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Outcomes of bowel program in spinal cord injury patients with neurogenic bowel dysfunction

Neural Regeneration Research 2015年第7期10卷 1153-1158页

作者： Zuhal Ozisler Kurtulus Koklu Sumru Ozel Sibel Unsal-Delialioglu Ankara Physical Medicine and Rehabilitation Education and Research Hospital PMR Clinics Ministry of Health

In this study, we aimed to determine gastrointestinal problems associated with neurogenic bowel dysfunction in spinal cord injury patients and to assess the efficacy of bowel program on gastrointestinal problems and the severity of neurogenic bowel dysfunction. Fifty-five spinal cord injury patients were included in this study. A bowel program according to the characteristics of neurogenic bowel dysfunction was performed for each patient. Before and after bowel program, gastrointestinal problems（constipation, difficult intestinal evacuation, incontinence, abdominal pain, abdominal distension, loss of appetite, hemorrhoids, rectal bleeding and gastrointestinal induced autonomic dysreflexia） and bowel evacuation methods（digital stimulation, oral medication, suppositories, abdominal massage, Valsalva maneuver and manual evacuation） were determined. Neurogenic bowel dysfunction score was used to assess the severity of neurogenic bowel dysfunction. At least one gastrointestinal problem was identified in 44（80%） of the 55 patients before bowel program. Constipation（56%, 31/55） and incontinence（42%, 23/55） were the most common gastrointestinal problems. Digital rectal stimulation was the most common method for bowel evacuation, both before（76%, 42/55） and after（73%, 40/55） bowel program. Oral medication, enema and manual evacuation application rates were significantly decreased and constipation, difficult intestinal evacuation, abdominal distention, and abdominal pain rates were significantly reduced after bowel program. In addition, mean neurogenic bowel dysfunction score was decreased after bowel program. An effective bowel program decreases the severity of neurogenic bowel dysfunction and reduces associated gastrointestinal problems in patients with spinal cord injury.

关键词： nerve regeneration spinal cord injury neurogenic bowel bowel program gastrointestinal problems bowel evacuation neural regeneration

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Diagnostic and therapeutic challenges of myeloid sarcoma in the oral cavity

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World Journal of Clinical Cases 2024年第32期12卷 6526-6533页

作者： Melissa Martínez Nieto Luis Antonio González Gómez Juan Carlos Gómez Mireles Sarah Monserrat LomelíMartínez Department of Integrated Dentistry clinics Centro Universitario de Ciencias de la SaludUniversidad de GuadalajaraGuadalajara 44340Mexico Department of Medical and Life Sciences Centro Universitario de la CiénegaUniversidad de GuadalajaraOcotlán 47810Mexico Department of Well-being and Sustainable Development Centro Universitario del NorteUniversidad de GuadalajaraColotlan 46200JaliscoMexico

Myeloid sarcoma(MS)is a rare neoplasm characterized by the proliferation of immature myeloid precursor cells outside the bone *** pathogenesis of MS is complex and not completely ***,it develops in any extramedullary site of the *** this editorial,we discuss the article published by Li et al,which presents a clinical case involving a 32-year-old man who exhibited gingival inflammation in the maxillary *** was initially diagnosed as periodontal ***,clinical evaluation revealed a firm,grayishwhite mass which underscored the need for comprehensive diagnostics to distinguish MS from other oral *** article emphasizes the different clinical presentations of similar case studies in the literature,and highlights the difficulty in diagnosing oral MS due to its rarity and variability in clinical *** treatment of MS depends on the clinical presentation,tumor location,and the patient's response to conventional *** various therapeutic options currently available are analyzed and *** intervention and multidisciplinary management are crucial for improving treatment *** awareness and education about the various clinical presentations of MS lead to earlier diagnosis and timely treatment,thereby enhancing patients'survival and quality of *** research is essential for optimizing therapeutic strategies and addressing the challenges presented by this rare neoplasm.

关键词： Myeloid sarcoma Acute myeloid leukemia Chloroma Granulocytic sarcoma Oropharyngeal neoplasms Gingiva

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Distal femoral extension and shortening osteotomy as a part of multilevel surgery in children with cerebral palsy

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World Journal of Pediatrics 2017年第4期13卷 353-359页

作者： Matthias C.M.Klotz Klemens Hirsch Daniel Heitzmann Michael W.Maier Sebastien Hagmann Thomas Dreher Department of Orthopedic and Trauma Surgery Heidelberg University ClinicsHeidelbergGermany

Background:There are several reports describing an increase in anterior pelvic tilt after hamstring lengthening in children with cerebral palsy (CP).Distal femoral extension and shortening osteotomy (DFESO) is an alternative treatment for correction of flexed knee gait,but investigations analyzing outcome and influence on adjacent joint are few in the *** purpose of this study was to analyze the influence of DFESO on knee and pelvis in children with ***,it was of interest if an additional patellar tendon advancement (PA) influences ***:In this retrospective study,31 limbs of 22 children (GMFCS Ⅰ-Ⅲ;mean age:12.1±3.1 years),who received DFESO were included and kinematic parameters (knee,pelvis) measured by 3-D-gait analysis were compared before and at least 1 year after surgery (mean follow-up period:15.6 months).Results:After surgery,during stance phase minimum knee flexion improved significantly by 20.5° (P<0.001) and mean anterior pelvic tilt increased by 4.0 degrees (P=0.045).In 16 limbs,the postoperative increase in maximum anterior pelvic tilt was more than 5°.Limbs who received an additional PA showed the biggest increase in anterior pelvic ***:DFESO is an effective method for correction of flexed knee gait in children with ***,the results of this study indicate that DFESO may lead to an increase in anterior pelvic tilt,which may lead to a recurrence of flexed knee *** this context,PA seemed to aggravate the effect on the pelvis.

关键词： cerebral palsy femoral extension osteotomy motion analysis

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Clinical and Histological Profile of Breast Cancer at University clinics of Kinshasa, Democratic Republic of Congo

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Open Journal of Obstetrics and Gynecology 2022年第8期12卷 760-769页

作者： Bisinkam Guillaume Malingisi Mbangama Muela Andy Mutombo Baleka Alex Lumaya Ambis Joelle Mukendi Tshitadi Jean Muamba Nkongolo Freddy Odimba Mpoy Jules Kazadi Nkashama Bienvenu Ndesanzim Otem Christian Lotoy Banza Jésual Etana Litambelo Serge Ombha Loshima Ernest Kabatantshi Mubengabantu Gérard Department of Obstetrics and Gynaecology University Clinics Kinshasa DRCongo

Context: Breast cancer represents a significant public health problem concern the world, given its frequency (20% to 25% of female cancers) and diagnosis clinical stage with a particular frequency of locally advanced cancers and inflammatory forms. Objectives: To describe the socio-demographic, clinical and histological characteristics of breast cancer at the University clinics of Kinshasa. Methods: A descriptive and retrospective study was completed at University clinics of Kinshasa from 1 January 2003 to 30 July 2018, including 300 cases of breast cancer diagnosed and treated. Results: The mean age of women at diagnosis was 47.5 ± 10.8 years. Most of the patients were married, multipara with an average parity of 3.7 ± 2.5 and non-menopausal. Breast mass was the main reason for medical visit (47.5%) and the majority of patients consulted 12 months after the onset of the disease (36.3%) at stage 3 (56%) and node extension was observed in 61.3%. The average size of the breast mass was 8.02 ± 3.7 cm. The infiltrating ductal carcinoma was the most common histological type in 82.5% of cases;the majority of tumors were histo-pronostic II in 47.5% of cases. 83% of the tumors were hormonal-dependent. Only 35.9% of the tumors over-expressed the HER 2/Neu receptor. Conclusion: Most patients consulted more than 12 months after the onset of the disease and the diagnosis was made at advanced stages. The tumor was large at diagnosis. The left breast was the most affected. The majority of tumors are of high histopronostic grade and are hormonal-dependent.

关键词： Breast Cancer Clinical and Histological Profile University clinics of Kinshasa

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Endobiliary radiofrequency ablation for malignant biliary obstruction

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Hepatobiliary & Pancreatic Diseases International 2013年第4期12卷 423-427页

作者： Halil Alis Cetin Sengoz Murat Gonenc Mustafa Uygar Kalayci Ali Kocatas General Surgery clinics Dr. Sadi Konuk Training and Research HospitalIstanbul 34147 Turkey General Surgery clinics Mugla Public HospitalMugla 48162 Turkey

BACKGROUND: The cornerstone of palliative treatment for inoperable extrahepatic cholangiocarcinoma is the relief of malignant biliary obstruction. The most commonly applied method is endoscopic stenting. However, the procedure can be complicated with stent obstruction. In this respect, endobiliary radiofrequency ablation may serve as an adjunctive tool for prolonging the stent patency. METHODS: Patients who underwent endoscopic retrograde cholangiopancreatography for differential diagnosis and/ or palliative treatment after the diagnosis of inoperable extrahepatic cholangiocarcinoma between March 2011 and January 2012 were analyzed. Those in whom endobiliary radiofrequency ablation and endoscopic stenting was successfully performed were included in the study. Technical details of the procedure, duration of stent patency, length of hospital stay, short-term morbidity and mortality rate were documented. RESULTS: Seventeen patients were analyzed, and 10 patients were included in the study. The morbidity and mortality rate within the first 30 days after the procedure was 20% and 0%, respectively. In 2 patients, mild pancreatitis occurred because of the endobiliary procedure. In 1 patient, endobiliary decompression could not be achieved, and therefore, percutaneous transhepatic biliary drainage was carried out. The median duration of stent patency in 9 patients with successful biliary decompression was 9 months (range 6-15). CONCLUSION: Endobiliary radiofrequency ablation seems to be safe and feasible as a palliative measure and may prolong the stent patency and overall survival in patients with malignant biliary obstruction due to inoperable extrahepatic cholangio-carcinoma.

关键词： obstructive jaundice cholangicarcinoma Klatskin tumor endobiliary stenting radiofrequency ablation

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Bravo (wireless) ambulatory esophageal pH monitoring: How do day 1 and day 2 results compare?

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World Journal of Gastroenterology 2007年第30期13卷 4091-4095页

作者： Matthew L Bechtold Jason-Scott L Holly Klaus Thaler John B Marshall Division of Gastroenterology University of Missouri Hospital and Clinics Columbia MO 65212 United States General Surgery University of Missouri Hospital and Clinics Columbia MO 65212 United States

AIM： To investigate if differences exist for patients＇ gastroesophageal reflux as measured by the Bravo ambulatory esophageal pH system between d 1 and d 2.METHODS： A retrospective study of 27 consecutive adult patients who underwent Bravo esophageal pH monitoring was performed. Patients underwent EGD under Ⅳ conscious sedation prior to Bravo placement. Acid reflux variables and symptom scores for d 1 were compared to d 2.RESULTS： The mean doses of fentanyl and midazolam were 90.4 μg and 7.2 mg, respectively. D 1 results were significantly more elevated than d 2 with respect to total time pH 〈 4, upright position reflux, and mean number of long refluxes. No statistical difference was noted between the two days for supine position reflux, number of refluxes, duration of longest reflux, episodes of heartburn, and symptom score.CONCLUSION： Patients undergoing Bravo esophageal pH monitoring in association with EGD and moderate conscious sedation experience significantly more acid reflux on d i compared to d 2. The Ⅳ sedation may be responsible for the increased reflux on d 1. Performed this way, 48-h Bravo results may not be entirely representative of the patients＇ true GE reflux profile.

关键词： Esophageal pH monitoring Bravo Gastroeso- phageal reflux disease Reflux pH testing

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Rehabilitation and return to sport after hamstring strain injury

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Journal of Sport and Health Science 2017年第3期6卷 262-270页

作者： Lauren N.Erickson Marc A.Sherry Sports Rehabilitation University of Wisconsin Hospital and ClinicsMadisonWI 53718USA

Hamstring strain injuries are common among sports that involve sprinting,kicking,and high-speed skilled movements or extensive muscle lengthening-type maneuvers with hip flexion and knee *** injuries present the challenge of significant recovery time and a lengthy period of increased susceptibility for recurrent *** one third of hamstring strains recur within the first year following return to sport with subsequent injuries often being more severe than the *** high re-injury rate suggests that athletes may be returning to sport prematurely due to inadequate return to sport *** this review article,we describe the epidemiology,risk factors,differential diagnosis,and prognosis of an acute hamstring *** on the current available evidence,we then propose a clinical guide for the rehabilitation of acute hamstring strains and an algorithm to assist clinicians in the decision-making process when assessing readiness of an athlete to return to sport.

关键词： Acute Muscle Performance Physical therapy Recurrence Re-injury Thigh

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Trends of Macrosomia at University clinics of Kinshasa

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Open Journal of Obstetrics and Gynecology 2018年第3期8卷 263-272页

作者： Mbangama-Muela Andy Mulumba Kapuku Sylvain Tozin Rahma Rachid Lumaya Ambis Joelle Tandu-Umba Barthélémy Mbungu Mwimba Roger Lokomba Bolamba Vicky Mbanzulu Pita Damien Department of Obstetrics and Gynaecology University ClinicsKinshasaDR Congo

Context. The prevalence of macrosomia varies through the world according to racial and ethnic factors, life style and importance of non communicable diseases (maternal obesity, diabetes-gestational and type 2), post-term gestation and multiparity. At the University clinics of Kinshasa (UCK), 30 years ago, the frequency of macrosomia was 2.4%. Objectives. To update data on the frequency of macrosomia at UCK, regarding variations in maternal anthropometrics (obesity) and socio-demographic factors. Methods. A cross-sectional study was conducted at UCK from 1 January 2007 to 31 December 2016. Mothers who delivered babies weighing at least 4000 g were included in this study. Results. The frequency of macrosomia was 3.7%. Trend shows a variation of this frequency over time with lowest frequency (2.1%) in 2012 and highest (5.3%) in 2009. The mother average age and parity were 32.3 ± 5.4 years and 3 ± 2, respectively. Pregnancies were complicated by polyhydramnios (48%) and gestational diabetes (19.7%). Caesarean section was performed in 60.5% cases, mainly for macrosomia (47.8%) and 81.6% of newborns had constitutional macrosomia. Adverse obstetrical outcomes of macrosomia were dominated by caesarean section (28.9%), lacerations of birth canal (23%) and neonatal distress (9.2%). Conclusion. Macrosomia remains a constant finding at UCK, and is associated with maternal, fetal and neonatal adverse outcomes. Trend shows a variation of the frequency over time between 2.1% and 5.3%.

关键词： Macrosomia Adverse Obstetrical Outcomes University clinics of Kinshasa

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Epidemiological and Clinical Profile of Children Exposed to SARS-CoV-2 at the COVID-19 Treatment Center at the ISIRO Hospital and WATSA in the Democratic Republic of the Congo

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Journal of Biosciences and Medicines 2024年第9期12卷 73-81页

作者： Hilaire Lisimo Abwa David Azako Michel Ngbatala Bienvenu Apenya Jolie Mambeizidra Julbert Malangu Eugene Kumbodimo George Mutuale Herman Luhavo Jean Claude Gbundu Fiston Bolanda François Enze Marie Tasile Yvette Kpakpo Nyange Nicholas Katembo clinics Universitaires Uele Department of Pediatrics Faculty of Medicine University of Uele Isiro Democratic Republic of the Congo General Hospital of Isiro Isiro Democratic Republic of the Congo Division Provinciale de la Sant du Haut Ul Isiro Democratic Republic of the Congo Additional Vaccination Program for Watsa Watsa Democratic Republic of the Congo Center Hospitalier KIBALI Durba Democratic Republic of the Congo Hospital General of Watsa Watsa Democratic Republic of the Congo

Introduction: COVID-19, an emerging infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), typically presents with mild clinical manifestations in pediatric populations. As in many other regions of the Democratic Republic of the Congo (DRC), the COVID-19 pandemic affected children in Haut-Uélé, a province bordering South Sudan and Uganda. This study aimed to describe the epidemiological profile of COVID-19 in pediatric population in this area. Materials and Methods: This descriptive cross-sectional study was conducted over a 6-month period from August 1, 2021 to February 7, 2022. It included all patients aged 0 to 19 years with confirmed COVID-19 using RT-PCR and managed at the COVID-19 Treatment Centers (CTCO) in ISIRO and WATSA. Data were collected from patient records supplemented by the dataset from the service of Health Information System (SNIS) and the Epidemiological Surveillance Commission of the Provincial Health Division (DPS). Epidemiological and clinical profiles were analyzed. All statistical analyses were performed using SPSS software, Version 18. Results: During the 4th wave of the pandemic, 5 out of 13 health zones in Haut-Uélé province were affected, with a total of 569 recorded cases;45 of them were children aged 0 to 19 years (7.9%). Asymptomatic cases accounted for 33.3% (15 cases). The mean age was 9.88 ± 5.49 years, with the most affected age group being 10 - 14 years (44.45%). There was a predominance of males (73.3%), with a male-to-female sex ratio of 2.75. Half of the patients (53.3%) were from Watsa Health Zone. A seasonal peak was observed between December and January. Comorbidities were present in 10% of infected patients, and nearly half of participants were contacts of infected individuals. The primary reasons for admission were fever (66.66%), followed by rhinorrhea (57.77%) and cough (31.11%). All patients responded favorably to treatment. Conclusion: The proportion of pediatric COVID-19 cases at t

关键词： COVID-19 Morbi-Mortal Emergency Haut-Uélé

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Safety of tirofiban and dual antiplatelet therapy in treating intracranial aneurysms

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Stroke & Vascular Neurology 2019年第1期4卷 36-42页

作者： Edgar A Samaniego Emilee Gibson Daichi Nakagawa Santiago Ortega-Gutierrez Mario Zanaty Jorge A Roa Pascal Jabbour David M Hasan Department of Neurology Neurosurgery and RadiologyUniversity of Iowa Hospitals and ClinicsIowa CityIowaUSA Department of Neurology University of Iowa Hospitals and ClinicsIowa CityIowaUSA Department of Neurosurgery University of Iowa Hospitals and ClinicsIowa CityIowaUSA Department of Neurosurgery Thomas Jefferson UniversityPhiladelphiaPennsylvaniaUSA

Background Endovascular treatment of intracranial aneurysms usually involves stent-assisted coiling(SAC)and flow *** IIb/IIIa inhibitors such as tirofiban and dual antiplatelet therapy(DAPT)are required to prevent thromboembolic complications *** sought to determine the safety of tirofiban and DAPT in these *** We conducted a retrospective analysis of our database for patients with intracranial aneurysms who underwent SAC or flow *** tirofiban-DAPT protocol used is *** regarding duration of infusion,placement of external ventricular devices(EVDs),complications,haemoglobin levels and platelet count before and 24 hours after antiplatelet therapy were collected and *** One-hundred and forty-one patients with 148 aneurysms/procedures were included.110 aneurysms were treated acutely and 38 *** and major haemorrhagic events were recognised in 20%(30/148)*** 5(3.4%)intracerebral haemorrhages were symptomatic:3 cortical/SAH and 2 *** average blood volume in symptomatic haemorrhages was 24.8 cc versus 5.42 cc in asymptomatic haemorrhages(p=0.002).The rate of EVD-related haemorrhages was 15.7%(19/121)and only 2(1.7%)were *** haemorrhagic events occurred in ruptured aneurysms(90.1%,p=0.01).No significant change in platelet count or haemoglobin levels before and 24 hours after administration of tirofiban and DAPT was *** administration of heparin did not increase haemorrhagic *** The use of the GP IIb/IIIa inhibitors tirofiban and DAPT in this series was *** and DAPT did not affect platelet count or haemoglobin levels and did not increase rate of symptomatic haemorrhages or thromboembolic complications.

关键词： aneurysm intracranial infusion

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