had similar demographics, surgical procedure and comorbidities. Menstruation (P = 0.02) and peptic ulcer disease (P = 0.01) were risk factors for the development of postoperative anemia.CONCLUSION: Iron deficiency anemia is frequent. RYGB surgery compounds occult blood loss. Increased ferrous sulfate supplementation may prevent iron depletion in populations at increased risk.

关键词： Anemia Complication Gastric bypass surgery Obesity

Preseason elimination impact on anterior cruciate ligament injury in the national football league

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World Journal of Orthopedics 2021年第11期12卷 833-841页

作者： michael Patetta Benjamin Mayo omar Zaki Martini Breanna Sullivan Leonard Onsen Mark Hutchinson Department of Orthopaedics University of Illinois Chicago College of MedicineChicagoIL 60612United States

BACKGROUND Anterior cruciate ligament(ACL)injuries represent detrimental injuries in the National Football League(NFL).A significant portion of these injuries often occur in preseason exhibitions.The Coronavirus disease 2019 pandemic presented a unique disruption to preseason NFL football with the cancelation of all preseason games.AIM To compare the incidence of ACL tears through the first eight weeks of the NFL season in 2020 to the mean incidence over the previous 5 seasons(2015-2019)and determine if there was any change in incidence with the elimination of the preseason.METHODS NFL players who suffered ACL tears during the preseason and first eight weeks of the NFL season from 2015-2020 were identified.The number of ACL injuries for the 2015-2019 seasons was compared to the 2020 season for four different timeframes.For each analysis,the cumulative number of ACL injuries to that time point was used to calculate the percent difference for descriptive analysis.Additionally,the number of teams with at least one player suffering an ACL tear were identified and compared using Chi-Squared testing.Finally,a cumulative relative risk was calculated for each week played.RESULTS There were 14 ACL tears through the first four games of the 2020 season,a 118.8%(14 vs 6.4)increase in comparison to the 5-year average over the first 4 regular season weeks of 2015-2019.However,when accounting for injuries occurring during the preseason from 2015-2019,there were 18.6%(14 vs 17.2)fewer total ACL injuries through regular season week 4 with no significant difference in percentage of teams impacted when these preseason injuries were accounted for P=0.394.Results were similar(19 vs 17.2)over 8 total games played(whether regular season or preseason),and over 8 regular season games(P=0.196,P=0.600).CONCLUSION The elimination of the NFL preseason resulted in a higher rate of injuries during the first 4 games of the regular season.However,these increases are offset by the injuries typically sustained during the preseason.This suggests th

关键词： Anterior cruciate ligament National football league Player safety Ligamentous injury Preseason COVID-19

Opening a window to skin biomarkers for diabetes stage with optoacoustic mesoscopy

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Light(Science & Applications) 2023年第11期12卷 2335-2349页

作者： Hailong He Nikolina-Alexia Fasoula Angelos Karlas Murad omar Juan Aguirre Jessica Lutz michael Kallmayer Martin Fuchtenbusch Hans-Henning Eckstein Annette Ziegler Vasilis Ntziachristos Institute of Biological and Medical Imaging Helmholtz Zentrum MunchenNeuherbergGermany Chair of Biological Imaging at the Central Institute for Translational Cancer Research(TranslaTUM) School of MedicineTechnical University of MunichMunichGermany Department for Vascular and Endovascular Surgery Klinikum rechts der IsarTechnical University of Munich(TUM)MunichGermany DZHK(German Centre for Cardiovascular Research) partner site Munich Heart AllianceMunichGermany Diabetes Center at Marienplatz MunichGermany Forschergruppe Diabetes e.V. Helmholtz Zentrum MunchenNeuherbergGermany Institute of Diabetes Research Helmholtz Zentrum MunchenNeuherbergGermany

Being the largest and most accessible organ of the human body,the skin could offer a window to diabetes-related complications on the microvasculature.However,skin microvasculature is typically assessed by histological analysis,which is not suited for applications to large populations or longitudinal studies.We introduce ultra-wideband rasterscan optoacoustic mesoscopy(RSOM)for precise,non-invasive assessment of diabetes-related changes in the dermal microvasculature and skin micro-anatomy,resolved with unprecedented sensitivity and detail without the need for contrast agents.Providing unique imaging contrast,we explored a possible role for RSOM as an investigational tool in diabetes healthcare and offer the first comprehensive study investigating the relationship between different diabetes complications and microvascular features in vivo.We applied RSOM to scan the pretibial area of 95 participants with diabetes mellitus and 48 age-matched volunteers without diabetes,grouped according to disease complications,and extracted six label-free optoacoustic biomarkers of human skin,including dermal microvasculature density and epidermal parameters,based on a novel image-processing pipeline.We then correlated these biomarkers to disease severity and found statistically significant effects on microvasculature parameters as a function of diabetes complications.We discuss how label-free RSOM biomarkers can lead to a quantitative assessment of the systemic effects of diabetes and its complications,complementing the qualitative assessment allowed by current clinical metrics,possibly leading to a precise scoring system that captures the gradual evolution of the disease.

关键词： diabetes anatomy precise