Objective Cognitive impairment(CI)in older individuals has a high morbidity rate worldwide,with poor diagnostic methods and susceptible population identification.This study aimed to investigate the relationship betwee...Objective Cognitive impairment(CI)in older individuals has a high morbidity rate worldwide,with poor diagnostic methods and susceptible population identification.This study aimed to investigate the relationship between different retinal metrics and CI in a particular population,emphasizing polyvascular status.Methods We collected information from the Asymptomatic Polyvascular Abnormalities Community Study on retinal vessel calibers,retinal nerve fiber layer(RNFL)thickness,and cognitive function of 3,785participants,aged 40 years or older.Logistic regression was used to analyze the relationship between retinal metrics and cognitive function.Subgroups stratified by different vascular statuses were also analyzed.Results RNFL thickness was significantly thinner in the CI group(odds ratio:0.973,95%confidence interval:0.953–0.994).In the subgroup analysis,the difference still existed in the non-intracranial arterial stenosis,non-extracranial carotid arterial stenosis,and peripheral arterial disease subgroups(P<0.05).Conclusion A thin RNFL is associated with CI,especially in people with non-large vessel stenosis.The underlying small vessel change in RNFL and CI should be investigated in the future.展开更多
Objective:To evaluate coagulation abnormalities and their relationship with bleeding manifestations among patients with dengue.Methods:This observational study was conducted on 292 adult dengue patients who were admit...Objective:To evaluate coagulation abnormalities and their relationship with bleeding manifestations among patients with dengue.Methods:This observational study was conducted on 292 adult dengue patients who were admitted to a tertiary care hospital of Western India from July 2021 to June 2022.Coagulation tests including prothrombin time(PT),international normalized ratio(INR),activated partial thromboplastin time(aPTT),fibrinogen,and D-dimer were performed.Patients were monitored for bleeding manifestations.Results:Coagulation abnormalities were reported in 42.8%of the patients.Overall,prolonged aPTT was the most common coagulation abnormality(40.8%),followed by low fibrinogen(38.7%),raised D-dimer(31.2%),raised INR(26.0%)and prolonged PT(19.2%).Bleeding manifestations were present in 19.9%patients.PT,INR,aPTT and D-dimer levels were significantly higher(P<0.01)and fibrinogen level was significantly lower(P<0.001)in patients with bleeding compared to patients without bleeding.Patients with bleeding had a significantly higher rate of all coagulation abnormalities than patients without bleeding(P<0.01).Conclusions:Patients with bleeding showed a significantly higher frequency of coagulation abnormalities compared to patients without bleeding.Patients with dengue should be assessed for coagulation abnormalities.展开更多
Introduction: Studies of abnormal ventilatory function in Côte d’Ivoire have been carried out in the workplace and in schools. The objective of this study was to determine the prevalence of respiratory symptoms ...Introduction: Studies of abnormal ventilatory function in Côte d’Ivoire have been carried out in the workplace and in schools. The objective of this study was to determine the prevalence of respiratory symptoms and ventilatory function abnormalities in the population of the lagoon district of Attécoubé in Abidjan. Material and Methods: A cross-sectional study was carried out on 170 people in the municipality of Attécoubé Lagune. A questionnaire was used to collect information on sociodemographic, clinical, and environmental characteristics. A basic spirometry and a beta mimetic test were carried out on all the subjects surveyed. Data analysis was done with the stata 15.1 software. Results: The study population was composed of 103 women and 67 men with a sex ratio (M/F) of 0.65. The average age was 35.92 ± 15.28 years. The most frequent respiratory symptoms were chest tightness (29.41%), dyspnea (28.82%), sneezing (22.94%) and cough (22.35%). The prevalence of ventilatory function abnormalities was 43.24% among residents of Attécoubé Lagune and the most frequent abnormality was ventilatory restriction (35.15%) followed by obstruction (4.85%). The risk factor for ventilatory function abnormalities was heavy pollution [OR = 2.66;IC: 1.053 - 6.743;P = 0.038]. Conclusion: Residents of the Attécoubé Lagune district had many respiratory symptoms and a high prevalence of ventilatory function abnormalities. Improving air quality is urgently needed in this municipality.展开更多
Karyotype prescription is based on clinical signs (or reasons for karyotype prescription) which are phenotypic manifestations associated with chromosomal abnormalities. The aim of this study was to establish a corresp...Karyotype prescription is based on clinical signs (or reasons for karyotype prescription) which are phenotypic manifestations associated with chromosomal abnormalities. The aim of this study was to establish a correspondence between karyotype indications and their results in patients. This was a retrospective study that was carried out in the Histology-Embryology-Cytogenetics laboratory of the University Hospital of Cocody-Abidjan from 2014 to 2019. 58 patient files were identified and included the indication or reason for prescribing a constitutional karyotype and the biological result obtained. An individual data sheet was used to collect the data. 17 reasons for prescription were identified and divided into 2 groups. Sexual ambiguity was the most frequent reason (29.3%). The first group (G1) represented the 10 reasons for which the karyotype results were normal. The second group (G2) corresponded of the 7 motives with normal or abnormal karyotype results. Several anomalies were listed according to these reasons: inversions, mosaics (anomalies of number and structure) and trisomy 21. The last was the most frequent chromosomal anomaly (69.24%). It was found in several reasons for karyotype prescription: malformations, neurological disorders, suspected trisomy and cardiac pathology. Several factors could explain these results, among which are the limits of the karyotype and the non-genetic causes that can induce these abnormal phenotypes. Complementary examinations to the karyotype are molecular cytogenetic techniques, notably fluorescence in situ hybridization (FISH) and array comparative genomic hybridization (Array-CGH).展开更多
Introduction: SARS-COV-2 infection is a real public health challenge for the World Health Organization and for our country. It is responsible for numerous hematological abnormalities in infected patients. Objectives: ...Introduction: SARS-COV-2 infection is a real public health challenge for the World Health Organization and for our country. It is responsible for numerous hematological abnormalities in infected patients. Objectives: To describe the haemogram abnormalities in patients infected with SARS-COV-2 and to determine which ones are associated with death. Material and Method: We conducted a retrospective, descriptive, analytical, cross-sectional study from March 2020 to September 2021. The study included all patients hospitalized with RT-PCR-confirmed COVID-19 who performed a blood count. We evaluated the blood count profile, the pathologies found and the associated blood count abnormalities. Results: A total of 263 patients were included. The mean age of the patients was 63.77 years (range 12 - 90 years). The male sex represented 54.75% (n = 144) while the female sex was 45.25% (n = 119) (sex ratio = 1.21). The most common pathologies were: diabetes: 30.03% (n = 79), high blood pressure: 41.04% (n = 108), and Chronic kidney disease: 7.98 (n = 21). The abnormalities of the haemogram found were essential: anaemia 28.13% (n = 121), hyperleukocytosis with neutrophilic predominance: 29.3% (126), lymphopenia: 34.41% (n = 148), thrombocytopenia: 8.16% (n = 35). The search for hematological factors associated with death in patients showed a significant difference between hyperleukocytosis (p = 0.000) and lymphopenia (p = 0.0001). Conclusion: SARS-COV-2 disease was a mortality factor when associated with lymphopenia and hyperleukocytosis in our series.展开更多
Congenital abnormalities of the kidney and urinary tract(CAKUT) include a wide range of abnormalities ranging from asymptomatic ectopic kidneys to life threatening renal agenesis(bilateral). Many of them are detected ...Congenital abnormalities of the kidney and urinary tract(CAKUT) include a wide range of abnormalities ranging from asymptomatic ectopic kidneys to life threatening renal agenesis(bilateral). Many of them are detected in the antenatal or immediate postnatal with a significant proportion identified in the adult population with varying degree of severity. CAKUT can be classified on embryological basis in to abnormalities in the renal parenchymal development, aberrant embryonic migration and abnormalities of the collecting system. Renal parenchymal abnormalities include multi cystic dysplastic kidneys, renal hypoplasia, number(agenesis or supernumerary), shape and cystic renal diseases. Aberrant embryonic migration encompasses abnormal location and fusion anomalies. Collecting system abnormalities include duplex kidneys and Pelvi ureteric junction obstruction. Ultrasonography(US) is typically the first imaging performed as it is easily available, noninvasive and radiation free used both antenatally and postnatally. Computed tomography(CT) and magnetic resonance imaging(MRI) are useful to confirm the ultrasound detected abnormality, detection of complex malformations, demonstration of collecting system and vascular anatomy and more importantly for early detection of complications like renal calculi, infection and malignancies. As CAKUT are one of the leading causes of end stage renal disease, it is important for the radiologists to be familiar with the varying imaging appearances of CAKUT on US, CT and MRI, thereby helping in prompt diagnosis and optimal management.展开更多
AIM: To characterize the clinical features of ocular surface in gout patients in coastal area of Shandong Province in China. ·METHODS: A total of 380 consecutive gout patients were examined from January 2011 to M...AIM: To characterize the clinical features of ocular surface in gout patients in coastal area of Shandong Province in China. ·METHODS: A total of 380 consecutive gout patients were examined from January 2011 to May 2011. According to the course of gout, patients were divided into group A (<5 years), B (5 -10 years) and C (>10 years). Group D (control group) was consist of 50 healthy subjects. Eyelids, lateral canthus, medial canthus, palpebral conjunctiva, sclera and cornea, anterior chamber, lens, anterior vitreous were examined by slit lamp to find whether there were deposition of uric acid crystals, ocular vascular tortuosity, redness and subconjunctival hemorrhage. The ophthalmic exams of visual acuity, intraocular pressure, fundus were used to assess any gout-related eye disease. ·RESULTS: Uric acid crystals were found in 3 patients and the positions of the deposite were in corneal stroma, corneal epithelium and superficial stroma, and sclera respectively. The incidence was 0.79% . Dilatated and tortuous blood vessels in conjunctiva and sclera surface were found in 38 (23.8% ), 40 (44.0% ), 58 (45.0% ), 9 (18.0% ) patients in groups A, B, C and D, respectively. The differences between group B and D, group C and D were statistically significant(P <0.01, P <0.01).Transparent vesicles with metal-like reflected light in subconjunctiva were seen in 26 (16.2%), 29 (31.9%), 41 (31.8%), 2 (4.00%) patients in groups A, B, C and D, respectively. The differences between A and D, B and D, C and D were statistically significant (P <0.05, P <0.01, P <0.01). Subconjunctival hemorrhage was found in all groups, the difference among the four groups showed no statistically significance. · CONCLUSION: Gout can cause ocular surface abnormalities, such as tophi deposition, subconjunctival transparent vesicles and hemorrhage, and vascularchanges. These features have important clinical significance in early detection of the gout and prevention of eye injury.展开更多
Dexamethasone has been widely used after various neurosurgical procedures due to its anti-inflammatory property and the abilities to restore vascular permeability,inhibit free radicals,and reduce cerebrospinal fluid p...Dexamethasone has been widely used after various neurosurgical procedures due to its anti-inflammatory property and the abilities to restore vascular permeability,inhibit free radicals,and reduce cerebrospinal fluid production.According to the latest guidelines for the treatment of traumatic brain injury in the United States,high-dose glucocorticoids cause neurological damage.To investigate the reason why high-dose glucocorticoids after traumatic brain injury exhibit harmful effect,rat controlled cortical impact models of traumatic brain injury were established.At 1 hour and 2 days after surgery,rat models were intraperitoneally administered dexamethasone 10 mg/kg.The results revealed that 31 proteins were significantly upregulated and 12 proteins were significantly downregulated in rat models of traumatic brain injury after dexamethasone treatment.The Ingenuity Pathway Analysis results showed that differentially expressed proteins were enriched in the mitochondrial dysfunction pathway and synaptogenesis signaling pathway.Western blot analysis and immunohistochemistry results showed that Ndufv2,Maob and Gria3 expression and positive cell count in the dexamethasone-treated group were significantly greater than those in the model group.These findings suggest that dexamethasone may promote a compensatory increase in complex I subunits(Ndufs2 and Ndufv2),increase the expression of mitochondrial enzyme Maob,and upregulate synaptic-transmission-related protein Gria3.These changes may be caused by nerve injury after traumatic brain injury treatment by dexamethasone.The study was approved by Institutional Ethics Committee of Beijing Neurosurgical Institute(approval No.201802001)on June 6,2018.展开更多
An integrated energy service company in an industrial park or commercial building is responsible for managing all energy sources in their local region, including electricity, water, gas, heating, and cooling. To reduc...An integrated energy service company in an industrial park or commercial building is responsible for managing all energy sources in their local region, including electricity, water, gas, heating, and cooling. To reduce energy wastage and increase energy utilization, it is necessary to perform efficiency analyses and diagnoses on integrated energy systems(IESs). However, the integrated energy data necessary for energy efficiency analyses and diagnoses come from a wide variety of instruments, each of which uses different transmission protocols and data formats. This makes it challenging to handle energy-flow data in a unified manner. Thus, we have constructed a unified model for diagnosing energy usage abnormalities in IESs. Using this model, the data are divided into working days and non-working days, and benchmark values are calculated after the data have been weighted to enable unified analysis of several types of energy data. The energy-flow data may then be observed, managed, and compared in all aspects to monitor sudden changes in energy usage and energy wastage. The abnormal data identified and selected by the unified model are then subjected to big-data analysis using technical management tools, enabling the detection of user problems such as abnormalities pertaining to acquisition device, metering, and energy usage. This model facilitates accurate metering of energy data and improves energy efficiency. The study has significant implications in terms of fulfilling the energy saving.展开更多
Insomnia is one of the most frequently observed sleep disorders, affecting nearly 10% of the general population. It has multiple etiological factors. Recently, it has been reported that EEG abnormalities are associate...Insomnia is one of the most frequently observed sleep disorders, affecting nearly 10% of the general population. It has multiple etiological factors. Recently, it has been reported that EEG abnormalities are associated with insomnia in patients previously diagnosed as idiopathic insomniacs. In addition, transcranial magnetic stimulation (TMS) has shown to be effective in the treatment of disorders characterized by neural hyper-excitability. Method: In the present study, patients with insomnia and EEG abnormalities were submitted to slow repetitive trans-cranial magnetic stimulation, for 15 minutes daily during 10 days. Polysomnographic recordings were performed before and after TMS. Results: The results indicate that the presence of EEG abnormalities significantly decreased after TMS. In addition, most of the sleep parameters showed significant improvement. Conclusions: These data support the notion that TMS is a reliable therapeutic tool for patients affected with abnormalities linked to neuronal hyper-excitability.展开更多
Objective to study the possible association between erosion of cervix in pregnant women (ECP) and structural birth defects, i.e. congenital abnormalities (CA) in their offspring. Study design: Comparison of cases with...Objective to study the possible association between erosion of cervix in pregnant women (ECP) and structural birth defects, i.e. congenital abnormalities (CA) in their offspring. Study design: Comparison of cases with CA and all matched controls without any CA born to wo- men with prospectively and medical record ECP in the population-based large data set of the Hungarian Case-Control Surveillance of Congenital Abnormalities (HCCSCA). Results: HCC- SCA contained 22,843 cases and 38,151 matched controls, the informative offspring of 40 (0.18%) case mothers and the newborns of 25 control mothers (0.07%) with ECP were compared and the higher risk for total CA (adjusted OR with 95% CI: 2.7, 1.6-4.4) was found explained by the higher risk of 9 cases with hypospadias (OR with 95% CI: 4.5, 2.1-9.7) and 10 cases with car-diovascular CAs (OR with 95% CI: 3.4, 1.6-7.1), particularly with conotruncal CAs. Conclusions: An unexpected possible association of ECP with higher risk for hypospadias and conotrun-cal cardiovascular CAs was found and these findings are considered as signals that need confirmation or展开更多
Objective:To assess the cardiovascular abnormalities in patients with spontaneous subarachnoid hemorrhage(SAH).Methods:All patients admitted to our institution with a primary diagnosis of spontaneous SAH and had a tra...Objective:To assess the cardiovascular abnormalities in patients with spontaneous subarachnoid hemorrhage(SAH).Methods:All patients admitted to our institution with a primary diagnosis of spontaneous SAH and had a transthoracic echocardiogram(TTE)performed from 1st of July 2011 until 30th of May 2014 were enrolled.Results:Out of 2058 patients admitted to our institution with a diagnosis of SAH,over a three year period,only 244 patients(12%) had TTE performed during the index hospitalization.In this selected cohort,the mean age was 59 years and 66% of patients were female.Elevated troponin T was noticed in 37% of patients and QTc prolongation was the commonest ECG abnormality occurring in 49% of the patients.Thirty nine patients(16%) had a resting segmental wall motion abnormality on the TTE,including fi ve patients with apical ballooning.In-hospital mortality was 15.6% (38 patients).Conclusion:Cardiovascular abnormalities in selected patients with SAH who had cardiac ultrasound are relatively common;however the incidence of ventricular ballooning is low.In order to attain the correct incidence of cardiovascular abnormalities in SAH patients,all patients admitted with SAH should undergo TTE and have ECG and cardiac markers checked during their hospitalization.展开更多
Purpose: The clinical significance of newly identified left atrial anatomic abnormalities (LAAA)— accessory appendages, diverticula, septal pouches—by multidetector CT (MDCT) remains unclear. Similar anatomical outp...Purpose: The clinical significance of newly identified left atrial anatomic abnormalities (LAAA)— accessory appendages, diverticula, septal pouches—by multidetector CT (MDCT) remains unclear. Similar anatomical outpouchings, i.e., the left atrial appendage, have been associated with cardioembolisms and arrhythmia. To test the hypothesis that LAAA are also associated with increased risk of these events, we performed a retrospective analysis to examine the association of LAAA in patients undergoing CT with embolic events and arrhythmia. Methods: 242 patients (mean age 56 SD 12 years, 41% female) were selected who had CT coronary angiography performed with 64-row MDCT between 2007 and 2012 if complete clinical history records were available. CT images were independently reviewed for the presence of LAAA. Association of cerebrovascular accident (CVA) or transient ischemic attack (TIA), atrial fibrillation, and palpitations to LAAA was calculated using odds ratios (OR) with 95% confidence interval (CI) and Fisher’s exact test. Results: After adjusting for age, sex, hypertension, dyslipidemia and diabetes via multiple logistic regression, patients with accessory appendages are more likely to have reported palpitations (OR: 1.80;CI: 1.03 - 3.16). Patients with diverticula and septal pouches are significantly older than those without these abnormalities (p = 0.01 and p = 0.02, respectively). Septal pouches are associated with diabetes (OR: 2.29;95%CI: 1.15 - 4.54). Conclusions: Accessory left atrial appendages are associated with palpitations. Patients with septal pouches and diverticula are significantly older than those patients without these anatomic abnormalities, suggesting age dependency of these findings. None of these anatomic abnormalities were associated with thromboembolic events after adjustment for potentially confounding comorbidities.展开更多
Bacterial diseases affecting corals pose an enormous threat to the health of coral reefs. The relationship between certain bacterial species and coral diseases remain largely unknown. Pigment abnormalities are common ...Bacterial diseases affecting corals pose an enormous threat to the health of coral reefs. The relationship between certain bacterial species and coral diseases remain largely unknown. Pigment abnormalities are common in Porites lutea. Here we used Illumina 16S rRNA gene sequencing to analyze the bacterial communities associated with healthy P. lutea and P. lutea with pigment abnormalities. We observed an increase of alpha diversity of the bacterial community of P. lutea with pigment abnormalities, relative to healthy corals. We then identified changes in the abundance of individual operational taxonomic units(OTUs) between pigmented and healthy corals. We were able to identify eight OTUs associated with pigment abnormalities, which are possibly the causative agents of pigment abnormalities.展开更多
Objective: To explore the genotoxic potential and histopathological changes induced in liver, kidney, testis, brain and heart after using the antibiotic drug amoxicillin/clavulanic acid(4:1).Methods: The study include...Objective: To explore the genotoxic potential and histopathological changes induced in liver, kidney, testis, brain and heart after using the antibiotic drug amoxicillin/clavulanic acid(4:1).Methods: The study included chromosomal aberration analysis in bone-marrow and mouse spermatocytes, induction of sperm morphological abnormalities and histopathological changes in different body organs. The drug was administrated orally at a dose of81 mg/kg body weight twice daily(Total = 162 mg/kg/day) for various periods of time equivalent to 625 mg/men(twice daily).Results: The results revealed non-significant chromosomal aberrations induced after treatment with amoxicillin/clavulanic acid(AC) in both bone marrow and mouse spermatocytes after 7 and 10 days treatment. On the other hand, statistically significant percentages of sperm morphological abnormalities were recorded. Such percentage reached 8.10 ± 0.55, 9.86 ± 0.63 and 12.12 ± 0.58 at the three time intervals tested(7, 14 and 35 days after the 1 st treatment respectively)(treatment performed for 5 successive days) compared with 2.78 ± 0.48 for the control. The results also revealed histopathological changes in different body organs after AC treatment which increased with the prolongation of the period of therapy. Congestion of central vain, liver hemorrhage and hydropic changes in hepatocytes were noticed in the liver. Degenerative changes were found in kidney glomerulus and tubules while testis showed atrophy of seminiferous tubules, and reduction of spermatogenesis. AC also induced neurotoxicity and altered brain neurotransmitter levels. Hemorrhage in the myocardium, disruption of cardiac muscle fibers and pyknotic nuclei in cardiomyocytes were recorded as side effects of AC in heart tissue.Conclusions: The results concluded that AC treatment induced sperm morphological abnormalities and histopathological changes in different body organs. Clinicians must be aware of such results while describing the drug.展开更多
Wireless Capsule Endoscopy(WCE)is an imaging technology,widely used in medical imaging for stomach infection recognition.However,a one patient procedure takes almost seven to eight minutes and approximately 57,000 fra...Wireless Capsule Endoscopy(WCE)is an imaging technology,widely used in medical imaging for stomach infection recognition.However,a one patient procedure takes almost seven to eight minutes and approximately 57,000 frames are captured.The privacy of patients is very important and manual inspection is time consuming and costly.Therefore,an automated system for recognition of stomach infections from WCE frames is always needed.An existing block chain-based approach is employed in a convolutional neural network model to secure the network for accurate recognition of stomach infections such as ulcer and bleeding.Initially,images are normalized in fixed dimension and passed in pre-trained deep models.These architectures are modified at each layer,to make them safer and more secure.Each layer contains an extra block,which stores certain information to avoid possible tempering,modification attacks and layer deletions.Information is stored in multiple blocks,i.e.,block attached to each layer,a ledger block attached with the network,and a cloud ledger block stored in the cloud storage.After that,features are extracted and fused using a Mode value-based approach and optimized using a Genetic Algorithm along with an entropy function.The Softmax classifier is applied at the end for final classification.Experiments are performed on a private collected dataset and achieve an accuracy of 96.8%.The statistical analysis and individual model comparison show the proposed method’s authenticity.展开更多
A growing body of evidence explicitly suggests the significant role of inflammatory processes in the development and progressive deterioration of vascular diseases and cardiomyopathies.1-3 In recent years, a large var...A growing body of evidence explicitly suggests the significant role of inflammatory processes in the development and progressive deterioration of vascular diseases and cardiomyopathies.1-3 In recent years, a large variety of infections have been reported to be associated with the development of cardiomyopathy; the pathogenic factors include rickets, bacteria, protozoa and other parasites,and also, at least 17 viruses.2。展开更多
BACKGROUND Hemophagocytic lymphohistiocytosis(HLH)is a rare but life-threatening disorder,characterized by a hyperimmune response.The mortality is high despite progress being made in the diagnosis and treatment of the...BACKGROUND Hemophagocytic lymphohistiocytosis(HLH)is a rare but life-threatening disorder,characterized by a hyperimmune response.The mortality is high despite progress being made in the diagnosis and treatment of the disease.HLH is traditionally divided into primary(familial or genetic)and secondary(reactive)according to the etiology.Secondary HLH(sHLH),more common in adults,is often associated with underlying conditions including severe infections,malignancies,autoimmune diseases,or other etiologies.CASE SUMMARY The case involves a 31-year-old woman,presented with a high persistent fever,rash,and splenomegaly.She met the diagnostic criteria of the HLH-2004 guideline and thus was diagnosed with HLH,with positive anti-nuclear antibody(ANA)and positive cytomegalovirus(CMV)-DNA.The patient responded well to a combination of immunomodulatory,chemotherapy,and supportive treatments.When her PCR evaluation for CMV turned negative,her serum ferritin also dropped significantly.Her clinical symptoms improved dramatically,and except for ANA,the abnormal laboratory findings associated with HLH returned to normal.Our previous study has shown that the median overall survival of HLH patients is only 6 mo;however,our patient has been cured and has not presented with any relapse of the disease for 6 years.CONCLUSION This case emphasizes that thorough early removal of the CMV infection is significant for the prognosis of this HLH patient.展开更多
Background: Evidence indicates a growing burden of glucose homeostasis abnormalities (namely type 2 diabetes mellitus (T2DM) and prediabetes) in Cameroun. The aim of this study was to assess the prevalence and correla...Background: Evidence indicates a growing burden of glucose homeostasis abnormalities (namely type 2 diabetes mellitus (T2DM) and prediabetes) in Cameroun. The aim of this study was to assess the prevalence and correlates of glucose homeostasis abnormalities (GHA) in the Far-North region of Cameroon, where these variables have not been explored so far. Methods: We included in this population-based cross-sectional survey 461 participants living urban area (Maroua) and 428 dwellers living in rural area (Tokombere) aged at least 18 years, using a multistage-cluster sampling frame. In all participants, we recorded sociodemographic, medical history, clinical data and fasting blood (capillary) glucose (FBG). Diabetes was considered for FBG ≥ 126 mg/dL or being on glucose-lowering medications, and impaired fasting glycemia (IFG) for FBG 100 - 125 mg/dL. Results: The overall age-standardized prevalence of GHA, IFG and diabetes was 33.6%, 21.7% and 11.9%, respectively. Those data were similar between urban and rural areas. Determinants of GHA were age, overweight/obesity, abdominal obesity and hypertension. IFG was only related to abdominal obesity, while diabetes was related to age, family history of diabetes, overweight/obesity, abdominal obesity and hypertension. Conclusion: Glucose homeostasis abnormalities are alarmingly high in Far North Cameroon. Efforts are needed to promote healthier lifestyles and initiate diabetes-screening campaigns in Cameroon.展开更多
BACKGROUND Asymptomatic infections and mild symptoms are common in patients infected with the Omicron variant,and data on liver test abnormalities are rare.AIM To evaluated the clinical characteristics of asymptomatic...BACKGROUND Asymptomatic infections and mild symptoms are common in patients infected with the Omicron variant,and data on liver test abnormalities are rare.AIM To evaluated the clinical characteristics of asymptomatic and mild coronavirus disease 2019(COVID-19)patients with abnormal liver test results.METHODS This retrospective study included 661 laboratory-confirmed asymptomatic and mild COVID-19 patients who were treated in two makeshift hospitals in Ningbo from April 5,2022 to April 29,2022.Clinical information and viral shedding time were collected,and univariate and multivariate logistic regression models were performed in statistical analyses.RESULTS Of the 661 patients,83(12.6%)had liver test abnormalities,and 6(0.9%)had liver injuries.Abnormal liver tests revealed a reliable correlation with a history of liver disease(P<0.001)and a potential correlation with male sex and obesity(P<0.05).Elevated alanine aminotransferase was reliably associated with obesity(P<0.05)and a history of liver disease(P<0.001).Elevated aspartate transaminase(AST)was reliably correlated with a history of liver disease(P<0.001),and potentially correlated with age over 30 years(P<0.05).There was a reliable correlation between AST≥2×the upper limit of normal and a longer viral shedding time,especially in mild cases.CONCLUSION Obesity and a history of liver disease are risk factors for liver test abnormalities.Being male and an older age are potential risk factors.Attention should be given to liver tests in asymptomatic and mild COVID-19 patients,which has crucial clinical significance for evaluating the viral shedding time.展开更多
基金supported by National Natural Science Foundation of China(No.82001239)Beijing Hospitals Authority Innovation Studio of Young Staff Funding Support,code(NO.202112)。
文摘Objective Cognitive impairment(CI)in older individuals has a high morbidity rate worldwide,with poor diagnostic methods and susceptible population identification.This study aimed to investigate the relationship between different retinal metrics and CI in a particular population,emphasizing polyvascular status.Methods We collected information from the Asymptomatic Polyvascular Abnormalities Community Study on retinal vessel calibers,retinal nerve fiber layer(RNFL)thickness,and cognitive function of 3,785participants,aged 40 years or older.Logistic regression was used to analyze the relationship between retinal metrics and cognitive function.Subgroups stratified by different vascular statuses were also analyzed.Results RNFL thickness was significantly thinner in the CI group(odds ratio:0.973,95%confidence interval:0.953–0.994).In the subgroup analysis,the difference still existed in the non-intracranial arterial stenosis,non-extracranial carotid arterial stenosis,and peripheral arterial disease subgroups(P<0.05).Conclusion A thin RNFL is associated with CI,especially in people with non-large vessel stenosis.The underlying small vessel change in RNFL and CI should be investigated in the future.
文摘Objective:To evaluate coagulation abnormalities and their relationship with bleeding manifestations among patients with dengue.Methods:This observational study was conducted on 292 adult dengue patients who were admitted to a tertiary care hospital of Western India from July 2021 to June 2022.Coagulation tests including prothrombin time(PT),international normalized ratio(INR),activated partial thromboplastin time(aPTT),fibrinogen,and D-dimer were performed.Patients were monitored for bleeding manifestations.Results:Coagulation abnormalities were reported in 42.8%of the patients.Overall,prolonged aPTT was the most common coagulation abnormality(40.8%),followed by low fibrinogen(38.7%),raised D-dimer(31.2%),raised INR(26.0%)and prolonged PT(19.2%).Bleeding manifestations were present in 19.9%patients.PT,INR,aPTT and D-dimer levels were significantly higher(P<0.01)and fibrinogen level was significantly lower(P<0.001)in patients with bleeding compared to patients without bleeding.Patients with bleeding had a significantly higher rate of all coagulation abnormalities than patients without bleeding(P<0.01).Conclusions:Patients with bleeding showed a significantly higher frequency of coagulation abnormalities compared to patients without bleeding.Patients with dengue should be assessed for coagulation abnormalities.
文摘Introduction: Studies of abnormal ventilatory function in Côte d’Ivoire have been carried out in the workplace and in schools. The objective of this study was to determine the prevalence of respiratory symptoms and ventilatory function abnormalities in the population of the lagoon district of Attécoubé in Abidjan. Material and Methods: A cross-sectional study was carried out on 170 people in the municipality of Attécoubé Lagune. A questionnaire was used to collect information on sociodemographic, clinical, and environmental characteristics. A basic spirometry and a beta mimetic test were carried out on all the subjects surveyed. Data analysis was done with the stata 15.1 software. Results: The study population was composed of 103 women and 67 men with a sex ratio (M/F) of 0.65. The average age was 35.92 ± 15.28 years. The most frequent respiratory symptoms were chest tightness (29.41%), dyspnea (28.82%), sneezing (22.94%) and cough (22.35%). The prevalence of ventilatory function abnormalities was 43.24% among residents of Attécoubé Lagune and the most frequent abnormality was ventilatory restriction (35.15%) followed by obstruction (4.85%). The risk factor for ventilatory function abnormalities was heavy pollution [OR = 2.66;IC: 1.053 - 6.743;P = 0.038]. Conclusion: Residents of the Attécoubé Lagune district had many respiratory symptoms and a high prevalence of ventilatory function abnormalities. Improving air quality is urgently needed in this municipality.
文摘Karyotype prescription is based on clinical signs (or reasons for karyotype prescription) which are phenotypic manifestations associated with chromosomal abnormalities. The aim of this study was to establish a correspondence between karyotype indications and their results in patients. This was a retrospective study that was carried out in the Histology-Embryology-Cytogenetics laboratory of the University Hospital of Cocody-Abidjan from 2014 to 2019. 58 patient files were identified and included the indication or reason for prescribing a constitutional karyotype and the biological result obtained. An individual data sheet was used to collect the data. 17 reasons for prescription were identified and divided into 2 groups. Sexual ambiguity was the most frequent reason (29.3%). The first group (G1) represented the 10 reasons for which the karyotype results were normal. The second group (G2) corresponded of the 7 motives with normal or abnormal karyotype results. Several anomalies were listed according to these reasons: inversions, mosaics (anomalies of number and structure) and trisomy 21. The last was the most frequent chromosomal anomaly (69.24%). It was found in several reasons for karyotype prescription: malformations, neurological disorders, suspected trisomy and cardiac pathology. Several factors could explain these results, among which are the limits of the karyotype and the non-genetic causes that can induce these abnormal phenotypes. Complementary examinations to the karyotype are molecular cytogenetic techniques, notably fluorescence in situ hybridization (FISH) and array comparative genomic hybridization (Array-CGH).
文摘Introduction: SARS-COV-2 infection is a real public health challenge for the World Health Organization and for our country. It is responsible for numerous hematological abnormalities in infected patients. Objectives: To describe the haemogram abnormalities in patients infected with SARS-COV-2 and to determine which ones are associated with death. Material and Method: We conducted a retrospective, descriptive, analytical, cross-sectional study from March 2020 to September 2021. The study included all patients hospitalized with RT-PCR-confirmed COVID-19 who performed a blood count. We evaluated the blood count profile, the pathologies found and the associated blood count abnormalities. Results: A total of 263 patients were included. The mean age of the patients was 63.77 years (range 12 - 90 years). The male sex represented 54.75% (n = 144) while the female sex was 45.25% (n = 119) (sex ratio = 1.21). The most common pathologies were: diabetes: 30.03% (n = 79), high blood pressure: 41.04% (n = 108), and Chronic kidney disease: 7.98 (n = 21). The abnormalities of the haemogram found were essential: anaemia 28.13% (n = 121), hyperleukocytosis with neutrophilic predominance: 29.3% (126), lymphopenia: 34.41% (n = 148), thrombocytopenia: 8.16% (n = 35). The search for hematological factors associated with death in patients showed a significant difference between hyperleukocytosis (p = 0.000) and lymphopenia (p = 0.0001). Conclusion: SARS-COV-2 disease was a mortality factor when associated with lymphopenia and hyperleukocytosis in our series.
文摘Congenital abnormalities of the kidney and urinary tract(CAKUT) include a wide range of abnormalities ranging from asymptomatic ectopic kidneys to life threatening renal agenesis(bilateral). Many of them are detected in the antenatal or immediate postnatal with a significant proportion identified in the adult population with varying degree of severity. CAKUT can be classified on embryological basis in to abnormalities in the renal parenchymal development, aberrant embryonic migration and abnormalities of the collecting system. Renal parenchymal abnormalities include multi cystic dysplastic kidneys, renal hypoplasia, number(agenesis or supernumerary), shape and cystic renal diseases. Aberrant embryonic migration encompasses abnormal location and fusion anomalies. Collecting system abnormalities include duplex kidneys and Pelvi ureteric junction obstruction. Ultrasonography(US) is typically the first imaging performed as it is easily available, noninvasive and radiation free used both antenatally and postnatally. Computed tomography(CT) and magnetic resonance imaging(MRI) are useful to confirm the ultrasound detected abnormality, detection of complex malformations, demonstration of collecting system and vascular anatomy and more importantly for early detection of complications like renal calculi, infection and malignancies. As CAKUT are one of the leading causes of end stage renal disease, it is important for the radiologists to be familiar with the varying imaging appearances of CAKUT on US, CT and MRI, thereby helping in prompt diagnosis and optimal management.
文摘AIM: To characterize the clinical features of ocular surface in gout patients in coastal area of Shandong Province in China. ·METHODS: A total of 380 consecutive gout patients were examined from January 2011 to May 2011. According to the course of gout, patients were divided into group A (<5 years), B (5 -10 years) and C (>10 years). Group D (control group) was consist of 50 healthy subjects. Eyelids, lateral canthus, medial canthus, palpebral conjunctiva, sclera and cornea, anterior chamber, lens, anterior vitreous were examined by slit lamp to find whether there were deposition of uric acid crystals, ocular vascular tortuosity, redness and subconjunctival hemorrhage. The ophthalmic exams of visual acuity, intraocular pressure, fundus were used to assess any gout-related eye disease. ·RESULTS: Uric acid crystals were found in 3 patients and the positions of the deposite were in corneal stroma, corneal epithelium and superficial stroma, and sclera respectively. The incidence was 0.79% . Dilatated and tortuous blood vessels in conjunctiva and sclera surface were found in 38 (23.8% ), 40 (44.0% ), 58 (45.0% ), 9 (18.0% ) patients in groups A, B, C and D, respectively. The differences between group B and D, group C and D were statistically significant(P <0.01, P <0.01).Transparent vesicles with metal-like reflected light in subconjunctiva were seen in 26 (16.2%), 29 (31.9%), 41 (31.8%), 2 (4.00%) patients in groups A, B, C and D, respectively. The differences between A and D, B and D, C and D were statistically significant (P <0.05, P <0.01, P <0.01). Subconjunctival hemorrhage was found in all groups, the difference among the four groups showed no statistically significance. · CONCLUSION: Gout can cause ocular surface abnormalities, such as tophi deposition, subconjunctival transparent vesicles and hemorrhage, and vascularchanges. These features have important clinical significance in early detection of the gout and prevention of eye injury.
基金This study was supported by the National Natural Science Foundation of China,No.81771327(to BYL)the Platform Construction of Basic Research and Clinical Translation of Nervous System Injury,China,No.PXM2020_026280_000002(to BYL)the Scientific Research and Cultivation Fund of the Beijing Neurosurgical Institute,China,No.2020002(to FN).
文摘Dexamethasone has been widely used after various neurosurgical procedures due to its anti-inflammatory property and the abilities to restore vascular permeability,inhibit free radicals,and reduce cerebrospinal fluid production.According to the latest guidelines for the treatment of traumatic brain injury in the United States,high-dose glucocorticoids cause neurological damage.To investigate the reason why high-dose glucocorticoids after traumatic brain injury exhibit harmful effect,rat controlled cortical impact models of traumatic brain injury were established.At 1 hour and 2 days after surgery,rat models were intraperitoneally administered dexamethasone 10 mg/kg.The results revealed that 31 proteins were significantly upregulated and 12 proteins were significantly downregulated in rat models of traumatic brain injury after dexamethasone treatment.The Ingenuity Pathway Analysis results showed that differentially expressed proteins were enriched in the mitochondrial dysfunction pathway and synaptogenesis signaling pathway.Western blot analysis and immunohistochemistry results showed that Ndufv2,Maob and Gria3 expression and positive cell count in the dexamethasone-treated group were significantly greater than those in the model group.These findings suggest that dexamethasone may promote a compensatory increase in complex I subunits(Ndufs2 and Ndufv2),increase the expression of mitochondrial enzyme Maob,and upregulate synaptic-transmission-related protein Gria3.These changes may be caused by nerve injury after traumatic brain injury treatment by dexamethasone.The study was approved by Institutional Ethics Committee of Beijing Neurosurgical Institute(approval No.201802001)on June 6,2018.
基金supported by National Key Research and Development Program of China (No.2017YFB903304)the State Grid Science and Technology Program (Hybrid Simnlation Key Technology for Integrated Energy System and Platform Construction)
文摘An integrated energy service company in an industrial park or commercial building is responsible for managing all energy sources in their local region, including electricity, water, gas, heating, and cooling. To reduce energy wastage and increase energy utilization, it is necessary to perform efficiency analyses and diagnoses on integrated energy systems(IESs). However, the integrated energy data necessary for energy efficiency analyses and diagnoses come from a wide variety of instruments, each of which uses different transmission protocols and data formats. This makes it challenging to handle energy-flow data in a unified manner. Thus, we have constructed a unified model for diagnosing energy usage abnormalities in IESs. Using this model, the data are divided into working days and non-working days, and benchmark values are calculated after the data have been weighted to enable unified analysis of several types of energy data. The energy-flow data may then be observed, managed, and compared in all aspects to monitor sudden changes in energy usage and energy wastage. The abnormal data identified and selected by the unified model are then subjected to big-data analysis using technical management tools, enabling the detection of user problems such as abnormalities pertaining to acquisition device, metering, and energy usage. This model facilitates accurate metering of energy data and improves energy efficiency. The study has significant implications in terms of fulfilling the energy saving.
文摘Insomnia is one of the most frequently observed sleep disorders, affecting nearly 10% of the general population. It has multiple etiological factors. Recently, it has been reported that EEG abnormalities are associated with insomnia in patients previously diagnosed as idiopathic insomniacs. In addition, transcranial magnetic stimulation (TMS) has shown to be effective in the treatment of disorders characterized by neural hyper-excitability. Method: In the present study, patients with insomnia and EEG abnormalities were submitted to slow repetitive trans-cranial magnetic stimulation, for 15 minutes daily during 10 days. Polysomnographic recordings were performed before and after TMS. Results: The results indicate that the presence of EEG abnormalities significantly decreased after TMS. In addition, most of the sleep parameters showed significant improvement. Conclusions: These data support the notion that TMS is a reliable therapeutic tool for patients affected with abnormalities linked to neuronal hyper-excitability.
文摘Objective to study the possible association between erosion of cervix in pregnant women (ECP) and structural birth defects, i.e. congenital abnormalities (CA) in their offspring. Study design: Comparison of cases with CA and all matched controls without any CA born to wo- men with prospectively and medical record ECP in the population-based large data set of the Hungarian Case-Control Surveillance of Congenital Abnormalities (HCCSCA). Results: HCC- SCA contained 22,843 cases and 38,151 matched controls, the informative offspring of 40 (0.18%) case mothers and the newborns of 25 control mothers (0.07%) with ECP were compared and the higher risk for total CA (adjusted OR with 95% CI: 2.7, 1.6-4.4) was found explained by the higher risk of 9 cases with hypospadias (OR with 95% CI: 4.5, 2.1-9.7) and 10 cases with car-diovascular CAs (OR with 95% CI: 3.4, 1.6-7.1), particularly with conotruncal CAs. Conclusions: An unexpected possible association of ECP with higher risk for hypospadias and conotrun-cal cardiovascular CAs was found and these findings are considered as signals that need confirmation or
文摘Objective:To assess the cardiovascular abnormalities in patients with spontaneous subarachnoid hemorrhage(SAH).Methods:All patients admitted to our institution with a primary diagnosis of spontaneous SAH and had a transthoracic echocardiogram(TTE)performed from 1st of July 2011 until 30th of May 2014 were enrolled.Results:Out of 2058 patients admitted to our institution with a diagnosis of SAH,over a three year period,only 244 patients(12%) had TTE performed during the index hospitalization.In this selected cohort,the mean age was 59 years and 66% of patients were female.Elevated troponin T was noticed in 37% of patients and QTc prolongation was the commonest ECG abnormality occurring in 49% of the patients.Thirty nine patients(16%) had a resting segmental wall motion abnormality on the TTE,including fi ve patients with apical ballooning.In-hospital mortality was 15.6% (38 patients).Conclusion:Cardiovascular abnormalities in selected patients with SAH who had cardiac ultrasound are relatively common;however the incidence of ventricular ballooning is low.In order to attain the correct incidence of cardiovascular abnormalities in SAH patients,all patients admitted with SAH should undergo TTE and have ECG and cardiac markers checked during their hospitalization.
文摘Purpose: The clinical significance of newly identified left atrial anatomic abnormalities (LAAA)— accessory appendages, diverticula, septal pouches—by multidetector CT (MDCT) remains unclear. Similar anatomical outpouchings, i.e., the left atrial appendage, have been associated with cardioembolisms and arrhythmia. To test the hypothesis that LAAA are also associated with increased risk of these events, we performed a retrospective analysis to examine the association of LAAA in patients undergoing CT with embolic events and arrhythmia. Methods: 242 patients (mean age 56 SD 12 years, 41% female) were selected who had CT coronary angiography performed with 64-row MDCT between 2007 and 2012 if complete clinical history records were available. CT images were independently reviewed for the presence of LAAA. Association of cerebrovascular accident (CVA) or transient ischemic attack (TIA), atrial fibrillation, and palpitations to LAAA was calculated using odds ratios (OR) with 95% confidence interval (CI) and Fisher’s exact test. Results: After adjusting for age, sex, hypertension, dyslipidemia and diabetes via multiple logistic regression, patients with accessory appendages are more likely to have reported palpitations (OR: 1.80;CI: 1.03 - 3.16). Patients with diverticula and septal pouches are significantly older than those without these abnormalities (p = 0.01 and p = 0.02, respectively). Septal pouches are associated with diabetes (OR: 2.29;95%CI: 1.15 - 4.54). Conclusions: Accessory left atrial appendages are associated with palpitations. Patients with septal pouches and diverticula are significantly older than those patients without these anatomic abnormalities, suggesting age dependency of these findings. None of these anatomic abnormalities were associated with thromboembolic events after adjustment for potentially confounding comorbidities.
基金The China-Indonesia Maritime Cooperation Fund Project "China-Indonesia Bitung Ecological Station Establishment"the National Natural Science Foundation of China under contract No.41506180the Public Science and Technology Research Funds Projects of Ocean under contract No.201505009
文摘Bacterial diseases affecting corals pose an enormous threat to the health of coral reefs. The relationship between certain bacterial species and coral diseases remain largely unknown. Pigment abnormalities are common in Porites lutea. Here we used Illumina 16S rRNA gene sequencing to analyze the bacterial communities associated with healthy P. lutea and P. lutea with pigment abnormalities. We observed an increase of alpha diversity of the bacterial community of P. lutea with pigment abnormalities, relative to healthy corals. We then identified changes in the abundance of individual operational taxonomic units(OTUs) between pigmented and healthy corals. We were able to identify eight OTUs associated with pigment abnormalities, which are possibly the causative agents of pigment abnormalities.
基金supported by the project in National Research Centre under grant number: 10090013, Cairo, Egypt
文摘Objective: To explore the genotoxic potential and histopathological changes induced in liver, kidney, testis, brain and heart after using the antibiotic drug amoxicillin/clavulanic acid(4:1).Methods: The study included chromosomal aberration analysis in bone-marrow and mouse spermatocytes, induction of sperm morphological abnormalities and histopathological changes in different body organs. The drug was administrated orally at a dose of81 mg/kg body weight twice daily(Total = 162 mg/kg/day) for various periods of time equivalent to 625 mg/men(twice daily).Results: The results revealed non-significant chromosomal aberrations induced after treatment with amoxicillin/clavulanic acid(AC) in both bone marrow and mouse spermatocytes after 7 and 10 days treatment. On the other hand, statistically significant percentages of sperm morphological abnormalities were recorded. Such percentage reached 8.10 ± 0.55, 9.86 ± 0.63 and 12.12 ± 0.58 at the three time intervals tested(7, 14 and 35 days after the 1 st treatment respectively)(treatment performed for 5 successive days) compared with 2.78 ± 0.48 for the control. The results also revealed histopathological changes in different body organs after AC treatment which increased with the prolongation of the period of therapy. Congestion of central vain, liver hemorrhage and hydropic changes in hepatocytes were noticed in the liver. Degenerative changes were found in kidney glomerulus and tubules while testis showed atrophy of seminiferous tubules, and reduction of spermatogenesis. AC also induced neurotoxicity and altered brain neurotransmitter levels. Hemorrhage in the myocardium, disruption of cardiac muscle fibers and pyknotic nuclei in cardiomyocytes were recorded as side effects of AC in heart tissue.Conclusions: The results concluded that AC treatment induced sperm morphological abnormalities and histopathological changes in different body organs. Clinicians must be aware of such results while describing the drug.
基金supported by Korea Institute for Advancement of Technology(KIAT)grant funded by the Korea Government(MOTIE)(P0012724The Competency Development Program for Industry Specialist)and the Soonchunhyang University Research Fund.
文摘Wireless Capsule Endoscopy(WCE)is an imaging technology,widely used in medical imaging for stomach infection recognition.However,a one patient procedure takes almost seven to eight minutes and approximately 57,000 frames are captured.The privacy of patients is very important and manual inspection is time consuming and costly.Therefore,an automated system for recognition of stomach infections from WCE frames is always needed.An existing block chain-based approach is employed in a convolutional neural network model to secure the network for accurate recognition of stomach infections such as ulcer and bleeding.Initially,images are normalized in fixed dimension and passed in pre-trained deep models.These architectures are modified at each layer,to make them safer and more secure.Each layer contains an extra block,which stores certain information to avoid possible tempering,modification attacks and layer deletions.Information is stored in multiple blocks,i.e.,block attached to each layer,a ledger block attached with the network,and a cloud ledger block stored in the cloud storage.After that,features are extracted and fused using a Mode value-based approach and optimized using a Genetic Algorithm along with an entropy function.The Softmax classifier is applied at the end for final classification.Experiments are performed on a private collected dataset and achieve an accuracy of 96.8%.The statistical analysis and individual model comparison show the proposed method’s authenticity.
文摘A growing body of evidence explicitly suggests the significant role of inflammatory processes in the development and progressive deterioration of vascular diseases and cardiomyopathies.1-3 In recent years, a large variety of infections have been reported to be associated with the development of cardiomyopathy; the pathogenic factors include rickets, bacteria, protozoa and other parasites,and also, at least 17 viruses.2。
基金Natural Science Foundation of Jiangsu Province of China,No.BK20181492the National Key Clinical Department of Laboratory Medicine of China in Nanjing,Key laboratory for Laboratory Medicine of Jiangsu Province,No.ZDXKB2016005。
文摘BACKGROUND Hemophagocytic lymphohistiocytosis(HLH)is a rare but life-threatening disorder,characterized by a hyperimmune response.The mortality is high despite progress being made in the diagnosis and treatment of the disease.HLH is traditionally divided into primary(familial or genetic)and secondary(reactive)according to the etiology.Secondary HLH(sHLH),more common in adults,is often associated with underlying conditions including severe infections,malignancies,autoimmune diseases,or other etiologies.CASE SUMMARY The case involves a 31-year-old woman,presented with a high persistent fever,rash,and splenomegaly.She met the diagnostic criteria of the HLH-2004 guideline and thus was diagnosed with HLH,with positive anti-nuclear antibody(ANA)and positive cytomegalovirus(CMV)-DNA.The patient responded well to a combination of immunomodulatory,chemotherapy,and supportive treatments.When her PCR evaluation for CMV turned negative,her serum ferritin also dropped significantly.Her clinical symptoms improved dramatically,and except for ANA,the abnormal laboratory findings associated with HLH returned to normal.Our previous study has shown that the median overall survival of HLH patients is only 6 mo;however,our patient has been cured and has not presented with any relapse of the disease for 6 years.CONCLUSION This case emphasizes that thorough early removal of the CMV infection is significant for the prognosis of this HLH patient.
文摘Background: Evidence indicates a growing burden of glucose homeostasis abnormalities (namely type 2 diabetes mellitus (T2DM) and prediabetes) in Cameroun. The aim of this study was to assess the prevalence and correlates of glucose homeostasis abnormalities (GHA) in the Far-North region of Cameroon, where these variables have not been explored so far. Methods: We included in this population-based cross-sectional survey 461 participants living urban area (Maroua) and 428 dwellers living in rural area (Tokombere) aged at least 18 years, using a multistage-cluster sampling frame. In all participants, we recorded sociodemographic, medical history, clinical data and fasting blood (capillary) glucose (FBG). Diabetes was considered for FBG ≥ 126 mg/dL or being on glucose-lowering medications, and impaired fasting glycemia (IFG) for FBG 100 - 125 mg/dL. Results: The overall age-standardized prevalence of GHA, IFG and diabetes was 33.6%, 21.7% and 11.9%, respectively. Those data were similar between urban and rural areas. Determinants of GHA were age, overweight/obesity, abdominal obesity and hypertension. IFG was only related to abdominal obesity, while diabetes was related to age, family history of diabetes, overweight/obesity, abdominal obesity and hypertension. Conclusion: Glucose homeostasis abnormalities are alarmingly high in Far North Cameroon. Efforts are needed to promote healthier lifestyles and initiate diabetes-screening campaigns in Cameroon.
基金the Ningbo Medical Science and Technology Program,No.2019Y32Ningbo 2025 Science and Technology Major Project,No.2021Z018Ningbo Natural Science Foundation of China,No.2021J263.
文摘BACKGROUND Asymptomatic infections and mild symptoms are common in patients infected with the Omicron variant,and data on liver test abnormalities are rare.AIM To evaluated the clinical characteristics of asymptomatic and mild coronavirus disease 2019(COVID-19)patients with abnormal liver test results.METHODS This retrospective study included 661 laboratory-confirmed asymptomatic and mild COVID-19 patients who were treated in two makeshift hospitals in Ningbo from April 5,2022 to April 29,2022.Clinical information and viral shedding time were collected,and univariate and multivariate logistic regression models were performed in statistical analyses.RESULTS Of the 661 patients,83(12.6%)had liver test abnormalities,and 6(0.9%)had liver injuries.Abnormal liver tests revealed a reliable correlation with a history of liver disease(P<0.001)and a potential correlation with male sex and obesity(P<0.05).Elevated alanine aminotransferase was reliably associated with obesity(P<0.05)and a history of liver disease(P<0.001).Elevated aspartate transaminase(AST)was reliably correlated with a history of liver disease(P<0.001),and potentially correlated with age over 30 years(P<0.05).There was a reliable correlation between AST≥2×the upper limit of normal and a longer viral shedding time,especially in mild cases.CONCLUSION Obesity and a history of liver disease are risk factors for liver test abnormalities.Being male and an older age are potential risk factors.Attention should be given to liver tests in asymptomatic and mild COVID-19 patients,which has crucial clinical significance for evaluating the viral shedding time.