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Far lateral lumbar disc herniation part 1: Imaging, neurophysiology and clinical features

World Journal of Orthopedics 2021年第12期12卷 961-969页

作者： Luigi Valentino Berra Andrea Di Rita Federico Longhitano Enrico Mailland Paolo Reganati Alessandro Frati Antonio Santoro Department of Neurosurgery Policlinico Umberto I-Sapienza Universitàdi RomaRoma 00161Italy Department of Neurosurgery San Carlo Borromeo HospitalMilano 20153Italy Department of Neurology San Carlo Borromeo HospitalMilano 20153Italy Department of Neuroradiology Manzoni HospitalLecco 23900Italy Neurosurgery Division Human Neurosciences Department Sapienza UniversityRoma 00135Italy andDepartment of NeurosurgeryIRCCS NeuromedPozzilli IS 86077Italy Department of Human Neurosciences Sapienza Universitàdi RomaRoma 00161Italy

Far lateral lumbar disc herniations(FLLDH)represent a separate category of disc pathology which includes both intraforaminal and extraforaminal lumbar disc herniations,that are characterized by a peculiar clinical presentation,diagnostic and treatment modalities as compared to the more frequent median and paramedian disc *** treatment often represents the only effective weapon for the cure of this disease and over the years different approaches have been developed that can reach the region of the foramen or external to it,with different degrees of *** diagnosis is more demanding and still underestimated as it requires a more detailed knowledge in the spine anatomy and dedicated radiological *** tomography and in particular magnetic resonance imaging are the appropriate tools for the diagnosis of *** the widespread use of these diagnostic tests,many cases of FLLDH are overlooked due to insufficiently detailed radiological examinations or due to the execution of exams not focused to the foraminal or the extraforaminal *** studies represent a valid aid in the diagnostic classification of this pathology and in some cases they can facilitate the differential diagnosis with other types of *** the present study,a comprehensive review of the clinical presentation,epidemiology,radiological study and the neurophysiological aspects is presented.

关键词： Far lateral lumbar disc herniaton Magnetic resonance imaging diagnosis clinical presentation Neurophysiology Epidemiology

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Surgical treatment for primary hyperparathyroidism

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Chinese Medical Journal 1997年第8期110卷 36-40页

作者： Chung-YauLo AnnieW.C.Kung KarenS.L.Lam Department of Surgery The University of Hong Kong Queen Mary Hospital Hong Kong China Department of Medicine The University of Hong Kong Queen Mary Hospital Hong Kong China

Objective To document the recent surgical results in the treatment of primary hyperparathyroidism (HPT) at Queen Mary Hospital. Methods From 1995 to 1996, 30 patients underwent 31 operations for primary HPT. The data of 11 men and 19 women with ages ranging from 19 to 86 years (median: 57 years) were prospectively recorded with emphasis on the need of preoperative localization. Results Symptoms of hypercalcemia were present in 20 (67%) and complications in 17 (57%) patients, respectively. Seventy seven localization studies were performed in 28 patients (average: 2.6 tests/patient). Localization was accurate in 12 of 23 (52%) ultrasonographies, 11 of 26 (42%) CT scans and 16 of 27 (59%) scintigraphies. Twenty six patients had a single adenoma excised while 3 patients with multiple endocrine neoplasia type Ⅰ (MEN Ⅰ) had subtotal parathyroidectomy for multiglandular hyperplasia during cervical exploration. Immediate normocalcemia was achieved in 29 patients. One patient had persistent hypercalcemia due to a supernumerary fifth gland in the superior mediastinum that was successfully excised in a second operation. One patient had a unilateral vocal cord paralysis and 4 patients needed calcium supplement on discharge. During a median follow up of 5 months, all patients were normocalcemic with one requiring calcium supplements. Conclusion Surgical treatment for primary HPT is a safe procedure and is associated with a high success rate. In our experience routine preoperative localization study is not cost effective.

关键词： ASYMPTOMATIC PRIMARY HYPERPARATHYROIDISM PREOPERATIVE LOCALIZATION clinical presentation PARATHYROID TUMORS EXPLORATION MANAGEMENT DISEASE GLANDS

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Tuberculous peritonitis in children:Report of nine patients and review of the literature

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World Journal of Gastroenterology 2008年第47期14卷 7235-7239页

作者： Gnül Dinler Gülnar Sensoy Deniz Helek Ayhan Gazi Kalayc■ Division of Pediatric Gastroenterology Hepatology and NutritionOndokuz May■s University HospitalSamsun55139Turkey Division of Pediatric Infectious Diseases Ondokuz May■s University HospitalSamsun55139Turkey Division of Pediatrics Ondokuz May■s University HospitalSamsun55139Turkey

AIM:To present our experience with tuberculous peritonitis treated in our hospital from 2002-2007. METHODS: We reviewed the medical records of 9 children with tuberculous peritonitis. RESULTS: Nine patients (5 boys, 4 girls) of mean age 14.2 years were diagnosed with peritoneal tuberculosis. All patients presented with abdominal distention. Abdominal pain was seen in 55.5% and fever in 44.4% of the patients. Four cases had coexisting pleural effusion and two had pulmonary tuberculosis with parenchymal consolidation. Ultrasonography found ascites with septation in 7 patients. Two patients had only ascites without septation. Ascitic fluid analysis of 8 patients yielded serum-ascite albumin gradients of less than 1.1 gr/dL. Laparoscopy and laparotomy showed that whitish tuberculi were the most common appearance. Adhesions were also seen in three cases. The diagnosis of peritoneal tuberculosis was confirmed histo-pathologically in 7 patients and microbiologically in two. Two patients had been diagnosed by ascitic fluid diagnostic features and a positive response to antituberculous treatment. All patients completed the antituberculous therapy without any complications. CONCLUSION: Tuberculous peritonitis has to be clinically suspected in all patients with slowly progressive abdominal distension, particularly when it is accompanied by fever and pain. Laparoscopy and peritoneal biopsy are still the most reliable, quick and safe methods for the diagnosis of tuberculous peritonitis.

关键词： Child clinical presentation Diagnosis Tuberculous peritonitis

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Pediatric clinical Features of Covid-19 in Cameroon

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Open Journal of Pediatrics 2022年第1期12卷 231-237页

作者： Meguieze Claude-Audrey Nseme Etouckey Eric Mekone Nkwele Isabelle Kalla Ginette Claude Mireille Kamgaing Noubi Nelly Ngo Nyeki Adèle-Rose Onambele Paul Ntoukem Mbakop Carlin Koki Ndombo Paul Pediatric Department Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaounde Cameroon Department of Morphological Sciences and Anatomopathology Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaounde Cameroon Department of Ophthalmology-ENT Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaounde Cameroon Nkolndongo District Health Service Yaounde Cameroon

Introduction: The Covid-19 pandemic is a public health emergency characterized by severe acute respiratory distress syndrome. It has many clinical forms and affects all age groups. Despite the magnitude of this pandemic, data from pediatric cohorts in Cameroon remain sparse. Objective: The aim of this study was to describe the clinical presentation of Covid-19 in the pediatric population of the Nkolndongo health district. Materials and method: A cross-sectional study was conducted for a duration of 5 months from January to May 2021 and covered a period of 9 months (March to December 2020). All patients aged 0 to 19 years, suspected of having Covid-19, confirmed by real-time RT-PCR targeting the N and ORF1 ab viral genes and managed in the Nkolndongo health district were included. The results were analyzed using IBM SPSS.23.0 software and the data expressed as frequencies, percentages, and means. The threshold of statistical significance was set at 0.05. Results: This study revealed that 48 patients out of 154 suspected cases were tested positive. The most affected age group was adolescents aged 13 - 19 years (92.85%). The most frequent symptoms were cough (33%), fever (42%) and nasal discharge (25%). Infants were the least affected. 58% of patients were asymptomatic, 47.91% were in mild stage, 8.33% in moderate stage and 4.16% in severe stage. All the children tested positive survived. Patients with comorbidity were 20 times more likely to develop moderate to severe clinical forms, this being statistically significant. Conclusion: The clinical presentation reported mainly fever, cough and anterior nasal discharge. There was a significant association between the presence of comorbidity and the moderate to severe degrees of severity.

关键词： Covid-19 Children clinical presentation Cameroon Sub Saharan Africa

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Cardiac Tamponade: Epidemioclinical, Therapeutic and Evolutionary Aspects at the University Hospital of Brazzaville

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World Journal of Cardiovascular Diseases 2021年第12期11卷 572-582页

作者： Solange Flore Mongo Ngamami Armel Landry Batchi-Bouyou Evariste Pabingui Christian Michel Kouala Landa Bertrand Fikahem Ellenga Mbolla Jean Joseph Ekwa Sima Méo Stéphane Ikama Suzy-Gisèle Kimbally Kaky Department of Cardiology University Hospital of Brazzaville Brazzaville Republic of the Congo Department of Doctoral Studies Faculty of Health Sciences Marien Ngouabi University Brazzaville Republic of the Congo

Objectives: Contribute to improving the management of cardiac tamponade in Congo. Background: Cardiac tamponade is an acute or subacute compression of the heart chambers by pericardial effusion responsible for uncertain prognosis for patients. The objective of this study is to help improve the management of patients with cardiac tamponade. Patients and Methods: We conducted a retrospective and descriptive study at the University Hospital of Brazzaville, from January 2015 to December 31, 2019. Included were all patients hospitalized for cardiac tamponade. Epidemioclinical, therapeutic and evolutionary data were analyzed. Results: An overall of 14 patients were divided into 9 men (64.2%) and 5 women (35.7%), i.e. a sex ratio of 1.8. The mean age of patients was 34.2 ± 15.1 years old (18 years to 64). The most represented comorbidity was hypertension (n = 2;14.3%). The most frequent clinical sign was dyspnea (n = 14;100%). The ECG showed diffuse and concordant repolarization disturbances (n = 14;100%), sinus tachycardia (n = 13;92.8%), microvoltage (n = 12;85.7%). Cardiomegaly was constant (n = 14;100%). In terms of transthoracic ultrasound, we found: diastolic compression of the right ventricle (RV) (n = 12;85.7%), dilation of the inferior vena cava (IVC) (n = 12;85.7%). Treatment consisted of crystalloid vascular filling in all patients, pericardial punc

关键词： Cardiac Tamponade clinical presentation Treatment Congo

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The influence of innate and adaptative immune responses on the differential clinical outcomes of leprosy

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Infectious Diseases of Poverty 2017年第1期6卷 34-41页

作者： Adriana Barbosa de Lima Fonseca Marise do Vale Simon Rodrigo Anselmo Cazzaniga Tatiana Rodrigues de Moura Roque Pacheco de Almeida Malcolm S.Duthie Steven G.Reed Amelia Ribeiro de Jesus Department of Medicine Molecular Biology LaboratoryUniversity HospitalUniversidade Federal de SergipeSao CristovaoSergipeBrazil Infectious Disease Research Institute SeattleUSA Instituto de Investigacao em Imunologia Institutos Nacionais de Ciência e TecnologiaCNPqSao PauloSPBrazil.

Leprosy is a chronic infectious disease caused by Mycobacterium *** to official reports from 121 countries across five WHO regions,there were 213899 newly diagnosed cases in *** leprosy affects the skin and peripheral nerves,it can present across a spectrum of clinical and histopathological forms that are strongly influenced by the immune response of the infected *** forms comprise the extremes of tuberculoid leprosy(TT),with a ***-specific Th1,but also a Th17,response that limits *** multiplication,through to lepromatous leprosy(LL),with ***-specific Th2 and T regulatory responses that do not control *** replication but rather allow bacterial *** interpolar borderline clinical forms present with similar,but less extreme,immune *** inflammatory episodes,known as leprosy reactions,are complications that may occur before,during or after treatment,and cause further neurological damages that can cause irreversible chronic *** review discusses the innate and adaptive immune responses,and their interactions,that are known to affect pathogenesis and influence the clinical outcome of leprosy.

关键词： Leprosy clinical presentation Immunology Innate immunity Immune pathogenesis

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Report of moderate or severe sodium and chloride disturbance on 82 cases with acute cerebral stroke

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中国临床神经科学 2000年第Z1期8卷 54-页

作者： Ma shun-tian YiWu People′ s Hospital YiWu Zhejiang322000

Abtract Objective: To decrease the fatality rate and prevalence rotc of acute cerebral stroke complicated with morderate or servere serum sodium and chioride disturbance by explonng the relation between the pathogency and prognosis Methods: Medical records were surveyed and clinical presentation, laboratory test, complicated。 Actiology pathogency and prognosis were analyzed m 82 cases with moderate or severe serum sodium and chloride disturbance among 736 cases with acute cerebral stroke collected, Results: The prevalence rate and fatality rate of acutc cerebral stroke complicated with moderate or severe serum sodium and chlorede disturbance were 11.3% (82/ 736) and 60.8% (49/52) which were different significantly form that complicated with normal or minimal sedium sodium and chloride disturbame (p (0.001) 。 The 82 cases occured at 3-13 days after hospitalization (mean 6 days) 。 The actiology and pathogency were mainly ralated with some endogenic and iatrogenic factors such as hypothalamic-pituitary system were destroyed resultly from acute cerbral stroke which led to SIADH。 Conclusion: The fatality rate of acute cerebral stroke complicatee with moderate or seyere serum sodium and chloride disturbance is mcreased significantly, Put prophylaxis first to decrease the prevalence rate and fatalty rate。 Pay attlention to comprehensive therapy of acute cerebral stoke to prevent endogenic sodium and chloride disturbance and especially place importance on iatrogenic disturbance。

关键词： acute cerebral stroke serum sodium prevalence rate comprehensive therapy clinical presentation

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