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Does topical vancomycin prevent fracture-related infections in closed fractures undergoing open reduction and internal fixation?A randomised controlled trial

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Chinese Journal of Traumatology 2024年第2期27卷 71-76页

作者： Mohit Gandhi Gopisankar Balaji Jagdish Menon Ruben Raj Thomas department of Orthopaedics Jawaharlal Institute of Postgraduate Medical Education and ResearchPondicherryIndia department of Preventive and Social Medicine Jawaharlal Institute of Postgraduate Medical Education and ResearchPondicherryIndia

Purpose:The role of topical vancomycin in fracture-related infection(FRI)is debatable.Very few studies have reported their efficacy in open and high-risk extremity fractures.This study aimed to assess topical vancomycin's role in reducing FRI in closed fractures undergoing open surgical intervention with an implant.Methods:This prospective randomized cohort study was carried out between February 2021 to January 2022.Patients with isolated closed fractures,who were planned for open reduction and internal fixation within 2 weeks from the time of injury were included for this study.The data collected included age,gender,socioeconomic status,mechanism of injury,diagnosis,Tscherne classification,and time interval to take up for surgery.Patients were randomized into the intervention and control groups using the block randomization technique.The control group received only systemic antibiotic prophylaxis,whereas the intervention group received topical application of vancomycin powder in the surgical wound alongside systemic antibiotic prophylaxis.The primary outcome measure was the incidence of FRI among these individuals.Clinical and radiological findings and culture reports(in cases with infection)were recorded during the post-operative period and at 6 weeks of follow-up.All relevant statistical calculations were done using STATA statistical/data analysis-parallel edition version 16.0(StataCorp LLC).The quantitative variables like age and duration of the surgery were assessed for normalcy by Shapiro-Wilk W test.An independent samples t-test with equal variances was applied to the age data.Fisher's exact test was used for the analysis of the primary outcome measure(presence of FRI following surgery),and"Risk of FRI"and"Risk difference"between the 2 groups was calculated.The strength of the association between qualitative variables was assessed using the Fisher's exact and Chi-square tests,respectively.Results:There were 88 patients included in this study.No statistical significance was found about FRI between both grou

关键词： Infections Antibiotics Vancomycin Fractures

Ultrasound-guided erector spine plane block (ESPB) utilization in managing refractory renal colic pain in the emergency department

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World Journal of Emergency Medicine 2023年第3期14卷 231-234页

作者： Mehdi Torabi Javad Darijani Moghaddameh Mirzaee Amin Honarmand department of Emergency Medicine Clinical Research Development UnitShahid Bahonar HospitalKerman University of Medical SciencesKerman ***Iran Health research Center Institute for Futures Studies in HealthKerman University of Medical SciencesKerman ***Iran

Due to the acute and terrible pain that patients with renal colic experience,the most essential therapeutic priority for these patients in the emergency department(ED)is to reduce pain.[1]Although numerous medications are utilized to reduce pain in patients with acute renal colic,no therapy has yet been developed to totally and quickly relieve pain.[2,3]Intravenous opioids and nonsteroidal anti-inflammatory drugs(NSAIDs)are commonly administered intravenously to control pain in these patients in the ED;however,the need for frequent monitoring for possible complications and relatively slow-acting features render these strategies undesirable.

关键词： pain acute drugs

Comorbidity of bipolar and anxiety disorders:An overview of trends in research

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World Journal of Psychiatry 2019年第1期9卷 7-29页

作者： Mamidipalli Sai Spoorthy Subho Chakrabarti Sandeep Grover department of Psychiatry Postgraduate Institute of Medical Education and Research

Over the last three decades burgeoning research has shown that anxiety disorder comorbidity is not only highly prevalent in bipolar disorder(BD),but it also adversely impacts the course,outcome,and treatment of BD.The present review provides an overview of the current trends in research on comorbid anxiety and BDs based on prior reviews and meta-analyses(n=103),epidemiological surveys,and large-scale clinical studies.The results reiterated the fact that at least half of those with BD are likely to develop an anxiety disorder in their lifetimes and a third of them will manifest an anxiety disorder at any point of time.All types of anxiety disorders were equally common in BD.However,there was a wide variation in rates across different sources,with most of this discrepancy being accounted for by methodological differences between reports.Comorbid anxiety disorders negatively impacted the presentation and course of BD.This unfavourable clinical profile led to poorer outcome and functioning and impeded treatment of BD.Despite the extensive body of research there was paucity of data on aetiology and treatment of anxiety disorder comorbidity in BD.Nevertheless,the substantial burden and unique characteristics of this comorbidity has important clinical and research implications.

关键词： Comorbidity Bipolar disorder Anxiety disorders Correlates Impact Aetiology Treatment

Vectorcardiographic QRS area as a predictor of response to cardiac resynchronization therapy

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Journal of Geriatric Cardiology 2022年第1期19卷 9-20页

作者： Mohammed A Ghossein Antonius MW van Stipdonk Frits W Prinzen Kevin Vernooy department of Physiology Cardiovascular Research Institute Maastricht(CARIM)Maastricht UniversityMaastrichtThe Netherlands department of Cardiology Cardiovascular Research Institute Maastricht(CARIM)Maastricht University Medical CenterMaastrichtThe Netherlands department of Cardiology Radboud University Medical CentreNijmegenThe Netherlands

Cardiac resynchronization therapy(CRT)is a good treatment for heart failure accompanied by ventricular conduction abnormalities.Current ECG criteria in international guidelines seem to be suboptimal to select heart failure patients for CRT.The criteria QRS duration and left bundle branch block(LBBB)QRS morphology insufficiently detect left ventricular activation delay,which is required for benefit from CRT.Additionally,there are various definitions for LBBB,in which each one has a different association with CRT benefit and is prone to subjective interpretation.Recent studies have shown that the objectively measured vectorcardiographic QRS area identifies left ventricular activation delay with higher accuracy than any of the current ECG criteria.Indeed,various studies have consistently shown that a high QRS area prior to CRT predicts both echocardiographic and clinical improvement after CRT.The beneficial relation of QRS area with CRT-outcome was largely independent from QRS morphology,QRS duration,and patient characteristics known to affect CRT-outcome including ischemic etiology and sex.On top of QRS area prior to CRT,the reduction in QRS area after CRT further improves benefit.QRS area is easily obtainable from a standard 12-lead ECG though it currently requires off-line analysis.Clinical applicability will be significantly improved when QRS area is automatically determined by ECG equipment.

关键词： ventricular synchronization conduction

Non-alcoholic fatty liver disease:Epidemiology,pathophysiology and an update on the therapeutic approaches

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Asian Pacific Journal of Tropical Biomedicine 2022年第3期12卷 99-114页

作者： Rehab F.Abdel-Rahman department of Pharmacology Medical Research and Clinical Studies InstituteNational Research Centre12622-DokkiGizaEgypt

Non-alcoholic fatty liver disease(NAFLD)denotes a spectrum of fatty liver disease in individuals without significant alcohol consumption.NAFLD is set to be the most common etiology of serious liver diseases in numerous nations when accompanied by obesity and type 2 diabetes.It is further histologically categorized into the non-alcoholic fatty liver(NAFL;steatosis without hepatocellular injury)and non-alcoholic steatohepatitis(NASH)which is characterized by the coexistence of hepatic steatosis and inflammation and is accompanied by hepatocyte injury(ballooning),either with or without fibrosis.NAFL is considered the benign and reversible stage arising from the excessive accumulation of triglycerides in hepatocytes.However,NASH is a more progressive stage of NAFLD,due to the increased risks of evolving more serious diseases such as cirrhosis,hepatocellular carcinoma.This concept,however,has been lately challenged by a hypothesis of multiple parallel hits of NAFLD,in which steatosis and NASH are separate entities rather than two points of the NAFLD spectrum,not only from a set of histological patterns but also from a pathophysiological perspective.The current review highlights the epidemiology and pathophysiology of NAFLD,and its progression towards steatohepatitis,with special focus on the novel imminent therapeutic approaches targeting the molecular aspects and the pathogenic pathways involved in the development,and progression of NAFLD.

关键词： Non-alcoholic fatty liver disease Steatosis Insulin sensitizers Glucagon-like peptide-1 analogues Dipeptidyl peptidase-4 inhibitors Farnesoid X receptor agonists

Circulating miR-548c-3p possesses good diagnostic potential for metabolic syndrome

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Genes & Diseases 2023年第3期10卷 683-686页

作者： Abdullahi Dandare Afrose Liaquat Muhammad Rafiq Mbah Ntepe Leonel Javeres Sidra Younis Muhammad Jawad Khan department of Biosciences COMSATS University IslamabadIslamabad 45550Pakistan department of Biochemistry Usmanu Danfodiyo University SokotoSokoto PMB 2346Nigeria department of Biochemistry Shifa College of MedicineShifa Tameer-E-Millat UniversityIslamabad 45550Pakistan institute of medical research and medical Plant studies Ministry of Scientific ResearchYaoindeCameroon department of Biological Sciences National University of Medical SciencesRawalpindiPunjab 46000Pakistan

studies have shown that dysregulated expression of miRNAs is a major underlying event in the onset and progression of many metabolic diseases.The pathological role of miR-548c-3p in various cancer types,including breast cancer,glioma,prostate cancer,and gastric cancer,has been documented.1 However,experimental evidences validating the role of miR-548c-3p in the development of metabolic diseases are still lacking,and no data is available on its diagnostic potential for metabolic syndrome(MS).Recently,we predicted the involvement of miR-548c-3p in the pathogenesis of MS and its progression to cardiovascular diseases(CVD)via the regulation of target genes necessary for the proper function of insulin resistance,mTOR,and JAK/STAT signaling pathways.2 Therefore,we deemed it necessary to engage in wet laboratory analysis and validate these claims in patients with metabolic syndrome compared to healthy individuals.

关键词： JAK/STAT involvement diseases

Protection against symptomatic SARS-CoV-2 infection during the second wave among individuals with pre-existing binding antibodies to SARS-CoV-2: A population-based study from Puducherry, India

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Asian Pacific Journal of Tropical Medicine 2023年第10期16卷 476-478页

作者： Premkumar Ramasubramani Dhanajayan Govindan Nandini Balakrishnan Krishnan Tamilarasu Kadhiravan Sitanshu Sekhar Kar department of Preventive and Social Medicine Jawaharlal Institute of Postgraduate Medical Education and Research(JIPMER)PuducherryIndia department of General Medicine Jawaharlal Institute of Postgraduate Medical Education and Research(JIPMER)PuducherryIndia

During the COVID-19 pandemic,several studies have shown that severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection is associated with a substantial reduction in the risk of subsequent reinfection with a... 详细信息

关键词： infection acute respiratory

Prognostic role of C-reactive protein to albumin ratio in lung cancer:An updated systematic review and meta-analysis

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Chronic Diseases and Translational Medicine 2024年第1期10卷 31-39页

作者： Zhendong Lu Siyun Fu Wei Li Xiang Gao Jinghui Wang department of medical Oncology Beijing Tuberculosis and Thoracic Tumor Research InstituteBeijing Chest HospitalCapital Medical UniversityBeijingChina Cancer research Center Beijing Chest HospitalBeijing Tuberculosis and Thoracic Tumor Research InstituteCapital Medical UniversityBeijingChina

Background: C-reactive protein to albumin ratio(CRP/Alb ratio,CAR)has been suggested as a potential prognostic biomarker in lung cancer.This updated systematic review and meta-analysis aimed to assess the association between CAR and lung cancer prognosis in current literature.Methods: A systematic search of databases was conducted to identify relevant studies published up to April 2023.Pooled hazard ratios(HRs)and 95%confidence intervals(CIs)were calculated to assess the association between CAR and overall survival(OS)and progression-free survival(PFS)and recurrence-free survival(RF)in lung cancer patients.Results: This meta-analysis includes 16 studies with a total of 5337 patients,indicating a significant association between higher CAR and poorer OS,PFS,and RFS in lung cancer patients,with a pooled HR of 1.78(95%CI=1.60-1.99),1.57(95%CI=1.36-1.80),and 1.97(95%CI=1.40-2.77),respectively.Conclusions: This updated meta-analysis provides evidence for the potential prognostic role of CAR in lung cancer,suggesting its utility as an effective and noninvasive biomarker for identifying high-risk patients and informing treatment decisions in a cost-effective manner.However,further large-scale studies will be necessary to establish the optimal cut-off value for CAR in lung cancer and confirm the present findings.

关键词： C-reactive protein to albumin ratio inflammation:biomarker lung cancer prognosis

Role of bisphosphonates in the management of acute Charcot foot

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World Journal of Diabetes 2018年第7期9卷 115-126页

作者： Harsh Durgia Jayaprakash Sahoo Sadishkumar Kam-alanathan Rajan Palui Kalyani Sridharan Henith Raj department of Endocrinology Jawaharlal Institute of Postgraduate Medical Education and Research

Diabetes mellitus is the most common cause of Charcot neuropathy affecting foot and ankle. Acute Charcot foot(CF) presents with a red and swollen foot in co-ntrast to the painless deformed one of chronic CF. En-hanced osteoclastogenesis plays a central role in the pathogenesis of acute CF. Many studies have shown elevated levels of bone turnover markers in patients with acute CF confirming it. These findings have led cl-inicians to use anti-resorptive agents [bisphosphonates(BP), calcitonin, and denosumab] along with immobi-lization and offloading in acute CF patients. The ma-ximum evidence among all anti-resorptive agents is available for BPs, although its quality is low. Pamidronate has been shown to reduce the markers of activity of CF like raised skin temperature, pain, edema, and bone turnover markers in the majority of studies. Intravenous BPs are known to cause acute phase reactions leading to flu-like illness following their first infusion, which can be ameliorated by oral acetaminophen. Alendronate is the only oral BP used in these patients. It needs to be taken on an empty stomach with a full glass of water to avoid esophagitis. The side-effects and contraindications to BPs should be kept in mind while treating acute CF patients with them.

关键词： Charcot foot Diabetes mellitus Charcot neuroarthropathy Bisphosphonates Pamidronate