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Klingsor Syndrome: An Observation in a Patient with Schizophrenia

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Open Journal of Urology 2024年第5期14卷 346-351页

作者： Mbuya Musapudi Eric Ouake Hadidjatou Michel Agounkpe Yevi Dodji Magloire Inès Hodonou Fred Martin Avakoudjo Josué georges Dejinnin Department of Urology and Andrology Hubert Koutoukou Maga National Teaching Hospital Cotonou Benin Department of Surgery University Clinics of Lubumbashi Lubumbashi Democratic Republic of the Congo

Background: Klingsor syndrome refers to genital self-mutilation in man following delusional religious beliefs. Later, Schweitzer proposed expanding the term to include all psychotic disorders, drug and alcohol abuse. Apart from the noted hemorrhagic emergency and difficult surgical operation, there is a psychosocial impact, sexual and urinary complications (stenosis, urethral fistula) which make this pathology complex. Aim: The Aim of this study is to describe the clinical case of Klingsor syndrome and evaluate its management in light of the literature. Case Presentation: We report a rare case of genital self-mutilation in a 35-year-old man, non-compliant schizophrenic, received 04 days after the trauma and whose treatment consisted of remodeling of the penis stump and follow-up by psychiatrists. Conclusion: Klingsor syndrome is a rare but serious phenomenon. Its management remains complex, but it must be early and multidisciplinary.

关键词： Klingsor Syndrome génital Self-Mutilation Schizophrenia

Feasibility Study of Assist-Linked Brief Intervention for Substance Use Disorders in a Rural Community of Plateau State, Nigeria

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Open Journal of Psychiatry 2024年第3期14卷 206-222页

作者： Nwoga Charles Nnaemeka Audu Moses David Sambo Jacob Dusu Mafai Danboyi Kwei Dakwak Samuel Joseph Ndak Andarawus Zuhumnan Babatunde Stephen Psychiatry Department Faculty of Clinical Sciences College of Health Sciences University of Jos Jos Nigeria Department of Community Medicine Jos University Teaching Hospital Jos Nigeria Psychology Department Quintessential Healthcare Centre Jos Plateau State Nigeria Psychology Department University of Jos Jos Nigeria Plateau State hospital Management Board Jos Plateau State Nigeria Department of Psychology Olabisi Onabanjo University Ago-Iwoye Ogun State Nigeria

Objective: We studied the feasibility of using Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) linked with Brief Intervention (ALBI) in treating Substance Use Disorder in Nigeria. There is a clear gap in meeting the needs for treatment and care for people with drug use disorders in Nigeria with many users reporting a self-perceived need for treatment and about 40% of them wanting to receive drug treatment but were unable to access such services. Methods: ASSIST questionnaire was used to gather baseline data, and ALBI along with Motivational Interviewing (MI) was used to intervene for 6 weeks following which ASSIST score was repeated and compared with baseline. Results: Majority of the participants were aged 21 - 30 years, mostly males with (61.3%) lacking steady jobs. Lifetime prevalence of any drug use was (88.2%). Three months prevalence was nicotine (72.0%), alcohol (66.7%), cannabis (47.3%), opioids (11.8%) among others. The ASSIST scores were mostly on the severe ranges. ASSIST result after six weeks showed marked reduction. The Mean Difference (MD) in the ASSIST scores after intervention was significant for tobacco, opioids, alcohol, and cannabis. The Cohen’s D effect size was large for tobacco (1.08), alcohol (0.92) and cannabis (0.73) but low for other substances. Conclusion: ALBI along with MI was helpful in combating the menace of substance use.

关键词： ASSIST ALBI SUD Rural Community Nigeria

Progress in the treatment of advanced hepatocellular carcinoma with immune combination therapy

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World Journal of gastrointestinal Oncology 2024年第2期16卷 273-286页

作者： Di Pan Hao-Nan Liu Peng-Fei Qu Xiao Ma Lu-Yao Ma Xiao-Xiao Chen Yu-Qin Wang Xiao-Bing Qin Zheng-Xiang Han Department of Oncology The Affiliated Hospital of Xuzhou Medical UniversityXuzhou 221000Jiangsu ProvinceChina Department of gastroenterology The Second Affiliated Hospital of Xuzhou Medical UniversityXuzhou 221000Jiangsu ProvinceChina Department of general Surgery The Affiliated Hospital of Xuzhou Medical UniversityXuzhou 221000Jiangsu ProvinceChina

Advanced hepatocellular carcinoma(HCC)is a severe malignancy that poses a serious threat to human *** to challenges in early diagnosis,most patients lose the opportunity for radical treatment when ***,recent advancements in cancer immunotherapy provide new directions for the treatment of *** instance,monoclonal antibodies against immune check-point inhibitors(ICIs)such as programmed cell death protein 1/death ligand-1 inhibitors and cytotoxic t-lymphocyte associated antigen-4 significantly improved the prognosis of patients with ***,tumor cells can evade the immune system through various *** the rapid development of genetic engineering and molecular biology,various new immunotherapies have been used to treat HCC,including ICIs,chimeric antigen receptor T cells,engineered cytokines,and certain cancer *** review summarizes the current status,research progress,and future directions of different immunotherapy strategies in the treatment of HCC.

关键词： Hepatocellular carcinoma Immunotherapies Immune checkpoint inhibitor clinical efficacy Adverse reactions

Skin and Soft Tissue Infections in the Surgical Area at the Kara teaching hospital

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Surgical Science 2024年第2期15卷 48-53页

作者： Tamegnon Dossouvi Tchaa Hodabalo Towoezim Efoé-ga Olivier Amouzou Kokou Kouliwa Kanassoua Irokoura Kassagne Ayi Amavi Abossisso Sakiye Komlan Adabra Ekoué David Dosseh Department of general Surgery Dapaong Regional Hospital Center Dapaong Togo Department of Orthopedic and Traumatology Kara Teaching Hospital Kara Togo Department of general Surgery Kara Regional Hospital Center Kara Togo Department of general Surgery Sylvanus Olympio University Hospital Lomé Togo

Objective: To report the management of skin and soft tissue infections in the surgical area of Kara university hospital in Togo. Material and Methods: This study was conducted retrospectively from January 1, 2021, to December 31, 2022, in the general surgery and orthopedic trauma departments. The study focused on soft tissue infections of the pelvic and thoracic limbs and analyzed epidemiological, clinical, paraclinical, therapeutic, and evolutionary data. Results: We registered 165 patients, comprising 109 men and 56 *** sex ratio (F/H) were 0.51. The mean age was 45 years with extremes ranging from 23 to 90 years. Farmers (64.8%) followed by housewives (34.0%) were the social strata most affected. The consultation period varied between 1 and 90 days. The pathologies found were necrotizing fasciitis (53.3%), erysipelas (18.2%), infected limb wounds (12.1%), pyomyositis (9.7%), and necrotizing dermo-hypodermitis (1.8%). The main procedures performed were necrosectomy and grafting (62.9%), sample necrosectomy (18.8%), drainage (9.7%), and pelvic limb amputation (1.2%). Follow-up was favorable in 86.7% of cases. The study noted a death rate of 13.3% due to septic shock secondary to a delay in consultation. Conclusion: Skin and soft tissue infections were a common reason for surgical hospitalization at Kara university hospital, with a high mortality rate due to delayed consultations.

关键词： Skin and Soft Tissue Infections Necrotizing Fasciitis Erysipelas Emergency

Theoretical Analysis and Practical Reflection on the Role Conflict of Double-Qualified Teachers in university-Affiliated hospitals

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Journal of Contemporary Educational Research 2024年第5期8卷 27-36页

作者： Yuanyuan Jia Yu Cai Siqi Wang Ying Yang ge Wu Faculty Development and teaching Evaluation Office The First Affiliated Hospital of Xi’an Medical UniversityXi’an 710000Shaanxi ProvinceChina Xi’an Medical university Xi’an 710000Shaanxi ProvinceChina

Taking role conflict as the starting point,this article examines and reflects on the development of clinical *** the process of the occurrence,development,and resolution of role conflicts among clinical teachers,there are many hidden issues related to the development of clinical *** development of clinical teacher teaching and role conflict management contain similar educational philosophies and practical *** study draws on classic theories and research achievements in the development of university teachers and conducts theoretical analysis and practical reflection on the development of clinical teachers in medical colleges from the perspective of role conflict in social *** recommendations are proposed,including strengthening the construction of teaching systems at the hospital organizational environment level,enhancing the role identity and teacher beliefs of clinical teachers,promoting their teaching development and academic learning,and ensuring their normal teaching investment;promoting leadership support at the level of interpersonal interaction and leveraging the role of colleague support in alleviating role conflicts;enhancing individual teacher beliefs,teacher role learning,and role skills.

关键词： university-affiliated hospitals Double-qualified teachers Role conflict

Homogenization Construction of Three-Level teaching Bases for general Practice Medicine Under the Internet+Model

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Journal of Contemporary Educational Research 2024年第5期8卷 46-52页

作者： Yu Cai ge Wu Yuanyuan Jia Siqi Wang Chang Tian Yu Feng Faculty Development and teaching Evaluation Office The First Affiliated Hospital of Xi’an Medical UniversityXi’an 710000Shaanxi ProvinceChina Xi’an Medical university Xi’an 710000Shaanxi ProvinceChina

With the continuous expansion of medical student enrollment,the number of clinical teaching bases is gradually ***,there are significant differences in clinical teaching management models and teaching levels among different *** clinical teaching bases have incomplete teaching management systems,inadequate teaching management institutions,insufficient teaching personnel,and inadequate implementation of teaching rules and *** article combines the construction practice of three-level clinical teaching base of the general Medicine College and the First Affiliated hospital of Xi’an Medical *** establish a standardized management system for the three-level clinical teaching base;implement a teaching supervision system and strengthen the monitoring of teaching quality;adopt multiple evaluations to test the effectiveness of clinical teaching implementation;explore the path of homogenization construction of teaching bases in terms of unified teacher training,promoting the development of teacher teaching abilities with equal quality and excellence,and providing a reference for improving the quality of medical talent training.

关键词： clinical teaching base Homogenization construction general practice medicine

Epidemiological, clinical and Coronary Angiography Aspects of Acute Coronary Syndrome in the Cardiology Department of the hospital Mother-Child “Le Luxembourg”Mali

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World Journal of Cardiovascular Diseases 2024年第4期14卷 228-233页

作者： Sidibé Samba Toure Mamadou Konate Massama Sankaré Hamma Traoré Ousmane Mahamat guire Sadik Diall Mahan Ameri Dicko Bahaide Daffe Sanoussy Keita Asmaou Thiam Coumba Adiaratou Diarra Soumaila Menta Ichaka Cardiology Department CHU-M&#232re Enfant Bamako Mali Cardiology Department CHU-Point G Bamako Mali Faculty of Medicine University of Sciences Techniques and Technologies of Bamako Bamako Mali Cardiology Department CHU-Gabriel Tour&#233 Bamako Mali Cardiology Department Mali Hospital Bamako Mali

Introduction: Cardiac catheterisation plays a fundamental role in the management of acute coronary syndrome. These explorations require heavy, complex and costly equipment and a large team of doctors, nurses and technicians with highly specialized training. Aims: To describe epidemiological, clinical and coronary angiography aspects of patients with acute coronary syndrome. Patients and Methods: Descriptive study from September 2019 to December 2023 in the Cardiology Department of the Hôpital Mère-Enfant of Bamako. Inclusion criteria were patients admitted for coronary angiography with the diagnosis of acute coronary syndrome. Results: During the study period, 1253 patients underwent coronary angiography, 596 of whom had acute coronary syndrome as an indication, representing a hospital frequency of 47%. Sex-ratio was 2.10. Mean age of patients was 58.5 ± 11.39 years. ST elevation acute coronary syndrome was the most common indication with 63.92% of cases. High blood pressure was the main cardiovascular risk factor with 58.7% of cases, and radial access approach was used in 98% of cases. Coronary angiography was pathological in 91.70% of cases (n = 548). Patients with lesions of anterior interventricular artery were 73.73% of cases. Tritruncal lesions accounted for 40.63% of cases. Conclusion: ST elevation acute coronary syndrome is the most frequent manifestation of acute coronary syndrome. Anterior interventricular artery is most often the culprit lesion for our patients.

关键词： Coronary Angiography Acute Coronary Syndrome Bamako Mali

Exploration of teaching Development Strategies for Double-Qualified Teachers in university- Affiliated hospitals Based on Role Conflict Theory

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Journal of Contemporary Educational Research 2024年第6期8卷 121-127页

This study draws on the classic theories and research achievements of university teacher development,and from the perspective of role conflict in social psychology,proposes policy recommendations for the development of clinical teachers in medical colleges,including following different stages of teacher development and designing teaching development strategies at different levels;designing the content and form of teaching development activities to meet the temporal and spatial needs of clinical teachers;and building an academic community for clinical teachers to promote the creation of teaching development behaviors.

关键词： university-affiliated hospitals Double-qualified teachers Role conflict theory teaching development strategies

Prehospital transdermal glyceryl trinitrate for ultra- acute ischaemic stroke: data from the RIgHT- 2 randomised sham- controlled ambulance trial

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Stroke & Vascular Neurology 2024年第1期9卷 38-49,I0035-I0046页

作者： Jason Philip Appleton Lisa J Woodhouse Craig S Anderson Sandeep Ankolekar Lesley Cala Mark Dixon Timothy J England Kailash Krishnan grant Mair Keith W Muir John Potter Christopher I Price Marc Randall Thompson g Robinson Christine Roffe Else C Sandset Jeffrey L Saver Angela Shone Aloysius Niroshan Siriwardena Joanna M Wardlaw Nikola Sprigg Philip M Bath Stroke University Hospitals Birmingham NHS Foundation TrustBirminghamUK Institute of Applied HealthResearch University of Birmingham College of Medical and Dental SciencesBirminghamUK Stroke Trials Unit Mental Health and Clinical NeurosciencesUniversity of NottinghamNottinghamUK Faculty of Medicine The George Institute for Global HealthSydneyNew South WalesAustralia The george Institute China at Peking university Health Science Center BeijingChina Neurology Royal Prince Alfred HospitalSydney Health PartnersSydneyNew South WalesAustralia Department of Neurology King's College Hospital NHS Foundation TrustLondonUK Faculty of Health and Medical Sciences University of Western AustraliaCrawleyWestern AustraliaAustralia East Midlands Ambulance Service NHS Trust NottinghamUK Stroke Queen's Medical CentreNottingham University Hospitals NHS TrustNottinghamUK Centre for clinical Brain Sciences Dementia Research InstituteUniveristy of EdinburghEdinburghUK Institute of Neurology and Psychology University of GlasgowGlasgowUK Bob Champion Research and Education Building University of East AngliaNorwichUK Institute of Neuroscience Newcastle UniversityNewcastle upon TyneUK Department of Neurology Leeds Teaching Hospitals NHS TrustLeedsUK Department of Cardiovascular Sciences and NIHR Leicester Biomedical Research Centre University of LeicesterLeicesterUK Stroke Research in Stoke Institute for Science and Technology in MedicineKeele UniversityStoke-on TrentUK Department of Neurology Oslo University HospitalOsloNorway Research and Development Norwegian Air Ambulance FoundationOsloNorway Department of Neurology and Comprehensive Stroke Center David Geffen School of MedicineUCLALos AngelesCaliforniaUSA Research and graduate Services University of NottinghamNottinghamUK Community and Health Research Unit University of LincolnLincolnUK

Background The effect of transdermal glyceryl trinitrate(gTN,a nitrovasodilator)on clinical outcome when administered before hospital admission in suspected stroke patients is ***,we assess the safety and efficacy of gTN in the prespecified subgroup of patients who had an ischaemic stroke within the Rapid Intervention with glyceryl trinitrate in Hypertensive stroke Trial-2(RIgHT-2).Methods RIgHT-2 was an ambulance-based multicentre sham-controlled blinded-endpoint study with patients randomised within 4hours of *** primary outcome was a shift in scores on the modified Rankin scale(mRS)at day *** outcomes included death;a global analysis(Wei-Lachin test)containing Barthel Index,EuroQol-5D,mRS,telephone interview for cognitive status-modified and Zung depression scale;and neuroimaging-determined‘brain frailty’*** were reported as n(%),mean(SD),median[IQR],adjusted common OR(acOR),mean difference or Mann-Whitney difference(MWD)with 95%*** 597 of 1149(52%)patients had a final diagnosis of ischaemic stroke;age 75(12)years,premorbid mRS>2107(18%),glasgow Coma Scale 14(2)and time from onset to randomisation 67[45,108]***‘brain frailty’was common:median score 2[2,3](range 0–3).At day 90,gTN did not influence the primary outcome(acOR for increased disability 1.15,95%CI 0.85 to 1.54),death or global analysis(MWD 0.00,95%CI-0.10 to 0.09).In subgroup analyses,there were non-significant interactions suggesting gTN may be associated with more death and dependency in participants randomised within 1hour of symptom onset and in those with more severe *** In patients who had an ischaemic stroke,ultra-acute administration of transdermal gTN in the ambulance did not improve clinical outcomes in a population with more clinical and radiological frailty than seen in previous in-hospital *** IS ALREADY KNOWN ON THIS TOPIC⇒Transdermal glyceryl trinitrate(gTN)was associat-ed with less death and dependency in those w

关键词： glasgow nitrate random