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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 *** few studies have reported their efficacy in open and high-risk extremity *** study aimed to assess topical vancomycin's role in reducing FRI in closed fractures undergoing open surgical intervention with an ***:This prospective randomized cohort study was carried out between February 2021 to January *** 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 *** data collected included age,gender,socioeconomic status,mechanism of injury,diagnosis,Tscherne classification,and time interval to take up for *** were randomized into the intervention and control groups using the block randomization *** control group received only systemic antibiotic prophylaxis,whereas the intervention group received topical application of vancomycin powder in the surgical wound alongside systemic antibiotic *** primary outcome measure was the incidence of FRI among these *** and radiological findings and culture reports(in cases with infection)were recorded during the post-operative period and at 6 weeks of *** 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 *** independent samples t-test with equal variances was applied to the age ***'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 *** strength of the association between qualitative variables was assessed using the Fisher's exact and Chi-square tests,***:There were 88 patients included in this *** statistical si

关键词： Infections Antibiotics Vancomycin Fractures

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Advancements in medical treatment for pancreatic neuroendocrine tumors:A beacon of hope

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World Journal of Gastroenterology 2024年第12期30卷 1670-1675页

作者： Somdatta Giri Jayaprakash Sahoo department of Endocrinology and Metabolism Jawaharlal Institute of Postgraduate Medical Education and ResearchPuducherry605006India

This editorial highlights the remarkable advancements in medical treatment strategies for pancreatic neuroendocrine tumors(pan-NETs),emphasizing tailored approaches for specific *** surgery and somatostatin analogs(SSAs)play pivotal roles in managing tumors,while palliative options such as molecular targeted therapy,peptide receptor radionuclide therapy,and chemotherapy are reserved for SSA-refractory ***,insul-inomas,glucagonomas,carcinoid tumors and VIPomas necessitate distinct thera-peutic *** the genetic basis of pan-NETs and exploring immunotherapies could lead to promising avenues for future *** review underscores the evolving landscape of pan-NET treatment,offering renewed hope and improved outcomes for patients facing this complex disease.

关键词： Pancreatic neuroendocrine tumor Medical management Somatostatin analog Immunotherapy Everolimus

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Can we predict the incidence of high-grade Clavien-Dindo complications in patients with forgotten encrusted stents undergoing endourologic management?

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Asian Journal of Urology 2024年第1期11卷 99-104页

作者： Praanjal Gupta Ramanitharan Manikandan Lalgudi Narayanan Dorairajan Kodakattil Sreenivasan Sreerag Sidhartha Kalra Swapnil Singh Kushwaha department of Urology Jawaharlal Institute of Postgraduate Medical Education and ResearchPondicherryIndia

Objective:Ureteral stents are customarily inserted to facilitate urinary drainage,but they come with their own glitches of being forgotten and/or encrusted leading to serious *** present study aimed to report the complications in patients with forgotten and encrusted stents according to the Clavien-Dindo system specific to urological procedures and identify the factors leading to high-grade(Clavien-Dindo Grade 4A or above)***:The hospital records of patients with forgotten encrusted double-J stents over a period of 8 years were *** parameters recorded included patient demographics,indwelling time,need for percutaneous nephrostomy,hemodialysis,urine culture,blood culture,total blood counts,serum creatinine,radiologic findings,management techniques,number of surgical interventions,modified Clavien-Dindo complications,follow-up,and mortality,if ***:Forty patients were included in the *** median age was 52(range 6-85)*** the total,25(62.5%)patients had a“significant”stent load;31(77.5%)had renal failure or acute kidney injury on presentation;19(47.5%)patients had sepsis at *** the patients presented with sepsis,11(57.9%)patients demonstrated a positive urine culture;and 7/11(63.6%)patients exhibited pan-resistant *** out of 40(30.0%)patients in our series developed high-grade Clavien-Dindo *** univariate analysis,sepsis at presentation(p=0.007),stent load(p=0.031),diabetes(p=0.023),positive urine culture(p=0.007),and stent indwelling time of more than 1 year(p=0.031)were found to be *** multivariate logistic regression analysis,sepsis at presentation(p=0.017)and positive urine culture(p=0.016)were significant predictors for high-grade ***:It is prudent to identify specific risk factors,namely sepsis at presentation and positive urine culture to triage and optimize these patients before surgical management.

关键词： Forgotten Encrusted stent Outcome Predictor Clavien-Dindo complication

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Actuality and underlying mechanisms of systemic immuneinflammation index and geriatric nutritional risk index prognostic value in hepatocellular carcinoma

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World Journal of Gastrointestinal Surgery 2024年第2期16卷 260-265页

作者： Konstantin Y Tchilikidi department of Surgery with postgraduate Education Altai State Medical UniversityBarnaul 656031Russia

This editorial contains comments on the article“Correlation between preoperative systemic immune inflammation index,nutritional risk index,and prognosis of radical resection of liver cancer”in a recent issue of the World Journal of Gastrointestinal *** pointed out the actuality and importance of the article and focused primarily on the underlying mechanisms making the systemic immuneinflammation index(SII)and geriatric nutritional risk index(GNRI)prediction features *** are few publications on both SII and GNRI together in hepatocellular carcinoma(HCC)and patient prognosis after radical *** release cytokines,chemokines,and enzymes,degrade extracellular matrix,reduce cell adhesion,and create conditions for tumor cell *** promote the adhesion of tumor cells to endothelial cells,through physical *** results in the migration of tumor ***-angiogenic factors from platelets enhance tumor angiogenesis to meet tumor cell supply *** can form a protective film on the surface of tumor *** allows avoiding blood flow damage as well as immune system *** also induces the epithelial-mesenchymal transformation of tumor cells that is critical for *** SII is also associated with macro-and microvascular invasion and increased numbers of circulating tumor cells.A high GNRI was associated with significantly better progression-free and overall *** patients are a very special population that requires increased *** and GNRI have significant survival prediction value in both palliative treatment and radical surgery *** underlying mechanisms of their possible predictive properties lie in the field of essential cancer *** features provide tumor nutrition,growth,and distribution throughout the body,such as vascular *** the other hand,they are tied to the possibility of patients to resist tumor progression and development of complications in bot

关键词： Systemic immune-inflammation index Geriatric nutritional risk index Radical surgery Transarterial chemoembolization Hepatocellular carcinoma Prognosis

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Ex vivo liver resection and auto-transplantation and special systemic therapy in perihilar cholangiocarcinoma treatment

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World Journal of Gastrointestinal Surgery 2024年第3期16卷 635-640页

作者： Konstantin Y Tchilikidi department of Surgery with postgraduate Education Altai State Medical UniversityBarnaul 656031Russia

This editorial contains comments on the article“Systematic sequential therapy for ex vivo liver resection and autotransplantation:A case report and review of li-terature”in the recent issue of World Journal of Gastrointestinal *** points out the actuality and importance of the article and focuses primarily on the role and place of ex vivo liver resection and autotransplantation(ELRAT)and systemic therapy,underlying molecular mechanisms for targeted therapy in perihilar cho-langiocarcinoma(pCCA)*** is a tough malignancy with a high proportion of advanced disease at the time of *** only curative option is radical *** excision and reconstruction become extremely com-plicated and not always could be performed even in localized *** the other hand,ELRAT takes its place among surgical options for carefully selected pCCA *** advanced disease,systemic therapy becomes a viable option to prolong *** editorial describes current possibilities in chemotherapy and reveals underlying mechanisms and projections in targeted therapy with ki-nase inhibitors and immunotherapy in both palliative and adjuvant ***-broblast grow factor and fibroblast grow factor receptor,human epidermal grow-th factor receptor 2,isocitrate dehydrogenase,and protein kinase cAMP activated catalytic subunit alpha(PRKACA)and beta(PRKACB)pathways have been ac-tively investigated in CCA in last *** agents were introduced and approved by the Food and Drug *** all demonstrated mean-ingful activity in CCA patients with no global change in *** is why every successfully treated patient counts,especially those with advanced *** conclusion,pCCA is still hard to treat due to late diagnosis and extremely complicated surgical *** also brings some hope,but it could be performed in very carefully selected *** disease requires systemic anticancer treatment,which is supposed to be indivi

关键词： Perihilar cholangiocarcinoma Klatskin’tumor Ex vivo liver resection and autotransplantation Chemotherapy Immunotherapy Targeted therapy

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Digital psychiatry in low-and-middle-income countries:New developments and the way forward

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World Journal of Psychiatry 2024年第3期14卷 350-361页

作者： Subho Chakrabarti department of Psychiatry Postgraduate Institute of Medical Education and ResearchChandigarh 160012UTIndia

Low-and middle-income countries(LMICs)bear the greater share of the global mental health burden but are ill-equipped to deal with it because of severe resource constraints leading to a large treatment *** remote provision of mental health services by digital means can effectively augment conventional services in LMICs to reduce the treatment *** psychiatry in LMICs has always lagged behind high-income countries,but there have been encouraging developments in the last *** is increasing research on the efficacy of digital psychiatric ***,the evidence is not adequate to conclude that digital psychiatric interventions are invariably effective in LMICs.A striking development has been the rise in mobile and smartphone ownership in LMICs,which has driven the increasing use of mobile technologies to deliver mental health *** innovative use of mobile technologies has been to optimize task-shifting,which involves delivering mental healthcare services in community settings using non-specialist health *** evidence from LMICs shows that it is possible to use digital tools to train non-specialist workers effectively and ensure that the psychosocial interventions they deliver are *** these promising developments,many barriers such as service costs,underdeveloped infrastructure,lack of trained professionals,and significant disparities in access to digital services impede the progress of digital psychiatry in *** overcome these barriers,digital psychiatric services in LMICs should address contextual factors influencing the delivery of digital services,ensure collaboration between different stakeholders,and focus on reducing the digital divide.

关键词： Digital psychiatry Low-and middle-income countries Developments Mental health

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Unlocking new potential of clinical diagnosis with artificial intelligence:Finding new patterns of clinical and lab data

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World Journal of Diabetes 2024年第3期15卷 308-310页

作者： Pradeep Kumar Dabla department of Biochemistry Govind Ballabh Pant Institute of Postgraduate Medical Education and ResearchDelhi 110002India

Recent advancements in science and technology,coupled with the proliferation of data,have also urged laboratory medicine to integrate with the era of artificial intelligence(AI)and machine learning(ML).In the current practices of evidencebased medicine,the laboratory tests analysing disease patterns through the association rule mining(ARM)have emerged as a modern tool for the risk assessment and the disease stratification,with the potential to reduce cardiovascular disease(CVD)*** are the well recognised leading global cause of mortality with the higher fatality rates in the Indian population due to associated factors like hypertension,diabetes,and lifestyle ***-driven algorithms have offered deep insights in this field while addressing various challenges such as healthcare systems grappling with the physician *** medicine,well driven by the big data necessitates the integration of ML techniques and high-quality electronic health records to direct the meaningful *** technological advancements enhance the computational analyses for both research and clinical *** plays a pivotal role by uncovering meaningful relationships within databases,aiding in patient survival prediction and risk factor *** potential in laboratory medicine is vast and it must be cautiously integrated while considering potential ethical,legal,and privacy ***,an AI ethics framework is essential to guide its responsible *** AI algorithms with existing lab practices,promoting education among healthcare professionals,and fostering careful integration into clinical settings are imperative for harnessing the benefits of this transformative technology.

关键词： Laboratory medicine Artificial intelligence Machine learning Association rule mining Cardiovascular diseases

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Therapeutic cancer vaccines:advancements,challenges,and prospects

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Signal Transduction and Targeted Therapy 2024年第1期9卷 150-172页

作者： Ting Fan Mingna Zhang Jingxian Yang Zhounan Zhu Wanlu Cao Chunyan Dong department of Oncology East Hospital Affiliated to Tongji UniversityTongji University School of MedicineShanghaiChina postgraduate Training Base Shanghai East HospitalJinzhou Medical UniversityShanghai 200120China

With the development and regulatory approval of immune checkpoint inhibitors and adoptive cell therapies,cancer immunotherapy has undergone a profound transformation over the past ***,therapeutic cancer vaccines have shown promise by eliciting de novo T cell responses targeting tumor antigens,including tumor-associated antigens and tumor-specific *** objective was to amplify and diversify the intrinsic repertoire of tumor-specific T ***,the complete realization of these capabilities remains an ongoing ***,we provide an overview of the current landscape of cancer vaccines in this *** range of antigen selection,antigen delivery systems development the strategic nuances underlying effective antigen presentation have pioneered cancer vaccine ***,this review addresses the current status of clinical trials and discusses their strategies,focusing on tumor-specific immunogenicity and anti-tumor efficacy ***,current clinical attempts toward developing cancer vaccines have not yielded breakthrough clinical outcomes due to significant challenges,including tumor immune microenvironment suppression,optimal candidate identification,immune response evaluation,and vaccine manufacturing ***,the field is poised to overcome hurdles and improve patient outcomes in the future by acknowledging these clinical complexities and persistently striving to surmount inherent constraints.

关键词： breakthrough approval overcome

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Experimental and Numerical Investigation on the Aerodynamic Characteristics of High-Speed Pantographs with Supporting Beam Wind Deflectors

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Fluid Dynamics & Materials Processing 2024年第1期20卷 127-145页

作者： Shiyang Song Tongxin Han postgraduate department China Academy of Railway SciencesBeijing100081China Locomotive&Car Research Institute China Academy of Railway Sciences Corporation LimitedBeijing100081China

Aiming to mitigate the aerodynamic lift force imbalance between pantograph strips,which exacerbates wear and affects the current collection performance of the pantograph-catenary system,a study has been conducted to support the beam deflector optimization using a combination of experimental measurements and computational fluid dynamics(CFD)*** results demonstrate that the size,position,and installation orientation of the wind deflectors significantly influence the amount of force *** also indicate that the front strip deflectors should be installed downwards and the rear strip deflectors upwards,thereby forming a“π”***,the lift force compensation provided by the wind deflectors increases with the size of the *** wind compensation strategies,such as control circuits,are also discussed,putting emphasis on the pros and cons of various pantograph types and wind compensation approaches.

关键词： High-speed pantograph aerodynamic lift force supporting beam wind deflectors computational fluid dynamics(CFD)

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ChatGPT and exercise prescription:Human *** or human plus machine?

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Journal of Sport and Health Science 2024年第5期13卷 661-662页

作者： Timothy Gustavo Cavazzotto Diego Bessa Dantas Marcos Roberto Queiroga department of Physical Education Midwestern Parana State UniversityParana 85040-167Brazil postgraduate Program in Physical Education UEM-UEL State University of LondrinaParana 86057-970Brazil

The power of artificial intelligence(AI)to create stories,music,art,and other creative projects has been demonstrated and criticized over recent decades in media,mainly because of the idea that AI will replace human *** recently,in November 2022,reactions to Chat Generative Pre-training Transformer(ChatGPT)release for public use reverberated in news and social media headlines,while its users exceeded100 million in just a few *** is a natural language processing program created by AI non-profit OpenAI Inc.

关键词： prescription replace Human

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