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Protocol for lower back pain management: Insights from the French healthcare system

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World Journal of Clinical Cases 2024年第11期12卷 1875-1880页

作者： lea Evangeline Boyer Mathieu Boudier-Revéret Min Cheol Chang Department of Physical Medicine and Rehabilitation CHU de la RéunionReunion Island CIC 1410France Department of Rehabilitation Medicine University of Montreal Health CenterMontrealQC H2X 3E4Canada Department of Physical Medicine and Rehabilitation Yeungnam University HospitalDaegu 705-717South Korea

In this editorial we comment on the article published in a recent issue of the World Journal of Clinical *** article described a novel ultrasound-guided lateral recess block approach in treating a patient with lateral recess *** impact of spinal pain-related disability extends significantly,causing substantial human suffering and medical *** county has its preferred treatment strategies for spinal ***,we explore the lower back pain(LBP)treatment algorithm recommended in *** treatment algorithm for LBP recommended by the French National Authority for health emphasizes early patient activity and minimal medication *** encourages the continuation of daily activities,limits excessive medication and spinal injections,and incorporates psychological assessments and non-pharmacological therapies for chronic ***,the algorithm may not aggressively address acute pain in the early stages,potentially delaying relief and increasing the risk of ***,the recommended infiltrations primarily involve caudal epidural steroid injections,with limited consideration for other injection procedures,such as transforaminal or interlaminar epidural steroid *** fixed follow-up timeline may not accommodate patients who do not respond to initial treatment or experience intense pain,potentially delaying the exploration of alternative *** these limitations,understanding the strengths and weaknesses of the French approach could inform adaptations in LBP treatment strategies globally,potentially enhancing patient outcomes and satisfaction across diverse healthcare systems.

关键词： Lower back pain Protocol France Treatment Chronic pain

Differences between the healthcare systems of Quebec and France for the treatment of pain due to spinal disorders

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World Journal of Clinical Cases 2024年第15期12卷 2682-2685页

作者： lea Evangeline Boyer Mathieu Boudier-Revéret Min Cheol Chang Department of Physical Medicine and Rehabilitation CHU de la RéunionReunion Island CIC 1410France Department of Rehabilitation Medicine University of Montreal Health CenterMontrealQC H2X 3E4Canada Department of Physical Medicine and Rehabilitation College of MedicineYeungnam UniversityDaegu 705-717South Korea

In Quebec,Canada,the public healthcare system offers free medical ***,patients with spinal pain often encounter long waiting times for specialist appointments and limited physiotherapy *** contrast,private clinics provide expedited care but are relatively scarce and entail out-of-pocket *** a patient with pain caused by a spinal disorder meets a pain medicine specialist,spinal intervention is quickly performed when indicated,and patients are provided lifestyle *** epidural steroid injections are frequently administered to patients with radicular pain,and steroid injections are administered on a facet joint to control low back or neck ***,medial branch blocks are performed prior to ***’s universal healthcare system ensures accessibility at controlled *** emphasizes physical activity and provides free physical therapy ***,certain interventions,such as transforaminal and interlaminar epidural injections,are not routinely used in France owing to limited therapeutic efficacy and safety *** underutilization may be a potential cause of chronic pain for many *** examining the differences,strengths,and weaknesses of these two systems,valuable insights can be gained for the enhancement of global spinal pain management strategies,ultimately leading to improved patient outcomes and satisfaction.

关键词： Spinal pain healthcare system France Quebec Pain treatment

COVID-19 patient experiences in prehospital pathways:a processual approach using life-events calendar method and state sequence analysis shows detrimental delays

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Family Medicine and Community health 2024年第1期12卷 45-56页

作者： Romain Lutaud Sebastien Cortaredona lea Delorme Patrick Peretti-watel Juliette Mirouse Manon Borg Lucie Cattaneo Didier Thery Gaetan Gentile Christian Pradier Touitou Irit Philippe Brouqui Sophie Tardieu Michel Carles Stéphanie Gentile Department of General Practice Aix-Marseille UniversityMarseilleFrance ADES MarseilleFrance Institut de Recherche pour le Développement(IRD) MarseilleFrance Assistance Publique-hôpitaux de Marseille(AP-hM) MarseilleFrance INSERM MarseilleFrance Department of Public health Archet University HospitalNiceFrance MEPhI MarseilleFrance CEReSS-health Service Research and Quality of life Center MarseilleFrance Department of Infectious Diseases Centre Hospitalier Universitaire de NiceNiceFrance

Objectives To our best knowledge,no study in France has comprehensively investigated the prehospital history of patients admitted for severe cases of COVID-19.‘Patients’voice is an excellent means to capture data on primary care *** aimed to identify clusters of COVID-19 hospitalised patients with similar prehospital symptom sequences,and to test whether these clusters were associated with a higher risk of poor clinical *** Cross-sectional online survey using life-event *** All patients hospitalised for COVID-19 between September 2020 and May 2021 in the Infectious Disease Departments in Nice and in Marseilles in *** 312 patients responded to the *** outcome measures From the day of symptom onset to the day of hospitalisation,we defined a symptom sequence as the time-ordered vector of the successive symptom grades(grade 1,grade 2,grade 3).State sequence analysis with optimal matching was used to identify clusters of patients with similar symptom *** logistic regressions were performed to test whether these clusters were associated with admission to intensive care unit(ICU)and COVID-19 sequelae after *** Three clusters of symptom sequences were identified among 312 complete prehospital pathways.A specific group of patients(29%)experienced extended symptoms of severe COVID-19,persisting for an average duration of 7.5 days before *** group had a significantly higher probability of being admitted to ICU(adjusted OR 2.01).They were less likely to know a loved one who was a healthcare worker,and more likely to have a lower level of ***,this group of patients,who were more likely to have previously visited the emergency room without exhibiting severe symptoms at that time,may have been inclined to postpone reassessment when their health *** relatives played a decisive role in their *** and relevance This study h

关键词： admitted likely life

s age at puberty associated with semen quality ant ＇eproductive hormones in young adult life？

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Asian Journal of Andrology 2017年第6期19卷 625-632页

作者： lea LB Lauridsen Linn h Arendt henrik Stovring Jorn Olsen Cecilia h Ramlau-hansen 1Department of Public health Section for Epidemiology Aarhus University 8000 Aarhus C Denmark Department of Public health Section for 8iostatistics Aarhus University 8000 Aarhus C Denmark Department of Clinical Epidemiology Aarhus University Hospital 8200 Aarhus N Denmark

The evidence is scarce on the association between age at puberty and semen quality. A cohort of 320 Danish men aged 18-21 years enrolled in the ＂healthy habits for Two＂ birth cohort provided self-reported data on pubertal indicators and delivered semen and blood samples. The results indicated an association between older age at pubertal development and lower semen quality and altered reproductive hormones concentrations as measured in young adult life. Men who had their first nocturnal emission, start of pubic hair growth and first voice break episode when older than 15 years had 37.0%, 45.0% and 32.7% lower sperm concentration; 37.8%, 44.2% and 29.1% lower total sperm count; 7.4%, 13.4% and 15.3% lower testosterone concentration; and 21.3%, 1.5% and 3.7% lower inhibin B concentration, respectively, compared with the men who were younger than 13 years at their first pubertal indicators. Only few of the results were statistically significant, but similar tendencies were seen in several of the reproductive parameters suggesting an association between the timing of pubertal development and reproductive health later in life.

关键词： pubertal development puberty reproductive health reproductive hormones semen quality

Food Insecurity in US Families with Children with Limiting health Conditions

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health 2014年第18期6卷 2461-2468页

作者： lea Anne DeRigne Linda Quinn Patricia Stoddard-Dare Christopher mallett School of Social Work Florida Atlantic University Boca Raton FL USA Mathemathics Department Cleveland State University Cleveland OH USA School of Social Work Cleveland State University Cleveland OH USA

Food insecurity in US households with children with limiting health conditions was compared to households with children without limiting health conditions, controlling for demographic variables. Multivariable logistic regression was used to calculate the odds ratios. Data from the 2008-2011 Making Connections Survey (N = 1940) of households with children in seven high poverty communities in the US were used. having a child with a limiting health condition made a household’s odds 1.41 times (95% C.I., 1.110, 1.790) more likely to be food insecure. When there are two or more children with limiting conditions in the household, the odds of food insecurity are 1.67 times (95% CI, 1.16, 2.40), higher than a family with no children with a disabling health condition. Families with children with limiting health conditions in high poverty communities are especially at risk of experiencing food insecurity, which can complicate health conditions. Nutrition assistance programs are vital to keep children and families food secure.

关键词： Child health Financing Disabilities

Early acute kidney injury after liver transplantation: Predisposing factors and clinical implications

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World Journal of hepatology 2017年第18期9卷 823-832页

作者： Suehana Rahman Susan V mallett Brian R Davidson Royal Free Perioperative Research Group Department of Anaesthesia Royal Free Hospital Royal Free NHS Foundation Trust Department of Surgery Royal Free Hospital Royal Free NHS Foundation Trust

To investigate the additional clinical impact of hepatic ischaemia reperfusion injury (hIRI) on patients sustaining acute kidney injury (AKI) following liver transplantation. METhODSThis was a single-centre retrospective study of consecutive adult patients undergoing orthotopic liver transplantation (OLT) between January 2013 and June 2014. Early AKI was identified by measuring serum creatinine at 24 h post OLT (> 1.5 × baseline) or by the use of continuous veno-venous haemofiltration (CVVhF) during the early post-operative period. Patients with and without AKI were compared to identify risk factors associated with this complication. Peak serum aspartate aminotransferase (AST) within 24 h post-OLT was used as a surrogate marker for hIRI and severity was classified as minor ( 5000 IU/L). The impact on time to extubation, intensive care length of stay, incidence of chronic renal failure and 90-d mortality were examined firstly for each of the two complications (AKI and hIRI) alone and then as a combined outcome. RESULTSOut of the 116 patients included in the study, 50% developed AKI, 24% required CVVhF and 70% sustained moderate or severe hIRI. Median peak AST levels were 1248 IU/L and 2059 IU/L in the No AKI and AKI groups respectively (P = 0.0003). Furthermore, peak serum AST was the only consistent predictor of AKI on multivariate analysis P = 0.02. AKI and hIRI were individually associated with a longer time to extubation, increased length of intensive care unit stay and reduced survival. however, the patients who sustained both AKI and moderate or severe hIRI had a longer median time to extubation (P h of stay (P = 0.001) than those with either complication alone. Ninety-day survival in the group sustaining both AKI and moderate or severe hIRI was 89%, compared to 100% in the groups with either or neither complication (P = 0.049). CONCLUSIONhIRI has an important role in the devel

关键词： hepatic ischaemia reperfusion injury Liver transplantation Perioperative care Acute kidney injury Marginal grafts

Stool antigen tests in the diagnosis of helicobacter pylori infection before and after eradication therapy

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World Journal of Gastroenterology 2005年第46期11卷 7340-7344页

作者： lea Veijola Eveliina Myllyluoma Riitta Korpela hilpi Rautelin Department of Bacteriology and Immunologyhaartman Institute University of Helsinkiand Malmi HospitalHelsinkiFinland Institute of BiomedicinePharmacology University of Helsinkiand Foundation for Nutrition ResearchHelsinkiFinland Institute of BiomedicinePharmacology University of Helsinkiand Valio Ltd. Research CentreHelsinkiFinland Department of Bacteriology and Immunologyhaartman Institute University of Helsinkiand HUSLABHelsinki University Central Hospital LaboratoryHelsinkiFinland

Aim： To evaluate two enzyme immunoassay-based stool antigen tests, Premier Platinum hpSA and Amplified IDEIA hpStAR, and one rapid test, ImmunoCard SLAT! hpSA, in the primary diagnosis of helicobacter pylon （h pylori） infection and after eradication therapy. METhODS： Altogether 1 574 adult subjects were screened with a whole-blood h pylori antibody test and positive results were confirmed with locally validated serology and ^13C-urea breath test. All 185 subjects, confirmed to be h pylori positive, and 97 h pylorinegative individuals, randomly selected from the screened study population and with negative results in serology and UBT, were enrolled. After eradication therapy the results of 182 subjects were assessed. RESULTS： At baseline, the sensitivity of hpSA and hpStARwas 91.9% and 96.2%, respectively, and specificity was 95.9% for both tests. ImmunoCard had sensitivity of 93.0% but specificity of only 88.7%. After eradication therapy, hpSA and hpStAR had sensitivity of 81.3% and 100%, and specificity of 97.0% and 97.6%, respectively. ImmunoCard had sensitivity of 93.8% and specificity of 97.0%. hpSA, hpStAR, and ImmunoCard had PPV 77%, 80%, and 75%, and NPV 98%, 100%, and 99%, respectively. CONCLUSION： In primary diagnosis, the EIA-based tests performed well. After eradication therapy, negative results were highly accurate for all the three tests. hpStAR had the best overall performance.

关键词： Diagnosis Feces helicobacter pylori Therapy

Effect of replacement of soybean oil by hermetia illucens fat on performance,digestibility,cecal microbiome,liver transcriptome and liver and plasma lipidomes of broilers

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Journal of Animal Science and Biotechnology 2023年第4期14卷 1466-1484页

作者： lea Schäfer Sarah M.Grundmann Garima Maheshwari Marcus höring Gerhard Liebisch Erika Most Klaus Eder Robert Ringseis Institute of Animal Nutrition and Nutrition Physiology Justus Liebig University GiessenHeinrich-Buff-Ring 26-3235392 GiessenGermany Institute of Nutritional and Food Sciences Molecular Food TechnologyUniversity of BonnFriedrich-Hirzebruch-Allee 753115 BonnGermany Institute of Clinical Chemistry and Laboratory Medicine University Hospital of RegensburgFranz-Josef-Strauss-Allee 1193053 RegensburgGermany.

Background In contrast to protein-rich insect meal,the feed potential of insect fat is generally less explored and knowledge about the suitability of insect fat as a fat source specifically in broiler diets is still *** view of this,the present study aimed to comprehensively investigate the effect of partial(50%) and complete replacement of soybean oil with insect fat from hermetia illucens(hI) larvae in broiler diets on performance,fat digestibility,cecal microbiome,liver transcriptome and liver and plasma ***,100 male,1-day-old Cobb 500 broilers were randomly assigned to three groups and fed three different diets with either 0(group hI-0,n cens(hI) larvae fat for 35 d.= 30),2.5%(group hI-2.5,n %(hI-5.0,n = 35) or 5.0= 35) hermetia illuResults Body weight gain,final body weight,feed intake,and feed:gain ratio during the whole period and apparent ileal digestibility coefficient for ether extract were not different between *** microbial diversity did not differ between groups and taxonomic analysis revealed differences in the abundance of only four low-abundance bacterial taxa among groups;the abundances of phylum Actinobacteriota,class Coriobacteriia,order Coriobacteriales and family Eggerthellaceae were lower in group hI-5.0 compared to group hI-2.5(P hort-chain fatty acids in the cecal digesta were not different between the three *** transcriptomics revealed a total of 55 and 25 transcripts to be differentially expressed between groups hI-5.0 ***-0 and groups hI-2.5 ***-0,respectively(P he concentrations of most lipid classes,with the exception of phosphatidylethanolamine,phosphatidylglycerol and lysophosphatidylcholine in the liver and cholesterylester and ceramide in plasma(P he sum of all lipid classes were not different between *** Partial and complete replacement of soybean oil with hI larvae fat in broiler diets had no effect on gro

关键词： Broilers Cecal microbiota hermetia illucens Insect fat Liver lipidome Medium-chain fatty acids

Growth inhibition of colon cancer cells by compounds affecting AMPK activity

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World Journal of Gastrointestinal Oncology 2014年第7期6卷 244-252页

作者： Michael A lea Jacob Pourat Rupali Patel Charles desBordes Department of Biochemistry and Molecular Biology New Jersey Medical School Rutgers University Newark NJ 07103 United States Department of Biology Medgar Evers Col-lege-City University of New York Brooklyn NY 11225 United States

AIM:To determine if other molecules reported to modulate AMP-dependent protein kinase(AMPK)activ-ity would have effects resembling those of metformin and phenformin on colon cancer cell proliferation and ***:Studies were performed with four hu-man colon cancer cell lines,Caco-2,hCT116,hT29 and *** compounds that were studied included A-769662,5-aminoimidazole-4-carboxamide-1-ribofu-ranoside,butyrate,(-)-epigallocatechin gallate(EGCG),KU-55933,quercetin,resveratrol and *** parameters that were measured were cell proliferation and viability,glucose uptake,lactate production and acidification of the incubation ***:Investigations with several molecules that have been reported to be associated with AMPK activa-tion(A-769662,5-aminoimidazole-4-carboxamide-1-b-D-ribofuranoside,EGCG,KU-55933,quercetin,resve-ratrol and salicylates)or AMPK inhibition(compound C)failed to reveal increased medium acidification and increased glucose uptake in colon cancer cells as previ-ously established with metformin and *** only exception was 5-aminosalicylic acid with which there were apparently lower glucose levels in the me-dium after incubation for 72 *** study in the absence of cells revealed that the effect was an artifact due to inhibition of the enzyme-linked glucose *** compounds were studied at concentrations that inhibited cell ***:It was concluded that treatment with several agents that can affect AMPK activity resulted in the inhibition of the proliferation of colon cancer cells under conditions in which glucose metabolism is not enhanced,in contrast to the effect of biguanides.

关键词： Colon cancer cells Proliferation AMP-dependent protein kinase Glucose metabolism