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Anti-N-Methyl-D-Aspartate Receptor Encephalitis with Concomitant Detection of <i>Epstein-Barr</i>Virus

Neuroscience & medicine 2019年第3期10卷 194-198页

作者： Neuza Soares Emanuel Dias Mariana Formigo P. Torres-Ramalho Luis Braz Reina-Couto Marta Internal medicine department Centro Hospitalar Universário de S&#227 o Joã o Porto Portugal Gastroenterology department Centro Hospitalar Universitário de S&#227 o Joã o Porto Portugal Internal medicine department Hospital Senhora da Oliveira Guimar&#227 es Portugal Intensive medicine department Centro Hospitalar Universitário de S&#227 o Joã o Porto Portugal department of Neurology Centro Hospitalar Universitário de S&#227 o Joã o Porto Portugal department of Clinical Neurosciences and Mental Health Faculdade de Medicina da Universidade do Porto Porto Portugal Pharmacology and Therapeutics department Faculdade de Medicina da Universidade do Porto Porto Portugal

Introduction: Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is an important cause of encephalitis worldwide. While some cases are associated with neoplasms, in the remaining cases the etiology is unclear. Recent literature suggests that viral brain infections, mainly of the herpesviridae family, may be associated and/or trigger NMDAR encephalitis. Case Report: A 34-year-old woman with a 1-month-long history of progressive behavioral and language deterioration came to emergency department after a first unprovoked seizure followed by a focal status epilepticus. Brain computerized tomography was normal, but electroencephalography showed epileptiform activity over the left fronto-temporal region. She was admitted to the intensive care unit. Brain magnetic resonance imaging showed subtle T2 hypersignal in the parietal, fronto-opercular and insular regions. Cerebrospinal fluid (CSF) was positive for Epstein Barr virus (EBV) DNA whilst anti-NMDA antibodies were identified both in the CSF and blood. No tumors were detected after thorough investigation. Following intravenous steroids, plasma exchange and rituximab treatment she slowly improved being discharged home and at a 3-month follow-up she was sequels free. Conclusion: Despite the clear association between herpes virus simplex and NMDAR encephalitis, no such unequivocal relation has been reported for other virus, namely EBV. We report a case of NMDAR encephalitis which might be associated and triggered by EBV infection, identified by polymerase chain reaction.

关键词： Autoimmune Encephalitis Infectious Encephalitis Herpesviridae Infections

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Prediction of fatal adverse prognosis in patients with fever-related diseases based on machine learning:a retrospective study

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Chinese Medical Journal 2020年第5期133卷 583-589页

作者： Chun-Hong Zhao Hui-Tao Wu He-Bin Che Ya-Nan Song Yu-Zhuo Zhao Kai-Yuan Li Hong-Ju Xiao Yong-Zhi Zhai Xin Liu Hong-Xi Lu Tan-Shi Li Medical School of Chinese People’s Liberation Army Beijing 100853China department of emergency The First Medical Center of Chinese People’s Liberation Army General HospitalBeijing 100853China National Engineering Laboratory for Medical Big Data Application Technology The First Medical Center to Chinese People’s Liberation Army General HospitalBeijing 100853China

Background:Fever is the most common chief complaint of emergency *** identification of patients at an increasing risk of death may avert adverse *** aim of this study was to establish an early prediction model of fatal adverse prognosis of fever patients by extracting key indicators using big data ***:A retrospective study of patients’data was conducted using the emergency Rescue Database of Chinese People’s Liberation Army General *** were divided into the fatal adverse prognosis group and the good prognosis *** commonly used clinical indicators were *** feature elimination method was used to determine the optimal number of the included *** the training model,logistic regression,random forest,adaboost,and bagging were *** also collected the emergency room data from December 2018 to December 2019 with the same inclusion and exclusion *** performance of the model was evaluated by accuracy,F1-score,precision,sensitivity,and the areas under receiver operator characteristic curves(ROC-AUC).Results:The accuracy of logistic regression,decision tree,adaboost and bagging was 0.951,0.928,0.924,and 0.924,F1-scores were 0.938,0.933,0.930,and 0.930,the precision was 0.943,0.938,0.937,and 0.937,ROC-AUC were 0.808,0.738,0.736,and 0.885,***-AUC of ten-fold cross-validation in logistic and bagging models were 0.80 and 0.87,*** top six coefficients and odds ratio(OR)values of the variables in the logistic regression were cardiac troponin T(CTnT)(coefficient=0.346,OR=1.413),temperature(T)(coefficient=0.235,OR=1.265),respiratory rate(RR)(coefficient=–0.206,OR=0.814),serum kalium(K)(coefficient=0.137,OR=1.146),pulse oxygen saturation(SPO2)(coefficient=–0.101,OR=0.904),and albumin(ALB)(coefficient=–0.043,OR=0.958).The weights of the top six variables in the bagging model were:CTnT,RR,lactate dehydrogenase,serum amylase,heart rate,and systolic blood ***

关键词： Fever Infection Machine learning Prognosis

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Pedestrian Physical Education Training Over Visualization Tool

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Computers, Materials & Continua 2022年第11期73卷 2389-2405页

作者： Tamara al Shloul Israr Akhter Suliman A.Alsuhibany Yazeed Yasin Ghadi Ahmad Jalal Jeongmin Park department of Humanities and Social Science Al Ain UniversityAl Ain15551UAE department of Computer Science Air UniversityIslamabad44000Pakistan department of Computer Science College of ComputerQassim UniversityBuraydah51452Saudi Arabia department of Computer Science and Software Engineering Al Ain UniversityAl Ain15551UAE department of Computer Engineering Korea Polytechnic UniversitySiheung-siGyeonggi-do237Korea

E-learning approaches are one of the most important learning platforms for the learner through electronic *** study techniques are useful for other groups of learners such as the crowd,pedestrian,sports,transports,communication,emergency services,management systems and education sectors.E-learning is still a challenging domain for researchers and developers to find new trends and advanced tools and *** of them are currently working on this domain to fulfill the requirements of industry and the *** this paper,we proposed a method for pedestrian behavior mining of aerial data,using deep flow feature,graph mining technique,and convocational neural *** input data,the state-of-the-art crowd activity University of Minnesota(UMN)dataset is adopted,which contains the aerial indoor and outdoor view of the pedestrian,for simplification of extra information and computational cost reduction the pre-processing is *** flow features are extracted to find more accurate ***,to deal with repetition in features data and features mining the graph mining algorithm is applied,while Convolution Neural Network(CNN)is applied for pedestrian behavior *** proposed method shows 84.50%of mean accuracy and a 15.50%of error ***,the achieved results show more accuracy as compared to state-ofthe-art classification algorithms such as decision tree,artificial neural network(ANN).

关键词： Artificial intelligence behavior mining convolution neural network(CNN) deep flow e-learning environment

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Dramatic recovery from stroke following intravenous thrombolysis in a patient on prasugrel for recent percutaneous coronary angioplasty

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Neuroimmunology and Neuroinflammation 2017年第10期4卷 216-218页

作者： Salvadeeswaran Meenakshi-Sundaram Palanikumar Subburamakrishnan Jude Vinoth Simon Victor Rajah Sanjeevi Madhan-Rajah Somalinga Nagendran Karthik Pandi Suresh department of Neurosciences Apollo Speciality HospitalsLake View RoadKK NagarMaduraiTamil Nadu625020India department of Cardiology Apollo Speciality HospitalsLake View RoadKK NagarMaduraiTamil Nadu625020India department of emergency Services Apollo Speciality HospitalsLake View RoadKK NagarMaduraiTamil Nadu625020India.

The authors report the first case of thrombolysis in a patient already receiving both aspirin and prasugrel following a recent ischemic coronary event. A 55-year-old gentleman was treated for inferior wall myocardial infarction with aspirin, prasugrel and percutaneous angioplasty of right coronary artery. Three days following the procedure he developed acute ischemic stroke due to a left middle cerebral artery infarction with a National Institute of Health Stroke Scale (NIHSS) of 24 and was treated with alteplase. Therapy was interrupted after completion of 29 mg (for a body weight of 65 kg) dose due to oral bleeding. Fifteen minutes post thrombolysis NIHSS was 5 and dropped to zero after 12 h. This report highlights the benefits of alteplase in the context of several relative contraindications like the setting of acute myocardial infarction treated with percutaneous intervention and high NIHSS.

关键词： Intravenous thrombolysis ischemic stroke percutaneous coronary angioplasty prasugrel

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From the perspective of t raditional Chinese medicine nursing in the context of COVID-19

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Nursing Communications 2022年第1期6卷 64-67页

作者： Hong Chen Jie Zhou department of Surgery II Breast Dongfang Hos pit al of Beijing University of Chinese MedicineBeijing 100078China emergency department Dongfang Hos pit al of Beijing University of Chinese MedicineBeijing 100078China.

TCM has played an important role in the treatment of *** nursing is an important part of traditional Chinese medicine,and TCM nursing has unique advantages in clinical care of *** paper,from the perspective of TCM nursing,interprets the application of TCM nursing techniques in COVID-19,and provides a reference for further research.

关键词： COVID-19 i ntegrated traditional Chinese and Western medicine nursing TCM

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Pattern of Cardiac Trauma in Sulaimani Province of Southern Kurdistan: 5 Years’ Experience

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World Journal of Cardiovascular Surgery 2015年第8期5卷 82-90页

作者： Aram Baram Goran Majeed Hewa Sherzad Ftoon Flah Korea Rzgar Ghareeb Muhamed Fahmi H. Kakamad department of Surgery School of Medicine Faculty of Medical Sciences University of Sulaimani Sulaymaniyah Iraq department of Thoracic and Cardiovascular Surgery Sulaimani Teaching Hospital Sulaymaniyah Iraq Faculty of Medical Sciences University of Sulaimani Sulaymaniyah Iraq

Introduction: Cardiac injuries are one of the important causes of death in young population. With aggressive resuscitative therapy and emergency room thoracotomy, the salvage rate of these patients can reach 35%. In this case series the types of presentation, methods of resuscitation, surgical approaches, operative and postoperative outcomes are discussed. Patients and Methods: From January 2009 to January 2014 there were 3157 patients treated for thoracic injuries at Sulaimani university hospital, 14 patients had cardiac injuries. All admitted cases with central chest trauma were submitted to a thorough clinical examination, ECG and eFAST (extended Focused assessment with sonography for trauma) and/or transthoracic echocardiography. Results: Total of 14 cardiac injuries from 3157 causalities were identified, which is 0.44% of the total admissions. Male gender was predominant (85.7% vs. 14.28%) for females. Mechanism of injury was mostly penetrating (85.71%) among which stabs were majority (57.14%) while bullet and shrapnel each constituted (14.28%). Mean time of interval between the accident and our intervention was 2.96 hours. No diagnostic test was 100% specific and sensitive. Discussion: Cardiac injury regarded as a crucial injury because of its high fatality. It is reported that 10.3% of emergency surgical operations are thoracic type and about 1% of them are associated with cardiac injury. Although any penetrating injury to the thorax may injure the heart but those within the box are more suspicious. We conclude that cardiac trauma is a fatal injury but still if the facilities are available the mortality can be minimized.

关键词： Cardiac Trauma eFAST emergency Thoracotomy

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Hepatocellular carcinoma masquerading as a bleeding gastric ulcer: A case report and a review of the surgical management

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World Journal of Gastroenterology 2007年第33期13卷 4523-4525页

作者： Johnny CA Ong Pierce KH Chow Weng-Hoong Chan Alex YF Chung Choon Hua Thng Wai-Keong Wong department of General Surgery Singapore General Hospital Singapore 169608 Singapore department of Oncologic Radiology National Cancer Centre Singapore Singapore

Hepatocellular Carcinoma (HCC) is a common malignancyworldwide. While bleeding from the gastrointestinal tract(BGIT) has a well known association with HCC, suchcases are mainly due to gastric and esophageal *** as a result of invasion of the gastrointestinal tractby HCC is extremely rare and is reportedly associatedwith very poor prognosis. We describe a 67-year-oldmale who presented with BGIT. Endoscopy showed thesite of bleeding to be from a gastric ulcer, but endoscopictherapy failed to control the bleeding and emergencysurgery was required. At surgery, the ulcer was found tohave arisen from direct invasion of the gastrointestinaltract by HCC of the left lobe. Control of the bleedingwas achieved by surgical resection of the HCC en-bloc with the lesser curve of the stomach. The patientremains alive 33 mo after surgery. Direct invasion of thegastrointestinal tract by HCC giving rise to BGIT is veryuncommon. Surgical resection may offer significantlybetter survival over non-surgical therapy, especially if thepatient is a good surgical candidate and has adequatefunctional liver reserves. Prognosis is not uniformly grave.

关键词： Hepatocellular carcinoma Gastrointestinal bleeding Stomach invasion Hepatectomy

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Obstetric Anesthesia Practice Significantly Evolved: A Field for Cesarean Delivery Parturient for the Provision of Safe Anesthesia in Urgent Circumstances

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Open Journal of Anesthesiology 2024年第3期14卷 66-92页

作者： Mustafa Zakaria Amal Haoudar Said Makani Mariame Kabbour Oumaima Taoussi Karim Elaidaoui Yousra Rajaa Chafik El Kettani Adil Elghanmi department of Anesthesia and Resuscitation Hospital ZNA Middelheim Antwerpen Belgium European Society of Anaesthesiology and Intensive Care Ghent Belgium Anesthesia and Resuscitation Services Mohammed VI University of Sciences and Health-UM6SS Casablanca Morocco Cardiologist Vascular Surgery Mohammed VI University of Sciences and Health-UM6SS Casablanca Morocco Faculty of Science and Technology Hassan II University of Casablanca Casablanca Morocco Departement of Services Cardiology Mohammed VI University of Sciences and Health-UM6SS Casablanca Morocco department of Anesthesia and Resuscitation Mohammed VI University of Sciences and Health-UM6SS Casablanca Morocco Obstetrics and Gynecology Services Mohammed VI University of Sciences and Health-UM6SS Casablanca Morocco

General anesthesia and Obstetric Anesthesia is the gold standard for a cesarean section but there are some cases where general anesthesia is unavoidable. The use of general anesthesia for cesarean delivery has decreased in recent years due to the widespread use of neuraxial techniques. The choice of anesthesia techniques for cesarean delivery depends on several factors, including the patient’s psychology and the attending physician’s experience. It is chosen because of its safety profile and its benefits to the mother and fetus. It may be indicated due to emergency, maternal refusal of regional techniques, or regional contraindications. Major complications include failed intubation, gastric content aspiration, and increased bleeding risk. This study aims to evaluate the impact of a newly launched team on obstetric anesthesia practice.

关键词： General Anesthesia Cesarean Delivery Intubation Maternal Refusal Obstetric Anesthetists

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Man Overboard Detection System Using IoT for Navigation Model

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Computers, Materials & Continua 2022年第6期71卷 4955-4969页

作者： Hüseyin Gürüler Murat Altun Faheem Khan Taegkeun Whangbo department of Information Systems Engineering Mugla Sitki Kocman UniversityMuglaTurkey Artificial Intelligence Lab Department of Computer EngineeringGachon UniversityKorea

Security measures and contingency plans have been established in order to ensure human safety especially in the floating elements like ferry,roro,catamaran,frigate,yacht that are the vehicles services for the purpose of logistic and passenger *** this paper,all processes in the event of Man overboard(MOB)are initiated for smart *** MOB the falling person is totally dependent on the person who first saw the falling *** main objective of this paper is to develop a solution to this significant *** a staff member or a passenger does not see the fall into the sea,undesirable situations such as disappearance,injury and death can occur during the period until the absence of the fallen person is *** this paper,a comprehensive and improved solution is provided in terms of personnel and passenger security especially in all the floating elements,in which human resources are intensively involved like passengers,freight,logistics,fishing,business,yacht,leisure and naval *** this case,if the ship’s personnel or passengers fall into the sea in any way,it detected the fallen person into the sea by the sensors in the portable emergency device,which each person will *** warning system is activated via the in-ship automation system to which the information is transmitted by wireless ***,the case of MOB will be determined *** of things(IoT)has a key role in identifying the location and information of the person falling into the sea through sensors,radio frequency,GPS and connected ***,the alarm system on board will be activated and MOB flag(Oscar)will automatically be *** paper enables the Search and rescue(SAR)operations to be initiated and accelerated without losing time through decision-making process.

关键词： SAR internet of things man overboard arduino wireless communication smart transportation

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Eosinophilic enteritis presenting as a rare cause for ileo-ileal intussusception

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World Journal of Gastroenterology 2007年第47期13卷 6444-6445页

作者： Ashok Yadavrao Kshirsagar Sunil Vitthalrao Jagtap Rajkamal Prabhudayal Kanojiya Yogesh Bhupal Langade Sanjay Laxman Shinde Niraj Shekhar department of Surgery Department of PathologyKrishna Institute of Medical Sciences & Deemed UniversityDhebewadi RoadMalkapurKarad 415110MaharashtraIndia

Eosinophilic enteritis,a relatively rare entity,usually involves gastric antrum or proximal small bowel. Our case is rarer in its involvement of the distal small bowel and presents unusually as intussusception. The disease if diagnosed in the initial stages responds well to medical treatment but if associated with complications or misdiagnosed,surgical modality is the treatment of choice. In our case,the patient presented with acute intestinal obstruction due to intussusception and emergency laparotomy with ileoileal anastomosis was done. Histopathology confirmed the diagnosis as eosinophilic enteritis. This case with such a presentation is discussed here.

关键词： Eosinophilic enteritis Intussusception Intestinal obstruction Eosinophils Ileoileal

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