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A pilot prospective prevalence study of chronic rhinosinusitis associated with inflammatory bowel disease

World Journal of Otorhinolaryngology-Head and Neck Surgery 2022年第4期8卷 339-344页

作者： India dhillon Jennifer Ham ximena Maul Gregory Rosenfeld Andrew Thamboo division of Otolaryngology St.Paul's Sinus CentreUniversity of British ColumbiaVancouverBritish ColumbiaCanada division of Gastroenterology University of British ColumbiaVancouverBritish ColumbiaCanada

Background:Inflammatory bowel disease(IBd)is characterized by chronic inflammation of the gastrointestinal ***-intestinal manifestations such as pulmonary diseases have been *** rhinosinusitis(CRS),an inflammatory condition of the sinonasal mucosa,has been associated with several lung *** the relationship between lung and intestinal pathologies,and lung and sinus pathologies,we aimed to determine the prevalence of IBd among CRS ***:Pilot prevalence ***-two CRS patients were screened for IBd symptoms from October 2018 to January ***-reported disease symptoms and overall quality of life were evaluated using the Sino-Nasal Outcome Test 22(SNOT-22),Short Inflammatory Bowel disease Questionnaire(SIBdQ),and EuroQol 5 dimension 5 Level(EQ-5d-5L)*** Modified Lund-Kennedy(MLK)endoscopic and Lund-Mackay(LM)grading systems were used to confirm CRS *** who reported subjective symptoms of IBd were referred to a gastroenterologist clinic for further ***:Twenty of the 92(20.2%,95%CI:12.6%-29.8%)CRS patients reported symptoms of IBd and four individuals(4.26%,95%CI:1.17%-10.50%)were sub-sequently diagnosed with *** to patients without IBd symptoms(n=72),those with symptoms(n=20)reported significantly worse SNOT-22(P=0.002),SIBdQ(Pd EQ-5d-3L(P=0.0063)***,these patients did not exhibit significantly different MLK(P=0.81)or LM(P=0.04)***:The prevalence of IBd may be elevated among individuals with CRS relative to the general Canadian *** pilot study suggests that CRS with IBd is associated with lower quality of *** cross-sectional studies with larger sample sizes are required.

关键词： chronic rhinosinusitis microbiome Modified Lund–Kennedy quality of life Sino-Nasal Outcome Test 22(SNOT-22)

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Final diagnosis of Pediatric Patients with Prolonged in Activated Partial Thromboplastin Time Preoperative Study

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International Journal of Otolaryngology and Head & Neck Surgery 2015年第3期4卷 241-247页

作者： Noemi Aguirre Francisca Cordova Francisca Jaime ximena Fonseca Pamela Zúniga Pediatrics Resident Pontifical Catholic University of ChileSantiagoChile School of Medicine Pontifical Catholic University of ChileSantiagoChile Pediatrician Resident of Pediatric Gastroenterology and NutritionPontifical Catholic University of ChileSantiagoChile Otorhinolaryngologist Assistant ProfessorPediatrics DivisionMedical SchoolPontifical Catholic University of ChileSantiagoChile Hematologist-Oncologist Assistant ProfessorPediatrics DivisionMedical SchoolPontifical Catholic University of ChileSantiagoChile

Introduction: Activated partial thromboplastin time (aPTT) is one of the most used coagulation tests in preoperative evaluation. Incidental detection of a prolonged aPTT is a problem in primary care, in which the general pediatrician should be able to attend its initial management. Objective: To describe final diagnosis of patients with prolonged aPTT in preoperative study. Materials and Methods: This is a descriptive study of patients referred from otorhinolaryngology. Results: Totally, 508 adenoidectomies and/or tonsillectomies were performed in our center, 38 of which referred patients (7.5%) with prolonged aPTT, and 30 of which met inclusion criteria. The median age was 4 years. 56.6% of patients were males. 76.6% of patients normalized aPTT at the second follow-up. Among these, 73.9% showed a normal study, 4.3% ha2d lupus anticoagulant and in 21.7% Von Willebrand disease was detected. Among patients that persisted with prolonged aPTT, 42.8% had coagulant factors deficiency, 28.5% had lupus anticoagulant and in 28.5% of patients a diagnosis could not be achieved with the tests used in the present study. Multivariate analysis did not show correlation between final diagnosis and the variables measured. Conclusion: The presence of a prolonged aPTT in children under preoperative study is due to a pre-analytic factor in the majority of cases or to the presence of lupus anticoagulant, normalizing values on follow-up. We suggest that a new aPTT be performed on these patients, and only those that persist altered or present a symptoms and family history of coagulation disorders be referred to hematology.

关键词： aPTT Preoperative Study Tonsillectomy Adenoidectomy Coagulopathy

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High-frequency ultrasound features of basal cell carcinoma and its association with histological recurrence risk

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Chinese Medical Journal 2019年第17期132卷 2021-2026页

作者： Shi-Qi Wang Jie Liu Qing-Li Zhu Chen-Yang Zhao Tao Qu Feng Li ximena Wortsman Hong-Zhong Jin department of dermatology Peking Union Medical College Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing 100730 China department of Ultrasound Peking Union Medical College Hospital Chinese Academy of Medical Sciences and Peking Union Medical College Beijing 100730 China department of dermatology Faculty of Medicine University of Chile Santiago Chile department of Imaging Institute for Diagnostic Imaging and Research of the Skin and Soft Tissues Santiago Chile

Background: due to advances in high-frequency ultrasound technology, it is easier to detect fine structures of skin lesions. The aim of this study was to examine the ultrasonographic features and use recurrence risk stratification to assess the diagnostic performance of pre-operative ultrasound examination of basal cell carcinoma (BCC). Methods: This was a retrospective study. Forty-six BCC lesions underwent pre-operative ultrasound examination using 50- and 20- MHz probes. Ultrasonographic shape, margin, internal echoes, hyper-echoic spots, posterior echoes, and depth of the lesion were evaluated and correlated with the risk of recurrence based on histological features. Results: Forty-two patients had 46 skin lesions in total. The high-risk (n = 6) and low-risk (n = 40) groups exhibited considerable overlap in the ultrasonographic manifestations and no significant difference in margin (χ^2 = 3.231, P = 0.072), internal echo (χ^2 = 1.592, P = 0.207), or posterior echo (P = 0.169). However, high-risk BCCs tended to be irregular in shape than low-risk lesions (χ^2 = 4.313, P = 0.038). Both types presented hyper-echoic spots (χ^2 = 1.850, P = 0.174). Additionally, 78% of low-risk lesions were confined to the dermis (31/40), and 100% of high-risk lesions infiltrated into the sub-cutaneous tissue, resulting in a significant difference between the two groups (χ^2 = 10.951, P = 0.001). Ultrasound detected sub-clinical lesions in five patients. Conclusions: High-frequency ultrasound can provide important information for pre-operative evaluation of risk in BCC foci and reveal hidden lesions. The technique may play a crucial role in guiding therapeutic options for BCC.

关键词： High-frequency ultrasound Basal cell carcinoma Ultrasound Skin ultrasound Skin cancer ultrasound Skin cancer

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政治领导者在外交政策变化中的作用——以阿根廷与哥伦比亚为例

政治领导者在外交政策变化中的作用——以阿根廷与哥伦比亚为例

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作者：美娜（Laura ximena Vera）吉林大学

学位级别：硕士

在过去的几十年里阿根廷与哥伦比亚已经成为美国亲密的盟友。在90年代，阿根廷是美国领导的自由主义政策成功的展示国家。从90年代中期开始哥伦比亚成为了美国最亲密的盟友，允许美国在该地区的存在是因为它在打击游击队和毒品组织中提... 详细信息

在过去的几十年里阿根廷与哥伦比亚已经成为美国亲密的盟友。在90年代，阿根廷是美国领导的自由主义政策成功的展示国家。从90年代中期开始哥伦比亚成为了美国最亲密的盟友，允许美国在该地区的存在是因为它在打击游击队和毒品组织中提供援助，以达到疏远它邻国的目的。然而,在基什内尔和胡安曼努埃尔桑托斯的政府，人们可以看到这两个传统的美国盟友外交议程的变化：都转向去修补和加强它们与传统的地区竞争对手的关系。桑托斯一上任就迅速恢复与委内瑞拉和厄瓜多尔的双边关系，并开始寻求发展与巴西的战略伙伴关系。然而，在修补区域关系时，桑托斯也采取了一些不同于美国利益的政策。基什内尔，在他上任的上半阶段期间，与美国保持温和与亲切的关系，同时寻求与巴西的进一步一体化进程。这是他的目标，从区域一体化汲取力量来面对国家的经济问题。缓慢的区域一体化进程使其不再抱有幻想，他宁愿寻求和发展与查韦斯的委内瑞拉的密切联系，能为他提供快速的（或短期的）他所需要的资源。在他任期的下半阶段期间，他日益发展反美言论。是什么引起了这些国家外交议程的突然变化？为什么这两个传统的美国盟友使它们自己远离了北部的权力？为什么基什内尔寻求与传统的竞争对手巴西发展进一步的一体化进程，尽管互不信任和有竞争力？以及是什么使基什内尔后来与委内瑞拉建立密切的关系，一个以前很少接触的国家？为什么桑托斯恢复与高度对抗的查韦斯政权的关系，以及后来又与厄瓜多尔，在指责它们两国协助哥伦比亚游击队之后。这些情况很有趣，因为这两个国家放弃了一个有益的与美国长期的结盟关系，为了应付短暂的国内问题。本篇论文分析了在胡安·曼努埃尔·桑托斯（2010-2014年）和基什内尔（2003-2007）执政时期外交政策变化背后的原因。本论文的第二章形成理论框架来分析这些变化。国内政治方法是关键，哈德森和Vore在外交政策的分析中强调国内政治的重要性：国家不再被视为一个单一的合理的角色，但是各种国内角色的利益和他们要面对国内地制约，也是相关的。第二部分阐述国内政治对小的第三世界国家外交政策影响的重要性，考虑到这些国家的领导者往往受到国内政府机关的挑战。它将分析这些第三世界国家政府结构的特点，它允许在行政部门集中更大的权力，以及这如何，再加上连任的可能性，可能会导致资源的滥用来确保执政的延续。哈根说，领导者在定义外交议程时，必须合乎国内地做两个游戏：一个是旨在建立联盟，另一个旨在稳固权力。他指出，为了获得成功，他们会使用外交关系去动员公众支持他们的政权。本章的最后一部分探讨了领导者在定义外交政策中的作用。玛格丽特·赫尔曼开发了一个框架来理解哪些决策单元使外交政策成形;她指出决策单元可能是一个卓越的领导者，如果政府有一个人赋予权力去负责政府资源，就像在总统政治制度中可能出现的情况。她还进一步指定，在下列情况下这些领导者往往更容易负责和行使决策权：高层外交事件，危机的条件下，或因为它符合领导者的兴趣或专长而去这样做。在这些情况下决策的轨迹趋于走向政府高层，远离中层行政人员。有较少的选择性或创造性的问题需要解决时，决策群组就会被减少了。对于政治领导者有一种趋向是，不关注长期的国家利益，去参与短期的外交和政治目标，为了实现他们自己的个人议程。赫尔曼说，政治领导者可以被某种反馈的欲望激发积极性：寻求赞成，认可，权力，支持，地位或赞誉。第三章为了确定这些变化，分析了前总统基什内尔执政时阿根廷的外交政策，。然后分析了基什内尔任职期间带来的变化。基什内尔由于选举表现不佳，削弱了上台执政，加上庇隆主义党的分裂，以及在经济危机之中。由于害怕社会动员，如早在2001年一个被驱逐的总统德拉鲁阿，他利用他作为总统的卓越的角色去设置国际议程，在一个不像是国家面临经济复苏和社会动荡的国内领域——他喜欢有更多的回旋余地。基什内尔在他任期的上半阶段，试图改善与巴西的关系（通过南方共同市场一体化进程）以在处理它的国际债权人方面获得力量。然而由于进展缓慢，和急需经济上的帮助，他会变成一个不太可能的盟友：查韦斯。查韦斯提供了短期的财政援助和石油，使基什内尔藐视美国的政策。这诱使阿根廷中产阶级的支持，在2001经济危机期间仍然表现不满，他们把这归结为90年代的新自由主义的十年和与美国的“世俗的关系”。与美国为敌和寻求委内瑞拉的援助，基什内尔选择了短期的外交政策：为了个人利益和稳定，他牺牲了国家的利益。这在2007年选举中得到了回报，他的妻子获得了压倒性的胜利。第四章分析了在桑托斯之前的哥伦比亚的外交政策，以及介绍他一旦掌权的变化。桑托斯外交政策的形成是由于国内限制和他的野心。他的权力削弱是由于温和的绿色党惊人的竞选活动，以及前总统乌里韦仍然强大。改进内部安全形势意味着选民现在关心其它的问题，如失业，区域关系，腐败等。桑托斯上任是处于高层外交以及乌里韦与查尔斯之间有个人危机

关键词：外交政策的改变国内政治政治领导人的作用阿根廷内斯托尔·基什内尔哥伦比亚胡安·曼努埃尔·桑托斯

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Proposed Scales for Measuring Suicidal Ideation in Adult Cancer Patients

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Open Journal of Medical Psychology 2014年第1期3卷 79-86页

作者： diego Armando Leal-Hernández Lucía Sandoval ximena Palacios-Espinosa José Rafael Tovar Cuevas Universidad del Rosario Bogotá Colombia

Suicidal ideation, which can occur in oncology patients, is associated with suffering and a reduced quality of life. Empirical studies indicate that the incidence of suicide in people with cancer is approximately twice that of the general population. Objective: This cross-sectional descriptive study was designed to establish the prevalence of suicidal ideation in adult oncology patients based on a combination of scales to measure this variable. Method: A battery of three instruments (Scale for Suicidal Ideation. Item 9 of Beck’s depression Inventory, and a semi-structured interview) was used to make estimates that are not based on just one test and can thus make a comprehensive evaluation of suicidal ideation in the study sample. Four approximations, based on different items from suicidal ideation assessment scales, were developed to determine the most sensitive combination for identifying the presence of suicidal ideation in adult cancer patients. Results: The highest prevalence of suicidal ideation found with the proposed scales was 24.5% (CI = 16%-33%) with Scale 1;23.6% (CI = 15.2%-32%) with Scale 2;and 19.1% (CI = 11.3%-26.9%) with Scale 4. The lowest prevalence of suicidal ideation was 17.3% (CI = 9.8%-24.8%) with Scale 3. Conclusions: Suicidal behavior in the oncology patient should be assessed;however, there is a need to select sensitive instruments that can be applied easily and are suitable for the target group, which faces difficulties in participating in extensive evaluations.

关键词： Cancer Suicidal Ideation Assessment Scales

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Approach to Massive Bleeding in Obstetrics: Changing Management Paradigms Oriented by Early Goals [Early Goal Therapy in Postpartum Hemorrhage]

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Open Journal of Obstetrics and Gynecology 2021年第4期11卷 369-380页

作者： Sandra ximena Olaya-Garay Juan david Hernandez david Ricardo Murillo-Garcia Manuel Andrés Garay-Fernández Obstetrics Gynecology and Critical Care Universidad de Manizales Manizales Colombia Critical Care E.S.E. Hospital Universitario San Jorge Pereira Colombia The Jewish Hospital Cincinnati OH USA Pulmonary and Critical Care Hospital Santa Clara Bogotá D.C. Colombia

Recent findings: Approximately 830 women die every day worldwide as a result of complications related to pregnancy or childbirth with obstetric hemorrhage that remains a major cause of maternal morbidity and mortality. A systematic analysis by the World Health Organization [WHO] on the global causes of maternal deaths from 2003 to 2009 found that bleeding was the leading direct cause of maternal mortality followed by hypertensive disorders and sepsis. Overall, bleeding accounted for 27.1% of all maternal deaths worldwide. The need to implement strategies that mitigate the impact of bleeding in this clinical scenario is increasingly growing. Purpose of review: The purpose of this review is to propose a management strategy based on goals established through dynamic coagulation assessment. Summary: Effective management of obstetric hemorrhage requires rapid recognition, rapid response and mobilization of the multidisciplinary team. Volumetric resuscitation, hemodynamic stability, as well as the simultaneous identification and treatment of the source of bleeding and the resolution of coagulopathy in the shortest possible time remain the cornerstones of the management of Postpartum Hemorrhage (PPH).

关键词： Bleeding Coagulopathy Postpartum Fibrinogen

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diagnostic Approach of Thrombocytopenia in Pregnancy: A Review

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Open Journal of Obstetrics and Gynecology 2022年第8期12卷 784-792页

作者： John Alexander Yela Cono Sandra ximena Olaya david Ricardo Murillo-Garcia Brahyan Osorio Juan david Hernández Susana Lopez de Valencia Hospital Popayán Colombia Institución Universitaria Visión de las Américas Pereira Colombia The Jewish Hospital Cincinnati USA Universidad Tecnológica de Pereira Pereira Colombia

Thrombocytopenia (defined as platelet count 9/L) is present in 7% - 12% of pregnant women at delivery. Although there are mild etiologies of this condition that are often diagnosed incidentally, there are more severe causes that can be life threating. Thrombocytopenia also has a great implication in surgical risk and regional anesthesia. A structured evaluation of thrombocytopenia is necessary to allow an adequate diagnostic approach. Here we summarized the current knowledge of thrombocytopenia in pregnancy.

关键词： Pregnancy Thrombocytopenia Gestational Thrombocytopenia Preeclampsia HELLP Syndrome Immune Thrombocytopenia Thrombotic Microangiopathy Heparin-Induced Thrombocytopenia disseminated Intravascular Coagulation

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奔跑的意义

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疯狂英语（新悦读） 2023年第3期 49-49,77页

作者： ximena Pérez Gómez 不详

帕拉坚持跑马拉松,并参加其他比赛,为坐在轮椅上的儿童筹集资金,这些资金被用来救助患West综合征的儿童。Julieta Escobar Parra runs for a cause.A resident of Puebla,a city in Mexico,Parra runs marathons and other races to raise money for children in *** are used to help children with a rare disease called West *** has been running for about seven *** the past four years,she has run in China Poblana,a traditional Mexican outfit.

关键词： money West综合征 children

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<i>Chlamydia trachomatis</i>in a girl suspected of sexual abuse in the city of Córdoba, Argentina

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Case Reports in Clinical Medicine 2014年第2期3卷 97-100页

作者： Ana ximena Kiguen Graciela Ochonga Fernando Venezuela Marina Monetti María Celia Frutos Jessica Mosmann Cecilia Cuffini Cátedra de Odontopediatría de la Facultad de Odontología Universidad Nacional de Córdoba Córdoba Argentina Facultad de Ciencias Médicas Instituto de Virología “Dr. JM Vanella” Universidad Nacional de Córdoba Córdoba Argentina

Chlamydia trachomatis (***) infections are the most prevalent bacterial sexually transmitted infections worldwide. They are often asymptomatic and therefore underdiagnosed as there is no routine screening surveillance. This case supports the possibility of sexual abuse as a route of transmission of ***. It is well known that nearly one third of sexually assaulted children are at risk for infection by a sexually transmitted agent. This is why in cases of sexual abuse, it is standardized that *** positive results by Nucleic Acid Amplification Techniques (NAATs) should be confirmed looking for another *** target;for this reason, we used a Polimerase Chain Reaction (PCR) directed to cryptic plasmid of ***. Confirmation was specified by the use of another PCR with a different genetic target (ompA) and sequencing. We concluded that our patient’s oral lesions were probably originated by her father’s sexual abuse.

关键词： Chlamydia trachomatis Sexual Abuse Girl Argentina

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向更深处漫溯

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疯狂英语（新悦读） 2023年第6期 49-49,76,77页

作者： ximena Pérez Gómez 不详

每一所学校都有学习能力和学习渴望特别突出的学生。那么如何更好地满足这些学生的学习需求呢?一起到文中来看看吧!Every school has students who stand out for their abilities and their eagerness to *** Mexico,the American Scho... 详细信息

每一所学校都有学习能力和学习渴望特别突出的学生。那么如何更好地满足这些学生的学习需求呢?一起到文中来看看吧!Every school has students who stand out for their abilities and their eagerness to *** Mexico,the American School of Puebla created a program to work with them.

关键词：一所漫溯 who 学生的学习

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