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Risk Factors of Bacterial Resistance to Antibiotics in Internal Medicine and Hemodialysis Nephrology Services at the Edith Lucie Bongo Ondimba general Hospital

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Open Journal of Nephrology 2021年第1期11卷 9-20页

作者： Gandzali-Ngabe Pierre Eric Ngoyi Ontsira Nina Gakosso Odou Philippe Loumingou Richard Nephrology Hemodialysis édith Lucie BONGO ONDIMBA General Hospital Oyo Congo Laboratory Hospital and University Center of Brazzaville Brazzaville Congo Laboratory édith Lucie BONGO ONDIMBA General Hospital Oyo Brazzaville Congo Nephrology Brazzaville Hospital and University Center Brazzaville Congo

Introduction: Antibiotic resistance is a public health problem. It is due to multi-resistant bacteria (MRB). The objective of this study was to determine bacterial resistance to antibiotics in chronic renal failure at the Edith Lucie BONGO ONDIMBA general hospital (HGELBO). Patients, material and method: This was an analytical cross-sectional study conducted from January 1 to August 31, 2019 at the HGELBO. It concerned all patients admitted to the HGELBO with positive bacteriological samples. After a study of the sensitivity to isolated species, the patients were divided into two (02) groups: those MRB positive (+) and not MRB or negative (-). Epi Info software version 3.5.1 was used for the calculation of the rates and the comparison of the variables. The adjusted odds ratio (ORa) with a 95% confidence interval was used to measure the specific effect of each risk factor such as chronic kidney disease and diabetes, in order to rule out confounding factors. Multivariate analysis by binomial logistic regression was used. Results: There were 375 bacteriological samples from 258 patients, among them 247 patients with 235 positive samples or 63%. The eleven (11) are healthy patients. The median age was 33 with extremes ranging from 16 to 90. The female sex was predominant with a sex ratio of 0.6. The majority of MRB+ cases were found in internal medicine and nephrology with 12 cases (38.7%) and hemodialysis with 4 cases (12.9%). Urinary samples were in the majority with 74.5%. Escherichia coli was predominant in 30.3%. After studying the sensitivity to antibiotics of the 247 species included, 113 were MRB+ and 134 BMR- i.e. a frequency of 45.7%. Methicilin-resistant Staphylococcus aureus (MRSA) was predominant (51.3%). Multivariate logistic regression analysis showed that the main risk factor was antibiotic use (0Ra: 3.2 [1.9 - 5.4];p-value < 0.01). Chronic renal failure and diabetes were not risk factors for carriage. The other risk factors identifi

关键词： Risk Factors Bacterial Resistance Antibiotics Chronic Renal Failure general Hospital Edith Lucie BONGO ONDIMBA

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Development and validation of a nomogram for predicting postoperative in-hospital poor outcome in abdominal related emergency general surgery diseases complicated with sepsis

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Chinese Medical Journal 2021年第20期134卷 2512-2514页

作者： Wei-Yong Sheng Ping Cheng Peng Xu Qing-Yong Chen Yang Wang Jin-Xiang Zhang Department of Emergency general Surgery Union HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhanHubei 430022China

To the Editor:Patients who undergo emergency general surgery(EGS)procedures are up to eight times more likely to die than those undergoing the same procedure electively.[1]The development of an appropriate EGS risk stratification tool could facilitate accurate triage of high-risk patients,thereby supporting surgical decision-making,informed consent,and identification of EGS patients for transfer to a higher level of care.[2]However,the ideal EGS risk stratification tool does not exist *** 2016,a uniform system[American Association for the Surgery of Trauma(AAST)grade]for measuring anatomic severity of 16 common EGS diseases has been reported by the AAST Patient Assessment ***,the committee pointed out that this system is not intended to serve alone as a predictor of *** important factors of the outcome,such as physiological status,comorbidities,age,and complexity of operation procedures,should be integrated into the system for risk stratification.[3]In our EGS center,the spectrum of diseases is mainly abdominal related diseases among the 16 diseases including acute appendicitis,acute cholecystitis,acute diverticulitis of the colon,hernias,infectious colitis,intestinal obstruction,acute pancreatitis,pelvic inflammatory disease,perirectal abscess,and perforated peptic *** have identified abdominal related EGS diseases complicated with sepsis to be a major cause of morbidity and mortality in our EGS *** assumed that the integration of anatomical severity of EGS diseases plus physiological severity and other parameters(eg,intra-operative variables,age,and comorbidities)together could work ***,this study aimed to develop and validate a nomogram for predicting post-operative in-hospital outcome in abdominal related EGS diseases complicated with sepsis.

关键词： diseases Surgery predicting

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Gastro-esophageal reflux disease symptoms are more common in general practice in Japan

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World Journal of Gastroenterology 2007年第31期13卷 4219-4223页

作者： Toshiyasu Watanabe Yoshihisa Urita Motonobu Sugimoto Kazumasa Miki Division of Gastroenterology and Hepatology Department of Internal Medicine Toho University School of Medicine Omori Hospital Tokyo Japan Division of Gastroenterology and Hepatology Department of Internal Medicine Toho University School of Medicine Omori Hospital Tokyo Japan Department of General Medicine and Emergency Care and Toho University School of Medicine Omori Hospital Tokyo Japan

To accurately assess the prevalence of GERD symptoms in general practice. METHODS： 4139 consecutive patients （2025 men and 2114 women with a mean age of 43 years）, who first attended the Outpatient Department of general Medicine and Emergency Care at Toho University Omori Hospital, were asked to respond to the F-scale questionnaire regardless of their chief complaints. The questionnaire is a self-report instrument, written in a simple and easy-to- understand language, containing 12 questions. RESULTS： Of 4139 subjects, 1554 patients （37.6%） were identified as GERD according to their F-scale score （〉 7）. However, there were only 45 consultations （1.1%） for typical GERD symptoms. Although GERD symptoms are common in adults of all ages, the prevalence of GERD was highest in the 20-29 years age group and the age group 70-79 years had the lowest prevalence for both males and females. CONCLUSION： Although there was a high rote indicating GERD in our primary care population, only 1.1% of outpatients attended our hospital with a chief complaint of GERD symptoms. Since about one-third of GERD patients are affected by atypical symptoms, general physicians need to be cautious about extrapolating these results to patients with a chief complaint other than typical GERD *** T, Urita Y, Sugimoto M, Miki K. Gastro-esophagea reflux disease symptoms are more common in genera practice in Japan. World J Gastroenterol 2007; 13（31） 4219-4223

关键词： Gastroesophageal reflux disease (GERD) F-scale Questionnaire general practice

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Incidence and Predictors of Complications of Acute Achilles Tendon Rupture Repair at Hamad general Hospital, Doha, Qatar

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Surgical Science 2014年第2期5卷 46-52页

作者： Sameh M. Abolfotouh Mohamed A. Al Dosari Nader Sayed Hussam Banna Mostafa A. Abolfotouh Hamad general Hospital Doha Qatar King Abdullah International Medical Research Center Riyadh KSA

Aim: The aims of this study were: 1) to estimate the prevalence and pattern of complications after Achilles tendon (AT) repair, and 2) to determine the significant predictors of post-operative infection. Methods: A retrospective cohort study of all patients who were operated at Hamad general Hospital (HGH) between June 2010 and June 2012 for AT rupture (n = 102), was conducted. Data was collected on 1) patient’ characteristics such as age, sex;2) disease characteristics such as mechanism of rupture, type of rupture (partial or complete), whether an anterior or posterior slab was applied, number of suture materials, number of antibiotics, surgical time, time to surgery and length of hospital stay (LOS), number of follow up visits, and 3) complications. Descriptive and analytical statistical analyses were applied. Receiver operating characteristic curve was applied to identify the validity of different LOS values, with a significance level at p ≤ 0.05. Results: Of the 102 patients with Achilles rupture, almost males (96.1%), with a mean age 31.07 ± 9.71 years, 52% with complete rupture, the majority were open ruptures (81.4%) and bathroom-related (70.6%). Anterior slab was applied to 58.2% and 2 types of suture materials to 71.6% of cases. Fifteen cases (14.7%, 95% CI: 7.8% - 21.6%) presented with one or more complications (9.8% post-operative infections, 5.9% stiffness and 2% re-rupture). Post-operative infections were significantly associated with: old age (z = 2.11, p = 0.035), longer LOS (z = 2.01, p = 0.04), and presence of diabetes (Fisher exact test: p = 0.003). After adjustment for age, LOS (p = 0.04) and diabetes (p = 0.017) remained as significant predictors of post-operative infections. LOS of 2.5 days was the optimum cut-off point above which post-operative infection is more likely to occur, with sensitivity of 80% and specificity of 54%. Conclusion: Achilles repair post operative infection ranks first as a complication of AT surgical repair, and its incid

关键词： Achilles Tendon Repair Surgical Outcome HGH Qatar

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Notice:Shanghai Archives of Psychiatry soon to be renamed general Psychiatry

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上海精神医学 2018年第3期 177-177页

Shanghai Mental Health Center will publish its last issue of the journal Shanghai Archives of Psychiatry,2018 volume 30 issue 3,on 30;June *** postal code is *** journal will be renamed general Psychiatry and presented to the readers as issue 4 on 30th August *** the name of the journal is a magnificent *** aim to publish a high quality

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How French general practitioners adapt their care to patients with social difficulties?

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Family Medicine and Community Health 2019年第4期7卷 10-17页

作者： Annie De Oliveira Barbara Chavannes Magali Steinecker Mady Denantes Julie Chastang Gladys Ibanez Department of general Practice Medicine Sorbonne UniversityParisFrance Sorbonne Université INSERMInstitut Pierre Louis d’Épidémiologie et de SantéPublique(IPLESP)F75012ParisFrance

Objective Several studies have shown the role of the primary care system in access to care and in reducing social inequalities in *** objective of this study was to describe the practices of general practitioners(GPs)in taking into account the social environment of their patient,and the ways they adapted to social *** Qualitative study comprising interviews and focus *** French primary care *** Twenty semistructured interviews and two focus groups were conducted with 33 *** were audio recorded,transcribed verbatim and analysed using thematic *** reporting of findings was guided by consolidated criteria for reporting qualitative *** This study identified adaptations at three levels:in the individual management of patients(alert system,full involvement in prevention,better communication,prioritised additional examinations,financial facilities,help in administrative tasks),in the collective management of patients in an office(consultation without appointment,pay-for performance indicators,medical staffs,multidisciplinary protocols,medical practice in group,medical student),and in the community management(patients description,cooperation with associations,public health sector and politics).Conclusion In France,GPs can take into account the social determinants of health in practice through simple or more complex actions.

关键词： patients prevention collective

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Cerebral Gliomas Patterns at the general Hospital of Douala, Cameroon

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Open Journal of Modern Neurosurgery 2018年第4期8卷 389-405页

作者： Aurélien Ndoumbe Mathieu Motah Bea Jesse Ikango Mireille Moumi Amadou Fewou Albert Mouelle Sone Faculty of Medicine & Pharmaceutical Sciences University of Douala Douala Cameroon Neurosurgeon Service of Surgery General Hospital of Douala Douala Cameroon Pathology Faculty of Medicine & Biomedical Sciences University of Yaoundé I. Head Service of Pathology General Hospital of Douala Douala Cameroon

The diagnosis and management of cerebral gliomas are challenging. The goal of this study was to evaluate the pattern of cerebral gliomas at the general Hospital Douala, Cameroon. A retrospective study was carried out over a period of 10 years. Non-glial lesions were not included. Data were analyzed with Epi info version 7.***.2.6 (Microsoft, Seattle, USA). 220 cases of brain tumors, comprising 56 gliomas (25.46% of all brain tumors) were managed during the study period. The mean age of the patients was 42.93 ± 16.90 years. 35 cases (62.5%) were males. Patients over 15 years of age represented 91.07% (n = 51) of the cases. The most frequent presenting complaints were headache and vomiting with 52 cases (92.86%) and 47 cases (83.93%) respectively. Brain computed tomography was done for all patients. The most frequent histological type was astrocytoma with 22 cases (39.29%) followed by glioblastoma with 20 cases (35.71%). The most performed surgical technique was partial removal with 33 cases (58.93%), followed by open biopsy with 14 cases (25.00%). Radiotherapy was administered to 54 patients (96.43%). The outcome ranged from full recovery in 8 cases (14.29%), recovery with persisting symptoms, in 15 cases (26.79%) and death in 26 cases (46.43%). Seven patients (12.50%) were lost to view. In this series, cerebral gliomas affected most often adult males. Most of them presented with signs of raised intracranial pressure. The outcome was poor with 46.43% of patients dying before 2 years after diagnosis.

关键词： Cerebral Gliomas Clinical Manifestations Histological Nature Management Outcome

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Attitudes of general Hospital Staff towards Persons with Mental Illness: Associations between Place of Training, Ethnicity, and Type of Profession

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Open Journal of Psychiatry 2020年第2期10卷 53-63页

作者： Leslie Lim Jeremy Heng Yiong-Huak Chan Department of Psychiatry Singapore General Hospital Singapore Biostatistics Unit Yong Loo Lin School of Medicine National University of Singapore Singapore

Objective: Persons with mental illnesses (PMI) commonly report encountering discriminatory attitudes and behaviours by Health Care Professionals (HCPs) involved in their care. Such stigmatising attitudes and behaviours may affect recovery rates and erode quality of care provided by these HCPs. We assess attitudes of HCPs towards PMI in a tertiary general hospital in Singapore. Methods: An anonymised online questionnaire was sent to HCPs working in the hospital. Attitudes were assessed using the Opening Minds Stigma Scale for Healthcare Professionals (OMS-HC), with responses rated on a 3-point Likert scale. Results: Doctors and Chinese staff trained locally were significantly more likely to feel more comfortable treating persons with physical than psychiatric problems, whereas Indian staff were less likely to express such reservations. HCPs generally accepted physical complaints at face value, while nurses tended to adopt critical attitudes toward patients and negatively perceived the utility of psychiatric treatment. For instance, nurses were more likely to judge persons with mental illness as not trying hard enough to get better, while admitting to having difficulty feeling compassion for those with psychiatric problems. Staff who received undergraduate and postgraduate training overseas were more likely to develop favourable attitudes toward PMI. Conclusions: The study has uncovered gaps in the understanding of mental disorders and their treatment. These knowledge deficits should be rectified so as to reduce negative attitudes toward PMI.

关键词： Attitudes Healthcare Professionals general Hospital

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Role of general practitioners in prevention and treatment of hepatitis B in China

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Hepatobiliary & Pancreatic Diseases International 2014年第5期13卷 495-500页

作者： Jing-Jing Ren Ying Liu Wen Ren Yan Qiu Bing Wang Ping Chen Kai-Jin Xu Shi-Gui Yang Jun Yao Lan-Juan Li Department of general Practice First Affiliated Hospital Zhejiang University School of Medicine Huzhou Teachers College The State Key Laboratory for Diagnosis and Treatment of Infectious Diseases First Affiliated Hospital Zhejiang University School of Medicine The Key Laboratory of Infectious Diseases the Center of Disease Control and Prevention Hangzhou

BACKGROUND： Hepatitis B virus（HBV） infection may impose an economic burden to patients or their families. The prevention and control of HBV could effectively reduce the burden. However, the management of HBV-related patients has not been well controlled in China. With the development of general practitioner（GP） system in this country, GPs may greatly improve the management of the patients with HBV infection. However, the role of GPs in controlling HBV infection has been rarely *** SOURCES： A literature search of PubMed, CNKI,Wanfang data and VIP was performed with the following key words：＂general practitioner＂, ＂family physician＂, ＂community management＂, ＂community health care workers＂, ＂family practice＂, ＂hepatitis B virus＂, ＂HBV＂, ＂HBV vaccination＂, ＂HBV prevention＂, ＂HBV management＂, ＂HBV treatment＂, ＂antiviral therapy＂ and ＂chronic hepatitis B（CHB）＂. The information about the GPs-involved prevention, diagnosis and treatment of CHB was ***： The reports on the role of GPs in the prevention,diagnosis and treatment of HBV infection are few. But the experiences from Western countries demonstrated that GPs could play a significant role in the management of patients withCHB. The importance of GPs is obvious although there are some difficulties in China. GPs and health officials at different levels should work together in the management of patients with ***： The involvement of GPs in the management of patients with HBV infection is effective in China. But GPs＇ knowledge and skills for the control of HBV infection have to be improved currently. GPs＇ involvement will enforce the management of CHB in China in the near future.

关键词： hepatitis B HBV vaccination general practitioner

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Postoperative Occlusion of the Small Bowel with Flanges and/or Adhesions in general Surgery of Kati BSS CHU

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Surgical Science 2018年第9期9卷 293-299页

作者： Abdoulaye Diarra Koniba Keita Amadou Traore Assitan Koné Issa Traore Idrissa Tounkara Abdoulaye Kante Fadima K.Tall Daouda Diallo Moustaph Issa Magané Madiassa Konate Aboubacar Koné Deborah Sanra Sanogo Ismael Konare Alhassane Traoré general Surgery Department KatiMali Anesthesia Service and Resuscitation Department KatiMali Gastroenterology Department KatiMali

Objectives were to determine the frequency, describe the epidemiological and clinical aspects, therapeutic and analyze the postoperative course. Methodology: This was a retrospective study that covered 08 years (January 2009-December 2017). Inclusion criteria: all patients operated for obstruction of the small bowel by hail and/or flanging. Exclusion criteria: other types of occlusion and non-operated patients. Result: We recorded a total of 162 cases of hail obstruction by adhesions and/or flanges at 2.87%. The average age was 32.04, the sex ratio was 1.2. The average consultation time was 4 days. Abdominal pain associated with stopping of material and gas was present in all our patients. X-ray of the abdomen without preparation carried out in all the patients made it possible to objectify in 150 patients (92.6%) of the hydro-hail levels. Inoperative occlusion of hail on flange was present in 80 patients (49.4%). Occlusion of the small bowel on flange and adhesion was present in 69 patients. Adhesion obstruction of hail accounted for 6.8% (11 cases). The most commonly used surgical technique was flange resection in 91 patients (56.2%). The follow-up was simple in 151 patients (93.2%). Mortality was 1.2% of cases, i.e. 2 deaths. The average duration of hospitalization was 6 days. Conclusion: Occlusion of the small bowel by flanging and/or adherence is a surgical emergency whose prognosis depends on early management.

关键词： Postoperative Occlusion Hail Bridle/Adherence Mali

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