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World Journal of Radiology 2024年第5期16卷 136-138页

作者： Min Ai Hang-Hang Zhang Yi Guo Jun-Bang Feng Department of Anesthesiology Nanan District People’s Hospital of ChongqingChongqing 400060China Department of Breast and Thyroid Surgery Chongqing Bishan District Maternal and Child Health Care HospitalChongqing 402760China Medical Imaging Department Chongqing University Central Hospital(Chongqing Emergency Medical Center)Chongqing 400014China

Determining whether sevoflurane sedation in children leads to“pseudo”prominent leptomeningeal contrast enhancement(pLMCE)on 3 Tesla magnetic resonance imaging will help reduce overdiagnosis by radiologists and clari... 详细信息

关键词： pediatrics patients Sevoflurane Brain Prominent leptomeningeal contrast enhancement Magnetic resonance imaging

Urinary Tract Infection in Pediatric emergency Department of Mohamed VI hospital in Marrakech: Epidemiological Profile and Antibiotic Resistance

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Journal of Biosciences and Medicines 2024年第6期12卷 85-93页

作者： Radia Laanait Soufiane Elmoussaoui Widad Lahmini Mounir Bourrous Pediatric emergency Department Mother and child hospital University Hospital Mohammed VI Marrakesh Morocco Laboratory Childhood Health and Development Faculty of Medicine and Pharmacy Cadi Ayyad University Marrakech Morocco Laboratory for Infectious Disease Control Faculty of Medicine and Pharmacy Cadi Ayad University Marrakech Morocco

Background: Urinary tract infection (UTI) is one of the most frequent bacterial infections in pediatrics. The aim of our work was to establish the epidemiological and bacteriological profile of UTIs in children and then to study the sensitivity of the bacterial strains isolated to antibiotics. Materials and methods: This is a retrospective descriptive study over 3 years (2019-2022), including all cytobacteriological examination of urine (CBEU), performed in children aged 3 months to 14 years, admitted and treated for UTI, in the pediatric emergency department of Mohamed VI University hospital. Results: A total of 239 children were included in our study. The mean age was 26 months. The sex ratio was 1.08. Escherichia coli was the most isolated bacterial strain in 79% of samples. The tested strains showed a high level of sensitivity to susceptibility rate toward amikacin (91%) and ciprofloxacin (100%) and whereas the level of resistance was high to the most current recommended antibiotics, mainly beta-lactams. Management was based, in severe forms of pyelonephritis, dual antibiotic therapy based on Third-generation cephalosporins combined with gentamycin. Favorable outcome was noted in 94% of children. Conclusion: Awareness-raising on the proper use of antibiotics, issuing national recommendations for the treatment of urinary tract infections in order to standardize therapeutic regimens is strongly recommended. Effective control of these infections requires a global prevention strategy that implies close collaboration between epidemiologists, clinicians, bacteriologists, hygienists and the health care team.

关键词： Child Urinary Tract Infection Bacteria Antibiotics Resistances

Child Victims of Road Traffic Accidents: Epidemiological and Clinical Aspects in the Medical and Surgical emergency Department of the Donka National hospital

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Case Reports in Clinical Medicine 2024年第3期13卷 63-72页

作者： Ibrahima Sory Diallo Mamadou Moustapha Diop Amadou Oury Toure Mamadou Aliou Doukouré Aîssata Barry M’mah Aminata Bangoura Mariama Sadjo Diallo Abdoulaye Oumare Diallo Salimatou Hassimiou Camara Thierno Mamadou Aliou Touré Ouo Ouo Kolié Mohamed Lamine Diallo Fatoumata Binta Diallo Ibrahima Sory Souaré Institute of Child Nutrition and Health Conakry Guinea Department of pediatrics Donka National Hospital Conakry Guinea UNICEF-Guinea Community Health Section Conakry Guinea Gamal Abdel Nasser University of Conakry Conakry Guinea

Introduction: Children involved in road accidents most often suffer head or limb injuries. The severity of these injuries varies according to the age of the child, the type of road user and whether or not protective devices are used. The aim of this study was to carry out a census of admissions and to identify the epidemiological and clinical profile of children involved in road traffic accidents at Donka National hospital. Methods: This is a descriptive cross-sectional study of children involved in traffic accidents over a 3-month period from September 1 to November 30, 2021. All children admitted to the emergency department for a traffic accident were included in the study. Results: During the study period, 435/530 children (82.1%) were victims of road accidents. Boys accounted for 54.94% of cases, compared with 45.06% for girls. The age group most affected was 12-17 years old (48.97%). October had the highest accident rate (36.4%). Pedestrians are most affected (52.87%). Bicycles and mopeds were involved in 59.77% of accidents. Head injury was the most frequent pathology (33.33%). The study showed that 12.64% of victims were referred to intensive care, pediatric surgery, etc. We recorded 8 cases of death (1.84%). Conclusion: This study highlighted the characteristics, incidence and risk factors for accidents in children admitted to emergency departments. Accident prevention, particularly serious accidents in children, requires more precise knowledge of the factors and circumstances leading to their occurrence.

关键词： Child Accident Public Highway Donka

Treat-to-target in Crohn's disease:Will transmural healing become a therapeutic endpoint?

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World Journal of Clinical Cases 2018年第12期6卷 501-513页

作者： Elena Daniela Serban 2nd Department of pediatrics "Iuliu Hatieganu" University of Medicine and PharmacyEmergency Hospital for Children

Crohn's disease(CD) represents a chronic transmural inflammatory condition of the gastrointestinal tract, which usually leads to structural damage and signific-ant disability. Deep remission--defined by both clinical and endoscopic remission, signifying mucosal healing-represents the current endpoint in the treat--to--target strategy, significantly improving patients' long--term outcomes. Transmural healing(TH) could be a more effe-ctive target, but this possibility remains unclear. This narrative review aims to critically review and summarize the available literature relating TH to long--term outcomes, being the first of its kind and to the best of the author's knowledge. A systematic literature search(from incep-tion to March 31 2018) was performed, using multiple databases, and identifying seven full--text manuscripts. In those studies, long--term favorable outcomes(≥ 52 wk) included sustained clinical remission, as well as fewer therapeutic changes, CD--related hospitalizations, and surgeries. Despite heterogeneous design and me-thodological limitations, six of the studies demonstrated that TH or intestinal healing(TH plus mucosal healing) were predictive for the aforementioned favorable out-comes. Therefore, TH may become a reasonable the-rapeutic target and be included in the concept of deep remission. Further prospective, well-designed, multicenter trials aiming to better define the role of TH in personalized therapy for CD and to determine the long-term influence of TH on bowel damage and disability are warranted.

关键词： Treat to target Cross sectional imaging Deep remission Transmural healing Intestinal healing Long-term outcomes Bowel damage Crohn’s disease

High-grade serous carcinoma of the fallopian tube in a young woman with chromosomal 4q abnormality:A case report

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World Journal of Clinical Cases 2024年第18期12卷 3539-3547页

作者： Kai-Cheng Zhang Shao-Yin Chu Dah-Ching Ding Department of Obstetrics and Gynecology Hualien Tzu Chi HospitalBuddhist Tzu Chi Medical FoundationTzu Chi UniversityHualien 970Taiwan Department of pediatrics Hualien Tzu Chi HospitalBuddhist Tzu Chi Medical FoundationTzu Chi UniversityHualien 970Taiwan Institute of Medical Sciences Tzu Chi UniversityHualien 970Taiwan

BACKGROUND Few studies have reported an association between an increased risk of acquiring cancers and survival in patients with 4q deletion *** study presents a rare association between chromosome 4q abnormalities and fallopian tube highgrade serous carcinoma(HGSC)in a young *** SUMMARY A 35-year-old woman presented with acute dull abdominal pain and a known chromosomal abnormality involving 4q13.3 duplication and 4q23q24 *** arrival at the emergency room,her abdomen appeared ovoid and distended with palpable shifting *** were identified through abdominal ultrasound,and computed tomography revealed an omentum cake and an enlarged bilateral *** tests showed elevated CA-125 *** was conducted,and immunohistochemistry indicated that the cancer cells favored an ovarian origin,making us suspect ovarian *** patient underwent debulking surgery,which led to a diagnosis of stage IIIC HGSC of the fallopian ***,the patient received adjuvant chemotherapy with carboplatin and paclitaxel,resulting in stable current *** This study demonstrates a rare correlation between a chromosome 4q abnormality and ***2D3 may affect crucial cancer-related pathways,including P53,BRCA,cyclin D,and tyrosine kinase receptors,thereby possibly contributing to cancer *** addition,ADH1 and DDIT4 may be potential influencers of both carcinogenic and therapeutic responses.

关键词： High-grade serous carcinoma Fallopian tube Young age Chromosomal abnormality Mental retardation Aging Case report

Availability and quality of procedural sedation and analgesia in emergency departments without emergency physicians: A national survey in the Netherlands

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World Journal of emergency Medicine 2020年第2期11卷 69-73页

作者： Maybritt IKuypers Adinda Klijn Nieke EMullaart-Jansen Frans BPlötz Amsterdam University Medical Center Amsterdamthe Netherlands emergency Department DijklanderziekenhuisHoornthe Netherlands Department of pediatrics Tergooi HospitalBlaricumthe Netherlands

BACKGROUND: emergency physicians have been successful in implementing procedural sedation and analgesia(PSA) to treat emergency department(ED) patients who need to undergo painful ***, 25% of the EDs in the Netherlands are not staffed by emergency *** aim of this study was to investigate PSA availability and quality in EDs without emergency ***: We performed an exploratory cross-sectional study amongst ED nurses and physicians in all 13 EDs without emergency physicians in the *** were gathered using a standardized ***: The response rate was 34.3%(148/432).Of the respondents, 84/148(56.8%) provided adult PSA and 30/148(20.3%) provided paediatric *** reasons for not providing PSA were insufficient numbers of trained staff to support PSA in the ED and insufficient training and *** providers agreed significantly stronger when reflecting their PSA competencies in adults compared to paediatric ***: The key to improve pain management in the ED-setting may lay in investing in continuous training of ED health care professionals and/or acquiring professionals who are both qualified in PSA and available in the ED.

关键词： Procedural sedation and analgesia emergency departments emergency physicians

Inpatient use of racemic epinephrine for children admitted with croup

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World Journal of pediatrics 2019年第6期15卷 586-594页

作者： Elaine Chiang Omar Afandi Sang Hoon Lee Srinivasan Suresh Raymond DPitetti Sriram Ramgopal Division of Pediatric emergency Medicine Department of PediatricsUniversity of Pittsburgh School of MedicinePittsburghPAUSA Department of pediatrics University of Pittsburgh School of MedicinePittsburghPAUSA Department of pediatrics University of CincinnatiCollege of MedicineCincinnatiOHUSA Division of emergency Medicine Cincinnati Children's Hospital Medical CenterCincinnatiOHUSA Division of Health Informatics Department of PediatricsUniversity of Pittsburgh School of MedicineChildren's Hospital of PittsburghPittsburghPAUSA UPMC Children's hospital of Pittsburgh PittsburghPAUSA

Background Pediatric patients with croup are frequently admitted if they require two doses of racemic epinephrine(RE)in the emergency department(ED).We aimed to identify factors associated with the need for additional therapy(>2 RE doses)among pediatric patients with *** We performed a single-center retrospective study of consecutive patients admitted from the ED with a diagnosis of croup between January 1,2011 and December 31,*** outcome was need for>2 doses of *** out-comes included time to third RE and 72-hour return *** performed logistic regression to identify factors associated with use of>2 RE doses during hospitalization,and survival analysis to identify time to dosing of 3rd RE from 2nd *** Of 353 included admissions[250(70.8%)males,median age 1.48,interquartile range 0.97-2.51 years],106/353(30.0%)required>2 *** univariate logistic regression,only recent use of steroids within 1 day prior to presentation(4.18,1.48-11.83;P=0.007)was associated with need for>2 *** from third RE was 0.74(95%CI 0.69-0.78),which was similar to the survival at 12 hours(0.70,95%CI 0.65-0.75).Return visits occurred in 19(5.4%)patients,of whom 12/19(63.2%)were given *** Patients hospitalized for croup with recent use of steroids prior to ED presentation have a greater need for>2 RE during *** majority who require inpatient RE will do so within 8-12 *** data provide informa-tion for risk stratification and duration of monitoring for patients hospitalized with croup.

关键词： Laryngotracheobronchitis Racemic epinephrine Spasmodic croup Steroids Viral croup

Validating a point of care lactate meter in adult patients with sepsis presenting to the emergency department of a tertiary care hospital of a low-to middle-income country

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World Journal of emergency Medicine 2017年第3期8卷 184-189页

作者： Muhammad Akbar Baig Hira Shahzad Erfan Hussain Asad Mian Department of emergency Medicine Aga Khan University Hospital Department of Medicine Aga Khan University Hospital Adult Critical Care Services Aga Khan University Hospital Department of emergency Medicine Pediatrics and Child Health Aga Khan University Hospital

BACKGROUND: Timely identifi cation of high blood lactate levels in septic patients may allow faster detection of those patients requiring immediate resuscitation. Point-of-care(POC) testing is being increasingly utilized in the emergency department(ED). We examined the accuracy and timesaving effect of a handheld POC lactate device for the measurement of fingertip and whole blood lactate as compared with reference laboratory blood testing in septic ED ***: A convenience sample of adult ED patients receiving serum lactate testing were enrolled prospectively in the ED of a multidisciplinary tertiary care hospital serving the population of one of the major cities of Pakistan. Participants underwent fi ngertip POC lactate measurement with a portable device and simultaneous whole blood sampling for analysis by both the POC lactate device and standard laboratory method. Lactate measurements were compared by intraclass correlation(ICC) and Bland and Altman ***: Forty-three septic patients were included in the study. The fingertip POC & whole blood POC lactate measurements each correlated tightly with the reference method(ICC=0.93 & ICC=0.92, respectively). Similarly at 6 hours, the fingertip POC & whole blood POC lactate measurements demonstrated satisfactory correlation with the reference method(ICC=0.95 & ICC=0.97, respectively).CONCLUSION: Fingertip POC lactate measurement is an accurate method to determine lactate levels in septic ED *** WORDS: Sepsis; Point of care; Lactate; emergency department;

关键词： Sepsis Point of care Lactate emergency department Pakistan

Urinary neutrophil gelatinase-associated lipocalin(NGAL)and serum cystatin C measurements for early diagnosis of acute kidney injury in children admitted to PICU

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World Journal of pediatrics 2018年第2期14卷 134-142页

作者： Jameela Abdulaziz Kari Mohamed Ahmed Shalaby Kholoud Sofyani Ahmad Saleh Sanad Albaraa Fuad Ossra Rayan Smeer Halabi Maha Hassan Aljuhani Wael Mohammad Toffaha Feras Aymen Moria Samar Sabry Hanan AbdelAziz Ahmed Khalid Abdulaziz Alhasan Sara Sharief Osama Safdar Pediatric Nephrology Center of Excellence and Department of pediatrics King Abdulaziz University80215Jeddah 21589Kingdom of Saudi Arabia Pediatric Intensive Care Unit Department of PediatricsKing Abdulaziz UniversityJeddahKingdom of Saudi Arabia Pediatric Department Cairo UniversityGizaEgypt Department of pediatrics College of MedicineKing Khalid University HospitalKing Saud UniversityRiyadhKingdom of Saudi Arabia

Background Acute kidney injury(AKI)is common in critically ill children with significant mortality and *** creatinine is an insensitive and late biomarker compared to newly proposed AKI *** Prospective study in pediatric intensive care unit(PICU)over three months to compare between serum cystatin-C(s-Cys-C)and urinary neutrophil gelatinase-associated lipocalin(uNGAL)as AKI biomarkers at multiple time points with pediatric risk,injury,failure,loss,end-stage renal disease(pRIFLE)classification in diagnosing *** Forty children were *** these 40 children,22 developed AKI according to pRIFLE *** was no significant difference between AKI and non-AKI in age(P=0.29).Post cardiac surgery,renal insult was the main cause of AKI(27.3%).There was a twofold increased risk of incident AKI in those patients with high baseline uNGAL at PICU admission and almost a fourfold increased risk in patients with high baseline s-Cys-C at PICU *** levels were highly predictive of AKI during the follow-up period[area under the curve(AUC)=0.76,95%confidence interval(CI)0.61-0.92].The cutoff point with the highest correctly classified proportion was 223 ng/mL(≥12 centiles)which correctly predict 80.0%patients with AKI,with a corresponding sensitivity of 72.7%and a specificity of 89.9%.AUC for s-Cys-C was 0.86(95%CI 0.75-0.97),and the highest correctly classified proportion was 1009μg/L(≥13 centiles);75%of patients with AKI,with a corresponding sensitivity of 63.6%and a specificity of 88.9%.Conclusion uNGAL and s-Cys-C predicts AKI early in critically ill children.

关键词： Acute kidney injury Neutrophil gelatinase-associated lipocalin Serum cystatin C

MicroRNA-219 alleviates glutamate-induced neurotoxicity in cultured hippocampal neurons by targeting calmodulin-dependent protein kinase Ⅱ gamma

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Neural Regeneration Research 2018年第7期13卷 1216-1224页

作者： Ting Wang Qun Cai Wen-Jie Yang Hai-Hua Fan Jian-Feng Yi Feng Xu Department of emergency First Affiliated Hospital of Soochow University Suzhou Jiangsu Province China Department of emergency Affiliated Hospital of Nantong University Nantong Jiangsu Province China Department of pediatrics Affiliated Hospital of Nantong University Nantong Jiangsu Province China Medical College of Nantong University Nantong Jiangsu Province China

Septic encephalopathy is a frequent complication of sepsis,but there are few studies examining the role of micro RNAs（mi Rs） in its *** this study,a mi R-219 mimic was transfected into rat hippocampal neurons to model mi R-219 overexpression.A protective effect of mi R-219 was observed for glutamate-induced neurotoxicity of rat hippocampal neurons,and an underlying mechanism involving calmodulin-dependent protein kinase II γ（Ca MKIIγ） was *** R-219 and Ca MKIIγ m RNA expression induced by glutamate in hippocampal neurons was determined by quantitative real-time reverse transcription-polymerase chain reaction（q RT-PCR）.After neurons were transfected with mi R-219 mimic,effects on cell viability and apoptosis were measured by 3-（4,5-dimethylthiazolyl-2）-2,5-diphenyltetrazolium bromide（MTT） assay and flow *** addition,a luciferase reporter gene system was used to confirm Ca MKIIγ as a target gene of mi *** blot assay and rescue experiments were also utilized to detect Ca MKIIγ expression and further verify that mi R-219 in hippocampal neurons exerted its effect through regulation of Ca MKIIγ.MTT assay and q RT-PCR results revealed obvious decreases in cell viability and mi R-219 expression after glutamate stimulation,while Ca MKIIγ m RNA expression was ***,flow cytometry,and caspase-3 activity assays showed that mi R-219 overexpression could elevate glutamate-induced cell viability,and reduce cell apoptosis and caspase-3 ***,luciferase Ca MKIIγ-reporter activity was remarkably decreased by co-transfection with mi R-219 mimic,and the results of a rescue experiment showed that Ca MKIIγ overexpression could reverse the biological effects of mi ***,these findings verify that mi R-219 expression was decreased in glutamate-induced neurons,Ca MKIIγ was a target gene of mi R-219,and mi R-219 alleviated glutamate-induced neuronal excitotoxicity by negatively controlling Ca MKIIγ expression.

关键词： nerve regeneration brain injury septic encephalopathy miR-219 hippocampal neurons glutamate excitotoxicity apoptosis caspase-3 calmodulin-dependent protein kinase Ⅱ γ luciferase reporter gene system neuroprotection neural regeneration