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Outcome of Anastomotic Leakage after Colorectal Surgery in patients with or without Preoperative Mechanical Bowel Irrigation: An Observational Study

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Surgical Science 2012年第3期3卷 105-110页

作者： Gerald Gubler Selim Dincler Johann Steurer Peter Buchmann Bethanien Hospital Zürich Switzerland Bülach Hospital Bülach Switzerland horten centre for patient oriented research and knowledge transfer University Zurich Zürich Switzerland Waid Hospital Zürich Switzerland

Background: Randomized controlled trials have demonstrated that the rate of anastomotic leakage after laparoscopic colorectal surgery does not differ between patients with or without preoperative bowel preparation. There is, however, still an ongoing discussion that infectious complications consequential to anastomotic leakage, in particular sepsis, are more severe in patients without preoperative bowel cleaning. The aim of this study is to evaluate the assumption that postoperative sepsis in patients undergoing colorectal surgery without mechanical preoperative bowel irrigation is more severe compared to patients with bowel preparation. Methods: In the surgical unit in a teaching hospital in Zurich pa- tients undergoing laparoscopic colorectal surgery were consecutively included in the study. 367 patients with colorectal surgery between December 2000 and April 2004 underwent preoperative mechanical bowel irrigation. From May 2004 until April 2008 colorectal surgery was performed in 367 patients without bowel irrigation. Outcomes of interest are: Severity of sepsis in patients with postoperative anastomotic leakage, assessed by the necessity of referral to ICU, length of stay in the ICU and total length of hospital stay. Results: 734 patients were included in the study, 367 patients with and 367 without preoperative bowel preparation. In 43 patients an anastomotic insufficiency was diagnosed, 26 in the group with and in 17 patients without preoperative irrigation. 14 of these cases developed sepsis and were referred to ICU, 8 (31%) in the group with and 6 (35%) in the group without preparative irrigation. Between the two groups there were no significant differences in mortality, length of stay on ICU and total length of hospital stay. Conclusions: The results of our study provide no indication that the course of sepsis, associated with anastomotic leakage after laparoscopic colorectal surgery, is more severe in patients without preoperative bowel preparation, compar

关键词： Colorectal Surgery Leakage Infection Bowel Irigation

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一项德尔菲调查法的结果:椎管狭窄的放射学诊断标准

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国际医学放射学杂志 2012年第5期 476-476页

作者： N.Mamisch M.Brumann J.Hodler U.Held F.Brunner J.Steurer 柯俊 Department of Diagnostic and Interventional Radiology and horten centre for patient oriented research and knowledge transfer University Hospital ZurichRaemistrasse 1008091 ZurichSwitzerland

摘要目的呈现一系列描述腰椎管狭窄的放射学标准,找出哪些参数是专家们认为最重要的,并评估专家们对这些最相关的标准的一致性强度。方法41名放射学专家(来自欧洲和美国的骨肌系统专家和神经放射学家)组成了专家组,共参与3轮德尔菲法调... 详细信息

摘要目的呈现一系列描述腰椎管狭窄的放射学标准,找出哪些参数是专家们认为最重要的,并评估专家们对这些最相关的标准的一致性强度。方法41名放射学专家(来自欧洲和美国的骨肌系统专家和神经放射学家)组成了专家组,共参与3轮德尔菲法调查。41名推荐的专家中的27名同意参与调查,21名完成了所有的三局调查。在第一局,专家们被要求列出一些推荐使用的参数及参考界值。

关键词：放射学腰椎管狭窄腰椎椎管狭窄椎间孔一致性系数专家组椎间盘突出脊柱病

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Rare uterine serosal pregnancy after in vitro fertilization in a woman with bilateral salpingectomy

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Clinical research Communications 2024年第3期7卷 38-42页

作者： Shu-Yi Dong Shu-Feng Liu Jun Tan Ping-Ping Sun The Reproductive Endocrinology Department of Gaomi Maternity and Child Care Hospital Weifang 261000China. The Reproductive Medicine centre of Weifang People’s Hospital Weifang 261000China.

Objective:To improve the understanding of ectopic pregnancy after bilateral salpingectomy through case analysis and literature ***:A case of uterine serosal pregnancy after in vitro fertilization and embryo transfer(IVF-ET)in a woman with bilateral salpingectomy was reported in detail and summarized,and relevant literatures searched in Pubmed were ***:The patient had a sudden abdominal pain 18 days after *** showed no pregnancy sac in the intrauterine cavity and bilateral adnexal areas,but there was a large amount of fluid in the Pouch of Douglas,which was an indication for surgical *** the operation,the pregnancy tissue was found on the uterine serosal and cleared in *** the patient recovered well after *** of the literatures showed that most of ectopic pregnancies after bilateral salpingectomy were treated surgically and had a good ***:Ectopic pregnancy after bilateral salpingectomy is extremely rare and should be early judged by the patients’*** treatment timely can achieve good outcome.

关键词： IVF-ET uterine serosal pregnancy ectopic pregnancy bilateral salpingectomy

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Anorexia nervosa:Outpatient treatment and medical management

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World Journal of Psychiatry 2022年第4期12卷 558-579页

作者： Stein Frostad Mette Bentz Department of Mental Health research Division of PsychiatryHaukeland University HospitalBergen 5021Norway Child and Adolescent Mental Health centre Capital Region of DenmarkUniversity of CopenhagenCopenhagen 2400Denmark

Anorexia nervosa(AN)is a disabling,costly and potentially deadly *** failure and relapse are common after completing treatment,and a substantial proportion of patients develop severe and enduring *** time from AN debut to the treatment initiation is normally unreasonably *** the past 20 years there has been empirical support for the efficacy of several treatments for ***,outpatient treatment with family-based therapy or individual psychotherapy is associated with good outcomes for a substantial proportion of *** intervention improves outcomes and should be a priority for all *** treatment is usually the best format for early intervention,and it has been demonstrated that even patients with severe or extreme AN can be treated as outpatients if they are medically *** care is more disruptive,more costly,and usually has a longer waiting list than does outpatient *** decision as to whether to proceed with outpatient treatment or to transfer the patient for inpatient therapy may be *** core aim of this opinion review is to provide the knowledge base needed for performing safe outpatient treatment of *** scientific essentials for outpatient treatment are described,including how to assess and manage the medical risks of AN and how to decide when transition to inpatient care is *** following aspects are discussed:early intervention,outpatient treatment of AN,including outpatient psychotherapy for severe and extreme AN,how to determine when outpatient treatment is safe,and when transfer to inpatient healthcare is *** treatments,ethical issues and outstanding research questions are also addressed.

关键词： Anorexia nervosa Outpatient treatment Medical management Outpatient psychotherapy Inpatient healthcare

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Misdiagnosis and Delayed Diagnosis for Ectopic and Heterotopic Pregnancies after In Vitro Fertilization and Embryo transfer

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Journal of Huazhong University of Science and Technology(Medical Sciences) 2014年第1期34卷 103-107页

作者：王琳琳陈薪叶德盛刘玉东何于夏郭薇陈士岭 centre for Reproductive Medicine Department of Gynecology and Obstetrics Nanfang Hospital Southern Medical University

This study examined the misdiagnosis and delayed diagnosis factors for ectopic pregnancy（EP） and heterotopic pregnancy（HP） after in vitro fertilization and embryo transfer（IVF-ET） in an attempt to reduce the diagnostic error. Clinical data of patients who underwent IVF-ET treatment and had clinical pregnancy from 12463 cycles were retrospectively analyzed. Their findings of serum β-hCG test and transvaginal ultrasonography were also obtained during follow-up. These patients were divided into two groups according to the diagnosis accuracy of EP/HP： early diagnosis and misdiagnosis/delayed diagnosis. The results showed that the incidence of EP and HP was 3.8%（125/3286） and 0.8%（27/3286） respectively for IVF/ICSI-ET cycle, and 3.8%（55/1431） and 0.7%（10/1431） respectively for frozen-thawed embryo transfer（FET） cycle. Ruptured EP occurred in 28 patients due to initial misdiagnosis or delayed diagnosis. Related factors fell in 3 categories：（1） clinician factors： misunderstanding of patients＇ medical history, insufficient training in ultrasonography and unawareness of EP and HP;（2） patient factors： noncompliance with medical orders and lack of communication with clinicians;（3） complicated conditions of EP： atypical symptoms, delayed elevation of serum β-hCG level, early rupture of cornual EP, asymptomatic in early gestation and pregnancy of unknown location. All the factors were interwoven, contributing to the occurrence of EP and HP. It was concluded that complicated conditions are more likely to affect the diagnosis accuracy of EP/HP after IVF-ET. Transvaginal ultrasonography should be performed at 5 weeks of gestation. Intensive follow-up including repeated ultrasonography and serial serum β-hCG tests should be performed in patients with a suspicious diagnosis at admission.

关键词： ectopic pregnancy heterotopic pregnancy misdiagnosis assisted reproductive technology early diagnosis

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Content of nursing discharge notes: Associations with patient and transfer characteristics

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Open Journal of Nursing 2012年第3期2卷 277-287页

作者： Rose Mari Olsen Ove Hellzen Liv Heidi Skotnes Ingela Enmarker Faculty of Health and Science Nord-Trondelag University CollegeNamsosNorway Department of Health Sciences Mid-Sweden UniversitySundsvallSweden Department of Medicine Division of GeriatricsNord-Trondelag Health TrustNamsosNorway centre for Care research Mid-Norway SteinkjerNorway

Background: In situations of care transfer of older people from hospital to home care at discharge, exchanging relevant and necessary information about the patient’s health status and individual needs are of importance to ensure continuity and appropriate nursing follow-up care. Objective: The objectives of the study were to: 1) examine the content of nurses’ discharge notes of older patients’ discharged from hospital to home care, and 2) investigate the association between the content of discharge notes and characteristics of patient and transfer. Methods: The nursing discharge notes of 70 older patients admitted to a geriatric unit and a general medicine ward at a local hospital in central Norway were analysed. The discharge notes were structured in accordance with the Well-being, Integrity, Prevention, and Safety (VIPS) model. Mean, standard deviations, and independent sample t-tests were performed to show and examine differences in use of VIPS keywords in relation to patient and transfer characteristics. To examine if use of VIPS keywords could be predicted by patient and transfer characteristics, linear multiple regression analyses were used. Results: Significant differences for mean scores on used VIPS keywords in the discharge note were found for gender, age, and medical department facility. While gender and medical department facility were significant predictors of mental related keywords in the discharge note, medical department facility was a significant predictor of physical related keywords. Conclusions: The result of this study indicate that documentation of patient status in the nursing discharge note of older patients transferred from hospital to home care is incomplete and are influenced by patient and transfer characteristics. In order to ensure continuity and appropriate nursing follow-up care, we emphasize the need for a more comprehensive approach to older patients, and that this must be reflected in the nursing discharge note.

关键词： Older People transfer Nursing Documentation Hospitalization Home Care

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Successful Pregnancy following transfer of Embryo with Dissolved Zona Pellucida

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Reproductive and Developmental Medicine 2020年第1期4卷 60-62页

作者： Li Hong-Xing Reproductive Medicine centre the First Hospital of Lanzhou UniversityLanzhou 730000China Key Laboratory for Reproductive Medicine and Embryo of Gansu Lanzhou 730000China

This study aimed to describe a case of a patient with the spontaneous dissolution of zona pellucida(ZP)during cleavage embryo development after intracytoplasmic sperm injection(ICSI).This patient experienced early abortion due to fetal chromosome 8 abnormality and received ICSI at 31 years of ***-lapse monitoring of embryo cleavage and blastocyst culture was performed,and we found that the ZP of embryos 1,2,4,and 5 dissolved gradually during the cleavage stage of embryo *** blastocysts that developed from 2 pronuclear zygotes were analyzed using next-generation sequencing,and one frozen-thawed blastocyst was transferred,resulting in intrauterine *** results of amniotic fluid puncture showed normal fetal *** our knowledge,this is the first report of ZP dissolution during the cleavage-stage embryo;however,the exact mechanism remains *** morphological changes inferred that the granular matter in the periocular space was related to the dissolution of ZP through time-lapse observation.

关键词： Blastocyst transfer Intracytoplasmic Sperm Injection Next-Generation Sequencing Zona Pellucida Dissolution

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Intelligent Firefly Algorithm Deep transfer Learning Based COVID-19 Monitoring System

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Computers, Materials & Continua 2023年第2期74卷 2889-2903页

作者： Mahmoud Ragab Mohammed W.Al-Rabia Sami Saeed Binyamin Ahmed A.Aldarmahi Information Technology Department Faculty of Computing and Information TechnologyKing Abdulaziz UniversityJeddah 21589Saudi Arabia centre for Artificial Intelligence in Precision Medicines King Abdulaziz UniversityJeddah 21589Saudi Arabia Mathematics Department Faculty of ScienceAl-Azhar UniversityNaser City 11884CairoEgypt Department of Medical Microbiology and Parasitology Faculty of MedicineKing Abdulaziz UniversityJeddah 21589Saudi Arabia Health Promotion Center King Abdulaziz UniversityJeddah 21589Saudi Arabia Computer and Information Technology Department The Applied CollegeKing Abdulaziz UniversityJeddah 21589Saudi Arabia Basic Science Department College of Science and Health ProfessionsKing Saud Bin Abdulaziz University for Health SciencesJeddah 21423Saudi Arabia King Abdullah International Medical research Center Ministry of National Guard-Health AffairsJeddah 21423Saudi Arabia

With the increasing and rapid growth rate of COVID-19 cases,the healthcare scheme of several developed countries have reached the point of *** important and critical steps in fighting against COVID-19 is powerful screening of diseased patients,in such a way that positive patient can be treated and isolated.A chest radiology image-based diagnosis scheme might have several benefits over traditional *** accomplishment of artificial intelligence(AI)based techniques in automated diagnoses in the healthcare sector and rapid increase in COVID-19 cases have demanded the requirement of AI based automated diagnosis and recognition *** study develops an Intelligent Firefly Algorithm Deep transfer Learning Based COVID-19Monitoring System(IFFA-DTLMS).The proposed IFFADTLMSmodelmajorly aims at identifying and categorizing the occurrence of COVID19 on chest *** attain this,the presented IFFA-DTLMS model primarily applies densely connected networks(DenseNet121)model to generate a collection of feature *** addition,the firefly algorithm(FFA)is applied for the hyper parameter optimization of DenseNet121 ***,autoencoder-long short term memory(AE-LSTM)model is exploited for the classification and identification of *** ensuring the enhanced performance of the IFFA-DTLMS model,a wide-ranging experiments were performed and the results are reviewed under distinctive *** experimental value reports the betterment of IFFA-DTLMS model over recent approaches.

关键词： COVID-19 artificial intelligence intelligent systems deep learning decision making

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Deep Learning-Enhanced Brain Tumor Prediction via Entropy-Coded BPSO in CIELAB Color Space

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Computers, Materials & Continua 2023年第11期77卷 2031-2047页

作者： Mudassir Khalil Muhammad Imran Sharif Ahmed Naeem Muhammad Umar Chaudhry Hafiz Tayyab Rauf Adham E.Ragab Department of Computer Engineering Bahauddin Zakariya UniversityMultan60000Pakistan Department of Computer Science Kansas State UniversityManhattanKS66506USA Department of Computer Science University of Management and TechnologyLahore54000Pakistan centre for Smart Systems AI and CybersecurityStaffordshire UniversityStoke-on-TrentST42DEUK Industrial Engineering Department Collage of EngineeringKing Saud UniversityPO Box 800Riyadh11421Saudi Arabia

Early detection of brain tumors is critical for effective treatment *** tumors in their nascent stages can significantly enhance the chances of patient *** there are various types of brain tumors,each with unique characteristics and treatment protocols,tumors are often minuscule during their initial stages,making manual diagnosis challenging,time-consuming,and potentially *** techniques predominantly used in hospitals involve manual detection via MRI scans,which can be costly,error-prone,and *** automated system for detecting brain tumors could be pivotal in identifying the disease in its earliest *** research applies several data augmentation techniques to enhance the dataset for diagnosis,including rotations of 90 and 180 degrees and inverting along vertical and horizontal *** CIELAB color space is employed for tumor image selection and ROI *** deep learning models,such as DarkNet-53 and AlexNet,are applied to extract features from the fully connected layers,following the feature selection using entropy-coded Particle Swarm Optimization(PSO).The selected features are further processed through multiple SVM kernels for *** study furthers medical imaging with its automated approach to brain tumor detection,significantly minimizing the time and cost of a manual *** method heightens the possibilities of an earlier tumor identification,creating an avenue for more successful treatment planning and better overall patient outcomes.

关键词： Brain tumor deep learning feature extraction feature selection feature fusion transfer learning

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