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Echocardiographic predictors and associated outcomes of multiple vegetations in infective endocarditis:A pilot study

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World Journal of Cardiology 2024年第6期16卷 318-328页

作者： Ajay Kumar Mishra Kannu Bansal Ibragim Al-Seykal Pradnya B Bhattad Anu Anna George Anil Jha Nitish Sharma Jennifer Sargent Mark J Kranis Division of Cardiology Saint Vincent HospitalWorcesterMA 01608United States Department of Internal Medicine Saint Vincent HospitalWorcesterMA 01608United States Department of Medicine Division of CardiologySaint Vincent HospitalWorcesterMA 01608United States Division of Cardiovascular Medicine Saint Vincent HospitalWorcesterMA 01608United States

BACKGROUND Infective endocarditis(IE)is a life-threatening infection with an annual mortality of 40%.Embolic events reported in up to 80%of *** of>10 mm size are associated with increased embolic events and poor *** is a paucity of literature on the association of multiple vegetations with *** To study the echocardiographic(ECHO)features and outcomes associated with the presence of multiple *** In this retrospective,single-center,cohort study patients diagnosed with IE were recruited from June 2017 to June 2019.A total of 84 patients were diagnosed to have IE,of whom 67 with vegetation were *** demographic,clinical,laboratory,and ECHO parameters were *** that were studied included recurrent admission,embolic phenomenon,and *** Twenty-three(34%)patients were noted to have multiple vegetations,13(56.5%)were male and 10(43.5%)were *** mean age of these patients was ***(35%)had a prior episode of *** features of moderate to severe valvular regurgitation[odds ratio(OR)=4],presence of pacemaker lead(OR=4.8),impaired left ventricle(LV)relaxation(OR=4),and elevated pulmonary artery systolic pressure(PASP)(OR=2.2)are associated with higher odds of multiple *** these moderate to severe valvular regurgitation(P=0.028),pacemaker lead(P=0.039)and impaired relaxation(P=0.028)were statistically *** patients were noted to have an increased association of recurrent admissions(OR=3.6),recurrent bacteremia(OR=2.4),embolic phenomenon(OR=2.5),intensive care unit stay(OR=2.8),hypotension(OR=2.1),surgical intervention(OR=2.8)and device removal(OR=4.8).Of this device removal(P=0.039)and recurrent admissions(P=0.017)were statistically *** This study highlights the associations of ECHO predictors and outcomes in patients with IE having multiple *** features of moderate to severe regurgitation,presence of pacemaker lead,impai

关键词： Endocarditis Echocardiography Vegetations Predictors Outcome

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Surgical management of the diabetic foot:The current evidence

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World Journal of Orthopedics 2024年第5期15卷 404-417页

作者： Richard Henry Randall Roberts Gareth Rhys Davies-Jones James Brock Vaishnav Satheesh Greg AJ Robertson Department of Trauma and Orthopaedics Wrexham Maelor HospitalWrexham LL137TDUnited Kingdom Department of Trauma and Orthopaedics The Robert Jones and Agnes Hunt Orthopaedic HospitalOswestry SY107AGUnited Kingdom

The prevalence of diabetes mellitus and its associated complications,particularly diabetic foot pathologies,poses significant healthcare challenges and economic burdens *** review synthesises current evidence on the surgical management of the diabetic foot,focusing on the interplay between neuropathy,ischemia,and infection that commonly culminates in ulcers,infections,and,in severe cases,*** escalating incidence of diabetes mellitus underscores the urgency for effective management strategies,as diabetic foot complications are a leading cause of hospital admissions among diabetic patients,significantly impacting morbidity and mortality *** review explores the pathophysiological mechanisms underlying diabetic foot complications and further examines diabetic foot ulcers,infections,and skeletal pathologies such as Charcot arthropathy,emphasising the critical role of early diagnosis,comprehensive management strategies,and interdisciplinary care in mitigating adverse *** addressing surgical interventions,this review evaluates conservative surgeries,amputations,and reconstructive procedures,highlighting the importance of tailored approaches based on individual patient profiles and the specific characteristics of foot *** integration of advanced diagnostic tools,novel surgical techniques,and postoperative care,including offloading and infection control,are discussed in the context of optimising healing and preserving limb function.

关键词： Diabetes Diabetic foot Charcot Osteomyelitis Amputation Diabetic foot attack Conservative surgery

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Hypertrophic cardiomyopathy and left ventricular non-compaction:Distinct diseases or variant phenotypes of a single condition?

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World Journal of Cardiology 2024年第9期16卷 496-501页

作者： Natalia Przytuła Ewa Dziewięcka Mateusz Winiarczyk Katarzyna Graczyk Agnieszka Stępień PawełRubiś Department of Cardiac and Vascular Diseases Saint John Paul II HospitalKrakow 31-202MAPoland Department of Cardiac and Vascular Diseases Institute of CardiologyJagiellonian University Collegium MedicumSaint John Paul II HospitalKrakow 31-202MAPoland

Hypertrophic cardiomyopathy(HCM)is a genetically determined myocardial disease characterized by an increased thickness of the left ventricle(LV)wall that cannot be solely attributed to abnormal loading *** may present with an intraventricular or LV outflow tract obstruction,diastolic dysfunction,myocardial fibrosis and/or ventricular *** HCM from other diseases associated with LV hypertrophy,such as hypertension,aortic stenosis,or LV non-compaction(LVNC),can at times be *** is defined by excessive LV trabeculation and deep recesses between trabeculae,often accompanied by increased LV myocardial *** studies indicate that the LVNC phenotype may be observed in up to 5%of the general population;however,in most cases,it is a benign finding with no impact on clinical ***,LVNC can occasionally lead to LV systolic dysfunction,manifesting as a phenotype of dilated or non-dilated left ventricular cardiomyopathy,with an increased risk of thrombus formation and arterial *** extreme cases,where LVNC is associated with a very thickened LV wall,it can even mimic *** is growing evidence of an overlap between HCM and LVNC,including similar genetic mutations and clinical *** raises the question of whether HCM and LVNC represent different phenotypes of the same disease or are,in fact,two distinct entities.

关键词： Left ventricle hypertrabeculation Hypertrophic cardiomyopathy Left ventricle non-compaction Left ventricle hypertrophy Left ventricle obstruction

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Neuroanatomical Basis of Postoperative Pain and Assessment of Its Management in a Series of Patients Undergoing Caesarean Sections

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Pain Studies and Treatment 2024年第2期12卷 21-32页

作者： Moustapha Diedhiou Philippe Manyacka Ma Nyemb Ndiamé Sarr Aissatou Sarr Ousmane Thiam Mohamed Lamine Fall Health Sciences Training and Research Unit Gaston Berger Saint Louis University Saint Louis Senegal Intensive Care Unit Saint Louis Regional Hospital Saint Louis Senegal

Introduction: In recent decades, the cost of postoperative pain has been the subject of many studies based on protocols developed by scientific societies for its assessment and optimization. At the Regional hospital of saint-Louis (Senegal), several protocols have been developed for pain management, but no study has focused on the assessment of postoperative pain management specifically. We therefore initiated this work, the objectives of which were to remind the neuroanatomical and neurophysiological bases of postoperative pain, and to analyze the assessment and management of this pain in patients who have undergone a caesarean section. Materials and methods: This was a prospective and descriptive study, which took place in the gynecology-obstetrics department, over a period from January 2019 to July 2020. All patients who gave birth by cesarean section were included. The data was collected from a survey sheet written for this purpose. For each of the patients, the information was taken every day throughout the duration of postoperative hospitalization. Results: It appears from our work that after a cesarean section, the pain felt evolves on the first postoperative days with a peak during the second day. As in the data reported in the literature, there does not seem to be a difference in terms of pain intensity and analgesia dosage between scheduled and emergency caesarean sections. However, young age and female gender—for other types of surgeries—are risk factors associated with high postoperative pain scores. This trend is probably related to the low pain experience of tested patients. Our initial hypothesis was that acute post-operative pain after caesarean sections could be linked to defects in the perception and processing of pain by caregivers. Indeed, we have shown that awareness-raising, information, and training actions have made it possible to significantly improve the management of pain after a cesarean section. Conclusion: After a cesarean section the p

关键词： Postoperative Pain Neuroanatomical Bases Assessment Cesarean Section

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Clinical and laboratory features of juvenile idiopathic arthritis with wrist involvement:Results of a retrospective cohort study

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World Journal of Clinical Pediatrics 2024年第3期13卷 22-33页

作者： Lyubov Sorokina Maria Kaneva Artem Artamonov Natalia Gordeeva Irina Chikova Mikhail Kostik hospital Pediatry Saint Petersburg State Pediatric Medical UniversitySaint Petersburg 194100Russia Department of Consulting and Diagnostic Saint-Petersburg Children’s Hospital#2n.a.Saint Mary MagdaleneSaint Petersburg 199004Russia Research Laboratory of Autoimmune and Autoinflammatory Diseases Almazov National Medical Research CenterSaint-Petersburg 197341Russia

BACKGROUND Previous studies in the pre-biological era showed an association of wrist inflammation in juvenile idiopathic arthritis(JIA)with progressive disease course,polyarticular involvement and failure of methotrexate *** To describe features of JIA,associated with wrist *** Data from about 753 JIA patients were included in this retrospective cohort *** clinical and laboratory features of patients with and without wrist involvement were *** Wrist involvement was found in oligoarthritis(5.8%),RF(−)/RF(+)polyarthritis(44.9%/15.0%),enthesitis-related arthritis(17.7%),and systemic(58.6%)JIA *** wrist involvement was typical for oligoarthritis patients,bilateral involvement was either equal to that of unilateral involvement or was more frequent in other *** arthritis was found to be associated with female sex,a low incidence of uveitis,and more indications of systemic inflammation,including elevated levels of C-reactive protein,erythrocyte sedimentation rate,and platelets,as well as involvement of the cervical spine,temporomandibular,shoulder,elbow,metacarpophalangeal,proximal interphalangeal,distal interphalangeal,hip,ankle,and tarsus *** number of patients with hip osteoarthritis and hip replacement was also *** arthritis was associated with a lower probability of achieving remission[hazard ratio(HR)=1.3(95%CI:1.0-1.7),P=0.055],and a higher probability of being treated with biologics[HR=1.7(95%CI:1.3-2.10,P=0.00009)].CONCLUSION Wrist arthritis in JIA patients is a marker of a severe disease course,characterized by more intensive inflammation,unfavorable outcomes,*** more intensive treatment with early administration of *** monitoring of wrist inflammation with ultrasound and MR assessment with early biological treatment might improve the outcomes.

关键词： Wrist Hand Juvenile idiopathic arthritis Outcomes Biologics Methotrexate

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Machine learning approach to assess the association between anthropometric,metabolic,and nutritional status and semen parameters

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Asian Journal of Andrology 2024年第4期26卷 349-355页

作者： Guillaume Bachelot Antonin Lamaziere Sebastien Czernichow Celine Faure Chrystelle Racine Rachel Levy Charlotte Dupont Nutrition and Fertility(ALIFERT)Group Author Information Sorbonne University School of Medicine Saint-Antoine Research CenterINSERM UMR 93827 rue ChalignyParis 75012France Reproductive Biology Department-CECOS Tenon HospitalAP-HP.Sorbonne UniversityParis 75020France Clinical Metabolomics Department Saint-Antoine HospitalAP-HP27 rue ChalignyParis 75012France Nutrition Department Obesity Specialist CentreGeorges Pompidou European HospitalAP-HPParis 75015France 不详

Many lifestyle factors,such as nutritional imbalance leading to obesity,metabolic disorders,and nutritional deficiency,have been identified as potential risk factors for male *** aim of this study was to evaluate the relationship between semen parameters and anthropometric,metabolic and nutritional *** was first assessed individually,then after the application of a previously constructed and validated machine learning score that allows their ***,metabolic,antioxidant,micronutrient,and sperm parameters from 75 men suffering from idiopathic infertility from four infertility centers in France(Jean-Verdier ART Center hospital,Bondy;North hospital ART Center,saint-Étienne;Navarre Polyclinic ART Center,Pau;and Cochin hospital ART Center,Paris)between September 2009 and December 2013 were *** assessing standard correlation analysis,a previously built machine learning model,providing a score ranging from 0(the poorest)to 1(the most favorable),was calculated for each man in the study *** machine learning model,which separates infertile/fertile men with unexplained infertility on the basis of their bioclinical signature,provides a more holistic evaluation of the influence of the considered markers(anthropometric,metabolic,and oxidative status).We observed a significant correlation of some anthropometric,metabolic,and nutritional disorders with some sperm ***,an unfavorable machine learning score was associated with a high level of sperm DNA *** anthropometric,metabolic,and oxidative patterns,which may reflect an appropriate lifestyle,appear to positively impact overall health,in particular reproductive *** study,consistent with previous publications,suggests that beyond semen quality parameters,in an essential assessment of male fertility,other key factors should be taken into *** this regard,the application of emerging artificial intelligence t

关键词： lifestyle machine learning metabolism nutrition sperm DNA fragmentation

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Clues to predict incidental gallbladder cancer

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Hepatobiliary & Pancreatic Diseases International 2018年第2期17卷 149-154页

作者： Naeem Goussous Hadia Maqsood Kalpesh Patel Hamid Ferdosi Naseem Muhammad Anne M.Sill Gopal C.Kowdley Steven C.Cunningham Department of Surgery Saint Agnes Hospital

Background: Consequences of incidental gallbladder cancer(iGBC) following cholecystectomy may include repeat operation(depending on T stage) and worse survival(if bile spillage occurred), both avoidable if iGBC were suspected ***: A retrospective single-institution review was done. Ultrasound images for cases and controls were blindly reviewed by a radiologist. Chi-square and Student’s t tests, as well as logistic regression and Kaplan–Meier analyses were used. A P ≤ 0.01 was considered ***: Among 5796 cholecystectomies performed 2000–2013, 26(0.45%) were iGBC cases. These patients were older(75.61 versus 52.27 years), had more laparoscopic-to-open conversions(23.1% versus3.9%), underwent more imaging tests, had larger common bile duct diameter(7.13 versus 5.04 mm) and higher alkaline phosphatase. Ultrasound imaging showed that gallbladder wall thickening(GBWT) without pericholecystic fluid(PCCF), but not focal-versus-diffuse GBWT, was associated significantly with iGBC(73.9% versus 47.4%). On multivariable logistic regression analysis, GBWT without PCCF, and age were the strongest predictors of iGBC. The consequences iGBC depended significantly on intraoperative bile spillage, with nearly all such patients developing carcinomatosis and significantly worse ***: Besides age, GBWT, dilated common bile duct, and elevated alkaline phosphatase, number of preoperative imaging modalities and the presence of GBWT without PCCF are useful predictors of *** spillage causes poor survival in patients with iGBC.

关键词： Gallbladder cancer Incidental findings Cholecystectomy Bile spillage Carcinomatosis

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A rare case of cardiac and ophthalmic manifestations of meningococcal septicemia

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World Journal of Emergency Medicine 2024年第4期15卷 328-330页

作者： Svetlana Rachina Anastasia Shchendrygina Heshan Radeesha de Silva Svetlana Tarasenko Nadezhda Mukhina Irina Komarova Ludmila Fedina Elena Burmistrova Elvira Martens Sergey Sidorenko Vladimir Gostev Dmitry Polev Alina Saitova Lyudmila Kraeva Nikita Goncharov Irina Zvetkova Department of hospital Therapy I M Sechenov First Moscow State Medical UniversityMoscow 119048Russia Outpatient Clinic#64 Moscow 119048Russia Department of Cardiology City Clinical Hospital n.a.S.S.YudinMoscow 119048Russia Department of Medical Microbiology and Molecular Epidemiology Pediatric Research and Clinical Center for InfectiousDiseasesSaint Petersburg 197022Russia Department of Medical Microbiology North-Western State Medical University Named After I.I.MechnikovSaintPetersburg 191015Russia Department of Epidemiology Saint-Petersburg Pasteur InstituteSaint Petersburg 197101Russia

Acute pericarditis is usually a self-limiting disorder that commonly occurs due to viral etiology or unexplained *** pericarditis(MP)is a remarkably uncommon clinical entity that manifests as a complication during the acute or convalescent phase of meningococcal ***,its occurrence within the context of meningococcal septicemia has also been *** report a rare case of a previously healthy male patient who developed both acute pericarditis and uveitis as a presentation of meningococcal septicemia,with no characteristic skin rashes or meningeal signs.

关键词： acute Acute rare

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Minimally invasive pelvic exenteration for primary or recurrent locally advanced rectal cancer:A glimpse into the future

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World Journal of Gastrointestinal Surgery 2024年第7期16卷 1960-1964页

作者： Dimitrios Kehagias Charalampos Lampropoulos Ioannis Kehagias Department of General Surgery General University Hospital of PatrasPatras 26504Greece Intensive Care Unit Saint Andrew’s General HospitalPatras 26335Greece Division of Bariatric and Metabolic Surgery Department of SurgeryUniversity of PatrasPatras 26504Greece

Surgeons have grappled with the treatment of recurrent and T4b locally advanced rectal cancer(LARC)for many *** main objectives are to increase the overall survival and quality of life of the patients and to mitigate postoperative ***,pelvic exenteration(PE)with or without neoadjuvant treatment is a curative treatment when negative resection margins are *** traditional open approach has been favored by many ***,the technological advancements in minimally invasive surgery have radically changed the surgical *** studies have demonstrated promising results in postoperative complications and oncological outcomes after robotic or laparoscopic PE.A recent retrospective study entitled“Feasibility and safety of minimally invasive multivisceral resection for T4b rectal cancer:A 9-year review”was published in the World Journal of Gastrointestinal *** we read this article with great interest,we decided to delve into the latest data regarding the benefits and risks of minimally invasive PE for ***,the small number of suitable patients,limited surgeon experience,and steep learning curve are hindering the establishment of minimally invasive PE.

关键词： Locally advanced rectal cancer Pelvic exenteration Multivisceral resection Minimally invasive surgical procedures Robotic surgical procedures

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HIDA scan for functional gallbladder disorder： ensure that you know how the scan was done

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Hepatobiliary & Pancreatic Diseases International 2017年第2期16卷 197-201页

作者： Naeem Goussous Hadia Maqsood Ethan Spiegler Gopal C Kowdley Steven C Cunningham Department of Surgery Saint Agnes Hospital Baltimore USA Department of Nuclear Medicine Saint Agnes Hospital Baltimore USA

BACKGROUND： Despite the increasing use of fatty meal（FM） as a substitute for cholecystokinin（CCK） in pain reproduction during hepato-imino-diacetic acid（HIDA） scan in functional gallbladder disorder, there are no studies comparing the differences between CCK and FM. The present study was to compare the efficacy of FM in comparison of CCK in FGBD application. METHODS： Patients undergoing HIDA scans from August 2013 to May 2014 were divided into two groups： those undergoing CCK-stimulated HIDA scan versus FM-stimulated HIDA scan. These groups were compared according to demographics and HIDA ***： Of 153 patients, 70 received CCK and 83 FM. There was no difference regarding age, gender, gallstones, gallbladder ejection fraction and time to visualization. However, significantly more of the patients receiving CCK than FM experienced pain reproduction（61% vs 30%, P〈0.01）.CONCLUSIONS： Stimulation of gallbladder contractility with a FM during HIDA is less than half as likely to reproduce biliary symptoms compared to CCK, despite similar ejection fractions and other parameters. It is essential that providers account for this difference when counseling patients regarding cholecystectomy for functional gallbladder disorder.

关键词： gallbladder dysfunction biliary dyskinesia cholecystokinin hepato-imino-diacetic acid

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