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Chinese Nursing Research 2016年第2期3卷 66-70页

作者： Feng-Ying Kang Yang Yang Yu-Ping Tong Ya-Li Hu Ning-Ning Xue resident Standardized Training Base First Hospital of Shanxi Medical University Emergency Station First Hospital of Shanxi Medical University College of Nursing Shanxi Medical University

Objective： The objective of this study was to reduce or avoid the occurrence of the cases of osteofascial compartment syndrome induced by a radial artery puncture for arterial blood gas analysis. Methods： We analyzed an adverse event using cheese model analysis, ＂fish bone＂ analysis, root cause analysis, and other methods. Results： There are three root causes leading to an adverse event： operation technique, assessment of the disease, and informing patient families. However, there are many reasons to promote the occurrence and development of the event. Conclusions： We should analyze and manage the adverse events in patients from the point of view of a system. Developing the measures of a system defense can enhance patient safety and create a good safety culture.

关键词： Radial arteryArteriopunctureOsteofascial compartment syndromeRoot cause analysisSystem defense

Spinal Cord Stimulation (SCS) for Pain Control in a Quadriplegic Patient: A Case Report

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Open Journal of Modern Neurosurgery 2016年第1期6卷 25-28页

作者： Arun Angelo Patil Jason Loden Soubrata Raikar Rita Lee Fowler Creighton University Medical Center Omaha USA Surgery resident Creighton University Medical Center Omaha USA Midwest Anesthesia Pain Management Omaha USA

Background: There are reports of pain relief from spinal cord stimulation (SCS) in patients with incomplete spinal cord injuries. However, the results for pain relief from SCS in patients with complete spinal cord injury are dismal. Patients with complete spinal cord injury therefore are generally not considered suitable candidates for SCS. The authors report a case in which a quadriplegic patient with cervical spinal cord injury got significant pain relief from spinal cord stimulation. Methods: The patient is 41 years old with quadriplegia secondary to C5-6 injury. He has no function below the level of the injury except for a few patchy areas of sensation. Ten years after the injury the patient had hemorrhoidectomy. This resulted in severe pain in the anal pain. The treatment for pain failed conservative treatment. He however did have good response to a trial of spinal cord stimulation through an epidural lead placed at T8-T9 vertebral body level. Permanent implantation of spinal cord stimulator was therefore performed. Results: At preoperative evaluation the patient rated his pain as a 7/10. Presently at 2 years’ follow-up the patient rates his pain at 1/10. Conclusions: Spinal cord stimulation proved to be a successful means of achieving adequate pain relief in a patient who had complete loss of motor function below the level of the injury. Therefore, although patients with such condition are unlike to benefit from SCS it is worthwhile trying this treatment if no other option is available there.

关键词： Spinal Cord Injury Chronic Pain Spinal Cord Stimulation

Research Progress on Acute Kidney Injury in Patients with Cardiogenic Shock Undergoing Venoarterial Extracorporeal Membrane Oxygenation

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Journal of Clinical and Nursing Research 2024年第10期8卷 95-105页

作者： Tuohong Wang Luo Fan Wenjing Mu Li Ji Kaisheng Fan Chenyang Jing Guobao He School of Nursing Lanzhou UniversityLanzhou 730030Gansu ProvinceChina Office of Standardized Training for resident Physicians The First Hospital of Lanzhou UniversityLanzhou 730030Gansu ProvinceChina

Cardiogenic shock(CS)is a life-threatening syndrome characterized by peripheral hypoperfusion and organ dysfunction caused by primary heart *** extracorporeal membrane oxygenation(VA-ECMO)is a temporary mechanical circulatory support device for CS,used in cases of profound shock,biventricular failure,respiratory failure,and cardiac arrest that require urgent maximal *** VA-ECMO provides effective tissue perfusion and ensures oxygen supply to organs,it is also associated with severe complications,among which acute kidney injury(AKI)is one of the most common and *** date,no comprehensive review has been conducted on the pathophysiology,influencing factors,and treatment of AKI associated with *** paper aims to elaborate on the pathophysiological mechanisms,influencing factors,and treatment options for AKI in patients with CS undergoing VA-ECMO,providing clinical and nursing references.

关键词： Cardiogenic shock Venoarterial extracorporeal membrane oxygenation Acute kidney injury Review

Digoxin and Heart Failure:Are We Clear Yet?

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Cardiovascular Innovations and Applications 2017年第B5期2卷 333-345页

作者： Amit Gupta,MD Melissa Dakkak,DO Alan Miller,MD Cardiology Fellow University of FloridaJacksonvilleFLUSA Internal Medicine resident University of FloridaJacksonvilleFLUSA Professor Department of CardiologyUniversity of FloridaJacksonvilleFLUSA

The Digoxin Investigation Group trial has multiple flaws in the trial design for the fi ndings to be universally *** in low serum concentrations(0.5-0.9ng/mL)has been shown to decrease mortality in heart failure *** trials in different patient populations also show benefit of digoxin in heart failure patients,including women,elderly patients,renal disease patients,and patients with heart failure with preserved ejection *** observational data linking digoxin use for treatment of atrial fi brillation to increased mortality is not seen in subgroups of randomized controlled trials or population *** remains a useful drug in the toolbox of physicians dealing with heart failure patients.

关键词： digoxin heart failure heart failure with reduced ejection fraction heart failure with preserved ejection fraction digoxin toxicity

Did the Scientific Innovations in the Management of Non-Muscle Invasive Bladder Cancer Patients Improve the Outcome during the Last 2 Decades?

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Open Journal of Urology 2022年第11期12卷 563-587页

作者： Walid F. Alame Nehme Raad Serge Ibrahim Division of Urology Sahel General Hospital-FAUMC Beirut Lebanon Department of Urology Mouwasat Hospital Dammam Saudi Arabia Urology resident Faculty of Medicine Lebanese University Beirut Lebanon

Objectives: Previous reviews reported the outcome of each scientific modality in the management of T1 high-grade bladder cancer. The objective of this review is to assess and evaluate the available scientific modalities used during the last two decades and determine whether they were able to improve the clinical outcome. Literature Search Methodology: A systematic literature review was conducted from 2000-2020 using PubMed, Medline, Embase, and other database sites looking at randomized controlled trials (RCTs), clinical trials, research, review articles, and original articles addressing the different scientific modalities used to diagnose and manage patients with non-muscle invasive Bladder cancer (NMIBC)during the last 2 decades. More than 573 studies were retrieved following the preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines and PICOS criteria (Population, Intervention, Comparators, Outcomes, and Study design). Only 85 articles were selected for review including 19 prospective trials, 44 RCTs, original articles, research articles, one review article, and clinical trials—Retrospective studies were excluded to limit bias as much as possible in the analysis. Results: Randomized controlled trials (RCTs) have become the gold standard for evaluating the efficacy of new treatments. They are considered the highest standard of evidence-based medicine and are the method of choice. Overall, we selected 85 studies for review, among them 63 prospective trials and RCTs, with a total of 21,895 patients, published between 2000 and 2020. Previously conducted studies have shown that identifying rare histological types with poor prognoses can help improve outcomes, mainly the plasmacytoid type. Many articles addressed the role of biomarkers in the early identification of patients with NMIBC for recurrence and progression—P-cadherin expression and others were used to predict recurrence and/or progression with promising results. Despite the nee

关键词： Non-Muscle Invasive Bladder Cancer Outcome Early Cystectomy Biomarkers Intravesical Agents Re-TURBT Histology Risk Stratification

Alcohol-induced Wnt signaling inhibition during bone fracture healing is normalized by intermittent parathyroid hormone treatment

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Animal Models and Experimental Medicine 2020年第2期3卷 200-207页

作者： Esha M.Kapania Taylor JReif Aaron Tsumura Jonathan M。Eby John J.Callaci Internal Medicine-Pediatric resident Rush University Medical CenterChicagoILUSA Limb Lengthening and Complex Reconstruction Fellowship Hospital for Special SurgeryNew YorkNYUSA Department of Orthopaedic Surgery and Rehabilitation Loyola University Medical CenterMaywoodILUSA Alcohol Research Program(ARP) Loyola University Chicago Stritch School of MedicineMaywoodILUSA

Nearly half of orthopaedic trauma patients are intoxicated at the time of injury, and excess alcohol consumption increases the risk for fracture nonunion. Previous studies show alcohol disrupts fracture associated Wnt signaling required for normal bone fracture repair. Intermittent parathyroid hormone(PTH) promotes bone growth through canonical Wnt signaling, however, no studies have investigated the effect of PTH on alcohol-inhibited bone fracture repair. Male C57 BL/6 mice received two-3 day alcohol binges separated by 4 days before receiving a mid-shaft tibia fracture. Postoperatively, mice received PTH daily until euthanasia. Wnt/β-catenin signaling was analyzed at 9 days post-fracture. As previously observed, acute alcohol exposure resulted in a >2-fold decrease in total and the active form of β-catenin and a 2-fold increase in inactive β-catenin within the fracture callus. Intermittent PTH abrogated the effect of alcohol on β-catenin within the fracture callus. Upstream of β-catenin, alcohol-treated animals had a 2-fold decrease in total LRP6, the Wnt co-receptor, which was restored with PTH treatment. Alcohol nor PTH had any significant effect on GSK-3β. These data show that intermittent PTH following a tibia fracture restores normal expression of Wnt signaling proteins within the fracture callus of alcohol-treated mice.

关键词： ethanol fracture callus parathyroid hormone Wnt signaling pathway

Genetic diagnosis of neonatal-onset seizures

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Genes & Diseases 2019年第4期6卷 441-447页

作者： Xueling Ma Fengzhu Yang Ziyu Hua The Department of Neonatology Children’s Hospital of Chongqing Medical UniversityChongqing400014China Ministry of Education Key Laboratory of Child Development and Disorders Chongqing400014China Chongqing International Science and Technology Cooperation Center for Child Development and Disorders Chongqing400014China Chongqing Key Laboratory of Child Infection and Immunity Chongqing400014China National Demonstration Base of Standardized Training Base for resident Physicians Chongqing400014China

Many seizures in neonates are due to early-onset epilepsy,which is often difficult to diagnose,especially to explore the ***,the development of next-generation sequencing(NGS)has led to the discovery of a large number of genes involved in *** may improve prompt detection of early-onset epilepsy in *** study aimed at analyzing the genotype-phenotype correlations in neonates with seizures in a bid to improve the understanding of genetic diagnosis of early-onset *** features and prognosis of 15 children who underwent genetic testing having had unexplained seizures from February 2016 to May 2018 in Children’s Hospital of Chongqing Medical University were analyzed *** salient findings were:poor response to stimulus and abnormal electroencephalogram(EEG)in the initial period were observed in the group with concomitant genetic *** the recent progress in genetic technology,molecular diagnosis for neonatal-onset epilepsy can be challenging due to genetic and phenotypic ***,some genotypes are associated with specific clinical manifestations and EEG ***,in-depth understanding of genotype-phenotype correlations would be useful to clinicians managing neonates with early-onset seizures.

关键词： Genetic Genotype-phenotype Molecular diagnosis Neonate Seizures

Visual Anosognosia (Anton-Babinski Syndrome): Report of Two Cases Associated with Ischemic Cerebrovascular Disease

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Journal of Behavioral and Brain Science 2012年第3期2卷 394-398页

作者： Juan JoseRomero Carvajal Augusto Alejandro Arias Cardenas German Zamora Pazmino Patricio Abad Herrera resident of Internal Medicine Department Hospital MetropolitanoUniversidadInternacional del EcuadorQuitoEcuador Department of Neuroradiology Hospital MetropolitanoQuitoEcuador Department of Neurology Hospital MetropolitanoQuitoEcuador

Visual anosognosia or Anton-Babinski syndrome is a rare neurological condition related to cortical blindness. The patients deny their blindness and affirm adamantly that they are capable of seeing. The clinical presentation includes confabulations and sometimes confusional states. In this article we report two patients with anosognosia related to ischemic stroke in two different sets of etiology and pathogenesis. We describe the major clinical manifestations of this syndrome and review the current medical literature. Two patients were identified, a 96-year-old male with visual anosognosia secondary to a right posterior cerebral artery thrombosis, and a 56-year-old female with the same syndrome but related to central nervous system angiitis in relation with multiple sclerosis and Hashimoto’s thyroiditis. Visual anosognosia or Anton-Babinski syndrome is a rare neurological condition, however the ischemic vascular cerebral disease is a frequent etiology. We believe that this is the first report of this syndrome in relation to angiitis with a clear autoimmune pathogenesis.

关键词： Visual Anosognosia Cortical Blindness Anton-Babinski Syndrome Stroke MRI

Final Diagnosis of Pediatric Patients with Prolonged in Activated Partial Thromboplastin Time Preoperative Study

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International Journal of Otolaryngology and Head & Neck Surgery 2015年第3期4卷 241-247页

作者： Noemi Aguirre Francisca Cordova Francisca Jaime Ximena Fonseca Pamela Zúniga Pediatrics resident Pontifical Catholic University of ChileSantiagoChile School of Medicine Pontifical Catholic University of ChileSantiagoChile Pediatrician Resident of Pediatric Gastroenterology and NutritionPontifical Catholic University of ChileSantiagoChile Otorhinolaryngologist Assistant ProfessorPediatrics DivisionMedical SchoolPontifical Catholic University of ChileSantiagoChile Hematologist-Oncologist Assistant ProfessorPediatrics DivisionMedical SchoolPontifical Catholic University of ChileSantiagoChile

Introduction: Activated partial thromboplastin time (aPTT) is one of the most used coagulation tests in preoperative evaluation. Incidental detection of a prolonged aPTT is a problem in primary care, in which the general pediatrician should be able to attend its initial management. Objective: To describe final diagnosis of patients with prolonged aPTT in preoperative study. Materials and Methods: This is a descriptive study of patients referred from otorhinolaryngology. Results: Totally, 508 adenoidectomies and/or tonsillectomies were performed in our center, 38 of which referred patients (7.5%) with prolonged aPTT, and 30 of which met inclusion criteria. The median age was 4 years. 56.6% of patients were males. 76.6% of patients normalized aPTT at the second follow-up. Among these, 73.9% showed a normal study, 4.3% ha2d lupus anticoagulant and in 21.7% Von Willebrand disease was detected. Among patients that persisted with prolonged aPTT, 42.8% had coagulant factors deficiency, 28.5% had lupus anticoagulant and in 28.5% of patients a diagnosis could not be achieved with the tests used in the present study. Multivariate analysis did not show correlation between final diagnosis and the variables measured. Conclusion: The presence of a prolonged aPTT in children under preoperative study is due to a pre-analytic factor in the majority of cases or to the presence of lupus anticoagulant, normalizing values on follow-up. We suggest that a new aPTT be performed on these patients, and only those that persist altered or present a symptoms and family history of coagulation disorders be referred to hematology.

关键词： aPTT Preoperative Study Tonsillectomy Adenoidectomy Coagulopathy

Motivations and Barriers towards Volunteer Work among Family Medicine residents and Primary Health Care Physicians in Qassim Region, Saudi Arabia

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Journal of Biosciences and Medicines 2022年第4期10卷 126-142页

作者： Tameem Alhomaid Amel A. Sulaiman Family Medicine R3 resident Family Medicine Academy Qassim Health Cluster Buraydah Kingdom of Saudi Arabia Trainer at Family Medicine Academy Qassim Health Cluster Buraydah Kingdom of Saudi Arabia

Introduction: Volunteering is an unpaid voluntary activity that provides some services to one or more other people or the community at large. Volunteer in the medical field is common. Physicians and medical students are participating in voluntary activities. This study assessed the motivations and barriers of Family Medicine (FM) residents and Primary Health Care (PHC) Physicians in Qassim Region, Saudi Arabia. Methods: This is a descriptive cross-sectional study was carried out between 12th March 2021 to 31st September 2021 in Qassim Region, Saudi Arabia. 63 FM residents and 89 PHC physicians were involved. A self-administered questionnaire using Volunteer Functions Inventory (VFI) questions was distributed. A 30-item questionnaire is divided into 6 scales of 5 items each, which are scored using a 5-point Likert-type scale (where 1 strongly disagrees and 5 strongly agree). Results: Of 152 FM residents and PHC physicians, 91 (59.9%) were males, and Saudi 90 (59.2%). The mean age was 35 (±SD8.6) years. The majority of respondents 126 (85.7%) participated in different kinds of volunteer work. The highest rank of the benefits selected 137 (90.1%) was gained Allah’s pleasure. About 66 (43.4%) of respondents reported different reasons as barriers;lack of time was the dominant reason for 59 (38.8%). A strong statistical association was found between gender and facing barriers (P-value Conclusions: This study highlighted that the values motivation factor was the highest among the six motivation determinants. The main reason preventing respondents from doing voluntary work was the lack of time. Male gender and Saudi nationality physicians participated more in previous voluntary work P-value < 0.001. Further future research into studying human behaviour towards voluntary work is highly needed.

关键词： Volunteers PHC Physicians VFI Functions Qassim Region