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Safeguarding children through pediatric surgical care in war and humanitarian settings: a call to action for pediatric patients in Gaza

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World Journal of Pediatric Surgery 2024年第1期7卷 59-65页

作者： Abirami Muthumani UCSF Center for Health Equity in Surgery and anesthesia Universityof California San FranciscoSan FranciscoCaliforniaUSA department of General Surgery Columbia University Irving Medical CenterNewYorkNew YorkUSA

INTRODUCTION Pediatric surgical interventions may represent more than one-third of the surgical caseload in humanitarian settings.1 The humanitarian crisis in Gaza has taken a devastating toll on children,many of whom have suffered injuries due to indiscriminate and heavy bombardment,resulting in severe polytraumatic injuries necessitating immediate and specialized pediatric surgical *** conflict has strained the region's fragile healthcare system,resulting in a significant number of casualties,a substantial proportion of which are *** exacerbates the demand for specialized pediatric surgical care,especially when the existing healthcare system and infrastructure has nearly collapsed and is under-resourced to handle the influx of pediatric patients.2 The urgency for specialized pediatric surgical care and support for children in Gaza cannot be *** to healthcare in Palestine has been an ongoing challenge.

关键词： pediatric injuries surgical

Opinions of Students on the Contribution of the DIVA 3D Virtual Dissection Table to the Teaching of Anatomy at the Faculty of Medicine and Odontostomatology of Bamako

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Forensic Medicine and Anatomy Research 2024年第2期12卷 13-25页

作者： Abdoulaye Kanté Tata Touré Ousmane Toumany Chérif Haidara Uhl Jean François Mariam Daou Mamadou A. Keita Bakary Keïta Bréhima Bengaly Drissa Traoré Adégné Togo Nouhoum Ongoïba Faculty of Medicine and Odontostomatology of Bamako Bamako Mali University of Paris Descartes Paris France department of Neurology The Gabriel Tour&#233 University Hospital Bamako Mali department of General Surgery The Kati Health Center Bamako Mali anesthesia-resuscitation Service Commune I Reference Health Center Bamako Bamako Mali department of General Surgery The Gabriel Tour&#233 University Hospital Bamako Mali

Objective: Study the contribution of the DIVA 3D dissection table in the teaching of anatomy at the Faculty of Medicine and Odontology of Bamako. Material and Methods: This was a qualitative study carried out from November 1 to December 30, 2023 at the clinical and morphological anatomy laboratory of the Faculty of Medicine and Odontostomatology of Bamako. Included in this study were students who participated in practical and tutorial sessions. The variables studied during this study were: the previous performance of dissection on a cadaver by the students, the opinion of the students on dissection on a cadaver, the replacement of dissection on a cadaver by virtual dissection in the absence of a body, the level student satisfaction. Results: We surveyed 130 participants. The average age was 22 ± 0.2 years with extremes of 17 and 29 years. 95.3% of participants were students. According to 66.7% of participants, virtual dissection is a good palliative in the absence of a corpse. 95.3% of participants found using the virtual dissection table easy with an average of 7.88 ± 1.4. The overall assessment was well rated by 99.3% of participants. Conclusion: According to the results of this study, the virtual dissection table should be improved by integrating commented videos. The use of the DIVA 3D virtual dissection table during practical and tutorial sessions is well appreciated by the students. We believe that the teaching of anatomy using 3D digital technology should be included in the study programs of the Faculty of Medicine and Odontostomatology.

关键词： Student Opinion Contribution DIVA 3D Virtual Dissection Table Anatomy Teaching FMOS

A Retrospective Analysis of Intoxicated Patients Admitted to the Intensive Care Unit: A Single-Institution Assessment in the Post-Pandemic Period

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Journal of Biosciences and Medicines 2024年第3期12卷 159-167页

作者： Müge Arikan Abdullah Yeşilkaya Büşra Nur Taşdelen İbrahim Özyiğit department of anesthesia and Intensive Care Faculty of Medicine Karabuk University Karabuk Turkey

Background: The aim of this study was to evaluate the clinical and epidemiological characteristics of patients with acute intoxication admitted to the Intensive Care Unit (ICU). Material and Methods: An observational retrospective study was conducted on intoxicated patients who admitted to ICU between January 2022 and January 2024. Data were collected from the patients medical records. The demographic characteristics, causes of intoxications, clinical parameters, the mean stay in the ICU, treatment modalities and prognosis were recorded. Results: A total of 2875 critically ill patients were admitted during the study period, and 109 (3.79%) of them were acute intoxications. Their mean of ages was 38.09 ± 12.29. The female-to-male ratio was 1.37/1. Drugs were found to be the primary cause (62.39%) of intoxications, and analgesics, antidepressants, and antibiotics were the most frequent agents. Suicidal attempts were present in 66 patients, most of them were female (62.13%) and between 17 - 24 years (40.91%). The other common causes of intoxications were carbon monoxide (CO) (22.02%), methyl/ethyl alcohol (8.26%) and mushroom (5.50%). The mean stay in the ICU was 2.69 ± 0.89 days. Mechanical ventilation was applied to 10 of our patients. Renal replacement therapy was required in 6 patients. Despite all treatments, 6 of our patients died, and we found the mortality rate to be 5.50%. Conclusion: Intoxications were more frequent in young female patients and drugs were the most common cause with suicidal intent. Unfortunately, CO poisoning continues to be a very important problem in our city. These findings provided significant information about the characteristics of intoxications in Karabuk.

关键词： Intoxication Intensive Care Unit Suicidal Mortality

Hypoxia in the pulmonary vein increases pulmonary vascular resistance independently of oxygen in the pulmonary artery

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Animal Models and Experimental Medicine 2024年第2期7卷 156-165页

作者： Sigridur Olga Magnusdottir Carsten Simonsen Dan Stieper Karbing Bodil Steen Rasmussen Benedict Kjaergaard Biomedical Research Laboratory Aalborg University HospitalAalborgDenmark department of Clinical Medicine Aalborg UniversityAalborgDenmark department of Cardiothoracic Surgery Aalborg University HospitalAalborgDenmark department of Health Science and Technology Aalborg UniversityAalborgDenmark department of anesthesia and Intensive Care Aalborg University HospitalAalborgDenmark

Introduction:Hypoxic pulmonary vasoconstriction(HPV)can be a challenging clinical *** is not fully elucidated where in the circulation the regulation of resistance takes *** is often referred to as if it is in the arteries,but we hypothesized that it is in the venous side of the pulmonary ***:In an open thorax model,pigs were treated with a veno-venous extra corporeal membrane oxygenator to either oxygenate or deoxygenate blood passing through the pulmonary *** the same time the lungs were ventilated with extreme variations of inspired air from 5%to 100%oxygen,making it possible to make combinations of high and low oxygen content through the pulmonary circulation.A flow probe was inserted around the main pulmonary artery and catheters in the pulmonary artery and in the left atrium were used for pressure monitoring and blood *** different combinations of oxygenation,pulmonary vascular resistance(PVR)was ***:With unchanged level of oxygen in the pulmonary artery and reduced inspired oxygen fraction lowering oxygen tension from 29 to 6.7 kPa in the pulmonary vein,PVR was *** more extreme hypoxia PVR suddenly *** with low oxygenation in the pulmonary artery did not systematic influence PVR if there was enough oxygen in the inspired air and in the pulmonary ***:The impact of hypoxia occurs from the alveolar level and forward with the blood *** experiments indicated that the regulation of PVR is mediated from the venous side.

关键词： animal models cardiopulmonary support Hypoxic pulmonary vasoconstriction pulmonary circulation

TREM-1 mediates interaction between substantia nigra microglia and peripheral neutrophils

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Neural Regeneration Research 2024年第6期19卷 1375-1384页

作者： Tong Shen Guiyun Cui Hao Chen Long Huang Wei Song Jie Zu Wei Zhang Chuanying Xu Liguo Dong Yongmei Zhang Jiangsu Province Key Laboratory of Anesthesiology Xuzhou Medical University Jiangsu Province Key Laboratory of anesthesia and Analgesia Application Technology Xuzhou Medical University NMPA Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs department of Neurology The Affiliated Hospital of Xuzhou Medical University

Microglia-mediated neuroinflammation is considered a pathological feature of Parkinson’s disease. Triggering receptor expressed on myeloid cell-1(TREM-1) can amplify the inherent immune response, and crucially, regulate inflammation. In this study, we found marked elevation of serum soluble TREM-1 in patients with Parkinson’s disease that positively correlated with Parkinson’s disease severity and dyskinesia. In a mouse model of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine-induced Parkinson’s disease, we found that microglial TREM-1 expression also increased in the substantia nigra. Further, TREM-1 knockout alleviated dyskinesia in a mouse model of Parkinson’s disease and reduced dopaminergic neuronal injury. Meanwhile, TREM-1 knockout attenuated the neuroinflammatory response, dopaminergic neuronal injury, and neutrophil migration. Next, we established an in vitro 1-methyl-4-phenyl-pyridine-induced BV2 microglia model of Parkinson’s disease and treated the cells with the TREM-1 inhibitory peptide LP17. We found that LP17 treatment reduced apoptosis of dopaminergic neurons and neutrophil migration. Moreover, inhibition of neutrophil TREM-1 activation diminished dopaminergic neuronal apoptosis induced by lipopolysaccharide. TREM-1 can activate the downstream CARD9/NF-κB proinflammatory pathway via interaction with SYK. These findings suggest that TREM-1 may play a key role in mediating the damage to dopaminergic neurons in Parkinson’s disease by regulating the interaction between microglia and peripheral neutrophils.

关键词： 1-methyl-4-phenylpyridiniumion dopaminergic neurons infiltration 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine microglia neutrophils neuroinflammation Parkinson's disease SYK TREM-1

Correction method for moderate and severe degrees of hallux valgus associated with transfer metatarsalgia

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World Journal of Orthopedics 2024年第3期15卷 238-246页

作者： Amangasy Zhanaspayev Nurlan Bokembayev Marat Zhanaspayev Aidos Tlemissov Sabina Aubakirova Alexander Prokazyuk department of Traumatology and Orthopaedics The National Scientific Center of Traumatology and Orthopaedics Named after Academician Batpenov NDAstana 010000Kazakhstan department of Traumatology and Paediatric Surgery Non-Commercial Joint-Stock Company“Semey Medical University”Semey 071400Kazakhstan department of Habilitation and Rehabilitation Center of Habilitation and Rehabilitation of Persons with Disabilities of the Abai RegionSemey 071400Kazakhstan department of Anaesthesiology and resuscitation Center of Nuclear Medicine and OncologySemey 071400Kazakhstan

BACKGROUND Hallux valgus(HV)is a common foot deformity that manifests with increasing age,especially in *** associated foot pain causes impaired gait and decreases quality of *** and severe HV is a deformity that is charac-terized by the involvement of lesser rays and requires complex surgical *** this study,we attempted to develop a procedure for this *** To analyse the treatment results of patients who underwent simultaneous surgical correction of all parts of a static forefoot *** We conducted a prospective clinical trial between 2016 and 2021 in which 30 feet with moderate or severe HV associated with Tailor’s bunion and metatarsalgia were surgically treated via a new method involving surgical correction of all associated *** method included a modified Lapidus procedure,M2M3 tarsometatarsal arthrodesis,intermetatarsal fusion of the M4 and M5 bases,and the use of an original external fixation apparatus to enhance correction ***,postoperative,and final follow-up radiographic data and American Orthopaedic Foot and Ankle Society(AOFAS)scores were compared,and P values<0.05 were considered to indicate statistical *** The study included 28 females(93.3%)and 2 males feet(6.7%),20(66.7%)of whom had a moderate degree of HV and 10(33.3%)of whom had severe deformity.M2 and M3 metatarsalgia was observed in 21 feet,and 9 feet experienced pain only at *** mean follow-up duration was 11 *** patients had good correction of the HV angle[preoperative median,36.5 degrees,interquartile range(IQR):30-45;postoperative median,10 degrees,IQR:8.8-10;follow-up median,11.5 degrees,IQR:10-14;P<0.01].At follow-up,metatarsalgia was resolved in most patients(30 vs 5).There was a clinically negligible decrease in the corrected angles at the final follow-up,and the overall AOFAS score was significantly better(median,65 points,IQR:53.8-70;vs 80 points,IQR:75-85;P<0.01).CONCLUSION The developed me

关键词： Hallux valgus Metatarsalgia Tailor’s bunion Lapidus procedure Proximal metatarsal osteotomy Splayfoot

Usefulness of the Surgical Apgar Score to Predict the Occurrence of Major Complications in the Early Post-Operative Period of Major Surgeries: Experience of Two Second-Category Hospitals in Cameroon

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Open Journal of Anesthesiology 2024年第3期14卷 51-65页

作者： Charles Emmanuel Toussaint Binam Bikoi Francis Ateba Ndongo Serge Vivier Nga Nomo Édouard Léa Mekoui Ze Fidèle Binam department of anesthesia and Intensive Care University of Ebolowa Ebolowa Cameroon Yaounde Mother and Child Center Chantal Biya Foundation University of Garoua Garoua Cameroon department of anesthesia and Intensive Care Catholic University of Central Africa Yaounde Cameroon

Objective: The Surgical Apgar Score (SAS) is a tool for intraoperative stratification of the risk of serious complications in the early postoperative period. It varies from 0 to 10 points divided into three risk categories (0 to 4 high, 5 to 7 moderate, 8 to 10 low). The aim of the study was to evaluate its relevance in predicting the appearance of these complications. Material and methods: This descriptive and analytical study was carried out at the “Laquintinie” Hospital in Douala and at the Central Hospital in Yaounde, Cameroon. The main data were collected on a population of patients over 18 years old and recorded on a survey form. They consisted of variables of main interest and exposure variables. Univariate and multivariate statistical analysis using top-down logistic regression models made it possible to evaluate the association of each variable of main interest and each exposure variable. The association was significant at P Results: Of the 88 patients studied, the SAS was 3 hours. In multivariate, this link persisted only and strongly for the SAS OR (IC) 0.1 (0.1 - 0.2) and p = 000. Conclusion: The study found a specific and powerful link between the SAS score < 4 and the occurrence of complications in the early postoperative period, in favor of its relevance in predicting them.

关键词： Early Postoperative Complications Major Surgeries Surgical Apgar Score

Compartmentalization of the inflammatory response during bacterial sepsis and severe COVID-19

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Journal of Intensive Medicine 2024年第3期4卷 326-340页

作者： Jean-Marc Cavaillon Benjamin G.Chousterman Tomasz Skirecki Institut Pasteur ParisFrance department of anesthesia and Critical Care Lariboisière University HospitalDMU ParabolAPHP NordParisFrance Inserm U942 University of ParisParisFrance department of Translational Immunology and Experimental Intensive Care Centre of Postgraduate Medical EducationWarsawPoland

Acute infections cause local and systemic disorders which can lead in the most severe forms to multi-organ failure and eventually to death. The host response to infection encompasses a large spectrum of reactions with a concomitant activation of the so-called inflammatory response aimed at fighting the infectious agent and removing damaged tissues or cells, and the anti-inflammatory response aimed at controlling inflammation and initiating the healing process. Fine-tuning at the local and systemic levels is key to preventing local and remote injury due to immune system activation. Thus, during bacterial sepsis and Coronavirus disease 2019 (COVID-19), concomitant systemic and compartmentalized pro-inflammatory and compensatory anti-inflammatory responses are occurring. Immune cells (e.g., macrophages, neutrophils, natural killer cells, and T-lymphocytes), as well as endothelial cells, differ from one compartment to another and contribute to specific organ responses to sterile and microbial insult. Furthermore, tissue-specific microbiota influences the local and systemic response. A better understanding of the tissue-specific immune status, the organ immunity crosstalk, and the role of specific mediators during sepsis and COVID-19 can foster the development of more accurate biomarkers for better diagnosis and prognosis and help to define appropriate host-targeted treatments and vaccines in the context of precision medicine.

关键词： Acute respiratory distress syndrome Bone marrow Cytokines Lungs Mucosa Vaccines

In-Hospital Outcomes in Minimally Invasive Mitral Valve Surgery: First Results in a Brazilian Single Center

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Open Journal of Thoracic Surgery 2024年第1期14卷 17-28页

作者： Daniel de Magalhães Freitas João Alberto Pansani Max Weyler Nery Stanlley de Oliveira Loyola Maurício Lopes Prudente Giulliano Gardenghi Artur Henrique de Souza department of Cardiovascular Surgery Encore Hospital Aparecida de Goiania Brazil anesthesia Clinic (Clianest) Goiania Brazil

Introduction: Treatments for cardiovascular diseases have increasingly evolved with the tendency to offer minimally invasive or transcatheter procedures instead of conventional sternotomy surgery. In this context, we highlight minimally invasive mitral valve surgery (MIMVS), which has been shown to be an increasingly solid option with some superior results when compared to the conventional technique: better pain control, shorter hospital stays, shorter recovery time, shorter readmission rate in the first postoperative year, better aesthetic results, and lower overall cost. Aim: This study aims to evaluate the stages of MIMVS, by primary mitral valve consultation, in our service and compare these results with data from the literature. Methods: All electronic medical records of patients who underwent MIMVS for primary mitral valve injury in the Encore Hospital from January 2020 to February 2023 were analyzed. Tabulation and statistical analysis were performed using the Microsoft Excel® program. Quantitative variables were presented as means, standard deviations. Results: 46 patients were enrolled in our study (Age: 59.1 ± 12.4 years old;60.8% Female, BMI: 26 ± 4.4 Kg/m2, Low risk STS score: 82.6%). The observed 30-day mortality was 2.1%, plastic rate of 23.9%, blood transfusion rate of 41.3%, length of stay in an intensive care bed (ICB) of 3.3 ± 3.3 days and hospital stay of 6.4 ± 5.1 days. Conclusions: We noticed that the MIMVS results carried out in our service agree with data from national and international literature with approximately 1.3 days more hospitalization in ICB.

关键词： Minimally Invasive Surgical Procedures Mitral Valve Outcome Assessment Health Care