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Phrenic nerve block: the key to managing acute biliary pain?

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World Journal of Emergency Med.cine 2024年第1期15卷 62-63页

作者： michael Shalaby Joshua Luftig Department of Emergency Med.cine and Critical Care Herbert Wertheim College of Medicine at Florida International UniversityMiami 33199USA Advanced.Emergency Ultrasound Mount Sinai Medical CenterMiami Beach 33140USA Department of Emergency Med.cine Highland HospitalAlameda Health SystemOakland 94602USA

Over the past two decades,the USA has witnessed.a steep rise in the incidence of acute cholecystitis(AC),[1]even among children,[2]with over 200,000 cases annually.[3]Patients with AC often present to the emergency department(ed.experiencing severe distress,with most describing their pain level as“intolerable.”[4]Furthermore,there is usually a considerable delay before surgery,with a med.an time from diagnosis of AC to surgery of 28.5 h,[5]and a substantial percentage of patients wait as long as 10 d.[6]Prolonged.delays before surgery lead to increased.opioid use,which is associated.with extended.hospital stays and higher rates of readmission after cholecystectomy.[7]Furthermore,opioids can lead to vomiting,respiratory depression,delirium,and ultimately addiction.[8]We propose a novel regional anesthesia technique for managing AC:right phrenic nerve *** method could offer improved.pain control and a more favorable risk profile in selected.patients when compared.to current ed.practices.

关键词： pain anesthesia diagnosis

Subsequent total joint arthroplasty: Are we learning from the first stage?

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World Journal of Orthoped.cs 2024年第3期15卷 230-237页

作者： Christine Jiang Wu Colin Penrose Sean Patrick Ryan michael Paul Bolognesi Thorsten Markus Seyler Samuel Secord Wellman Department of Orthopaed.c Surgery Duke University HospitalDurhamNC 27710United States Department of Orthopaed.c Surgery Midwest Center for Joint ReplacementIndianapolisIN 46241United States

BACKGROUND With the increasing incidence of total joint arthroplasty(TJA),there is a desire to red.ce peri-operative complications and resource *** degenerative conditions progress in multiple joints,many patients undergo multiple *** To determine if both physicians and patients learn from the patient’s initial arth-roplasty,resulting in improved.outcomes following the second *** The institutional database was retrospectively queried.for primary total hip arth-roplasty(THA)and total knee arthroplasty(TKA).Patients with only unilateral THA or TKA,and patients undergoing same-day bilateral TJA,were *** demographics,comorbidities,and implant sizes were collected.at the time of each proced.re and patients were stratified.by first vs second *** metrics evaluated.included.operative time,length of stay(LOS),disposition,90-d readmissions and emergency department(ed.*** A total of 642 patients,including 364 undergoing staged.bilateral TKA and 278 undergoing bilateral THA,were *** was no significant difference in demographics or comorbidities between the first and second proced.re,which were separated.by a mean of 285 *** THA and TKA,LOS was significantly less for the second surgery,with 66%of patients having a shorter hospitalization(Ped.operative time only when the same sized.implant was utilized.P=0.025).The vast majority(93.3%)of patients were discharged.to the same type of location following their second ***,when a change in disposition was present from the first surgery,patients were significantly more likely to be discharged.to home after the second proced.re(P=0.033).There was no difference between proced.res for post-operative readmissions(P=0.438)or ed.visits(P=0.915).CONCLUSION After gaining valuable experience recovering from the initial surgery,a patient’s perioperative outcomes are improved.for their second *** may

关键词： Staged.total joint arthroplasty Asynchronous total joint arthroplasty Subsequent total joint arthroplasty Contralateral total joint arthroplasty Perioperative outcomes

Evaluation of disease burden and symptom scores in patients with acute atrial fi brillation in the emergency department

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World Journal of Emergency Med.cine 2024年第5期15卷 397-400页

作者： Nikola Schütz Dominik Roth michael Prinz Filippo Cacioppo Sebastian Schnaubelt Alexander O.Spiel Hans Domanovits Harald Herkner Department of Emergency Med.cine Medical University of ViennaVienna 1090Austria Department of Emergency Med.cine Clinic OttakringVienna 1160Austria

Atrial fibrillation(AF)is a major public health problem and poses a substantial economic burden on healthcare systems worldwide.[1-4]The emergency department(ed.serves as the first point of contact with the healthcare system and plays a key role in the management of patients with AF,which accounts for 3%-10%of all hospital admissions.[5]Treatment plans are often discussed.and initiated.at the ed.

关键词： patients atrial acute

Epidemio-Clinical Aspects of Ecrectile Dysfunction in Type 2 Diabetics at Abeche Chu

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Open Journal of Urology 2024年第2期14卷 50-60页

作者： Vadandi Valentin Mahamat Ali Mahamat Minguemadji Allah Siyangar Temga Ouang michael Vounouzia Barthelemy Ndormadjita Allah Siyangar Abdelmahamoud Chene Konan Paul Gerard Rimtebaye Kimassoum Urology Department University Hospital Center Abeche Chad Urology Department University Hospital of National Reference N’Djamena Chad Urology Department University Hospital of Renaissance N’Djamena Chad Urology Department University Hospital Center Abidjan Cote d’Ivoire

Introduction: Erectile dysfunction (ed. is a frequent complication of diabetes and more frequently affects type 2 diabetics. It is often unrecognised.or its management is delayed.because it is often overshadowed.by other complications. The aim of our study was to describe the epidemiological and clinical aspects of ed. Patients and Method: This was a descriptive cross-sectional study over an 8-month period from April to December 2021, of type 2 diabetic subjects with erectile dysfunction (ed. seen at the University Hospital of Abeche. Erectile function was assessed.using the International Index of Erectile Function (IIEFS5). Results: Out of a total of 112 patients with type 2 diabetes, 64 agreed.to take part in the study. Only 40 patients correctly completed.the survey form. Of these, 34 (85%) had erectile dysfunction. On average, our patients were over 49.4 years old, and 55.9% of them had had diabetes for more than 10 years. Erectile dysfunction had affected.the social life of 21 patients (61.76% of cases) and 28 (82.35%) had not been informed.by a healthcare professional. Most of them, 31 cases or 91.17%, had never told their GP about their erectile dysfunction. The patients who thought that diabetes had an influence on their erectile dysfunction represented.74%. Diabetes was poorly controlled.in 22 patients (64.70%). According to the International Index of Erectile Function (IIEF5), 85% of diabetic patients suffer from erectile dysfunction, including 28.6% with severe erectile dysfunction, 35.7% with moderate erectile dysfunction and 14.3% with mild erectile dysfunction. Erectile dysfunction was significantly more frequent in diabetics with arterial hypertension and poor diabetic control. Conclusion: The hospital prevalence of erectile dysfunction in our patients is high. Early detection of this disorder therefore remains a challenge to be met in order to organise better psychological and drug treatment.

关键词： Diabetes Erectile Dysfunction Screening

PillCamColon2 after incomplete colonoscopy-A prospective multicenter study

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World Journal of Gastroenterology 2018年第31期24卷 3556-3566页

作者： Peter Baltes Marc Bota Jorg Albert michael Philipper Hans-Georg Horster Fried.ich Hagenmüller Ingo Steinbrück Ralf Jakobs Matthias Bechtler Dirk Hartmann Horst Neuhaus Jean-Pierre Charton Rupert Mayershofer Horst hohn Thomas Rosch Stefan Groth Tanja Nowak Peter Wohlmuth Martin Keuchel Clinic for Internal Med.cine Bethesda Krankenhaus BergedorfHamburg 21029Germany Schwerpunktpraxis Gastroenterologie Koblenz 56068Germany Clinic for Interdisciplinary Endoscopy University Hospital EppendorfHamburg 20251Germany CorporateHealth International Hamburg 20149Germany Biometry and data management asklepios proresearchHamburg 20099Germany Department of Internal Med.cine I Klinikum der JW.Goethe UniversitatFrankfurt 60590Germany Gastroenterologische Schwerpunktpraxis Düsseldorf 40227Germany Gastropraxis Rheydt Monchengladbach 41236Germany 1st Med.cal Department Asklepios Klinikum AltonaHamburg 22763Germany Med.cal Clinic C Klinikum der Stadt LudwigshafenLudwigshafen 67063Germany Clinic for Internal Med.cine Sana Klinikum LichtenbergBerlin 10365Germany Clinic for Internal Med.cine Evangelisches KrankenhausDüsseldorf 40217Germany Gastroenterologie am Burgweiher Bonn 53123Germany

AIM To evaluate the ability of PillCamColon2 to visualize colonic segments missed.by incomplete optical colonoscopy(OC) and to assess the diagnostic *** This prospective multicentre study included.81 patients from nine centres who underwent second-generation colon capsule endoscopy(CCE) following incomplete OC performed.by an experienced.gastroenterologist(> 1000 colonoscopies). Patients with stenosis were excluded. According to patient preferences, CCE was performed.the following day(protocol A) after staying on clear liquids and 0.75 L Moviprep in the morning or within 30 d after new split-dose Moviprep(protocol B). Boosts consisted.of 0.75 L and 0.25 L Moviprep, and phospho-soda was given as a rescue if the capsule was not excreted.after seven *** Seventy-four patients were analysed.51% of them in group A; 49% in group B). Bowel cleansing was adequate in 67% of cases, and CCE could visualize colonic segments missed.by incomplete colonoscopy in 90% of patients under protocol A and 97% of patients under protocol B(P = 0.35, n.s.). Significant polyps including adenocarcinoma were detected.in 24% of cases. Detection rates for all polyps and significant polyps per patient were similar in both protocols. Polyps were found pred.minantly in the right colon(86%) in segments that were not reached.by OC. Extracolonic findings-such as reflux esophagitis, suspected.Barrett esophagus, upper GI-bleed.ng, gastric polyps, gastric erosions and angiectasia-were detected.in eight patients. Pill Cam Colon2 capsule was retained.in the ileum of one patient(1.4%) without symptoms and removed.during an uneventful resection for unknown Crohn's disease that was diagnosed.as the cause of anemia, which was the indication for colonoscopy. CCE was well tolerated. One patient suffered.from selflimiting vomiting after consuming the *** Second-generation CCE using a low-volume preparation is useful after incomplete OC, and it allows for the detection of add

关键词： Colon capsule endoscopy PillCamColon2 Incomplete colonoscopy Low volume prep Moviprep Phospho-soda Cleanliness level Complementation rate Polyps

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设计与计算的双向集成

工程设计学报 2003年第2期10卷 57-61页

作者： michael Amft Andreas Dyla Bernd-Robert hohn Udo Lindemann 刘耀乙毛谦德慕尼黑工业大学产品开发教研室慕尼黑工业大学齿轮与传动装置研究所北京理工大学科学技术学院 100081 北京理工大学机械工程与自动化学院 100081

在CAD系统与计算程序协同工作中发生的数据交换,应理想地沿两个方向进行,以支持产品开发过程,这通常称为"双向数据交换".然而,如何对此概念准确理解,学术界在表述上都不尽相同.原本意义上的单向数据交换,可以按序反向地进行,而被说成是... 详细信息

在CAD系统与计算程序协同工作中发生的数据交换,应理想地沿两个方向进行,以支持产品开发过程,这通常称为"双向数据交换".然而,如何对此概念准确理解,学术界在表述上都不尽相同.原本意义上的单向数据交换,可以按序反向地进行,而被说成是"双向"的.这样,在一种事实上每时每刻都沿双向进行的数据交换之外,还存在一个相同的提法.然而,这两种方案有根本区别的.由此,对概念进行区分,并指出其差别.

关键词： CAD系统双向集成计算程序数据交换产品设计

Industrial implication of Integrated.Testing Strategy in Acute Local Toxicity Testing

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Industrial implication of Integrated Testing Strategy in Acu...

NT server 4 in the enterpriese Microsoft certified.systems engineer ed.Tittel, Kurt Hudson, James michael Stewart.

中国毒理学会第五次全国学术大会

作者： Yo-Chan Jeong michael Woolheiser ed.Carney Daniel Wilson The Dow Chemical Company

＜正＞The principal goal of this presentation is to demonstrate the industrial practice of integrated.testing strategy（ITS） in the assessment of acute skin/eye irritation. ITS includes:weight of evidence analysis;us...

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Genetics and epigenetics of circadian rhythms and their potential roles in neuropsychiatric disorders

2000年

作者： ed.Tittel Kurt Hudson James michael Stewart.

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Neuroscience Bulletin 2015年第1期31卷 141-159页

作者： Chunyu Liu michael Chung State Key Laboratory of Med.cal Genetics of China Department of Psychiatry University of Illinois at Chicago

Circadian rhythm alterations have been implicated.in multiple neuropsychiatric disorders,particularly those of sleep,addiction,anxiety,and mood. Circadian rhythms are known to be maintained.by a set of classic clock genes that form complex mutual and self-regulatory loops. While many other genes showing rhythmic expression have been identified.by genome-wide studies,their roles in circadian regulation remain largely unknown. In attempts to directly connect circadian rhythms with neuropsychiatric disorders,genetic studies have identifi ed.gene mutations associated.with several rare sleep disorders or sleep-related.traits. Other than that,genetic studies of circadian genes in psychiatric disorders have had limited.success. As an important med.ator of environmental factors and regulators of circadian rhythms,the epigenetic system may hold the key to the etiology or pathology of psychiatric disorders,their subtypes or endophenotypes. Epigenomic regulation of the circadian system and the related.changes have not been thoroughly explored.in the context of neuropsychiatric disorders. We argue for systematic investigation of the circadian system,particularly epigenetic regulation,and its involvement in neuropsychiatric disorders to improve our understanding of human behavior and disease etiology.

关键词： epigenetics circadian rhythms neuropsychiatry