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World Journal of Gastrointestinal Pharmacology and Therapeutics 2024年第5期15卷 1-14页

作者： Vignesh K Nagesh Hadrian Hoang-Vu Tran Daniel Elias Izage Kianifar Aguilar Tanni Sethi AiswaryaMenon Charlene Mansour Florchi Furman Kylie Tsotsos Talia Subar Auda Auda Aman Sidiqui JevonLamar Nikita Wadhwani Shraboni Dey Abraham Lo Adam Atoot Simcha Weissman Humberto Sifuentes Ayrton I Bangolo Department of internal medicine Hackensack Palisades Medical CenterNorth BergenNJ 07047United States Department of Gastroenterology Augusta UniversityAugustaGA 30912United States

Clostridium difficile infection(CDI)has been increasing due to the effect of recurrent *** use of antibiotics has been shown to alter the gut microbiome and lead to *** treatment is limited to three major antibiotics;however,the incidence of recurrent CDIs has been increasing and drug resistance is a major *** aspect is a growing concern in modern medicine especially in the elderly population,critical care patients,and immunocompromised individuals who are at high risk of developing *** difficile can lead to various complications including septic shock and fulminant colitis that could prove to be lethal in these *** modalities of treatment have been developed including bezlotoxumab,a monoclonal antibody and fecal microbiota *** have been studies showing asymptomatic carriers and drug resistance posing a major threat to the healthcare *** treatment options are being studied to treat and prevent *** review will provide an insight into the current treatment modalities,prevention and newer modalities of treatment and challenges faced in the treatment of CDIs.

关键词： Clostridium difficile Antibiotics vancomycin Fidaxomicin Prevention Bezlotoxumab Fecal microbiota transplant

Is endoscopic ultrasound a promising technique in the diagnosis and treatment of liver diseases?

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World Journal of Gastroenterology 2024年第22期30卷 2920-2922页

作者： Enver Zerem Željko Puljiz Boris Zdilar Suad Kunosic Admir Kurtcehajic Omar Zerem Department of medical Sciences The Academy of Sciences and Arts of Bosnia and HerzegovinaSarajevo 71000Sarajevo CantonBosnia and Herzegovina Department of Gastroenterology and Hepatology University Clinical Center SplitSplit 21000Croatia Department of medicine Croatian Military AcademyZagreb 10000Croatia Department of Physics Faculty of Natural Sciences and MathematicsUniversity of TuzlaTuzla 75000Tuzla KantonBosnia and Herzegovina Department of Gastroenterology and Hepatology Blue Medical GroupTuzla 75000Tuzla KantonBosnia and Herzegovina Department of internal medicine Cantonal Hospital“Safet Mujić”MostarMostar 88000Bosnia and Herzegovina

Percutaneous ultrasound has been a longstanding method in the diagnostics and interventional procedures of liver *** some countries,its use is restricted to radiologists,limiting access for other clinicians,such as *** ultrasound,as a novel technique,plays a crucial role in diagnosis and treatment of digestive ***,its use is sometimes recommended for conditions where no clear advantage over percutaneous ultrasound exists,leaving the impression that clinicians sometimes resort to an endoscopic approach due to the unavailability of percutaneous options.

关键词： Endoscopic ultrasound Percutaneous ultrasound Liver biopsy Fine needle aspiration Focal liver lesion Liver abscess drainage

Diabetic Macroangioapathy at the internal medicine Department of the Abass Ndao Hospital center (About 359 Cases)

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Journal of Diabetes Mellitus 2024年第1期14卷 1-12页

作者： Sow Djiby Djiba Boundia Ndour Michel Assane Diedhiou Demba Dieng Mouhamed Diallo Ibrahima Mané Fall Ndiouga Gueye Khoudia Gadji Fatou Kiné Sarr Anna Diop Said Nourou Ndour Mbaye Maimouna Department of internal medicine and medical Specialties H&#244pital Abass Ndao Dakar Senegal

Introduction: Macroangiopathy plays an important role, with a high prevalence of morbidity and mortality in diabetic patients. The aim was to study the epidemiological, clinical, paraclinical, therapeutic and evolutionary profile of macroangiopathy in diabetic patients in the internal medicine department of the Abass Ndao hospital. Patients and methods: This was a descriptive and analytical cross-sectional study. Our investigations were recruited over a 7-year period (January 1, 2016 to December 31, 2022). Results: Three hundred and fifty-nine (359) patients (10.22%) were enrolled. The mean age was 62.83 years, with extremes ranging from 17 to 98 years. The [60 - 69] age group was more representative (37.32%). Women accounted for 180 cases (50.1%), with a sex ratio (m/f) of 0.99. The average duration of diabetes was 11.86 years. Average consultation time was 38.07 days, with extremes ranging from 1 to 368 days. Average hospital stay was 7.65 days. Inaugural diabetes was noted in 12 cases (3.34%). Type 2 diabetes accounted for 95.82% (n = 344) of patients. Hypertension was present in 150 patients (41.8%). Patients with 2 risk factors accounted for 173 cases (48.18%). Nineteen patients had already had a stroke (5.29% of cases). Fourteen (14) patients (4.2%) were amputees. Obliterative arteriopathy of the lower limbs (AOMI) was noted in 193 patients (54%). Stroke was noted in 101 patients (28%). Ischemic heart disease (IHD) was noted in 38 patients (11%). AOMI was more common in males (110 patients, 57%) than in females (43%). Seventy-three (73) patients (20.3%) died. Predictors of death were age over 60 and the existence of more than two cardiovascular risk factors. Conclusion: Diabetic macroangiopathy is a major cause of morbidity and mortality. The development and implementation of a prevention and management program is essential.

关键词： Macroangiopathy Diabetes Risk Factors Senegal

Management Practices of Locally Advanced and Metastatic Urothelial Carcinoma: A Questionnaire-Based Survey among Lebanese Oncologists

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Open Journal of Urology 2024年第2期14卷 138-149页

作者： Joseph Kattan Sally Temraz Fadi Nasr Arafat Tfayli Christina Khater Anas Mugharbel Hady Ghanem Hampig Raphael Kourie Georges Hachem Sarah Masri Jamil Debs Ali Shamseddine Department of Hematology-Oncology H&#244tel-Dieu de France University Hospital Faculty of Medicine Saint-Joseph University of Beirut Beirut Lebanon Department of internal medicine Hematology-Oncology Division American University of Beirut Medical Center Beirut Lebanon Hematology-Oncology Division American University of Beirut Medical Center Beirut Lebanon Department of Hematology-Oncology Saint Charles Hospital Beirut Lebanon Department of internal medicine Makassed General Hospital Beirut Lebanon Hematology-Oncology Division Lebanese American University Medical Center - Rizk Hospital Beirut Lebanon Department of Hematology-Oncology Saint George Hospital University Medical Center Beirut Lebanon Pfizer medical Affairs Beirut Lebanon

Background and Objective: The outcome of locally advanced and metastatic urothelial carcinoma LA/mUC has improved over the past years with a plethora of new treatments and the approval of immune checkpoint inhibitors (ICIs), antibody-drug conjugates, and targeted agents, to identify locally advanced metastatic urothelial carcinoma’s current management practices in Lebanon and the implication of the ongoing economic crisis on the medical practice. Methods: An online questionnaire was used to survey ten Lebanese oncologists from six different hospitals, between July 5 and July 11, 2022, requesting information pertaining to their current clinical practice in the pharmacological treatment of locally advanced metastatic urothelial carcinoma. Key Findings: Cisplatin-based chemotherapy was the most frequently reported initial treatment of locally advanced metastatic urothelial carcinoma. Participants reported using immune checkpoint inhibitors in platinum-ineligible patients and those with PDL1 positive tumors. Also, they would not consider the concomitant use of immunotherapy and chemotherapy in the first-line setting. Participants believed that avelumab maintenance is effective in the absence of progression after first-line platinum-based chemotherapy;they would consider initiating it 2 - 10 weeks after completion of chemotherapy. Conclusions and Clinical Implications: After comparing with current international guidelines, this study shows that Lebanese oncologists follow international guidelines and have deep knowledge of recent clinical trials for the management of locally advanced metastatic urothelial carcinoma, regardless of economic crisis challenges.

关键词： Clinical Practice Chemotherapy Immune Checkpoint Inhibitors PDL1 Urothelial Carcinoma

Mindfulness training in medical education as a means to improve resilience,empathy,and mental health in the medical profession

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World Journal of Psychiatry 2024年第4期14卷 489-493页

作者： Edison Iglesias de Oliveira Vidal Luiz Fernando Alvarenga Ribeiro Marco Antonio de Carvalho-Filho Fernanda Bono Fukushima internal medicine Department Botucatu Medical SchoolSao Paulo State University(UNESP)Botucatu 18618-687SPBrazil Wenckebach Institute for Education and Training LEARN-Lifelong LearningEducation and Assessment Research NetworkUniversity Medical Center GroningenGroningen 9713AVGroningenNetherlands Assertiva Mindfulness Botucatu 18603-970SPBrazil Surgical Specialties and Anesthesiology Department Botucatu Medical SchoolSão Paulo State University(UNESP)Botucatu 18618-687SPBrazil

The high rates of depression,burnout,and increased risk of suicide among medical students,residents,and physicians in comparison with other careers signal a mental health crisis within our *** contend that this crisis coupled with the inadequate acquisition of interpersonal skills during medical education results from the interaction between a challenging environment and the mental capital of ***,we posit that mindfulness-based practices are instrumental for the development of major components of mental capital,such as resilience,flexibility of mind,and learning skills,while also serving as a pathway to enhance empathy,compassion,self-awareness,conflict resolution,and relational ***,the evidence base supporting the effectiveness of mindfulness-based interventions has been increasing over the years,and a growing number of medical schools have already integrated mindfulness into their *** we acknowledge that mindfulness is not a panacea for all educational and mental health problems in this field,we argue that there is currently an unprecedented opportunity to gather momentum,spread and study mindfulness-based programs in medical schools around the world as a way to address some longstanding shortcomings of the medical profession and the health and educational systems upon which it is rooted.

关键词： Mindfulness medical education Mental capital Mental health medical students Resilience

Constitution identification model in traditional Chinese medicine based on multiple features

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Digital Chinese medicine 2024年第2期7卷 108-119页

作者： XU Anying WANG Tianshu YANG Tao HAN Xiao ZHANG Xiaoyu WANG Ziyan ZHANG Qi LI Xiao SHANG Hongcai HU Kongfa School of Artificial Intelligence and Information Technology Nanjing University of Chinese MedicineNanjingJiangsu 210023China Institute of Basic Research in Clinical medicine China Academy of Chinese Medical SciencesBeijing 100700China Key Laboratory of internal medicine of Chinese medicine Ministry of EducationBeijing University of Chinese MedicineBeijing 100700China Dongfang Hospital Beijing University of Chinese MedicineBeijing 100078China Jiangsu Collaborative Innovation center of Traditional Chinese medicine in Prevention and Treatment of Tumor NanjingJiangsu 210023China Jiangsu Province Engineering Research center of TCM Intelligence Health Service Nanjing University of Chinese MedicineNanjingJiangsu 210023China Jiangsu Research center for Major Health Risk Management and TCM Control Policy Nanjing University of Chinese MedicineNanjingJiangsu 210023China

Objective To construct a precise model for identifying traditional Chinese medicine(TCM)constitutions;thereby offering optimized guidance for clinical diagnosis and treatment plan-ning;and ultimately enhancing medical efficiency and treatment *** First;TCM full-body inspection data acquisition equipment was employed to col-lect full-body standing images of healthy people;from which the constitutions were labelled and defined in accordance with the Constitution in Chinese medicine Questionnaire(CCMQ);and a dataset encompassing labelled constitutions was ***;heat-suppres-sion valve(HSV)color space and improved local binary patterns(LBP)algorithm were lever-aged for the extraction of features such as facial complexion and body *** addition;a dual-branch deep network was employed to collect deep features from the full-body standing ***;the random forest(RF)algorithm was utilized to learn the extracted multifea-tures;which were subsequently employed to establish a TCM constitution identification ***;precision;and F1 score were the three measures selected to assess the perfor-mance of the *** It was found that the accuracy;precision;and F1 score of the proposed model based on multifeatures for identifying TCM constitutions were 0.842;0.868;and 0.790;*** comparison with the identification models that encompass a single feature;either a single facial complexion feature;a body shape feature;or deep features;the accuracy of the model that incorporating all the aforementioned features was elevated by 0.105;0.105;and 0.079;the precision increased by 0.164;0.164;and 0.211;and the F1 score rose by 0.071;0.071;and 0.084;*** The research findings affirmed the viability of the proposed model;which incor-porated multifeatures;including the facial complexion feature;the body shape feature;and the deep *** addition;by employing the proposed model;the objectification and intel-ligence o

关键词： Traditional Chinese medicine(TCM) Constitution identification Deep feature Facial complexion feature Body shape feature Multiple features

The Impact of Health Information Technology on Hospital Performance: A Systematic Integrative Literature Review

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Health 2024年第4期16卷 257-279页

作者： Alisa Westerhof Cokky Hilhorst Willem Jan Bos Accounting Auditing & Control Nyenrode Business University Breukelen Netherlands St. Antonius Ziekenhuis Utrecht Netherlands Department of internal medicine Nephrology Leiden University Medical Center Leiden Netherlands

Objective: To review, categorise, and synthesise findings from literature on health information technology (HIT) functionalities, HIT use, and the impact of HIT on hospital performance. Materials and Methods: We conducted a systematic integrative literature review based on a compre-hensive database search. To organise, categorise and synthesise the ex-isting literature, we adopted the affordance actualization theory. To align the literature with our research framework, we used four categories: 1) the functionalities of HIT and how these functionalities are measured;2) use and immediate outcomes of HIT functionalities;3) different perfor-mance indicators and how HIT functionalities affect them;and 4) what hospital characteristics influence the outcome of hospital performance. Results: Fifty-two studies were included. We identified four types of HIT. Only ten studies (19.2%) define the use of HIT by explicitly meas-uring the use rate of HIT. We identified five dimensions of hospital per-formance indicators. Every dimension showed mixed results;however, in general, HIT has a positive impact on mortality and patient readmis-sions. We found several hospital characteristics that may affect the rela-tionship between HIT and hospital-level outcomes. Discussion: Further efforts should focus on embedded research on HIT functionalities, use and effects of HIT implementations with more performance indicators and adjusted for hospital characteristics. Conclusion: The proposed framework could help hospitals and researchers make decisions regard-ing the functionalities, use and effects of HIT implementation in hospi-tals. Given our research outcomes, we suggest future research opportuni-ties to improve understanding of how HIT affects hospital performance. .

关键词： Health Information Technology HIT Functionalities Hospital Performance Indicators

Development of novel 5-FU modified siRNA against BCL-2 with enhanced efficacy and vehicle-free cellular uptake

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Genes & Diseases 2024年第1期11卷 23-25页

作者： Andrew Fesler Ga-Ram Hwang Jingfang Ju Department of Pathology Renaissance School of MedicineStony Brook UniversityStony BrookNY 11794USA The Northport Veteran's Administration medical center NorthportNY 11768USA Curamir Therapeutics Inc. WoburnMA 01801USA

One of the major obstacles for nucleic acid-based medicine is cellular uptake due to the concern of efficiencyand potential toxicity of the *** this work,we developed a novel approach to eliminate the need for a vehicle to allow for the cellular uptake of siRNA-based therapy with a unique modification strategy that also further enhances therapeutic *** discovery may be of great importance for the development of siRNA-based therapeutics as cellular uptake remains a critical *** this study,we have tested the potential of this modification strategy for siRNA using a siRNA that targets B-cell lymphoma-2(BCL-2).

关键词： eliminate uptake modified

Global trends in hepatitis C-related hepatocellular carcinoma mortality:A public database analysis(1999-2019)

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World Journal of Virology 2024年第1期13卷 69-83页

作者： Hassam Ali Fnu Vikash Vishali Moond Fatima Khalid Abdur Rehman Jamil Dushyant Singh Dahiya Amir Humza Sohail Manesh Kumar Gangwani Pratik Patel Sanjaya K Satapathy Department of internal medicine/Gastroenterology East Carolina University Brody School of MedicineGreenvilleNC 27834United States Department of internal medicine Jacobi Medical Center/Albert Einstein College of MedicineBronxNY 10461United States Department of internal medicine Saint Peter's University Hospital/Robert Wood Johnson Medical SchoolNew BrunswickNJ 08901United States Department of internal medicine Quaid-e-Azam Medical CollegeBahawalpur 63100PunjabPakistan Department of internal medicine Samaritan Medical CentreWatertownMA 13601United States Division of Gastroenterology Hepatology&MotilityThe University of Kansas School of MedicineKansas CityKS 66160United States Department of Surgery New York University Winthrop HospitalNew YorkMineloaNY 11501United States Department of internal medicine The University of ToledoToledoOH 43606United States Department of Gastroenterology Mather Hospital/Hofstra University Zucker School of MedicineNY 11777United States Division of Hepatology Department of MedicineNorth Shore University HospitalManhassetNY 11030United States

BACKGROUND Hepatitis C is the leading cause of chronic liver disease worldwide and it significantly contributes to the burden of hepatocellular carcinoma(HCC).However,there are marked variations in the incidence and mortality rates of HCC across different geographical *** the advent of new widely available treatment modalities,such as direct-acting antivirals,it is becoming increasingly imperative to understand the temporal and geographical trends in HCC mortality associated with Hepatitis ***,gender disparities in HCC mortality related to Hepatitis C are a crucial,yet underexplored aspect that adds to the disease's global *** some studies shed light on gender-specific trends,there is a lack of comprehensive data on global and regional mortality rates,particularly those highlighting gender *** gap in knowledge hinders the development of targeted interventions and resource allocation *** The results of our study show an overall decline in the mortality rates of patients with hepatitis C-related HCC over the last two ***,females exhibited a remarkable decrease in mortality compared to ***,East Asia and the Pacific displayed a significant decline in mortality,while Europe and Central Asia witnessed an upward *** America and the Caribbean also experienced an increase in mortality ***,no significant difference was observed in the Middle East and North *** America exhibited a notable upward *** Asia and Sub-Saharan Africa significantly declined throughout the study *** raises the hope of identifying areas for implementing more targeted *** some progress,multiple challenges remain in meeting the WHO 2030 goal of eliminating viral hepatitis[24].

关键词： Carcinoma Hepatocellular Antiviral agents Global Burden of Disease Quality indicators Health care Liver neoplasms Hepatitis C Chronic hepatitis C

New direction for surgery:Super minimally invasive surgery

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World Journal of Gastroenterology 2024年第12期30卷 1676-1679页

作者： En-Qiang Linghu Department of Gastroenterology First Medical Center of Chinese PLA General HospitalBeijing 100853China

The top goal of modern medicine is treating disease without destroying organ structures and making patients as healthy as they were before their *** invasive surgery(MIS)has dominated the surgical realm because of its lesser ***,changes in anatomical structures of the body and reconstruction of internal organs or different organs are common after traditional surgery or MIS,decreasing the quality of life of patients ***,I propose a new treatment mode,super MIS(SMIS),which is defined as“curing a disease or lesion which used to be treated by MIS while preserving the integrity of the organs”.In this study,I describe the origin,definition,operative channels,advantages,and future perspectives of SMIS.

关键词： Super minimally invasive surgery Minimally invasive surgery Treatment mode Traditional Surgery New direction for surgery