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Multiparametric ultrasound as a new concept of assessment of liver tissue damage

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World Journal of Gastroenterology 2024年第12期30卷 1663-1669页

作者： Angela Peltec Ioan Sporea department of internal medicine Discipline of GastroenterologyState University of Medicine and Pharmacy"Nicolae Testemitanu"Chishinev 2019Moldova department of Gastroenterology and Hepatology "Victor Babes"University of Medicine and PharmacyTimisoara 300736Romania

Liver disease accounts for approximately 2 million deaths per year *** chronic liver diseases(CLDs),whether of toxic,genetic,autoimmune,or infectious origin,undergo typical histological changes in the structure of the *** changes may include the accumulation of extracellular matrix material,fats,triglycerides,or tissue *** methods for diagnosing CLD,such as conventional B-mode ultrasound(US),play a significant role in *** US,when coupled with B-mode US,can be helpful in evaluating the hemodynamics of hepatic vessels and detecting US findings associated with hepatic *** elastography can assess liver stiffness,serving as a surrogate marker for liver *** is important to note that interpreting these values should not rely solely on a histological ***-enhanced US(CEUS)provides valuable information on tissue perfusion and enables excellent differentiation between benign and malignant focal liver *** evaluation,the etiology of liver disease,and the patient current comorbidities all influence the interpretation of liver stiffness *** measurements are most clinically relevant when interpreted as a probability of compensated advanced CLD.B-mode US offers a subjective estimation of fatty infiltration and has limited sensitivity for mild *** controlled attenuation parameter requires a dedicated device,and cutoff values are not clearly ***-titative US parameters for liver fat estimation include the attenuation coefficient,backscatter coefficient,and speed of *** parameters offer the advantage of providing fat quantification alongside B-mode evaluation and other US *** US(MPUS)of the liver introduces a new concept for complete noninvasive *** encourages examiners to utilize the latest features of an US machine,including conventional B-mode,liver stiffness evaluation,fat quantification,dispersion imaging,

关键词： Multiparametric ultrasound Ultrasound-based elastography Liver stiffness Noninvasive diagnostic test for chronic liver disease Liver steatosis assessment Portal hypertension evaluation

Advancements in hemostatic strategies for managing upper gastrointestinal bleeding: A comprehensive review

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World Journal of Gastroenterology 2024年第15期30卷 2087-2090页

作者： Ah Young Lee Joo Young Cho Division of Gastroenterology Department of Internal MedicineCha Gangnam Medical CenterCha University College of MedicineSeoul 06135Korea

Upper gastrointestinal(GI)hemorrhage presents a substantial clinical *** management typically involves resuscitation and endoscopy within 24 h,although the benefit of very early endoscopy(<12 h)for high-risk patients is *** goals include stopping acute bleeding,preventing rebleeding,and using a multimodal approach encompassing endoscopic,pharmacological,angiographic,and surgical *** agents such as vasopressin,prostaglandins,and proton pump inhibitors are effective,but the increase in antithrombotic use has increased GI bleeding *** hemostasis,particularly for nonvariceal bleeding,employs techniques such as electrocoagu-lation and heater probes,with concerns over tissue injury from monopolar *** methods such as Hemospray and Endoclot show promise in creating mechanical tamponades but have ***,the first-line therapy includes thermal probes and hemoclips,with over-the-scope clips emerging for larger ulcer *** gold probe,combining bipolar electrocoagulation and injection,offers targeted coagulation but has faced device-related *** advancements involve combining techniques and improving endoscopic imaging,with studies exploring combined approaches showing *** research is crucial for developing standardized and effective hemorrhage management strategies.

关键词： Upper gastrointestinal bleeding Hemostasis Endoscopy Probe Spray Clip

Endoscopic hemostasis using self-expandable metal stent combinedwith PuraStat® for patient with high risk of post-endoscopicsphincterotomy bleeding (with video)

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Hepatobiliary & Pancreatic Diseases International 2024年第1期23卷 94-96页

作者： Takeshi Ogura Yuki Uba Masahiro Yamamura Nobu Nishioka Hiroki Nishikawa 2nd department of internal medicine Osaka Medical and Pharmaceutical UniversityOsakaJapan

To the Editor:Endoscopic sphincterotomy(EST)is an established technique for removal of bile duct stones and self-expandable metal stent(SEMS)***,bleeding can be considered an adverse event after EST,particularly for patients with high risk of bleeding such as those on *** the various techniques reported for obtaining endoscopic hemostasis[1-3].

关键词： bleeding stasis endoscopic

Ferritin and mortality in hemodialysis patients with COVID-19:A systematic review and meta-analysis

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Asian Pacific Journal of Tropical medicine 2024年第1期17卷 4-11页

作者： Ni Wayan Anantika Riani I Gde Raka Widiana Yenny Kandarini Nephrology Division Department of Internal MedicineUdayana University/Udayana University HospitalBaliIndonesia Nephrology Division Department of Internal MedicineUdayana University/Prof.Dr.I.G.N.G.Ngoerah General HospitalBaliIndonesia

Objective:To investigate the difference in serum ferritin levels between deceased and surviving regular hemodialysis patients with ***:We conducted a systematic search across four databases following the PRISMA statement *** reporting ferritin levels and mortality of regular hemodialysis patients with COVID-19 were *** the random-effects model,we performed a meta-analysis to determine the mean difference in serum ferritin levels between the studied groups,along with their corresponding 95%confidence *** meta-analysis was carried out using Review Manager 5.4 and Stata ***:A total of 1013 patients from seven studies were included in this *** meta-analysis showed higher mean serum ferritin in the deceased compared to surviving regular hemodialysis patients with COVID-19,with a mean difference of 449.43 ng/mL[95%CI(244.07,654.80),P<0.0001;I2=58%,P=0.003].Conclusions:Our study found a higher mean of serum ferritin levels in the deceased compared to surviving regular hemodialysis patients with COVID-19.

关键词： Ferritin Mortality Hemodialysis COVID-19 Inflammation

Importance of timely and adequate source control in sepsis and septic shock

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Journal of Intensive medicine 2024年第3期4卷 281-286页

作者： Jan J.De Waele department of Intensive Care medicine Ghent University HospitalGhentBelgium department of internal medicine and Pediatrics Faculty of Medicine and Health SciencesGhent UniversityGhentBelgium

Source control is defined as the physical measures undertaken to eliminate the source of infection and control ongoing contamination, as well as restore anatomy and function at the site of infection. It is a key component of the management of patients with sepsis and septic shock and one of the main determinants of the outcome of infections that require source control. While not all infections may require source control, it should be considered in every patient presenting with sepsis;it is applicable and necessary in numerous infections, not only those occurring in the abdominal cavity. Although the biological rationale is clear, several aspects of source control remain under debate. The timing of source control may impact outcome;early source control is particularly relevant for patients with abdominal infections or necrotizing skin and soft tissue infections, as well as for those with more severe disease. Percutaneous procedures are increasingly used for source control;nevertheless, surgery—tailored to the patient and infection—remains a valid option for source control. For outcome optimization, adequate source control is more important than the strategy used. It should be acknowledged that source control interventions may often fail, posing a challenge in this setting. Thus, an individualized, multidisciplinary approach tailored to the infection and patient is preferable.

关键词： Sepsis Septic shock Source control Drainage Debridement

Effects of Tai Chi in diabetes patients: Insights from recent research

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World Journal of Diabetes 2024年第1期15卷 1-10页

作者： Hidetaka Hamasaki department of Endocrinology and Metabolism Internal MedicineHamasaki ClinicKagoshima 890-0046Japan

Tai Chi,a practice that combines elements of both exercise and mindfulness,offers a wide range of health *** body of evidence concerning the impact of Tai Chi on diabetes has recently been *** editorial aims to provide a concise summary of the current state of evidence for Tai Chi's effects on individuals with type 2 diabetes(T2D).The review includes 3 randomized controlled trials(RCTs)and 5 systematic reviews and meta-analyses,all of which investigate the effectiveness of Tai Chi on various health outcomes in individuals with *** Chi demonstrates a significant effect to enhance glycemic control,lower blood pressure,improve serum lipid profiles,reduce insulin resistance,positively influence obesity-related indices,and improve overall quality of life in individuals with ***,it is noteworthy that recent RCTs have reported inconsistent findings regarding the effects of Tai Chi on glycemic control and insulin *** author also delves into potential mechanisms by which Tai Chi may exert its influence on the human ***,the editorial highlights the critical issues that warrant further exploration in the future.

关键词： Type 2 diabetes Tai Chi Exercise Mind-body exercise Chinese traditional exercise Randomized controlled trial Systematic review and meta-analysis

Biermer’s Disease at the Donka National Hospital in Guinea—Epidemio-Clinical, Therapeutic and Evolutionary Aspect in the internal medicine department

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Open Journal of internal medicine 2023年第3期13卷 218-224页

作者： Thierno Amadou Wann Mamadou Sarifou Diallo Djenabou Diallo Kadiatou Diallo Mamadou Lamine Yaya Bah Mamadou Diakhaby Mohamed Cissoko Amadou Kaké Djibril Sylla department of internal medicine Teaching Hospital of Conakry Conakry Guinea department of Hepato-Gastroenterology University Hospital of Conakry Conakry Guinea

Introduction: Biermer’s disease is an autoimmune disease characterized by a lack of absorption of vitamin B12 in connection with the production of antibodies (A) destroying the intrinsic factor (IF) which allows the absorption of vitamin B12 (cobalamin). These clinical manifestations are polymorphic and severe in our context. The objective of this work is to identify the epidemiological-clinical, therapeutic and evolutionary characteristics of Biermer’s disease in Guinean population. Materials and methods: This was a retrospective of patient files followed for Biermer’s disease at the internal medicine department of Donka National Hospital from January 2012 to December 2021. Results: Eight patients were included including 5 women and 3 men. The average age of the patients was 48 years old. The diagnostic delay was 3.6 years on average. All our patients had bioclinical anemia (8 cases, i.e. 100%) followed by epigastralgia in 4 cases (50%), neurological damage such as sensitive polyneuropathy in 3 cases (37.5%). Four patients had acquired melanoderma (50%). Hypovitaminosis B12 was found in 4 patients. The myelogram performed in three patients (37.5%) found medullary megaloblastosis. One patient had Hashimoto’s disease associated with Biermer’s disease in endoscopy, (FOGD) found fundica trophy on macroscopy in 4 cases (50%). Treatment consisted of B12 vitamin therapy in all cases with a favorable clinical and biological outcome. Conclusion: Biermer’s disease remains common in Africa and is characterized at a younger age in addition to the severity of clinical and biological manifestations. The care consists of taking vitamin B12 which remains accessible in our context.

关键词： Biermer’s Disease Donka Aspects Epidemiological-Clinical Therapeutics

Stroke (Cerebrovascular Accident): Epidemiological, Clinical and Evolving Aspects in the internal medicine department of the Public Health Establishment 1 (EPS1) of Tivaouane

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Open Journal of internal medicine 2023年第4期13卷 313-329页

作者： Fulgence Abdou Faye Bachir Mansour Diallo Awa Ba Amina Dia Guèye Abdou Khadre Mbaye Zeinabou Marone Adama Berthé Papa Soulèyemane Touré Madoky Magatte Diop Bernard Marcel Diop Mamadou Mourtalla Ka UFR of Health Sciences Alioune Diop University of Bambey Bambey Senegal department of internal medicine Regional Hospital Heinrich Lucké of Diourbel Diourbel Senegal department of internal medicine Abdou Aziz Sy Dabakh Hospital Tivaouane Senegal internal medicine department Regional Hospital of Thiès Thiès Senegal UFR of Health Sciences Iba Der Thiam University of Thiès Thiès Senegal

Introduction: The frequency, severity, cost of treatment, morbidity and mortality of stroke make it a real public health problem. In industrialized countries, strokes are the leading cause of physical disability in adults, the second leading cause of dementia (after Alzheimer’s disease), and the third leading cause of death (after cancer and cardiovascular disease). It’s also a major cause of depression. The objective of our study was to describe the epidemiological, clinical and evolutionary aspects of stroke in the internal medicine department of Tivaouane Hospital. Material and Method: This is a retrospective study carried out from January 1, 2015 to December 31, 2018 on the files of patients hospitalized for stroke in the medical department of the EPS1 in Tivaouane. We took into account all the patients who had a brain CT (computed tomography) scan. We collected data related to socio-demographic characteristics, history, risk factors, reasons for admission, clinical signs, paraclinical examinations, as well as evolution. Results: Out of 1999 patients, 206 files of patients with stroke were collected, i.e. a proportion of 10.3%. Our study population had a mean age of 65.53 years [16 - 97 years]. We noted a clear predominance of women (50.5%). The majority of the population came from the outskirts of Tivaouane (56.7%). Risk factors for stroke were dominated by hypertension (90.3%), dyslipidemia (19.4%), previous stroke (18.9%), and diabetes (16%). The clinical signs were dominated by a motor deficit (94.1%), speech disorders (67.4%) and consciousness disorders (47%). Ischemic strokes were predominant (65%) over hemorrhagic strokes (34.5%). The outcome was generally unfavorable with 14.6% total recovery, 58.7% recovery with sequelae and a case fatality of 26.7%. Conclusion: It emerges from this study that strokes still remain a real public health problem. Knowledge of populations of risk factors as well as their proper management is fundamental in primary preventio

关键词： Cerebrovascular Accident Epidemiology Risk Factors Tivaouane EPS1

Coronary artery disease and heart failure:Late-breaking trials presented at American Heart Association scientific session 2023

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World Journal of Cardiology 2024年第7期16卷 389-396页

作者： Avilash Mondal Sashwath Srikanth Sanjana Aggarwal Naga R Alle Olufemi Odugbemi Ikechukwu Ogbu Rupak Desai department of internal medicine Nazareth HospitalPhiladelphiaPA 19152United States department of internal medicine East Carolina University GreenvilleGreenvilleNC 27834United States department of internal medicine Hamdard Institute of Medical Sciences and ResearchNew Delhi 110062India department of medicine Narayana Medical CollegeNelloreAndhra Pradesh 524003India department of internal medicine Lincoln Medical CenterBronxNY 10451United States department of internal medicine Mountainview Hospital Sunrise GMELas VegasNV 89108United States Independent Researcher AtlantaGA 30079United States

The late-breaking science presented at the 2023 scientific session of the American Heart Association paves the way for future pragmatic trials and provides meaningful information to guide management strategies in coronary artery disease and heart failure(HF).The dapagliflozin in patient with acute myocardial infarction(DAPA-MI)trial showed that dapagliflozin use among patients with acute MI without a history of diabetes mellitus or chronic HF has better cardiometabolic outcomes compared with placebo,with no difference in cardiovascular *** MINT trial showed that in patients with acute MI and anemia(Hgb<10 g/dL),a liberal transfusion goal(Hgb≥10 g/dL)was not superior to a restrictive strategy(Hgb 7-8 g/dL)with respect to 30-day all-cause death and recurrent *** ORBITA-2 trial showed that among patients with stable angina and coronary stenoses causing ischemia on little or no antianginal therapy,percutaneous coronary intervention results in greater improvements in anginal frequency and exercise times compared with a sham *** ARIES-HM3 trial showed that in patients with advanced HF who received a HeartMate 3 levitated left ventricular assist device and were anticoagulated with a vitamin K antagonist,placebo was noninferior to daily aspirin with respect to the composite endpoint of bleeding and thrombotic events at 1 *** TEAMMATE trial showed that everolimus with low-dose tacrolimus is safe in children and young adults when given≥6 months after cardiac *** patients being treated for HF with reduced ejection fraction(HFrEF)with specific out-of-pocket(OOP)costs for multiple medication options at the time of the clinical encounter may reduce‘contingency planning’and increase the extent to which patients are taking the medications decided *** primary outcome,which was cost-informed decisionmaking,defined as the clinician or patient mentioning costs of HFrEF medication,occurred in 49%of encounters with the checklist only

关键词： Heart failure Coronary artery disease Clinical trials Myocardial infarction Cardiovascular outcome Percutaneous coronary intervention Blood transfusion Cardiac transplant