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A Multipathogen Bile Sample-based PCR Assay Can Guide Empirical Antimicrobial Strategies in Cholestatic Liver Diseases

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Journal of Clinical and Translational Hepatology 2022年第5期10卷 788-795页

作者： Michael Jahn Mustafa KÖzçürümez Sebastian Dolff Hana Rohn Dominik Heider Alexander Dechêne Ali Canbay Peter M.Rath Antonios Katsounas Department of Nephrology University Hospital EssenUniversity of Duisburg-EssenEssenGermany Department of Medicine Universitätsklinikum Knappschaftskrankenhaus BochumRuhr-University BochumBochumGermany Department of Infectious Diseases University Hospital EssenUniversity of Duisburg-EssenEssenGermany Department of Mathematics and Computer Science University of MarburgMarburgGermany Department for Internal Medicine Nuremberg Hospital NorthParacelsus Private Medical University NurembergNurembergGermany Institute of Medical Microbiology University Hospital EssenUniversity of Duisburg-EssenEssenGermany

Background and objectives:Polymerase chain reaction(PCR)techniques provide rapid detection of *** pilot study evaluated the diagnostic utility and clinical impact of multiplex real-time PCR(mRT-PCR,SeptiFast)*** microbial culture(CMC)in bile samples of patients with chronic cholestatic liver diseases(cCLDs),endoscopic retrograde cholangio-pancreatography(ERCP),and peri-interventional-antimicrobial-prophylaxis(pAP).Methods:We prospectively collected bile samples from 26 patients for microbiological analysis by CMC and *** of the results of both methods was determined by Krippendorff's alpha(α)for inter-rater reliability and the Jaccard index of ***:mRT-PCR_(bile)and CMC_(bile)results were concordant for only Candida albicans(α=0.8406;Jaccard index=0.8181).mRT-PCR_(bile)detected pathogens in 8/8 cases(100%),CMC_(bile)in 7/8(87.5%),and CMCblood in 5/8(62.5%)with clinical signs of ***_(bile),CMC_(bile),and CMCblood had identical detection results in 3/8(37.5%)with clinical signs of infection(two Klebsiella *** one Enterococcus faecium).The total pathogen count was significantly higher with mRT-PCR_(bile)than with CMC_(bile)(62 vs.31;χ^(2)=30.031,p<0.001).However,pathogens detected by mRT-PCR_(bile)were more often susceptible to pAP according to the patient infection/colonization history(PI/CH)and surveillance data for antibiotic resistance in our clinic(DARC).Pathogens identified by mRT-PC_(Rbile)and resistant to pAP by PI/CH and DARC were likely to be clinically ***:mRT-PCR in conjunction with CMCs for bile analysis increased diagnostic sensitivity and may benefit infection management in patients with cholestatic *** of mRT-PCR in a bile sample-based diagnostic routine can support more rapid and targeted use of antimicrobial agents in cCLD-patients undergoing ERCP and reduce the rate/length of unnecessary administration of broad-spectrum antibiotics.

关键词： ERCP PCR Antibiotic prophylaxis Cholestasis Cholangitis

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Comparative Study between the Elastic Nail versus Hip Spica Cast in Early Treatment of Pediatric Femoral Shaft Fractures

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Open Journal of Orthopedics 2016年第9期6卷 259-267页

作者： Rebar M. Noori Khaffaf Abbas Hasan Altaweel Department of Orthopedic Sulaimani School of Medicine KRG Iraq Al Kafeel private hospital Kerbala Iraq

Introduction: Femoral shaft fractures are among the most common pediatric injury, which have the highest incidence among other pediatric fractures, and treatment of them carries a lot of controversies. Aim of the study: To compare the outcome of fixation of femoral shaft fracture by elastic nail with Spica cast. Patient and method: This prospective comparative study was carried out in Sulaimani Teaching hospital, in the period from the 10th of December 2011 to the 10th of June 2012, for two groups of children whose ages were between 4 - 12 years (average 6.61 years), sustained traumatic femoral shaft fractures with follow-up period of about 6 months. The first group was consisting of 30 children treated by Elastic Intramedullary Nail, while the second group was consisted of 30 children treated by hip Spica. The selection was made on random bases. Results: Age range was between 4 - 12 years and showed male predominance in both groups with ratio of about 2:1 while fracture site showed predominance of the midshaft pattern in both groups. This study showed highly significant deference (P value of 0.001) between the two groups (Spica group of 3 days versus Nail group median of rate 4.5 days) in the admission period. Our sample showed shortening of about 2 cm in 2 case in the Nail group (6.7%) versus 6 cases (20%) in Spica group. We reported 4 cases of wound infection (13.3%) and 4 cases of pin site irritation (13.3%) in nail group. A higher rate of malunion was observed in the Spica group (10 cases more than 10° angulation in coronal plane) while the Nail group reported 2 case more than 10° in coronal plane. The mean operative time for Nail group was 55 minutes while in Spica group was 30 minutes. We reported shorter time to start mobilization and walking with support or independently in the nail group (weight bearing time 7.2 weeks) compared with the Spica casting group (weight bearing time 7.5 weeks). Conclusion: Elastic nail fixation yields bette

关键词： Femoral Shaft Fractures Elastic Nails Hip Spica

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Macrosomia in non-gestational diabetes pregnancy:glucose tolerance test characteristics and feto-maternal complications in tropical Asia Pacific Australia

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Asian Pacific Journal of Tropical Biomedicine 2014年第6期4卷 436-440页

作者： Algenes Aranha Usman H Malabu Venkat Vangaveti Elham Saleh Reda Yong Mong Tan Kunwarjit Singh Sangla Mater private hospital Townsville hospital Department of Diabetes & Endocrinology100 Angus Smith DriveTownsvilleQueenslandAustralia 4814 School of Medicine & Dentistry.James Cook University School of Medicine1 James Cook Drive TownsvilleQueenslandAustralia 4811 Gold Coast hospital Diabetes & Endocrinology 1 Hospital BoulevardSouthportGold CoastQueenslandAustralia 4215

Objective:To look into the glucose tolerance test characteristics and determine complications in non-gestational diabetes pregnant ***:From 2006 to 2009 all non-gestational diabetes mellitus(non-CDM)pregnant women who delivered macrosomia at the North Australia's Townsville hospital were retrospectively reviewed by extracting data from clinical *** tolerance tests results were analysed in the light of an earlier diagnosis of ***:Ninety-one non-CDM mothers with macrosomia were studied and compared with 41normoglycemic subjects without *** the subjects with non-GDM macrosomia,45(49.4%)had normal SO g glucose challenge test(GCT)without further testing,another 8(8.8%)had abnormal GCT but normal 75 g oral glucose tolerance test(OGTT).A total of 4(4.4%)subjects had normal GCT and ***.14 out of 16(87.5%)subjects who were tested with OGTT owing to past history of macrosomia had normal results but delivered macrosomic *** 12 subjects had both GCT and OGTT,the rest of the cohort had either of the two *** with non-CDM macrosomia had higher frequency of neonatal hypoglycaemia 34%as compared to 10%in nonmacrosomic babies(P=0.003).Other feto-maternal complications were similar in both ***:No significant pattern of glucose tolerance characteristics was identified in nonGDM mothers with macrosomic *** spite of being normoglycemic significant neonatal hypoglycaemia was recorded in non-GDM macrosomic *** prospective studies on a larger population are needed to verify our findings.

关键词： Non-gestational diabetes Macrosomia Glucose tolerance test characteristics Pregnancy

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Nasal flap preservation in endoscopic dacryocystorhinostomy for nasolacrimal duct obstruction

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International Journal of Ophthalmology(English edition) 2024年第9期17卷 1633-1638页

作者： Marianne Romanos Charbel Medawar Souheil Hallit Bassam Romanos School of Medicine and Medical Sciences Holy Spirit University of KaslikP.O.Box 446JouniehLebanon Department of Ophtalmology Eye and Ear Hospital InternationalNaccacheLebanon Applied Science Research Center Applied Science Private UniversityAmman 11937Jordan

AIM:To compare surgical outcomes between the conventional endoscopic dacryocystorhinostomy(DCR)and a modified endoscopic DCR for the treatment of nasolacrimal duct obstruction(NLDO),and evaluate factors associated with the surgical success ***:Medical records of patients who underwent primary DCR surgery between January 2016 and July 2020 at the Otorhinolaryngology Department of Eye and Ear International hospital,Lebanon were ***:The study group consisted of 50 consecutive modified endoscopic DCR and the control group consisted of 138 consecutive conventional endoscopic *** success rates at 1y were 98.0%(49 out of 50)for modified DCR,significantly higher compared to 84.8%(117/138)for the conventional DCR;there was no significant difference in the success rate throughout the years in terms of both surgical *** modified surgery vs traditional[adjusted odds ratio(aOR)=14.96]and having an adjunctive septoplasty surgery vs not(aOR=3.99)were significantly associated with higher odds of ***:Mucosal flap preservation and apposition shows significant improvement in the surgical success ***,there is no statistically significant difference found in terms of complication rate and mean operative time between the conventional and the modified techniques.

关键词： nasolacrimal duct obstruction endoscopic dacryocystorhinostomy mucosal flap

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Applications of phototheranostic nanoagents in photodynamic therapy

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Nano Research 2015年第5期8卷 1373-1394页

作者： Jayeeta Bhaumik Amit Kumar Mittal Avik Banedee Yusuf Chisti Uttam Chand Banerjee Department of Pharmaceutical Technology (Biotechnology) National Institute of Pharmaceutical Education and Research Sector 67 S.A.S. Nagar 160062 India Department of Radiology Dayanand Medical College and Hospital Ludhiana 141001 India School of Engineering Massey University Private Bag 11 222 Palmerston North New Zealand

Nanotherapeutics has an increasing role in the treatment of diseases such as cancer. In photodynamic therapy （PDT） a therapeutically inactive photosensitizer compound is selectively activated by light to produce molecules capable of killing diseased cells and pathogens. A phototheranostic agent can be defined as a single nanoentity with the capabilities for targeted delivery, optical imaging and photodynamic treatment of a disease. Malignant cells, tissue and microbial etiologic agents can be effectively targeted by PDT. Photodynamic therapy is noninvasive, or minimally invasive, and has few side effects as damage to healthy tissue is minimized and the killing effect is localized. Various forms of cancer, acne and other diseases may be treated. The in vivo efficacy of photosensitizers is further improved by attaching them to nanostructures capable of targeting the diseased site. Such photosensitizer-functionalized nanostructures, or nano- therapeutics, allow site-specific delivery of imaging and therapeutic agents for improved phototheranostic performance. This review explores the potential applications of phototheranostic nanostructures in diagnosis and therapy.

关键词： phototheranostics photodynamic therapy photosensitizers theranostics nanomedicine

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New flexible endoscopic controlled stapler technique for the treatment of Zenker's diverticulum:A case series

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World Journal of Gastroenterology 2017年第17期23卷 3084-3091页

作者： Johanna Wilmsen Robert Baumbach Dietmar Stüker Vincens Weingart Frank Neser Stefan Karl Golder Christof Pfundstein Ellen Claudia Notzel Thomas Rosch Siegbert Faiss Department of Gastroenterology and Interventional Endoscopy Asklepios Hospital BarmbekSemmelweis UniversityMedical Faculty Department of Interdisciplinary Endoscopy University Medical Center Tübingen Department of Internal Medicine Garmisch-Partenkirchen Medical Center Department of Internal Medicine II Hospital Chemnitz Department of Internal Medicine III private Practice for Internal Medicine and Gastroenterology Department of Internal Medicine and Gastroenterology Sana Hospital Lichtenberg Department of Interdisciplinary Endoscopy University Medical Center Hamburg-Eppendorf

AIMTo report about the combination and advantages of a stapler-assisted diverticulotomy performed by flexible *** November 2014 till December 2015 17 patients (8 female, 9 male, average age 69.8 years) with a symptomatic Zenker diverticulum (mean size 3.5 cm) were treated by inserting a new 5 mm fully rotatable surgical stapler (MicroCutter30 Xchange, Cardica Inc.) next to an ultrathin flexible endoscope through an overtube. The Patients were under conscious sedation with the head reclined in left position, the stapler placed centrally and pushed forward to the bottom of the diverticulum. The septum was divided by the staple rows under flexible endoscopic *** eleven patients (64.7%) the stapler successfully divided the septum completely. Mean procedure time was 21 min, medium size of the septum was 2.8 cm (range 1.5 cm to 4 cm). In four patients the septum was shorter than 3 cm, in seven longer than 3 cm. To divide the septum, averagely 1.3 stapler cartridges were used. Two minor bleedings occurred. Major adverse events like perforation or secondary haemorrhage did not occur. After an average time of two days patients were discharged from the hospital. In 6 patients (35.3%) the stapler failed due to a thick septum or insufficient reclination of the head. Follow up endoscopy was performed after an average of two months in 9 patients; 4 patients (44.4%) were free of symptoms, 5 patients (55.6%) stated an improvement. A relapse of symptoms did not *** endoscopic Zenker diverticulotomy by using a surgical stapler is a new, safe and efficient treatment modality. A simultaneously tissue opening and occlusion prevents major complications.

关键词： Zenker’s diverticulum Flexible endoscopic treatment Stapler technique Overtube Surgical stapler

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Serum Gelsolin Levels in PCOS-Related Androgenetic Alopecia

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International Journal of Clinical Medicine 2023年第9期14卷 383-388页

作者： Sule Gencoglu Zercan Kali Fatma Tanilir Cagiran Department of Dermatology Private G&#246zde Akademi Hospital Malatya Türkiye Department of Obstetrics and Gynecology Gozde Academy Hospital Malatya Türkiye Department of Obstetrics and Gynecology Private Clinic Diyarbak&#305r Türkiye

Aim: To compare serum gelsolin levels of women with androgenetic alopecia with PCOS and patients with non-PCOS alopecia. Materials and Methods: A total of 30 PCOS patients who applied to our dermatology clinic with the complaint of hair loss and were diagnosed with androgenetic alopecia (AGA) were included in the study. Thirty patients who were not diagnosed with PCOS but were diagnosed with AGA were considered as the control group. Patients in the control group were matched with PCOS in terms of age. AGA was diagnosed in cases of widespread thinning of the hair on the scalp and preservation of the frontal hairline. All participants underwent a complete clinical examination and blood examination. Serum gelsolin levels of both groups were measured by ELISA. Results: The number, age, and BMI values of the participants in both groups were recorded as similar. Serum total testosterone, insulin, HOMA-IR and LH values were significantly higher in the PCOS with AGA compared to the AGA without PCOS. There is no significant difference between groups in terms of serum FSH levels. Serum gelsolin levels of the PCOS group were significantly lower than the control group (160.1 ± 34.2 ng/mL vs. 188.6 ± 46.7 ng/mL, p Conclusions: Serum gelsolin levels in PCOS patients with androgenetic alopecia were found to be significantly lower than in non-PCOS alopecia patient groups.

关键词： Androgenenetic Alopecia PKOS Gelsolin Inflammation

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Management of cerebral amyloid angiopathy and atrial fibrillation:We are still far from precision medicine

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World Journal of Cardiology 2024年第5期16卷 231-239页

作者： Liuba Fusco Zefferino Palamà Antonio Scarà Alessio Borrelli Antonio Gianluca Robles Gabriele De Masi DeLuca Silvio Romano Luigi Sciarra Department of Cardiology University Hospital of NorthamptonshireNorthampton NN15BDUnited Kingdom Department of Cardiology Casa di Cura Villa VerdeTaranto 70124Italy Department of Life Health and Environmental SciencesUniversity of l'AquilaL'Aquila 67100Italy Department of Cardiology GVM Care and ResearchSan Carlo di Nancy HospitalRome 00100Italy

The use of anticoagulation therapy could prove to be controversial when trying to balance ischemic stroke and intracranial bleeding risks in patients with concurrent cerebral amyloid angiopathy(CAA)and atrial fibrillation(AF).In fact,CAA is an age-related cerebral vasculopathy that predisposes patients to intracerebral ***,many AF patients require oral systemic dose-adjusted warfarin,direct oral anticoagulants(such as factor Xa inhibitors)or direct thrombin inhibitors to control often associated with cardioembolic stroke *** prevalence of both CAA and AF is expected to rise,due to the aging of the *** clinical dilemma is becoming increasingly *** patients with coexisting AF and CAA,the risks/benefits profile of anticoagulant therapy must be assessed for each patient individually due to the lack of a clear-cut consensus with regard to its risks in scientific *** review aims to provide an overview of the management of patients with concomitant AF and CAA and proposes the implementation of a risk-based decision-making algorithm.

关键词： Anticoagulation Atrial fibrillation Cerebral amyloid angiopathy Intracerebral hemorrhage Stroke Watchman Secondary prevention Left atrial appendage closure

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Efficacy of rituximab in gastric diffuse large B cell lymphoma patients

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World Journal of Gastroenterology 2010年第20期16卷 2526-2530页

作者： Davide Leopardo Giuseppe Di Lorenzo Amalia De Renzo Piera Federico Serena Luponio Carlo Buonerba Elide Matano Gerardina Merola Martina Imbimbo Enzo Montesarchio Antonio Rea Maria Carmela Merola Sabino De Placido Giovannella Palmieri Department of Endocrinology and Clinical Oncology University Federico II80131NaplesItaly Department of Hematology University Federico II80131NaplesItaly Oncology Clinical Division Hospital"D.Cotugno"80131NaplesItaly Oncology Clinical Division Clinica Villa Maria83036Mirabella EclanoItaly Department of Endocrinology and Clinical Oncology University Fed-erico II80131NaplesItaly

AIM:To evaluate retrospectively the efficacy of rituximab plus chemotherapy in gastric diffuse large B cell lymphoma(DLBCL).METHODS:Sixty patients(median age:58 years)with histologically confirmed gastric DLBCL treated at four Italian institutions between 2000 and 2007,were included in this *** were selected by stage (Ⅰ-Ⅳ,Lugano staging system),European Cooperative Oncology Group performance status(0-2)and treatment *** strategies were chemotherapy alone(group A,n=30)[scheduled as cyclophosphamide,doxorubicin,vincristine and prednisone (CHOP)and CHOP-like],and chemotherapy combined with rituximab(group B,n=30).The primary end point of the study was complete response(CR)rate;the secondary end points were disease-free survival (DFS)at 5 years and overall survival(OS).RESULTS:Median follow-up was 62 mo(range:31102 mo).We observed a significant difference between the two groups(A vs B)in terms of CR[76.6%(23/30) vs 100%,P=0.04)and DFS at 5 years[73.3%(22/30) vs 100%,P=0.03).To date,19 group A(63.3%) patients are alive and 11 have died,while all group B patients are *** significant differences in toxicity were observed between the two ***:Rituximab in combination with chemotherapy improves CR rate,DFS and *** prospective trials are needed to confirm our results.

关键词： Rituximab Diffuse large B cell lymphoma Stomach neoplasms Chemotherapy

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Specific Immunotherapy in Advanced Cervical-Uterine Cancer Using Humanized Monoclonal Antibody Nimotuzumab and CIMAvax-EGF<sup>®</sup>Therapeutic Vaccine

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Journal of Cancer Therapy 2021年第3期12卷 146-156页

作者： Raiza Ruiz-Lorente Sayly Alfonso Eduardo Santiesteban Yamilka Sánchez Kirenia Camacho Erasmo Mendoza Carmen Elena Viada Ramón Ortiz Ihosvannys Carreño Mayelin Troche Meylan Cepeda Ana Rosa Vals Leticia Cabrera Annia Gorte Delmis Batista Milagros Domenech Yanela Santiesteban Yuliannis Santiesteban Daymys Estevez Jessica García-Viamontes Conrado Ramos Mico Mayra Ramos-Suzarte González Coro hospital La Habana Cuba Celestino Hernández Robau hospital Villa Clara Cuba Jose Ramón Lopez Tabranes hospital Matanzas Cuba III Congreso hospital Pinar del Río Cuba Faustino Perez hospital Matanzas Cuba Center of Molecular Immunology Havana Cuba

Cervical uterine cancer represents the fourth most common malignant neoplasm worldwide in the female sex in terms of incidence, principally from epithelial origen. The high expression of EGFR in this tumor leads to the search for therapeutic alternatives. An Expanded Access Clinical Program was carried out in parallel groups, randomized, multicenter and prospective study, to evaluate the survival of patients with advanced cervical carcinoma, without therapeutic alternative, who would be treated with the therapeutic vaccine CIMAvax-EGF®, the humanized mAb nimotuzumab or the combination of both products, which targeted EGF and EGFR respectively. The patients were included between 2008 and 2010 with a more than five years follow-up. The results show that the serious adverse events related to the experimental treatments were 0.9%;1.1% and 2.6% and a medi

关键词： CIMAvax-EGF® Nimotuzumab Survival Safety Advanced Cervical Cancer

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