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Phrenic nerve block: the key to managing acute biliary pain?

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World Journal of Emergency Medicine 2024年第1期15卷 62-63页

作者： Michael Shalaby Joshua Luftig Department of Emergency Medicine and Critical Care Herbert Wertheim College of Medicine at Florida International UniversityMiami 33199USA Advanced Emergency Ultrasound Mount Sinai Medical CenterMiami Beach 33140USA Department of Emergency Medicine Highland HospitalAlameda Health SystemOakland 94602USA

Over the past two decades,the USA has witnessed a steep rise in the incidence of acute cholecystitis(AC),[1]even among children,[2]with over 200,000 cases annually.[3]Patients with AC often present to the emergency department(ED)experiencing severe distress,with most describing their pain level as“intolerable.”[4]Furthermore,there is usually a considerable delay before surgery,with a median time from diagnosis of AC to surgery of 28.5 h,[5]and a substantial percentage of patients wait as long as 10 d.[6]Prolonged delays before surgery lead to increased opioid use,which is associated with extended hospital stays and higher rates of readmission after cholecystectomy.[7]Furthermore,opioids can lead to vomiting,respiratory depression,delirium,and ultimately addiction.[8]We propose a novel regional anesthesia technique for managing AC:right phrenic nerve *** method could offer improved pain control and a more favorable risk profile in selected patients when compared to current ED practices.

关键词： pain anesthesia diagnosis

The Burden of Undiagnosed Hypertension and Associated Risk Factors among Adults in a Rural Community in Imo Sate, South-East Nigeria

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International Journal of Clinical Medicine 2024年第2期15卷 101-122页

作者： Iwunze Anuli Egwim Jideuma Onuoha Frank Olekanma Chinonye Ndukwu Chiagozie Igbonagwam Hope Dike Victor Department of Family Medicine Federal University Teaching Hospital Owerri Nigeria Department of Public Health Central Michigan University Mount Pleasant Michigan USA

Background: Cardiovascular diseases are the leading cause of death globally and hypertension is a major contributor to this burden. Many people with hypertension have poorly controlled blood pressure and up to half of the adults with hypertension are unaware of their hypertensive status due to factors that bother on poor management and poor screening approaches. The implication is that people who have poor access to healthcare especially those in the rural communities are at increased risk of cardiovascular complications and all-cause mortality. Unfortunately, not much has been done to ascertain the burden of undiagnosed hypertension and associated risk factors in rural communities in Nigeria. Methods: We conducted a community-based cross-sectional study in a rural community in Imo State, Nigeria, on burden of undiagnosed hypertension with participants recruited via a multi-stage sampling method. An interviewer-administered questionnaire was used, and standardized instruments were applied to obtain, process and analyze the data. Tests of association between the independent variables and outcome were conducted using logistic regression. P-value of Results: A total of 380 adults participated in the study. The mean age was 44.2 years. The prevalence of undiagnosed hypertension was 35.8%. Logistic regression revealed that age, with the respondents in the age groups 26 - 35 years (OR = 10.647, 1.910 - 59.345, p-value = 0.007), 36 - 45 (OR = 3.680, 1.263 - 10.723, p-value = 0.017), 46 - 55 years (OR = 2.737, 1.114 - 6.727, p-value = 0.039), 56 - 65 years old (OR = 3.384, 1.610 - 7.115, p-value = 0.001);and being married (OR = 3.846, 1.118 - 13.233, p-value = 0.033), were independent risk factors for undiagnosed hypertension. Conclusion: The prevalence of undiagnosed hypertension in the rural population of South-East Nigeria is high. Younger age (26 - 35 years) had the highest odds of risk for occurrence of hypertension. Also being married was identified as a risk factor f

关键词： Hypertension Undiagnosed Hypertension Risk Factors Rural Community

Solitary fibrous tumor:A case report of this multifaceted tumor

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World Journal of Clinical Cases 2024年第25期12卷 5791-5797页

作者： Hani Maalouf Ribal Aby Hadeer Souad Ghattas Omar Tabbikha Hasan Numan Raja Wakim Department of General Surgery University of BalamandBeirut 100Lebanon Department of General Surgery Mount Lebanon Hospital University Medical CenterBeirut 7031Lebanon

BACKGROUND Solitary fibrous tumor(SFT)is a remarkably uncommon mesenchymal ***6 level and a combination of clinical,pathological,and molecular features are required to arrive at a proper *** SUMMARY In this report,we present an intriguing case involving a 43-year-old woman who initially exhibited symptoms of a bleeding retroperitoneal tumor,initially resembling a gastrointestinal stromal tumor,but later confirmed as an ***,a year later,what was initially believed to be a recurrence of her SFT was instead identified as a desmoid *** Distinguishing SFT from other tumors was *** misdiagnoses of tumor type initially and of recurrence later was necessary for appropriate treatment of the correct desmoid type.

关键词： Solitary fibrous tumor Retroperitoneal tumor Soft tissue neoplasms Sarcoma NAB2-STAT6 Case report

Mast cell activation syndrome:An up-to-date review of literature

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World Journal of Clinical Pediatrics 2024年第2期13卷 104-113页

作者： ÖnerÖzdemir Gökçe Kasımoğlu Ayşegül Bak Hüseyin Sütlüoğlu Süreyya Savaşan Department of Pediatric Allergy and Immunology Sakarya UniversitySakaryaAdapazarı54100Türkiye Department of Pediatrics Sakarya UniversitySakaryaAdapazarı54100Türkiye Department of Pediatrics Kocaeli City HospitalKocaeli 50123Türkiye Department of Pediatrics Children’s Hospital of MichiganHematology/OncologyCentral Michigan University College of MedicineMount PleasantMI 48859United States Barbara Ann Karmanos Cancer Institute Wayne State UniversityDetroitMI 12345United States

Mast cells are a subtype of white blood cells and are involved in the immune *** cells contain many chemical substances called mediators,which are involved in the allergic *** fact that mast cells play a role in many events that require urgent intervention,especially anaphylaxis,has led to a more detailed study of these *** diseases also caused by dysfunctions of mast cells have been examined in many *** instance,mast cell activation syndrome is known as an augmented number of cells due to decreased cell death,resulting in clinical symptoms affecting many *** main common symptoms include flushing,hypotension,urticaria,angioedema,headache,vomiting and *** the underlying mechanism is not yet clearly known,we aim to review the literature in a broad perspective and bring together the existing knowledge in the light of the literature due to the diversity of its involvement in the body and the fact that it is a little known syndrome.

关键词： Mast cell Mast cell activation syndrome Tryptase Histamine

Social-ecological perspective on the suicidal behaviour factors of early adolescents in China:a network analysis

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General Psychiatry 2024年第1期37卷 143-150页

作者： Yuan Li Peiying Li Mengyuan Yuan Yonghan Li Xueying Zhang Juan Chen Gengfu Wang Puyu Su Department of Maternal Child and Adolescent HealthSchool of Public HealthKey Laboratory of Population Health Across Life Cycle(Anhui Medical University)Ministry of Education of the People's Republic of ChinaAnhui Medical UniversityKey Laboratory of Population Health Across Life Cycle(Anhui Medical University)HefeiAnhuiChina Tianjin Anding hospital Mental Health Center of Tianjin Medical UniversityTianjin Medical UniversityTianjinChina Department of Environmental Medicine and Public Health Icahn School of Medicine at Mount SinaiNew YorkNew YorkUSA Afiliated Psychological hospital of Anhui Medical University Anhui Mental Health CenterFourth People's Hospital of HefeiHefeiAnhuiChina

Background In early adolescence,youth are highly prone to suicidal *** modifiable risk factors during this critical phase is a priority to inform effective suicide prevention *** To explore the risk and protective factors of suicidal behaviours(ie,suicidal ideation,plans and attempts)in early adolescence in China using a social-ecological *** Using data from the cross-sectional project‘Healthy and Risky Behaviours Among Middle School Students in Anhui Province,China',stratified random cluster sampling was used to select 5724 middle school students who had completed self-report questionnaires in November *** analysis was employed to examine the correlates of suicidal ideation,plans and attempts at four levels,namely individual(sex,academic performance,serious physical llness/disability,history of self-harm,depression,impulsivity,sleep problems,resilience),family(family economic status,relationship with mother,relationship with father,family violence,childhood abuse,parental mental illness),school(relationship with teachers,relationship with classmates,school-bullying victimisation and perpetration)and social(social support,satisfaction with society).Results In total,37.9%,19.0%and 5.5%of the students reported suicidal ideation,plans and attempts in the past 6 months,*** estimated network revealed that suicidal ideation,plans and attempts were collectively associated with a history of self-harm,sleep problems,childhood abuse,school bullying and *** analysis indicated that the most influential nodes in the network were history of self-harm and childhood ***,the network also showed unique correlates of suicidal ideation(sex,weight=0.60;impulsivity,weight=0.24;family violence,weight=0.17;relationship with teachers,weight=-0.03;school-bullying perpetration,weight=0.22),suicidal plans(social support,weight=-0.15)and suicidal attempts(relationship with mother,weight=-0.10;par

关键词： network analysis prevention

Pancreatic lymphangioma:two case reports from an institutional experience with a rare entity and review of literature

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Journal of Pancreatology 2022年第2期5卷 98-109页

作者： Alfonso Tan-Garcia Ser Yee Lee Jen San Wong Thomas W.T.Ho Keng Sin Ng Kiat Hon Tony Lim Division of Pathology Department of Anatomical PathologySingapore General HospitalSingapore Surgical Associates Mount Elizabeth Medical CentreSingapore Department of Hepatopancreatobiliary and Transplant Surgery Singapore General HospitalSingapore Hepatobiliary and Pancreatic Surgery Centre Mount Elizabeth Medical CentreSingapore Digestive Surgical Oncology Department of Diagnostic Imaging Mount Alvernia HospitalSingapore

Pancreatic lymphangiomas are very rare benign cystic lesions that pose a diagnostic dilemma due to their resemblance to other non-neoplastic and neoplastic pancreatic cystic *** such,pancreatic lymphangiomas are frequently diagnosed only after histological examination of the excised *** present 2 cases of pancreatic lymphangioma,determine its prevalence at our institution and perform a detailed review of published literature since *** 1 is a 36-year-old male and case 2 is a 35-year-old female,both of which presented with abdominal *** were the only cases of pancreatic lymphangiomas reported at our institution since *** reviewed 69 cases of pancreatic lymphangiomas from 52 *** affects predominantly females with a median age of 43 and such patients typically present with abdominal pain(58.8%)or are asymptomatic(27.9%).The median size is 8.6 cm,the most common location is the head of pancreas and the most common imaging finding is that of a multilocular *** of patients underwent surgical resection(69.6%).Endoscopic ultrasound-guided fine-needle aspiration features of pancreatic lymphangiomas include chylous cyst fluid,elevated fluid triglyceride levels(15/16 cases)and numerous lymphocytes on *** majority of patients with elevated fluid triglyceride levels(13/15 cases)were managed *** lymphangiomas are rare pancreatic cystic lesions that may be diagnosed preoperatively using a multidisciplinary and multimodal approach involving clinical,radiological,biochemical and cytological features,allowing greater confidence in the selection of patients who can be managed conservatively.

关键词： Case report Cystic Diagnostic features Literature review Lymphangioma management Pancreas Prevalence

Predictors of Abnormal Vaginal Discharge among Women of Reproductive Age in Southeast Nigeria

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International Journal of Clinical Medicine 2024年第7期15卷 240-256页

作者： Jideuma Egwim Victor Dike Hope Igbonagwam Nkechinyere Oke Uzoma Amajo Akuchi Okafor Angela Izegbune Ijedimma Okafor Department of Family Medicine Federal University Teaching Hospital Owerri Nigeria Department of Public Health Central Michigan University Mount Pleasant Michigan USA Department of Ophthalmology Enugu State University Teaching Hospital Enugu Nigeria Department of Family Medicine Lagos University Teaching Hospital Lagos Nigeria Department of Internal Medicine Alex Ekwueme Federal University Teaching Hospital Ebonyi State Nigeria Field Office World Health Organisation Imo State Nigeria Department of Internal Medicine Ebonyi State University College of Health Sciences Ebonyi State Nigeria

Background: An abnormal vaginal discharge is a common complaint among women of reproductive age, and it can indicate serious conditions like pelvic inflammatory disease and cervical cancer. This study aimed to assess the predictors of abnormal vaginal discharge in women of reproductive age group in Imo State, Southeast Nigeria. Methods: A cross-sectional study was conducted among 368 women of reproductive age group attending the clinic at Federal University Teaching hospital Owerri, in Imo State, Nigeria. Respondents were recruited using a systematic sampling technique. Data were collected using a pre-tested interviewer-administered questionnaire. Multivariable analysis was performed to determine predictors of abnormal vaginal discharge. Statistical significance was set at p Results: The mean age of the respondents was 30 ± 4.5 years. Predictors of abnormal vaginal discharge were: age 36 - 45 years (OR: 4.5;95% C.I: 1.023 - 8.967, p = 0.041), being a student (OR: 2.4: 95% C.I: 1.496 - 7.336, p = 0.003), use of oral contraceptives (OR: 3.4;95% C.I: 1.068 - 6.932, p = 0.010), use of water cistern (OR: 4.7;C.I: 1.654 - 5.210, p = 0.028) anal hygiene practices (OR: 2.7;95% C.I: 1.142 - 4.809, p Conclusion: These findings suggest that targeted sexual and reproductive health interventions should be provided to reduce the risk of abnormal vaginal discharge in women of reproductive age group.

关键词： Predictors Abnormal Vaginal Discharge

Circulating microRNA expression and nonalcoholic fatty liver disease in adolescents with severe obesity

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World Journal of Gastroenterology 2024年第4期30卷 332-345页

作者： Yi-Jie Li Brittney O Baumert Nikos Stratakis Jesse A Goodrich Hao-Tian Wu Jing-Xuan He Yin-Qi Zhao Max T Aung Hong-Xu Wang Sandrah P Eckel Douglas I Walker Damaskini Valvi Michele A La Merrill Justin R Ryder Thomas H Inge Todd Jenkins Stephanie Sisley Rohit Kohli Stavra A Xanthakos Andrea A Baccarelli Rob McConnell David V Conti Lida Chatzi Department of Population and Public Health Sciences Keck School of MedicineUniversity of Southern CaliforniaLos AngelesCA 90032United States Barcelona Institute of Global Health Barcelona Institute of Global HealthBarcelona 08036Spain Department of Environmental Health Sciences Mailman School of Public HealthColumbia UniversityNew YorkNY 10032United States Gangarosa Department of Environmental Health Rollins School of Public HealthEmory UniversityAtlantaGA 30329United States Department of Environmental Medicine and Public Health Icahn School of Medicine at Mount SinaiNew YorkNY 10029United States Department of Environmental Toxicology University of CaliforniaDavisCA 95616United States Department of Surgery Lurie Children’s Hospital of ChicagoChicagoIL 60611United States Northwestern University Feinberg School of Medicine Northwestern UniversityChicagoIL 60611United States Division of Biostatistics and Epidemiology Cincinnati Children's Hospital Medical CenterCincinnatiOH 45229United States Department of Pediatrics University of Cincinnati College of MedicineCincinnatiOH 45229United States Department of Pediatrics Children’s Nutrition Research Center USDA/ARSBaylor College of MedicineHoustonTX 77030United States Department of Gastroenterology Children’s Hospital Los AngelesLos AngelesCA 90027United States Division of Gastroenterology Hepatology and NutritionCincinnati Children's Hospital Medical CenterCincinnatiOH 45229United States

BACKGROUND Nonalcoholic fatty liver disease(NAFLD)is one of the most common chronic liver diseases in children and *** ranges in severity from isolated hepatic steatosis to nonalcoholic steatohepatitis(NASH),wherein hepatocellular inflammation and/or fibrosis coexist with *** microRNA(miRNA)levels have been suggested to be altered in NAFLD,but the extent to which miRNA are related to NAFLD features remains *** analysis tested the hypothesis that plasma miRNAs are significantly associated with histological features of NAFLD in *** To investigate the relationship between plasma miRNA expression and NAFLD features among adolescents with *** This study included 81 adolescents diagnosed with NAFLD and 54 adolescents without NAFLD from the Teen-Longitudinal Assessment of Bariatric Surgery ***-operative core liver biopsies were collected from participants and used to characterize histological features of *** samples were collected during surgery for miRNA profiling.A total of 843 plasma miRNAs were profiled using the HTG EdgeSeq *** examined associations of plasma miRNAs and NAFLD features using logistic regression after adjusting for age,sex,race,and other key *** Pathways Analysis was used to identify biological functions of miRNAs that were associated with multiple histological features of *** We identified 16 upregulated plasma miRNAs,including miR-193a-5p and miR-193b-5p,and 22 downregulated plasma miRNAs,including miR-1282 and miR-6734-5p,in adolescents with ***,52,16,15,and 9 plasma miRNAs were associated with NASH,fibrosis,ballooning degeneration,and lobular inflammation,***,16 miRNAs were associated with two or more histological features of *** those miRNAs,miR-411-5p was downregulated in NASH,ballooning,and fibrosis,while miR-122-5p,miR-1343-5p,miR-193a-5p,miR-193b-5p,and miR-7845-5p were consistently and posi

关键词： MicroRNA Nonalcoholic fatty liver disease Non-alcoholic steatohepatitis Liver fibrosis Lobular inflammation Ballooning degeneration

Associations between irritable bowel syndrome and non-alcoholic fatty liver disease:A systematic review

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World Journal of Hepatology 2023年第7期15卷 925-938页

作者： Jareth Jun Jie Ng Wai Mun Loo Kewin Tien Ho Siah Yong Loo Lin School of Medicine National University of SingaporeSingapore 117597Singapore AliveoMedical Mount Alvernia and Mount Elizabeth HospitalsSingapore 574623Singapore Department of Medicine National University HospitalSingapore 119228Singapore

BACKGROUND Irritable bowel syndrome(IBS)is associated with obesity and metabolic *** and non-alcoholic fatty liver disease(NAFLD)are highly prevalent entities worldwide and may share similar mechanisms including gut dysbiosis,impaired intestinal mucosal barrier and immune system *** To systematically review their association according to the Preferred Reporting Items for Systemic Review and Meta-analyses *** PubMed,EMBASE and Cochrane Database of Systematic Reviews were searched for relevant *** searches were also *** Six studies were *** IBS and NAFLD subjects had significantly more metabolic risk factors like hypertension,obesity,dyslipidaemia and *** review showed that 23.2%to 29.4%of NAFLD patients had *** was significantly higher in NAFLD patients compared with patients without NAFLD(23.2%vs 12.5%,P<0.01).A higher proportion of IBS patients had NAFLD(65.8%to 74.0%).IBS patients were three times more likely to have NAFLD compared with non-IBS patients(P<0.001).Two studies showed a significant correlation between the severity of IBS and *** proportion of NAFLD subjects with IBS increased with NAFLD *** Further prospective studies are warranted to evaluate the relationship and shared pathways between IBS and NAFLD,potentially leading to the development of future therapeutics.

关键词： Irritable bowel syndrome Functional gastrointestinal disorder Non-alcoholic fatty liver disease Non-alcoholic steatohepatitis Gut dysbiosis Metabolic syndrome