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Profile of Autoimmune Polyendocrinopathies at the Medical clinic II of the Abass Ndao hospital: About 40 Cases

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Open Journal of Internal Medicine 2024年第1期14卷 74-82页

作者： Michel Assane Ndour Djiby Sow Mouhamed Dieng Ibrahima Mané Diallo Boundia Djiba Mélaine Honorine Olympio Julie Borges Preira Muriel Diembou Fatou Kiné Gadji Fama Ndiaye El Hadj Mamadou Moussa Thioye Charles Halim Demba Diédhiou Anna Sarr Maïmouna Ndour Mbaye Abass Ndao hospital Internal Medicine Department Cheikh Anta Diop University Dakar Senegal Aristide Le Dantec hospital Internal Medicine Department Cheikh Anta Diop University Dakar Senegal

Introduction: Autoimmune polyendocrinopathies (AP) represent a group of rare concomitant pathologies, making them underdiagnosed. The objective was to study their profile at the Medical clinic II of the Abass Ndao hospital. Patients and Methods: This was an observational, descriptive and analytical study, lasting 24 months, from January 1, 2020 to December 31, 2022. We assessed the epidemiological, clinical and paraclinical characteristics of the patients and classified the APs found. Results: We included 40 patients divided into type III (38 cases) and IV (2 cases). A female predominance was noted with a sex ratio of 0.21. The mean age was 38.6 years. A family history of component diseases of autoimmune polyendocrine syndrome (APS) was found in 62.5%. Goiter (80%) was the main clinical sign present. All 38 patients with ISAP-3 had autoimmune thyroiditis, including 29 cases of Graves’ disease (72.5%) and 9 cases of Hashimoto’s thyroiditis (22.5%). They were associated with either type 1 diabetes (57.9%), Biermer’s disease (21.1%), vitiligo + alopecia (18.4%), lupus (2.6%). The 2 patients with AP-4 had Biermer’s disease associated with either Addison’s disease or type 1 diabetes. Management depended on the pathologies present and their possible complications. The immunological phenomena were also controlled. Conclusion: This series is globally similar to the literature. The polymorphous character of the clinical pictures requires a better collaboration between specialists leading to a clinical and holistic synthesis.

关键词： APS Biermer Graves’ Disease Hashimoto’s Addison’s Vitiligo Senegal

Diagnostic tools for fecal incontinence: Scoring systems are the crucial first step

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World Journal of Gastroenterology 2024年第6期30卷 516-522页

作者： Peter Liptak Martin Duricek Peter Banovcin clinic of Internal Medicine-Gastroenterology University Hospital in MartinJessenius Faculty of Medicine in MartinComenius UniversityMartin 03601Slovakia

The main aim of this editorial is to comment on the recent article published by Garg et al in the World Journal of Gastroenterology 2023;29:4593-4603.This original research presents a new scoring system for fecal incontinence.Fecal incontinence is a chronic disease with a severe impact on the quality of life of the patients.Substantial social stigmatization often leads to significant underreporting of the condition even during visits to a specialist and could lead to further misman-agement or non-existent management of the disease.An important fact is that patients are often unable to describe their condition when not asked precisely defined questions.This problem is partially resolved by scoring questionnaires.Several scoring systems are commonly used;however,each of them has their shortcomings.For example,the absence of different kinds of leakage besides flatus and stool could further lead to underscoring the incontinence severity.Therefore,there has long been a call for a more precise scoring system.The correct identification of the presence and severity of fecal incontinence is paramount for further diagnostic approach and for choosing the appropriate therapy option.This editorial describes fecal incontinence,its effect on quality of life in general and further evaluates the diagnostic approach with a particular focus on symptom scoring systems and their implications for clinical practice.

关键词： Incontinence Fecal Scoring system Questionary Quality of life

Injury and protection of spiral ganglion neurons

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Chinese Medical Journal 2024年第6期137卷 651-656页

作者： Beilei Duan Kevin A.Peng Line Wang Department of Otorhinolaryngology Head and Neck SurgeryBeijing Friendship HospitalCapital Medical UniversityBeijing 100050China Department of Neurotology House ClinicLos AngelesCA 90017USA

Cochlear spiral ganglion neurons(SGNs)are bipolar ganglion cells and are the first neurons in the auditory transduction pathway.They transmit complex acoustic information from hair cells to second-order sensory neurons in the cochlear nucleus for sound processing.Injury to SGNs causes largely irreversible hearing impairment because these neurons are highly differentiated cells and cannot regenerate,making treatment of sensorineural hearing loss(SNHL)arising from SGN injury difficult.When exposed to ototoxic drugs or damaging levels of noise or when there is loss of neurotrophic factors(NTFs),aging,and presence of other factors,SGNs can be irreversibly damaged,resulting in SNHL.It has been found that NTFs and stem cells can induce regeneration among dead spiral ganglion cells.In this paper,we summarized the present knowledge regarding injury,protection,and regeneration of SGNs.

关键词： Spiral ganglion Injury Protection Auditory hair cell Ototoxic drugs Aminoglycosides Presbycusis

Topic highlight on texture and color enhancement imaging in gastrointestinal diseases

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World Journal of Gastroenterology 2024年第14期30卷 1934-1940页

作者： Osamu Toyoshima Toshihiro Nishizawa Keisuke Hata Department of Gastroenterology Toyoshima Endoscopy ClinicTokyo 157-0066Japan Department of Gastroenterology and Hepatology International University of Health and WelfareNarita HospitalNarita 286-8520Japan Department of Gastroenterology Nihonbashi Muromachi Mitsui Tower Midtown ClinicTokyo 103-0022Japan

Olympus Corporation developed texture and color enhancement imaging(TXI)as a novel image-enhancing endoscopic technique.This topic highlights a series of hot-topic articles that investigated the efficacy of TXI for gastrointestinal disease identification in the clinical setting.A randomized controlled trial demonstrated improvements in the colorectal adenoma detection rate(ADR)and the mean number of adenomas per procedure(MAP)of TXI compared with those of white-light imaging(WLI)observation(58.7%vs 42.7%,adjusted relative risk 1.35,95%CI:1.17-1.56;1.36 vs 0.89,adjusted incident risk ratio 1.48,95%CI:1.22-1.80,respectively).A cross-over study also showed that the colorectal MAP and ADR in TXI were higher than those in WLI(1.5 vs 1.0,adjusted odds ratio 1.4,95%CI:1.2-1.6;58.2%vs 46.8%,1.5,1.0-2.3,respectively).A randomized controlled trial demonstrated non-inferiority of TXI to narrow-band imaging in the colorectal mean number of adenomas and sessile serrated lesions per procedure(0.29 vs 0.30,difference for non-inferiority-0.01,95%CI:-0.10 to 0.08).A cohort study found that scoring for ulcerative colitis severity using TXI could predict relapse of ulcerative colitis.A cross-sectional study found that TXI improved the gastric cancer detection rate compared to WLI(0.71%vs 0.29%).A cross-sectional study revealed that the sensitivity and accuracy for active Helicobacter pylori gastritis in TXI were higher than those of WLI(69.2%vs 52.5%and 85.3%vs 78.7%,res-pectively).In conclusion,TXI can improve gastrointestinal lesion detection and qualitative diagnosis.Therefore,further studies on the efficacy of TXI in clinical practice are required.

关键词： Endoscopy Texture and color enhancement imaging White-light imaging Narrow-band imaging Colorectal neoplasm Gastric cancer Adenoma Ulcerative colitis Helicobacter infections Colonoscopy

Interactivity software tools for teaching in ophthalmology

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Annals of Eye Science 2024年第1期9卷 10-23页

作者： Jesús Barrio-Barrio Department of Ophthalmology Navarra University Clinic HospitalNavarra Institute for Health ResearchIdiSNAPamplonaSpain

The use of interactive audience software,such as audience response systems(ARS),in medical education has become increasingly popular in recent years.This technology allows instructors to engage students in real time,encouraging active participation and promoting effective learning.The benefits of interactive audience software in medical education include increased student engagement,promotion of active learning,and enhanced learning outcomes.However,there are also several challenges to its implementation,including technical difficulties,careful planning and preparation,over-reliance on technology,and ethical concerns related to privacy and data security.The cost of implementing interactive audience software may also be a barrier for some institutions.This paper specifically reviews six interactive software platforms,including Socrative,Quizizz,Pear Deck,Slido,Wooclap and ClassPoint.These platforms allow for real-time assessment of student understanding,feedback,and participation.They also enable instructors to adjust their teaching strategies based on student responses and feedback.Overall,interactive audience software has shown great potential to enhance learning and engagement in medical education.It is important for instructors to carefully consider the benefits and challenges of its implementation.While the cost of implementing interactive audience software may be a barrier for some institutions,there are free and low-cost options available.

关键词： Interactive audience software mobile software audience response systems(ARS) medical education

Two big orifices in the second duodenal portion:A case of an atypical double papilla

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Hepatobiliary & Pancreatic Diseases International 2024年第1期23卷 83-85页

作者： Salvatore Francesco Vadalàdi Prampero Nikola Panic Marco Massidda Chiara Rocchi Pierluigi Maria Rinaldi Ana Malenkovic Milutin Bulajic Gastroenterology and GI Endoscopy Department Mater Olbia HospitalOlbia 07026Italy Digestive Endoscopy Unit University Clinic"Dr Dragisa Misovic-Dedinje"Belgrade 11000Serbia Radiology Department Mater Olbia HospitalOlbia 07026Italy

With the advent of endoscopic retrograde cholangiopancreatography(ERCP)in the early 1970s,anatomic anomalies of the Vaterian system were described endoscopically[1].Although the occurrence is rare,the common bile duct(CBD)and the pancreatic duct may fail to coalesce during embryologic development.This leads to double major papilla because both ducts open into the duodenum separately[1].In this way the cranial duct communicates with the CBD,while the caudal orifice communicates with the pancreatic duct[2].

关键词： orifice Vater atypical

Optimizing artificial intelligence in sepsis management: Opportunities in the present and looking closely to the future

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Journal of Intensive Medicine 2024年第1期4卷 34-45页

作者： Darragh O’Reilly Jennifer McGrath Ignacio Martin-Loeches Department of Intensive Care Medicine Multidisciplinary Intensive Care Research Organization(MICRO)St James’HospitalDublinIreland Department of Respiratory Intensive care Hospital ClinicUniversitat de BarcelonaIDIBAPSCIBERESBarcelonaSpain

Sepsis remains a major challenge internationally for healthcare systems.Its incidence is rising due to poor public awareness and delays in its recognition and subsequent management.In sepsis,mortality increases with every hour left untreated.Artificial intelligence(AI)is transforming worldwide healthcare delivery at present.This review has outlined how AI can augment strategies to address this global disease burden.AI and machine learning(ML)algorithms can analyze vast quantities of increasingly complex clinical datasets from electronic medical records to assist clinicians in diagnosing and treating sepsis earlier than traditional methods.Our review highlights how these models can predict the risk of sepsis and organ failure even before it occurs.This gives providers additional time to plan and execute treatment plans,thereby avoiding increasing complications associated with delayed diagnosis of sepsis.The potential for cost savings with AI implementation is also discussed,including improving workflow efficiencies,reducing administrative costs,and improving healthcare outcomes.Despite these advantages,clinicians have been slow to adopt AI into clinical practice.Some of the limitations posed by AI solutions include the lack of diverse data sets for model building so that they are widely applicable for routine clinical use.Furthermore,the subsequent algorithms are often based on complex mathematics leading to clinician hesitancy to embrace such technologies.Finally,we highlight the need for robust political and regulatory frameworks in this area to achieve the trust and approval of clinicians and patients to implement this transformational technology。

关键词： Artificial intelligence Data science Machine learning Intensive care unit(ICU) Critical care Sepsis

MiR-142-3p Regulates ILC1s by Targeting HMGB1 via the NF-κB Pathway in a Mouse Model of Early Pregnancy Loss

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Current Medical Science 2024年第1期44卷 195-211页

作者： Xiang-li PANG Jie LI Jing WANG Si-si YAN Jing YANG Department of Obstetrics and Gynecology Renmin Hospital of Wuhan UniversityWuhan 430060China Reproductive Medical Center Renmin Hospital of Wuhan UniversityWuhan 430060China clinic Research Center for Assisted Reproductive Technology and Embryonic Development in Hubei Province Wuhan 430060China

Objective Innate lymphoid cells(ILCs)are a class of newly discovered immunocytes.Group 1 ILCs(ILC1s)are identified in the decidua of humans and mice.High mobility group box 1(HMGB1)is predicted to be one of the target genes of miR-142-3p,which is closely related to pregnancy-related diseases.Furthermore,miR-142-3p and HMGB1 are involved in regulating the NF-κB signaling pathway.This study aimed to examine the regulatory effect of miR-142-3p on ILC1s and the underlying mechanism involving HMGB1 and the NF-κB signaling pathway.Methods Mouse models of normal pregnancy and abortion were constructed,and the alterations of ILC1s,miR-142-3p,ILC1 transcription factor(T-bet),and pro-inflammatory cytokines of ILC1s(TNF-α,IFN-γand IL-2)were detected in mice from different groups.The targeting regulation of HMGB1 by miR-142-3p in ILC1s,and the expression of HMGB1 in normal pregnant mice and abortive mice were investigated.In addition,the regulatory effects of miR-142-3p and HMGB1 on ILC1s were detected in vitro by CCK-8,Annexin-V/PI,ELISA,and RT-PCR,respectively.Furthermore,changes of the NF-κB signaling pathway in ILC1s were examined in the different groups.For the in vivo studies,miR-142-3p-Agomir was injected in the uterus of abortive mice to evaluate the abortion rate and alterations of ILC1s at the maternal-fetal interface,and further detect the expression of HMGB1,pro-inflammatory cytokines,and the NF-κB signaling pathway.Results The number of ILC1s was significantly increased,the level of HMGB1 was significantly upregulated,and that of miR-142-3p was considerably downregulated in the abortive mice as compared with the normal pregnant mice(all P<0.05).In addition,miR-142-3p was found to drastically inhibit the activation of the NF-κB signaling pathway(P<0.05).The number of ILC1s and the levels of pro-inflammatory cytokines were significantly downregulated and the activation of the NF-κB signaling pathway was inhibited in the miR-142-3p Agomir group(all P<0.05).Conclusion miR-142-3p can regulate ILC1s by targeting HMGB1

关键词： maternal-fetal interface group 1 innate lymphoid cells(ILCis) high mobility group box 1(HMGB1) miR-142-3p abortion

Unintended Pregnancy Determinants among Antenatal clinic Attendees: A University of Port Harcourt Teaching hospital Experience

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Journal of Biosciences and Medicines 2024年第4期12卷 229-245页

作者： Ijeoma Chioma Oppah Terhemen Kasso Emmanuel Okwudili Oranu Department of Obstetrics and Gynaecology University of Port Harcourt Teaching Hospital Port Harcourt Nigeria Department of Obstetrics and Gynaecology University of Port Harcourt Port Harcourt Nigeria

An unintended pregnancy is a pregnancy that is either mistimed or unplanned. The objectives of this study were to determine the prevalence of unintended pregnancy as well as to document the determinant factors among pregnant women attending antenatal clinics at the University of Port Harcourt Teaching hospital (UPTH), Port Harcourt, Rivers State, Nigeria. It was a descriptive, cross-sectional study of 215 women attending the antenatal clinic of UPTH from July to August 2022. Information on socio-demographic characteristics, reproductive history, desirability of the current pregnancy at the time of conception, knowledge and use of contraceptive methods were collected using a pretested questionnaire and analyzed using SPSS version 26.0. Chi-square test was used for test of associations with the level of significance set at P clinics was high, possibly due to low contraceptive usage. More efforts should be geared towards ensuring access to comprehensive contraceptive care and contraceptive methods, this will enhance uptake and reduce the rate of unintended pregnancy.

关键词： Unintended Pregnancy Determinants Prevalence Antenatal Attendees