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Improved survival at the cost of more chronic lung disease?Current management and outcomes in extremely preterm infants born in New South Wales and the Australian Capital Territory:2010-2020

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World Journal of Pediatrics 2024年第3期20卷 230-238页

作者： Nele Legge Himanshu Popat Dominic Fitzgerald liverpool hospital Corner Elizabeth and Goulburn StreetsLiverpoolNSWAustralia university of Sydney CamperdownAustralia Children's hospital Westmead WestmeadAustralia

Background Since 2010,most tertiary care hospitals in Australia have changed how they care for extremely premature ***,in-hospital and longer-term outcome data have suggested unchanged or even worse health outcomes in later epochs,especially respiratory *** study examined the trend in outcomes since these changes were introduced,particularly the prevalence of chronic neonatal lung disease(CLD).Methods This is a retrospective cross-sectional analysis of data from the Neonatal Intensive Care Units'(NICUS)database of all perinatal intensive care units in New South Wales and the Australian Capital Territory,including infants born at≥24 and≤28 weeks of gestational age in tertiary perinatal units between January 1,2010,and December 31,*** trends and changes in primary outcome were examined by linear and adjusted multivariable logistic regression *** This study included 3258 *** saw significant changes in antenatal magnesium sulfate(75% increase),delayed cord clamping(66% increase),delivery room intubations(30% decrease),any time(20% decrease),duration on mechanical ventilation(100-hour decrease),and hours on noninvasive ventilation(200-hour increase).Mortality decreased from 17% to 6%.The incidence of CLD increased significantly even when adjusted for confounders(15% increase).Any time and mean hours spent on mechanical ventilation significantly increased the odds of *** study could not find a significant association of any of the protective antenatal treatments on *** The last decade saw a significant improvement in survival and survival to discharge without major *** was increased use of magnesium sulfate,delayed cord clamping,and less invasive respiratory management of extremely preterm *** avoidance of mechanical ventilation may impact the incidence of CLD.

关键词： Chronic lung disease Extreme prematurity Health outcomes Survival

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Oral anti-coagulants use in Chinese hospitalized patients with atrial fibrillation

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Chinese Medical Journal 2024年第2期137卷 172-180页

作者： Jing Lin Deyong Long Chenxi Jiang Caihua Sang Ribo Tang Songnan Li Wei Wang Xueyuan Guo Man Ning Zhaoqing Sun Na Yang Yongchen Hao Jun Liu Jing Liu Xin Du Louise Morgan Gregg C.Fonarow Sidney C.Smith Jr Gregory Y.H.Lip Dong Zhao Jianzeng Dong Changsheng Ma On behalf of CCC-AF investigators Department of Cardiology Beijing Anzhen HospitalCapital Medical UniversityBeijing 100029China National Clinical Research Center for Cardiovascular Diseases Beijing 100029 China Department of Epidemiology Beijing Anzhen HospitalCapital Medical UniversityBeijing Institute of HeartLung and Blood Vessel DiseasesBeijing 100029China International Quality Improvement Department American Heart AssociationDallasTX 07076USA Division of Cardiology Geffen School of Medicine at University of CaliforniaLos Angeles CA 90024USA Division of Cardiology University of North CarolinaChapel HillNC 27599USA Department of Cardiology Liverpool Centre for Cardiovascular ScienceUniversity of Liverpool and Liverpool Heart&Chest HospitalLiverpool L143PEUK Department of Clinical Medicine Aalborg UniversityAalborg 9000Denmark 不详

Background:Oral anti-coagulants(OAC)are the intervention for the prevention of stroke,which consistently improve clinical outcomes and survival among patients with atrial fibrillation(AF).The main purpose of this study is to identify problems in OAC utilization among hospitalized patients with AF in ***:Using data from the Improving Care for Cardiovascular Disease in China-Atrial Fibrillation(CCC-AF)registry,guideline-recommended OAC use in eligible patients was ***:A total of 52,530 patients with non-valvular AF were enrolled from February 2015 to December 2019,of whom 38,203 were at a high risk of stroke,9717 were at a moderate risk,and 4610 were at a low *** admission,only 20.0%(6075/30,420)of patients with a diagnosed AF and a high risk of stroke were taking *** use of pre-hospital OAC on admission was associated with a lower risk of new-onset ischemic stroke/transient ischemic attack among the diagnosed AF population(adjusted odds ratio:0.54,95%confidence interval:0.43-0.68;Phospital rhythm control strategies,including catheter ablation(adjusted odds ratio[OR]11.63,95%confidence interval[CI]10.04-13.47;Phospitals participated in the CCC-AF project,>70%of AF patients were at a high risk of *** poor performance on guideline-recommended OAC use was found in this study,over time the CCC-AF project has made progress in stroke prevention in the Chinese AF ***

关键词： Atrial fibrillation Oral anti-coagulants OAC Stroke prevention Contraindication

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Bithalamic Ischemic Stroke in Sickle Cell Patient at the Kamenge university hospital in Burundi: Case Report

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Open Journal of Medical Imaging 2024年第2期14卷 72-78页

作者： Sébastien Manirakiza Daniel Nduwayo Patrice Barasukana Chantal Murekatete Jean Bosco Bizimana Alice Ndayishimiye Léopold Nzisabira Hélène Bukuru Department of Radiology Kamenge University Hospital Center University of Burundi Bujumbura Burundi Department of Internal Medicine Neurology Kamenge University Hospital Center University of Burundi Bujumbura Burundi Department of Surgery Neurosurgery Kamenge University Hospital Center University of Burundi Bujumbura Burundi Department of Pediatrics Kamenge University Hospital Center University of Burundi Bujumbura Burundi

Aim: To describe the clinical and radiological diagnostic for a sickle cell patient who got a bithalamic vasculature accident. Observation: This was a 4-year-old female child admitted to the pediatric ward for convulsive seizures in a feverish context. The physical examination did not find signs of meningeal irritation. The effective workup including thick gout, lumbar puncture, complete blood count, and C reactive protein was normal. An electrocencephalogram was not performed due to lack of availability of the device. Based on clinical data and the fact that Burundi is an area of high malaria prevalence, antimalarial and anticonvulsant treatment has been started. An alteration of consciousness (the Glasgow score of 7) had motivated a CT scan. Bithalamic hypodensities in favor of a vascular accident have been demonstrated. Etiological investigation revealed homozygous sickle cell disease ss during hemoglobin electrophoresis. The final evolution has been characterized by a return to normal consciousness. Conclusion: The complexity of the clinical picture following occlusion of Percherons artery makes it difficult to diagnose. Sickle cell disease may favour the occurrence of ischaemic lesions. Cerebral imaging enables the diagnosis to be made with certainty and avoids delays in treatment.

关键词： Stroke Bithalamic Infarction Sickel Cell Percheron Artery

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Outcome of patients with traumatic cranial nerve palsy admitted to a university hospital in Nepal

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中华神经外科杂志(英文) 2024年第2期10卷 1-7页

作者： Kumari Khusbu Gautam Naveen Parajuli Monika Singh Shreejana Pradhananga Amit Sedai Gopal Shilpakar Sushil Sharma Mohan Raj Maharajgunj Medical Campus Institute of Medicine Tribhuvan University Maharajgunj Kathmandu Nepal Department of Research Institute of Medicine Maharajgunj Kathmandu Nepal Department of Neurosurgery Tribhuvan University Teaching Hospital Maharajgunj Kathmandu Nepal

Background Cranial nerve palsy (CNP) is a common complication of traumatic brain injury (TBI). Despite a high incidence of TBI in Nepal (382 per 100,000), literature on the specific management and outcome of CNP is lacking. This study aimed to examine the outcomes of TBI patients involving single versus multiple *** A retrospective chart review of 170 consecutive TBI patients admitted to the tertiary neurosurgical center in Nepal between April 2020 and April 2022 was conducted. Demographic, clinical, and etiological characteristics; imaging findings; and management strategies were recorded, compared, and analyzed using descriptive statistics. The Glasgow Outcome Scale Extended (GOSE) was used to measure the outcomes in two groups of patients (single and multiple CNP) at 3 *** Out of 250 eligible patients, 80 were excluded and CNP was noted in 29 (17.1%) of the remaining 170. The median age was 34.9 years, and falls (60.6%) were the most common cause of trauma. TBI severity was categorized based on GCS: mild (82.4%), moderate (15.9%), and severe (1.8%). Cranial nerve involvement was seen in 29 (17.05%) patients: single cranial nerve involvement in 26 (89.65%) and multiple nerve involvement in 3 (10.34%). The most common isolated cranial nerve involved was the oculomotor nerve (37.9%). CT findings revealed a maximum of skull fractures with no significant association between CNP and CT *** CNP is a common consequence of TBI with the most common etiology being falls followed by RTA. Single CNP was more common than multiple CNP with no significant difference in the outcome in the 3-month GOSE score. Further research is needed to determine the burden of traumatic CNP and establish specific management guidelines for different types of CNP.

关键词： Cranial nerve palsy Nepal Outcome Traumatic brain injury

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Associated Factors to Poor Blood Pressure Control in Hypertensives Followed Up at the Campus university hospital of Lome (Togo)

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World Journal of Cardiovascular Diseases 2024年第6期14卷 374-380页

作者： Soulemane Pessinaba Yaovi Mignazonzon Afassinou Wiyao Dieudonné Kaziga Komlavi Yayehd Kolani Lamboni Sélim Bolarinwa Mohamed Kpélafia Ekpe Togbossi Akpe Adzodo Machihude Pio Soodougoua Baragou Findibé Damorou Cardiology Department University Hospital of Campus Lome Togo Cardiology Department Sylvanus Olympio University Hospital Lome Togo Cardiology Department Kara University Hospital Kara Togo

Introduction: Hypertension is a real public health issue and its control is very difficult. We aim to determine the frequency of uncontrolled hypertension in hypertensive patients followed up as an outpatient at the campus university hospital of Lome (Togo) and to search for the associated factors. Methodology: The study was cross-sectional, descriptive and analytical, carried out from February (2022) to August 2022 in 260 hypertensive patients aged 22 years old, followed up (on an) as an outpatient for at least 3 months at the Lome university hospital campus. A univariate then multivariate analysis were conducted in order to highlight the most common factors significantly linked to uncontrolled. Results: The mean age of hypertensives was 56.4 ± 12.7 years, the sex ratio (M/F) was 0.59. Prevalence of uncontrolled blood pressure was 42%. Associated Factors to poor blood pressure control in our study were age > 60 years (OR = 1.6 CI [1.17 - 2.50]), low socio-economic level (OR = 2.2 CI [1.96 - 4.33]), high cardiovascular risk level (OR = 3.1 CI [2.18 - 4.52]), non-adherence to regular blood pressure monitoring (OR = 3.3 CI [2.21 - 5.55]), low compliance to treatment (OR = 4.1 CI [2.33 - 6.76]) and a chronic renal failure (OR = 2.1 CI [1.21 - 3.10]). Conclusion: Nearly half of the hypertensives in our study had poorly controlled blood pressure by antihypertensive treatment medication. The factors of this poor control were age > 60 years, low socio-economic level, high or very high level of cardiovascular risk, low compliance to treatment, and renal failure.

关键词： Hypertension Poor Control Associated factors Togo

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Ureteroscopy with Holmium: YAG Laser—A Initial Study in the Urology Department of the Pr Bocar Sidy Sall university hospital of Kati

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Open Journal of Urology 2024年第4期14卷 207-216页

作者： Amadou Kassogue Idrissa Sissoko Daouda Sangare Moussa Salifou Diallo Hamed Sylla Mahamadou Traore Boureima Coulibaly Salia Coulibaly Modibo Diakite Modibo Togola Fadima Tall Ilias Guindo Ben Naoum Kamel Mamadou Lamine Diakite Urology Department University Hospital of Pr Bocar Sidy Sall Kati Mali Radiology Department University Hospital of Pr Bocar Sidy Sall Kati Mali Anesthesy and Reanimation Department University Hospital of Pr Bocar Sidy Sall Kati Mali Urology Department University Hospital Nimes France Urology Department University Hospital of Point G Bamako Mali

Introduction: Ureteroscopy is a minimally invasive endoscopic surgery which provides access to the ureter, pyelon and calyceal cavities via the urethra and the bladder. Laser ureteroscopy uses the laser as an energy source to treat the stone and eliminate it naturally. Minimally invasive endoscopic methods are struggling to become popular in sub-Saharan African countries, especially for the upper urinary tract. The objective of our work was to report the results of our first laser ureteroscopy experience in the department. Materials and Methods: This was a prospective and descriptive study running from December 1, 2023 to February 19, 2024. Included in our study was any case of upper urinary tract stone operated by Laser ureteroscopy. The characteristics of the lithiasis were determined by CT scan. Sterilization of urine was verified by carrying out a cytobacteriological examination of urine. Ureteral lithiasis was approached by semi-rigid ureteroscopy. Renal lithiasis was immediately addressed by flexible ureteroscopy. Ureteroscopy was coupled with a Holmium YAG laser. A double J ureteral catheter was placed after the operation. A 230 µm laser fiber was used in each case with a generator with a power of 35 watts (Storz Calculase III type). An access sheath was used in all cases of flexible ureteroscopy. The parameters studied were: sociodemographic characteristics, lithiasis (site, size, number, density, topography), type of anesthesia, duration of laser use, duration of intervention, postoperative outcomes. Data entry and analysis were carried out using the software (Word 2016 and SPSS). Result: We collected 30 cases of laser ureteroscopy. The average age was 37 years with extremes of 9 and 79 years. The male gender was more represented. The most common age group was 24-39 years old. Renal colic was the most frequent reason for admission, 12 patients (40%). On physical examination, lumbar tenderness was present in 47% (14 patients). ECBU was positive in 4 patients

关键词： Ureteroscopy Semi-Rigid Flexible Holmium YAG Laser

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Epidemiological, Diagnostic, Therapeutic, and Prognostic Profile of Non-Tuberculous Community-Acquired Purulent Pleurisy in Children at the Bouaké university hospital Center, 2017-2021

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Advances in Infectious Diseases 2024年第1期14卷 220-232页

作者： Yapo Thomas Aba Christian Yao Pacôme Monemo Richard Azagoh-Kouadio Iburaima Akandji Noelle Gonné Jean-Marie Karidioula Vincent Achi Vincent Kouadio Asse Department of Infectious and Tropical Diseases University Hospital of Bouaké Bouaké Ivory Coast university Alassane Ouattara of Bouake Bouake Ivory Coast Department of Pediatrics University Hospital of Bouaké Bouaké Ivory Coast Department of Bacteriology & Virology University Hospital of Bouake Bouaké Ivory Coast Department of Pediatrics University Hospital of Angré Abidjan Ivory Coast Department of Pneumology University Hospital of Bouake Bouaké Ivory Coast

Introduction: In Côte d’Ivoire, there is a scarcity of data on children’s purulent pleurisies. Objective: This study aims to elucidate the epidemiological, diagnostic, therapeutic, and evolutionary facets of non-tuberculous purulent pleurisies in pediatric patients. Methods: A retrospective analysis was conducted using the medical records of children aged one month to fifteen years with purulent pleurisies at Bouaké university hospital Center from January 2017 to December 2021. Results: The study identified 124 cases of purulent pleurisies, constituting 18% of lower respiratory tract infections and 0.8% of all hospitalizations. The majority of these cases (69%) were in children between 1 and 24 months of age. Prominent symptoms included dyspnea (85.5%), O2 saturation below 95% in room air (76.6%), respiratory distress (68.5%), cutaneous-mucosal pallor (63.7%), and fever (43.5%). Radiological findings predominantly showed right-sided pleurisy (62.1%). The pleurisy was often extensive (78.2%), accompanied by pneumothorax (37.1%), alveolo-interstitial opacities (8.1% of cases), and abscess formations (1.6%). Pleural fluid cultures were positive in 46.9% of cases, with Staphylococcus aureus (75%, methi-S) identified among 32 bacteria. Initial antibiotic treatment was empirical, favoring oxacillin (53.2%) or amoxicillin-clavulanic acid (53.2%) in dual (42%) or triple therapy (33%) with gentamicin (64.1%) and/or metronidazole (21.8%). Treatments also included pleural drainage (68.5%) or repeated evacuation punctures (33.1%), and blood transfusion (39%). The mortality rate was 18.8%. Conclusion: Non-tuberculous purulent pleurisy remains a significant concern in pediatric hospitalizations at the CHU of Bouaké, marked by high mortality rates.

关键词： Community-Acquired Purulent Pleurisies Children Mortality Bouaké

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Early anticoagulation in patients with stroke and atrial fibrillation is associated with fewer ischaemic lesions at 1 month: the ATTUNE study

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Stroke & Vascular Neurology 2024年第1期9卷 30-37,I0034页

作者： Angelos Sharobeam Longting Lin Christina Lam Carlos Garcia-Esperon Yash Gawarikar Ronak Patel Matthew Lee-Archer Andrew Wong Michael Roizman Amanda Gilligan Andrew Lee Kee Meng Tan Susan Day Christopher Levi Stephen M Davis Mark Parsons Bernard Yan Melbourne Brain Centre at Royal Melbourne hospital ParkvilleVictoriaAustralia university of New South Wales South Western Sydney Clinical School LiverpoolNew South WalesAustralia Department of Neurology John Hunter HospitalNewcastleNew South WalesAustralia Department of Neurology Calvary Public HospitalCanberraAustralian Capital TerritoryAustralia Department of Neurology Northern Hospital EppingEppingVictoriaAustralia Department of Neurology Royal Brisbane and Women's HospitalHerstonQueenslandAustralia The university of Queensland School of Medicine HerstonQueenslandAustralia Neurosciences Clinical Institute Epworth HealthcareRichmondVirginiaAustralia Department of Neurology Austin HealthUniversity of MelbourneHeidelbergVictoriaAustralia Flinders university College of Medicine and Public Health AdelaideSouth AustraliaAustralia Department of Neurology Gold Coast University HospitalSouthportQueenslandAustralia The university of Sydney Northern Clinical School St LeonardsNew South WalesAustralia Department of Neurology and Neurophysiology Liverpool HospitalLiverpoolNew South WalesAustralia

Background The optimal time to commence anticoagulation in patients with atrial fibrillation(AF)after ischaemic stroke or transient ischaemic attack(TIA)is unclear,with guidelines differing in recommendations.A limitation of previous studies is the focus on clinically overt stroke,rather than radiologically obvious diffusion-weighted imaging ischaemic *** aimed to quantify silent ischaemic lesions and haemorrhages on MRI at 1month in patients commenced on early(5mL,regardless of anticoagulation *** Commencing anticoagulation<4days after stroke or TIA is associated with fewer ischaemic lesions at 1month in AF *** is no increased rate of haemorrhage with early *** results suggest that early anticoagulation after mild-to-moderate acute ischaemic stroke associated w

关键词： patients lesions ischaemic

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Epidemiological, Diagnostic, Therapeutic and Progressive Aspects of Arterial Hypertension in Children at the university hospital Center of Bouaké (Côte d’Ivoire)

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Open Journal of Pediatrics 2024年第2期14卷 379-390页

作者： Richard Azagoh-Kouadio Yao Kossonou Roland Yeboua Kouassi Christian Yao John Patrick Yenan Iburaima Alamun Akanji Kouadio Vincent Assé Pediatric Department of Angré university hospital Abidjan Ivory Coast Pediatric Department of Bouaké university hospital Bouaké Ivory Coast

Introduction: Arterial hypertension (AH) in children is under-diagnosed and often has a poor prognosis. The aim of this study was to describe the epidemiological, diagnostic, therapeutic and evolutionary aspects of hypertension in children at the university hospital of Bouaké, with a view to improving the prognosis. Methods: This was a cross-sectional, analytical study carried out in the paediatrics department of Bouaké university hospital. It concerned the medical records of children aged 4 to 15 hospitalised from 1 January 2017 to 31 December 2020 for hypertension. Diagnosis was based on the simplified blood pressure guidelines of the Expert Consensus of the French Society of Hypertension. The variables studied were epidemiological, diagnostic, therapeutic and evolutionary. Quantitative variables were compared at the significance level p ≤ 0.05. Results: The hospital incidence of hypertension was 0.32% (69/21,642). The sex ratio was 0.72. 97.1% of the children were over five years of age. Oedema (49.3%) and breathing difficulties (20.2%) were the main reasons for consultation. Hypertension was classified as threatening (56.5%), confirmed (31.9%) and borderline (11.6%). The cause was renal in 66.7%, dominated by impure nephrotic syndrome (24.6%). Treatment for hypertension consisted mainly of a diuretic (79.7%) and a calcium channel blocker (47.8%). Outcome was favourable in 50.7% of cases. Mortality was 20.3%. No factor was significantly associated with death. Conclusion: Hypertension in children at Bouaké university hospital is serious. The aetiology is mainly renal. Early diagnosis and management are key to improving prognosis.

关键词： Hypertension Children Renal Pathologies Prognosis Côte d’Ivoire

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Therapeutic Compliance of Hypertensive Patients Followed in Ambulatory in the Cardiology Department of Kati university hospital

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World Journal of Cardiovascular Diseases 2024年第5期14卷 333-342页

作者： Boubacar Sonfo Coumba Thiam Mariam Sako Massama Konaté Youssouf Camara Mamadou Touré Boubacar Diarra Diakaridja Sacko Samba Sidibé Bassan Diarra Hamidou Camara Asmaou Keita Konimba Diarra Hamidou Oumar Bâ Ibrahima Sangaré Youssouf Guindo Sanoussi Daffe Daouda Fofana Souleymane Coulibaly Ichaka Menta Department of Cardiology University Hospital Bocar Sidy Sall Kati Mali Department of Cardiology University Hospital of Point G Bamako Mali Department of Cardiology Mali Hospital Bamako Mali Department of Cardiology University Hospital Mother-Child Luxembourg Bamako Mali Department of Cardiology University Hospital Gabriel Tour&#233 Bamako Mali Department of Cardiology Kayes Hospital Kayes Mali

Introduction: High blood pressure is a major public health problem worldwide due to its frequency and cardiovascular complications. Adherence to treatment for chronic diseases is a global problem. The aim was to study therapeutic adherence in hypertensive patients followed in ambulatory. Materials and Methods: This was a cross-sectional, descriptive study with prospective recruitment that took place from July 1 to December 31, 2022 (6 months) in the cardiology department of the university hospital of Kati. The variables studied were sociodemographic data, cardiovascular risk factors, comorbidities, the possession of insurance and compliance (the Girerd questionnaire was used to assess adherence). Results: A total of 1182 patients were consulted, including 887 for hypertension, a frequency of 75%. Fifty-six patients were included in the study. The average age was 58.18 ± 13.25 years with extremes of 30 and 80 years. There was a female predominance (75%) with a sex ratio of 0.3. The majority of patients lived in urban areas (89.3%). Out-of-school patients accounted for 44.6%, more than half of patients or 55.4% had no income, patients with medical coverage accounted for 67.9% of cases. The main risk factors were physical inactivity (25%) followed by smoking 14.3%. More than 71% of patients had a compliance problem and the main reasons were forgetting to take the drug with 73.2%, followed by delayed treatment of 50% and drug discontinuation of 28.6%. Conclusion: Compliance is a real challenge and a major public health issue. This study allowed us to find a real problem of compliance in our hypertensive patients. There was a statistically significant relationship between drug adherence and forgetting to take the drug and drug discontinuation.

关键词： Hypertensive Therapeutic Adherence university hospital of Kati

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