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Intervention in the Loneliness of the Elderly What Strategies, Challenges and Rewards？

Journal of Health Science 2015年第2期3卷 71-80页

作者： Manuela Dias Carla Silva Ricardo Dias Helena Oliveira Primary Care Unit of terceira island-Angra do Herolsmo Health Center Angra do Heroismo Terceira Azores 9701-869 Portugal terceira island hospital Angra do Herolsmo Terceira Azores 9700-049 Portugal University of the Azores College of Nursing S. Miguel Azores 9504-538 Portugal

The new challenges that the phenomenon of demographic aging imposes on society in general, and health services in particular, can impact active and healthy aging. The project was implemented for two years （2012/2013） and aimed to combat loneliness in the elderly, which constitutes an obstacle to healthy and active aging. Decrease the sense of loneliness of individuals from 65 to 84 years of age, the project was made by using the health planning methodology, starting with a descriptive study （health diagnosis of the independent elderly population） followed by the development, implementation and evaluation of a community intervention project, which included home visits to the elderly, assessment of the level of loneliness in two different times （UCLA scale） and various intergenerational activities of social life （dancing, walking, online courses, games...） using a cross-section of partnerships and community involvement. There was a decrease from 62.8% to 41.9% in the reported overall feeling of loneliness of independent individuals between the ages of 65 and 84 years of age. There was an increase from 50.0% to 86.4% of seniors who now have dreams/life projects. The reduction of social and emotional isolation resulted in the promotion of social networks, which not only encouraged social interaction but also considered the elderly who live alone. The health gains arising from it are evidenced in contributing more proactively and the improvement of the quality of life in the elderly community.

关键词： Elderly health planning loneliness active aging

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Dedifferentiated liposarcoma arising from the sigmoid mesocolon: A case report

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World Journal of Gastroenterology 2007年第30期13卷 4147-4148页

作者： Brody Winn John Gao Homayoon Akbari Baishali Bhattacharya Department of Pathology and Surgery Rhode Island Hospital Warren Alpert Medical School of Brown University Providence Rhode Island United States Department of Surgery Rhode Island Hospital Warren Alpert Medical School of Brown University Providence Rhode Island United States

Dedifferentiated liposarcoma is a variant of liposarcoma with a more aggressive course. It occurs most commonly in the retroperitoneum and rarely in other anatomic locations. In the present report, we describe a case of dedifferentiated liposarcoma that occurred in an unusual location, sigmoid mesocolon, which has not yet been documented.

关键词： Dedifferentiated liposarcoma Sigmoid mesocolon

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Eosinophilic colitis

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World Journal of Gastroenterology 2009年第24期15卷 2975-2979页

作者： Nnenna Okpara Bassam Aswad Gyorgy Baffy Division of Gastroenterology Department of Medicine Rhode Island Hospital and Alpert Medical School of Brown University Department of Pathology Rhode Island Hospital and Alpert Medical School of Brown University

Eosinophilic colitis (EC) is a rare form of primary eosinophilic gastrointestinal disease with a bimodal peak of prevalence in neonates and young adults. EC remains a little understood condition in contrast to the increasingly recognized eosinophilic esophagitis. Clinical presentation of EC is highly variable according to mucosal, transmural, or serosal predominance of inflammation. EC has a broad differential diagnosis because colon tissue eosinophilia often occurs in parasitic infection, drug-induced allergic reactions, inflammatory bowel disease, and various connective tissue disorders, which require thorough searching for secondary causes that may be specifically treated with antibiotics or dietary and drug elimination. Like eosinophilic gastrointestinal disease involving other segments of the gastrointestinal tract, EC responds very well to steroids that may be spared by using antihistamines, leukotriene inhibitors and biologics.

关键词： Eosinophilia Colitis Gastrointestinal disease Ascites

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Splenic arteriovenous fistula leading to non-cirrhotic portal hypertension:a case report

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Gastroenterology Report 2023年第1期11卷 545-547页

作者： Ahmad Abou Yassine Hassan Al Moussawi Malek Kreidieh Loai Dahabra Mustafa Al-Roubaie Sanjaya Satapathy Department of Internal Medicine Staten Island University HospitalNorthwell HealthStaten IslandNYUSA Division of Gastroenterology Department of Internal MedicineStaten Island University HospitalNorthwell HealthStaten IslandNYUSA Department of Radiology North Shore University HospitalNorthwell HealthManhassetNYUSA Department of Gastroenterology North Shore University HospitalNorthwell HealthManhassetNYUSA

Introduction Non-cirrhotic portal hypertension(NCPH)is a rare disease characterized by portal hypertension in the absence of cirrhosis or other causes of liver disease and splanchnic venous *** case is a rare presenta... 详细信息

关键词： hypertension fistula arteriovenous

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Fatal and non-fatal injuries due to suspension trauma syndrome: A systematic review of definition, pathophysiology, and management controversies

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World Journal of Emergency Medicine 2021年第4期12卷 253-260页

作者： Patrizio Petrone Sofía Espinoza-Villalobos Gerard ABaltazar Kjetil Søreide Adam Stright Collin E.M.Brathwaite D’Andrea K.Joseph Department of Surgery NYU Long Island School of MedicineNYU Langone Hospital–Long IslandMineola 11501USA 2 Department of Gastrointestinal SurgeryStavanger University HospitalStavanger 4011Norway

BACKGROUND: Suspension trauma syndrome is a life-threatening event that occurs when a person is "trapped" in a prolonged passive suspension. It is most commonly seen in people who engage in occupational or sport activities that require harness suspension. The aim of this study is to identify the predisposing factors, pathophysiology, and management of suspension ***: A review and analysis of the literature published in English and Spanish from 1972 to 2020 on suspension trauma were performed. Search sources were Pub Med, Medline, Cochrane Library, MeSH, Up To Date, and Google Scholar. Articles referring to suspension trauma associated with other injury mechanisms(traumatic impact injuries, drowning, asphyxiation, or bleeding), case reports, and pediatric population were ***: Forty-one articles were identified. Of these, 29 articles related to mechanism, pathophysiology, and management of individuals who suffered prolonged suspension trauma without associated traumatic injuries were included in the study. We encountered several controversies describing the putative pathophysiology, ranging from blood sequestration in the lower extremities versus accumulation of metabolic waste and hyperkalemia to dorsal hook-type harness as a trigger cause of positional asphyxia;to vascular compression of femoral vessels exerted by the harness causing decreased venous return. Pstients suspended in a full-body harness with dorsal hook showed more hemodynamic alterations in response to the compressive effect on the rib cage, causing a reduction in perfusion by presenting a decrease in pulse pressure. Management strategies varied across ***: Progress has been made in individualizing the population at risk and in the management of suspension trauma. We recommend the formation of consensus definitions, larger cohort or registry studies to be conducted, and experimental animal models to better understand the mechanisms in order to develop management

关键词： Suspension trauma Reflux syndrome Suspension trauma syndrome Harness suspension

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A comparison of burn related injuries following the natural disaster Super Storm Hurricane Sandy to the National Burn Repository of the American Burn Association

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Burns & Trauma 2016年第1期4卷 41-44页

作者： Michael Kalina Grigoriy Malyutin Michael L.Cooper Emergency Surgery Staten Island University Hospital256 Mason AvenueSuite CStaten IslandNY 10305USA

Background:Burn related injuries from natural disasters are not wel described and natural disasters are not identified as an etiology of burn injury in the National Burn Repository(NBR)of the American Burn *** natural disaster Super Storm Hurricane Sandy had devastating *** goal was to detail the burn related injuries fol owing this natural disaster and to compare the data to the ***:This was a retrospective chart review of thirty four patients who sustained burn related injuries following Super Storm Hurricane Sandy(SSHS)and were managed at Staten island University hospital Burn *** Review Board approval was *** variables included age,gender,race,past medical history(PMHx),burn type,percentage total body surface area(%TBSA),hospital length of stay(HLOS),and *** compared data from SSHS to the 2003-2013 *** data were summarized using frequency counts,percentages and Clopper-Pearson 95%confidence interval for *** outcome data were summarized by descriptive *** analyses performed with SAS?System Version 9.3(SAS Institute Inc.,Cary,NC)and p<0.05 was ***:In the SSHS group,average age was 36+24 years,range 1-80 years,and 44.1%were males(15/34,95%CI:27.2-62.1).Caucasians comprised 58.8%,(20/34,95%CI:40.7,75.4)and 73.5%had no PMHx(25/34,95%CI:55.6,87.1).The most common burn type was scald,55.9%,(19/34,95%CI:37.9,72.8)and%TBSA ranged 1%–47%,average of 7%+12%.The average HLOS was 13+26 days,range of 1–113 *** was 2.9%(1/34,95%CI:0.07–15).In comparison,the NBR reported an average age of 32 years and 69%were *** comprised 59.1%.The most common burn type was flame,43.2%and the%TBSA ranged 1%–9.9%.HLOS ranged 8.4–10.2 days and mortality was 3.4%.Conclusion:We conclude that burn related injuries following a natural disaster differ as compared to those most commonly reported in the NBR.

关键词： Natural disaster Super Storm Hurricane Sandy Burn

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Gangrenous cholecystitis: A silent but potential fatal disease in patients with diabetic neuropathy. A case report

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World Journal of Clinical Cases 2018年第15期6卷 1007-1011页

作者： Melorin Mehrzad Charles C Jehle Lauren O Roussel Raman Mehrzad Department of Plastic and Reconstructive Surgery Rhode Island Hospital Brown University

Gangrenous cholecystitis(GC) is a severe and potentially deadly complication of acute cholecystitis. We present a 83-year-old gentleman with a past medical history of type 2 diabetes mellitus with significant associated neuropathy, presenting to a community hospital in a major metropolitan area with 10 days nausea and vomiting and a benign abdominal exam. While the patient was admitted for hyperglycemia, he was subsequently found to have severe GC requiring urgent surgical intervention.

关键词： Gangrenous cholecystitis Diabetes mellitus Hyperglycemia Complications Case report

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Neural Regeneration Research 2020年第4期15卷 676-681页

作者： Yan Cheng Mandy Pereira Neha P.Raukar John L.Reagan Mathew Quesenberry Laura Goldberg Theodor Borgovan W Curt LaFrance Jr Mark Dooner Maria Deregibus Giovanni Camussi Bharat Ramratnam Peter Quesenberry Department of Medicine Division of Hematology/OncologyRhode Island HospitalProvidenceRIUSA Department of Emergency Medicine Mayo ClinicRochesterMNUSA Department of Psychiatry and Neurology Rhode Island HospitalProvidenceRIUSA Department of Medicine Division of Infectious DiseasesRhode Island HospitalProvidenceRIUSA Department of Medical Sciences University of TurinTorino TOItaly

At present,there is no reliable biomarker for the diagnosis of traumatic brain injury(TBI).Studies have shown that extracellular vesicles released by damaged cells into biological fluids can be used as potential biomarkers for diagnosis of TBI and evaluation of TBI *** hypothesize that the genetic profile of salivary extracellular vesicles in patients with head trauma differs from that in uninjured *** from this hypothesis would help investigate the severity of *** study included 19 subjects,consisting of seven healthy controls who denied history of head trauma,six patients diagnosed with concussion injury from an outpatient concussion clinic,and six patients with TBI who received treatment in the emergency department within 24 hours after ***-time PCR analysis of salivary extracellular vesicles in participants was performed using TaqMan Human Inflammation *** expression analysis revealed nine upregulated genes in emergency department patients(LOX5,ANXA3,CASP1,IL2RG,ITGAM,ITGB2,LTA4H,MAPK14,and TNFRSF1A)and 13 upregulated genes in concussion clinic patients compared with healthy participants(ADRB1,ADRB2,BDKRB1,HRH1,HRH2,LTB4R2,LTB4R,PTAFR,CYSLTR1,CES1,KLK1,MC2R,and PTGER3).Each patient group had a unique *** between groups showed that 15 inflammation-related genes had significant expression *** results indicate that inflammation biomarkers can be used for diagnosis of TBI and evaluation of disease *** study was approved by the Institutional Review Board on December 18,2015(approval No.0078-12)and on June 9,2016(approval No.4093-16).

关键词： chronic traumatic encephalopathy emergency department extracellular vesicles inflammation outpatient concussion clinic real-time PCR analysis saliva traumatic brain injury

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TGR5 expression in benign, preneoplastic and neoplastic lesions of Barrett's esophagus: Case series and findings

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World Journal of Gastroenterology 2017年第8期23卷 1338-1344页

作者： Shivali Marketkar Dan Li Dongfang Yang Weibiao Cao Department of Pathology Rhode Island Hospital and Warren Alpert Medical School of Brown University Department of Medicine Rhode Island Hospital and Warren Alpert Medical School of Brown University

To examined the bile acid receptor TGR5 expression in squamous mucosa, Barrett’s mucosa, dysplasia and esophageal adenocarcinoma (EA).METHODSSlides were stained with TGR5 antibody. The staining intensity was scored as 1+, 2+ and 3+. The extent of staining (percentage of cells staining) was scored as follows: 1+, 1%-10%, 2+, 11%-50%, 3+, 51%-100%. A combined score of intensity and extent was calculated and categorized as negative, weak, moderate and strong staining. TGR5 mRNA was measured by real time *** found that levels of TGR5 mRNA were significantly increased in Barrett’s dysplastic cell line CP-D and EA cell line SK-GT-4, when compared with Barrett’s cell line CP-A. Moderate to strong TGR5 staining was significantly higher in high-grade dysplasia and EA cases than in Barrett’s esophagus (BE) or in low-grade dysplasia. Moderate to strong staining was slightly higher in low-grade dysplasia than in BE mucosa, but there is no statistical significance. TGR5 staining had no significant difference between high-grade dysplasia and EA. In addition, TGR5 staining intensity was not associated with the clinical stage, the pathological stage and the status of lymph node *** conclude that TGR5 immunostaining was much stronger in high-grade dysplasia and EA than in BE mucosa or low-grade dysplasia and that its staining intensity was not associated with the clinical stage, the pathological stage and the status of lymph node metastasis. TGR5 might be a potential marker for the progression from BE to high-grade dysplasia and EA.

关键词： TGR5 Esophageal adenocarcinoma Bile acid

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Clostridioides difficile infection in liver cirrhosis patients: A population-based study in United States

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World Journal of Hepatology 2021年第8期13卷 926-938页

作者： Syeda Sahra Mohammad Abureesh Shivantha Amamath Motasem Alkhayyat Rawan Badran Abdullah Jahangir Vivek Gumaste Department of Internal Medicine Staten Island University HospitalStaten IslandNY 10305United States Department of Internal Medicine Cleveland Clinic FoundationClevelandOH 44195United States Department of Gastroenterology Staten Island University HospitalStaten IslandNY 10305United States

BACKGROUND Clostridioides(formerly Clostridium)difficile infection(CDI)is an increasingly frequent cause of morbidity and mortality in hospitalized *** risk factors are documented in the literature that includes,but are not limited to,antibiotics use,advanced age,and gastric acid *** epidemiological studies have reported an increased incidence of CDI in advanced liver disease *** have also demonstrated a higher prevalence of nosocomial infections in cirrhotic *** To use a large nationwide database,we sought to determine CDI’s risk among liver cirrhosis patients in the United *** We queried a commercial database(Explorys Inc^(TM),Cleveland,OH,United States),and obtained an aggregate of electronic health record data from 26 major integrated United States healthcare systems comprising 360 hospitals in the United States from 2018 to *** were organized into the Systematized Nomenclature of Medicine Clinical Terms(SNOMED–CT)*** analysis for the multivariable model was performed using Statistical Package for Social Sciences(SPSS version 25,IBM CorpTM).For all analyses,a two-sided P value of<0.05 was considered statistically *** There were a total of 19387760 patients in the database who were above 20 years of age between the years *** those,133400 were diagnosed with liver *** prevalence of CDI amongst the liver cirrhosis population was 134.93 per 100.000 vs 19.06 per 100.000 in non-cirrhotic patients(P<0.0001).The multivariate analysis model uncovered that cirrhotic patients were more likely to develop CDI(OR:1.857;95%CI:1.665-2.113,P<0.0001)compared to those without any prior history of liver *** In this large database study,we uncovered that cirrhotic patients have a significantly higher CDI prevalence than those without *** cirrhosis may be an independent risk factor for *** prospective studies are needed to cl

关键词： patients cirrhosis infection

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