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Rapid correction of chronic hyperglycemia and bone remodeling,warning against overdoing

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World Journal of Diabetes 2024年第9期15卷 1858-1861页

作者： Dured Dardari Beatrice Segurens department of Diabetology Centre Hospitalier Sud FrancilienCorbeil Essonne 91100France universitéParis-Saclay CEACentre National de Recherche en Génomique Humaine(CNRGH)Evry CourcouronnesFrance

It is widely recognized that chronic hyperglycemia decreases bone quality,although little is known about the impact of the rapid correction of chronic hyperglycemia on the quality of bone *** spotlight article explore... 详细信息

关键词： Bone remodeling Chronic hyperglycemia Intensive hyperglycemia treatment Diabetes complication Rapid correction of hyperglycemia

Incidental and secondary findings in trio exome sequencing

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Genes & Diseases 2024年第4期11卷 152-154页

作者： Camille Cohen Emeline Bellanger Jeremie Mortreux laure Raymond Francois Vialard Rodolphe Dard department of Genetics Centre Hospitalier Intercommunal de Poissy-Saint-Germain-en-LayePoissy 78300France RHuMA UMR-BREEDINRA-ENVA-UVSQMontigny le Bretonneux 78180France Service de Genetique Laboratoire Eurofins BiomnisLyon 69007France

Exome sequencing(ES)generates secondary findings(SFs)in 2%of tested individuals if one follows the American College of Medical Genetics and Genomics(ACMG)guide-lines.i,z2 However,the rate of incidental and secondary findings(ISFs)is higher in routine clinical practice because of(i)the use of trio ES instead of solo sequencing and(i)the exclusion of the incidental findings(IFs)of medical value concerning genes in the ACMG ***,it is not clear how sufficient is a restricted list of genes to detect every ISF of major clinical value;and what is the amount of additional workload for the laboratory.

关键词： routine clinical finding

Insights into upper blepharoplasty: Conservative volume-preserving techniques

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World Journal of Clinical Cases 2024年第27期12卷 6129-6131页

作者： Andrew Gorgy Rawan al Hashemi Johnny Ionut Efanov Plastic Reconstructiveand Aesthetic SurgeryMcGill UniversityMontreal H4A3J1QuebecCanada Plastic and Reconstructive Surgery Jaber Al Ahmad HospitalKuwait CityKuwait Plastic and Reconstructive Surgery Centre Hospitalier de l’Universitéde MontréalMontreal H2X 3E4QuebecCanada

This editorial commentary critically examines the systematic review by Miotti et al,which discusses the evolving trends in upper lid blepharoplasty towards a conservative,volume-preserving *** review emphasizes the shift from traditional tissue resection to techniques that maintain anatomical integrity,paralleling broader trends in panfacial *** et al delve into the nuances of fat pad management,advocating for conservation over reduction to sustain natural contours and improve long-term aesthetic *** perspective is supported by comparative studies and empirical data,such as those from Massry and alghoul et al,highlighting the benefits of conservative approaches in terms of patient satisfaction and aesthetic *** review also stresses the importance of surgeon discretion in adapting procedures to diverse patient demographics,particularly in addressing distinct features such as the Asian upper ***,it identifies a significant gap in long-term comparative research,underscoring the need for future studies to substantiate the safety and efficacy of these minimalist ***,Miotti et al.'s work contributes profoundly to the discourse on personalized,conservative cosmetic surgery,urging ongoing research to refine and validate surgical best practices in upper eyelid blepharoplasty.

关键词： Upper lid blepharoplasty Volume preservation Panfacial rejuvenation Aesthetic longevity,Blepharoplasty

Extensive Bi-Atrial Remodeling on Hypertensive Patient with Permanent Atrial Fibrillation delayed Diagnosis of Fatal Cardiac lambda Amyloidosis

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World Journal of Cardiovascular Diseases 2024年第6期14卷 409-420页

作者： Houzéiph Abdou lassissi Ngardjibem Djita Ibrahima Sory Sylla Thome Masset Abdelrhani Moumen Sedjolo Emmanuelle Bibiane Kpomalegni centre hospitalier Nord Mayenne Mayenne France centre hospitalier le Mans Le Mans France centre hospitalier Vierzon Vierzon France centre hospitalier universitaire de Grenoble Grenoble France

Background: Amyloidosis is a disease characterized by the deposition of fibrillar proteins in tissues. The nature of the protein defines the type of amyloidosis. Cardiac involvement is most often secondary to deposits of transthyretin and immunoglobulin light chains. Treatment depends on the type of amyloidosis. Cardiac light chain amyloidosis is a medical emergency. Aim: To highlight the importance of an early diagnosis of cardiac light chain amyloidosis. Case Presentation: We report the case of an 88-year-old hypertensive female patient with sustained atrial fibrillation and recurrent heart failure, in whom echocardiography showed concentric left ventricle hypertrophy with mildly reduced left ventricle ejection fraction (lVEF) to 45%. Bone scintigraphy was normal. Serum analysis showed increased lambda free light chains. Accessory salivary gland biopsy revealed weak Kappa light chain staining and clear overexpression of lambda light chain deposits. The diagnosis of stage 3B cardiac amyloidosis secondary to lambda light chain myeloma was made. After a multidisciplinary meeting, it was decided to start treatment with DARATUMUMAB + lENalIDOMIde. Patient’s general condition deteriorated with the occurrence of febrile pancytopenia. Chemotherapy was stopped and management was limited to comfort care until the patient’s death. Conclusion: Cardiac light-chain amyloidosis must be diagnosed early as it can be rapidly fatal.

关键词： Myeloma Cardiac lambda light Chain Amyloidosis Monoclonal Gammopathy Heart Failure

Prevalence of depression and Anxiety in Patients with Autoimmune Disease: A Comparative Study with a Diabetic Population

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Open Journal of Internal Medicine 2024年第2期14卷 159-166页

作者： Michel Assane Ndour Mouhamed Dieng Omar Boun Khatab Diouf léon Birwe Boundia Djiba Ibrahima Mané Diallo Matar Ndiaye Nousradine Mourno Tarsa Djiby Sow Anna Sarr demba Diedhiou Maimouna Ndour Mbaye Service de Mdecine Interne Centre Hospitalier Abass Ndao Dakar Senegal Service de Mdecine Interne Centre Hospitalier Aristide Le Dantec Dakar Senegal

Introduction: Systemic diseases are a variety of heterogeneous autoimmune and/or autoinflammatory diseases and syndromes usually affecting multiple systems and resulting from immune system dysregulation. We evaluated risk factors for depression and anxiety in an autoimmune disease cohort compared with diabetic patients. Patients and Methods: We conducted an observational, cross-sectional, case-control survey comparing two groups: individuals with connective tissue disease (CTD) and diabetic controls who were followed within three Dakar university hospitals during the period from April to June 2023. Results: The sample comprised 106 participants, of whom 51 (48%) had CTD and 55 (52%) served as diabetic controls. In the CTD group, the majority had lupus (19) and rheumatoid arthritis (23). The CTD patients had a mean age of 41.0 years (SD 16.9), while the diabetic patients had a mean age of 55.9 years (SD 11.7), with a significant difference observed (p Conclusion: Compared to a chronic disease, devastating in Africa and evolving over the long term, autoimmune diseases are more strongly and more frequently associated with anxiety and depression. This is a factor to be taken into account in the holistic management of these patients.

关键词： Connective Tissue Disease lupus Rhumatoid Arthritis Diabetes depression Anxiety Disability

Factors associated with decreased compliance after on-site extracorporeal membrane oxygenation cannulation for acute respiratory distress syndrome:A retrospective,observational cohort study

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Journal of Intensive Medicine 2024年第2期4卷 194-201页

作者： Sylvain le Pape Florent Joly François Arrivé Jean-Pierre Frat Maeva Rodriguez Maïa Joos laura Marchasson Mathilde Wairy Arnaud WThille Rémi Coudroy centre hospitalier universitaire de Poitiers Service de Médecine Intensive RéanimationPoitiersFrance INSERM centre d'Investigation Clinique 1402 IS-ALIVE Research GroupUniversitéde PoitiersPoitiersFrance

Background Extracorporeal membrane oxygenation(ECMO)for acute respiratory distress syndrome(ARDS)is systematically associated with decreased respiratory system compliance(CRS).It remains unclear whether transportation to the referral ECMO center,changes in ventilatory mode or settings to achieve ultra-protective ventilation,or the natural evolution of ARDS drives this change in respiratory ***,we assessed the precise moment when CRS decreases after ECMO cannulation and identified factors associated with decreased *** To rule out the effect of transportation and the different modes of ventilation on CRS,we conducted a retrospective,single-center,observational cohort study from January 2013 to May 2020,on 22 patients with severe ARDS requiring on-site ECMO and ventilated in pressure-controlled mode to achieve ultra-protective *** was assessed at different time points ranging from 12 h before ECMO cannulation to 72 h after ECMO *** primary outcome was the relative change in CRS between 3 h before and 3 h after ECMO *** secondary outcomes included variables associated with the relative changes in CRS within the first 3 h after ECMO cannulation and the relative changes in CRS at each time *** CRS decreased within the first 3 h after ECMO cannulation(−28.3%,95%confidence interval[CI]:−38.8 to−17.9,Ple the decrease was mild before and after these first 3 h after ECMO *** achieve ultra-protective ventilation,respiratory rate decreased in the mean by–13 breaths/min(95%CI:−15 to−11)and driving pressure by−8.3 cmH2O(95%CI:−11.2 to−5.3),resulting in decreased tidal volume by−3.3 ml/kg of predicted body weight(95%CI:−3.9 to−2.6)as compared to before ECMO cannulation(Pall).Plateau pressure reduction,driving pressure reduction,and tidal volume reduction were significantly associated with decreased CRS after ECMO cannulation,whereas neither respiratory rate,positive end-expiratory pr

关键词： Acute respiratory distress syndrome Extracorporeal membrane oxygenation Driving pressure Respiratory compliance

Eradication Treatment of Helicobacter pylori Infection: Evaluation of Therapeutic Strategies in N’Djamena

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Open Journal of Gastroenterology 2024年第2期14卷 59-67页

作者： Mayanna Habkréo ali Mahamat Moussa Tahir Mahamat Saleh Djerabet Franckly Fany Haby Mairé dehainssala Adama Ngaré Mahamat ali Hachim Service de Medecine Interne et Gastroenterologie Centre Hospitalier Universitaire La Reference Nationale N’Djamena Tchad Service de Medecine Interne Centre Hospitalier Universitaire La Renaissance N’Djamena Tchad Service de Médecine Hopital de l’Amitié Tchad-Chine N’Djamena Tchad

Background: Helicobacter pylori (Hp) infection is the most widespread bacterial infection in the world. The infection is generally acquired in childhood, but can persist into adulthood. Eradication therapy has undergone several modifications. The aim of this study was to evaluate the different therapeutic strategies used in the eradication of Helicobacter pylori infection in the centre hospitalier universitaire la Reference Nationale of N’Djaména. Patients and Methods: This was a prospective, descriptive analytical study spread over one year, from September 2021 to September 2022. Patients at least 15 years of age presenting with dyspeptic symptoms, seen consecutively in a hepato-gastroenterology consultation and with a positive stool test for H. pylori infection, were included in the study. Equally, 1/3 of patients were treated with dual or triple therapy. The remaining third received quadritherapy. Results: A total of 268 patients were included in the study (mean age 38.40 ± 14.66 with extremes of 16 and 80 years). Males predominated in 58% of cases. Overall therapeutic efficacy was 88.9%. According to different therapeutic strategies, efficacy was 90.75% for dual therapy with PPI (Rabeprazole) and Amoxicillin. On the other hand, efficacy was 87% and 88.88% for PPI-based triple therapy and dual antibiotic therapy, and for PPI-based quadruple therapy and triple antibiotic therapy. Conclusion: H. pylori infection is a common disease in Chad. Dual therapy with rabeprazole combined with a high dose of amoxicillin over a period of at least two weeks showed similar if not better efficacy than triple or quadruple therapy.

关键词： Helicobacter pylori Therapeutic Strategies Eradication Dyspepsia Chad

Evaluation of the Strategy and Efficacy of Treatment of Chronic Viral Hepatitis C with the Sofosbuvir/Daclatasvir Combination in a Resource-limited Country

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Open Journal of Gastroenterology 2024年第7期14卷 233-240页

作者： Mayanna Habkreo ali Mahamat Moussa Adama Ahmed Ngare Abdraman Kossou Tahir Mahamat Saleh Maire dehainsala Mahamat ali Hachim Mahamat ali Bolti Oumaima Djarma Joseph Madtoingue Service de Gastroentrologie/Mdecine Interne du centre hospitalier universitaire la Rfrence Nationale NDjamena Chad Service de Gastroentrologie du centre hospitalier universitaire la Renaissance NDjamena Chad Service de Maladies Infectieuses du centre hospitalier universitaire la Renaissance NDjamena Chad Service de Maladies Infectieuses du centre hospitalier universitaire la Rfrence Nationale NDjamena Chad

Introduction: The treatment of viral hepatitis C (HCV), a major public health problem, has evolved considerably since the introduction of direct-acting anti-virals (DAAs). The aim of this study was to evaluate the strategy for initiating treatment with Sofosbuvir/Daclatasvir, and also to assess its efficacy. Patients and Methods: Included were patients aged at least 15 years, with detectable hepatitis C viremia and treated with a pan-genotypic Sofosbuvir/Daclatasvir regimen at the centre “hospitalier universitaire la Référence Nationale de N’Djamena” between October 2019 and October 2023. The APRI score was used to assess fibrosis. Cure was defined by an undetectable viral load 12 weeks after the end of treatment. Results: A total of 835 patients were included (sex ratio 1.55, mean age 50.5 ± 13.73, extremes 20 and 84 years). The 60 - 69 age group was the most represented. The mean APRI score was 0.42 ± 0.29, with extremes of 0.019 and 1.84. The mean viral load was 2,316,193.086 IU/ml. all subjects had good renal function. Cytolysis was absent in 70% of cases. Without genotyping, a pan-genotypic regimen was used in all patients: Sofosbuvir (400 mg)/Daclatasvir (60 mg). The cure rate was 99.4%, with good tolerability. However, four cases of failure were recorded out of the 668 patients who underwent follow-up HCV-PCR testing after 12 weeks of treatment. Conclusion: The Sofosbuvir/Daclatasvir regimen is highly effective, with an excellent safety profile. However, the still high cost of these molecules limits their accessibility to a large proportion of patients.

关键词： Efficacy Tolerance Sofosbuvir/Daclatasvir HCV Chad

Prevalence and Associated Factors of Postpartum depression: A Study Conducted in Health centres in Dakar (Senegal)

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Open Journal of Psychiatry 2024年第1期14卷 45-66页

作者： Sokhna Seck Momar Camara Racky Wade Kane Djeynaba Bassine Baldé El Hadj Makhtar Bâ Adama Koundoul Idrissa Bâ Ibrahima Ndiaye Papa lamine Faye Aida Sylla Service de psychiatrie Centre Hospitalier National Universitaire de Fann Dakar Sénégal

Introduction: Postpartum depression is the most common psychiatric disorder affecting women in the perinatal period. According to the WHO, it affects 10% - 15% of women who have just given birth. In Africa, and particularly in Senegal, epidemiological studies focusing exclusively on postpartum depression are rare or non-existent. For this reason, we conducted this screening study on postpartum depression to assess the socio-demographic characteristics and associated factors. Methods: This was a prospective cross- sectional study with descriptive and analytical aims. It was carried out in the twelve Dakar referral health centres during the period August 2021 to June 2022. Results: At the end of our survey we had recruited one hundred and twenty-two (122) participants with a PPD prevalence rate of 25.41%. The most common age group was 24 - 29 years. 40% of the participants were of Fulani ethnicity, followed by Wolof. Married women made up 93% of the sample. The school enrolment rate was 89%. Most participants were not in paid employment. Domestic violence was present in 14% of couples. 28% of mothers reported experiencing a stressful life event during their pregnancy. 22% of the women had a chronic medical condition, of which 55% had high blood pressure. 1% of the women reported a personal psychiatric history and 5% a family psychiatric history. Most women had between two and four healthy living children. The pregnancy was unwanted in 17% of cases and 12% of participants had a complication. 6% were dissatisfied with the quality of their antenatal care. The caesarean section rate was 18%. In terms of associated factors, eight factors were identified in a bivariate analysis: single marital status, lack of support from partner, domestic violence, conflict with in-laws, and the occurrence of a stressful life event during pregnancy, the presence of a personal medical history, lack of satisfaction with pregnancy follow-up, and mode of delivery by caesarean section. Conclusi

关键词： Postpartum depression Prevalence Associated Factors Senegal