BACKGROUND Several studies have explored the long-term prognosis of patients with asymp-tomatic gallbladder stones.These reports were primarily conducted in facilities equipped with beds for addressing symptomatic cas...BACKGROUND Several studies have explored the long-term prognosis of patients with asymp-tomatic gallbladder stones.These reports were primarily conducted in facilities equipped with beds for addressing symptomatic cases.AIM To report the long-term prognosis of patients with asymptomatic gallbladder stones in clinics without bed facilities.METHODS We investigated the prognoses of 237 patients diagnosed with asymptomatic gallbladder stones in clinics without beds between March 2010 and October 2022.When symptoms developed,patients were transferred to hospitals where appropriate treatment was possible.We investigated the asymptomatic and survival periods during the follow-up.RESULTS Among the 237 patients,214(90.3%)remained asymptomatic,with a mean asymptomatic period of 3898.9279±46.871 d(50-4111 d,10.7 years on average).Biliary complications developed in 23 patients(9.7%),with a mean survival period of 4010.0285±31.2788 d(53-4112 d,10.9 years on average).No patient died of biliary complications.CONCLUSION The long-term prognosis of asymptomatic gallbladder stones in clinics without beds was favorable.When the condition became symptomatic,the patients were transferred to hospitals with beds that could address it;thus,no deaths related to biliary complications were reported.This finding suggests that follow-up care in clinics without beds is possible.展开更多
Objective:To investigate the clinical profile and risk factors of symptomatic and asymptomatic hypoglycemia in neonates admitted to a neonatal intensive care unit in a tertiary care center.Methods:The prospective obse...Objective:To investigate the clinical profile and risk factors of symptomatic and asymptomatic hypoglycemia in neonates admitted to a neonatal intensive care unit in a tertiary care center.Methods:The prospective observational study was conducted in a tertiary care center in the Specialty Department of Pediatric.196 Newborn babies with blood glucose levels<45 mg/dL were examined with a simple random sampling method between December 2019 and November 2021.Maternal and neonatal risk factors and clinical signs were recorded and compared between symptomatic and asymptomatic cases.Results:The proportion of symptomatic hypoglycemia neonates born to gestational diabetes mellitus mothers was significantly higher(23.4%vs.8.4%)(P<0.05).Small for gestational age,low birth weight,respiratory distress syndrome,hypothermia,and endocrine disorders were risk factors.The death rate in asymptomatic hypoglycemia neonates was significantly higher(58%vs.39%)(P<0.05).Conclusions:The study indicates that maternal gestational diabetes mellitus is associated with symptomatic hypoglycemia and asymptomatic hypoglycemia is associated with neonatal mortality.It is important to take vigilance and timely interventions to address associated symptoms,particularly poor feeding,in the management of neonatal hypoglycemia.展开更多
It is known that the pathogenicity of Plasmodium induces the breakdown of haemoglobin, which leads to the induction of oxidative stress. This study aimed to identify the possible effects of oxidative stress and antiox...It is known that the pathogenicity of Plasmodium induces the breakdown of haemoglobin, which leads to the induction of oxidative stress. This study aimed to identify the possible effects of oxidative stress and antioxidant defence systems in symptomatic and asymptomatic Plasmodium falciparum malaria infection in children (1 - 15 years old) in the Mount Cameroon vicinity. This cross-sectional study involved blood samples collected from 473 children and examined for malaria parasitaemia. Full blood counts were performed using an automated haemoanalyser. Serum oxidative stress status (malondialdehyde (MDA), nitric oxide (NO), reduced glutathione (GSH), catalase (CAT), superoxide dismutase (SOD) and vitamin C (Vit C)) were each determined by colorimetric enzymatic assays. The prevalence of malaria parasite infection was 32.1% among the participants. Out of that, 62.5% of patients with parasitaemia were symptomatic. Anaemia prevalence increased significantly with parasite density. MDA levels were significantly higher in patients with malaria symptoms than in those without symptoms. A significant and positive correlation was detected between MDA (r = 0.831, P < 0.05), NO (r = 0.779, P < 0.05), and malaria parasite density while, a significant and negative relationship occurred between parasite density and GSH (r = ?0.763, P < 0.05) and Vit C (r = ?0.826, P < 0.05) levels, SOD (r = ?0.621, P < 0.05) and CAT (r = ?0.817, P < 0.05) activities. The SOD activity and GSH level significantly decreased (P < 0.05) with an increase in the MDA levels. These findings showed that MDA and nitric oxide levels increased both in malaria participants with or without symptoms. A similar decrease in the antioxidant defence system was observed in both symptomatic and asymptomatic patients. Therefore, there is a need to develop public health policies that encourage routine diagnosis and treatment of malaria in seemingly healthy people (asymptomatic cases), and this will play an essential role in controlling malaria in tropical countries.展开更多
Neuromyelitis optica spectrum disorder(NMOSD)is a humoral immune-mediated inflammatory demyelinating disease of the central nervous system with an unclear pathogenesis,often associated with autoimmune diseases such as...Neuromyelitis optica spectrum disorder(NMOSD)is a humoral immune-mediated inflammatory demyelinating disease of the central nervous system with an unclear pathogenesis,often associated with autoimmune diseases such as systemic lupus erythematosus and dry syndrome.The pathology of the disease shows demyelinating changes and axonal damage,and the lesions mostly involve the optic nerve and spinal cord,and the last region of the medulla oblongata,thalamus,paraventricular,and other sites with high aquaporin-4 expression can also be involved.The clinical manifestations are closely related to the location of the lesion,with common symptoms such as optic neuritis,acute myelitis,and intractable eruption,and most patients have recurrent episodes that can leave sequelae such as visual impairment and urinary and bowel disorders.However,a few patients present with less common symptoms,which can easily be missed or misdiagnosed,delaying the diagnosis and treatment of the disease.In this paper,we report the case of a middle-aged female patient with the first symptoms of optic neuritis who developed seizures after 2 months.After completing relevant tests,cerebrospinal fluid and serum anti-aquaporin-4 antibodies were positive,and NMOSD with symptomatic epilepsy was considered.Seizures did not recur after hormone therapy was given again.The purpose of this report is to improve awareness and diagnosis of NMOSD among clinicians.展开更多
Objective The aim of this study was to assess quality of results of elderly patients with coronary disease after medical or revascularisation therapy. Methods In this study, we enrolled 103 patients aged 75 years or o...Objective The aim of this study was to assess quality of results of elderly patients with coronary disease after medical or revascularisation therapy. Methods In this study, we enrolled 103 patients aged 75 years or older with chronic angina in which 47 patients were assigned coronary angiography and revascularisation and 56 patients with optimised medical therapy. The primary endpoint was quality of life after 6 months, as assessed by questionnaire and the presence of major adverse cardiac events (death, non fatal myocardial infarction, or hospital admission for acute coronary syndrome with or without the need for revascularisation). Results After 6 months follow up, angina severity decreased and measures of quality of life increased in both treatment groups( P <0.05 ); however, these improvements were significantly greater after revascularisation( P <0.01 ). Major adverse cardiac events occurred in 30 ( 53.6% ) of patients in the medical group and 9 ( 19.1% ) in the invasive group ( P <0.01 ).Conclusions Patients aged 75 years or older with angina benefit more from revascularisation than from optimised medical therapy in terms of symptom relief and quality of life. Therefore, these patients should be offered invasive assessment despite their high risk profile followed by revascularisation if feasible.展开更多
Objective To investigate neutralizing antibody levels in symptomatic and asymptomatic patients with coronavirus disease 2019(COVID-19)at 6 and 10 months after disease onset.Methods Blood samples were collected at thre...Objective To investigate neutralizing antibody levels in symptomatic and asymptomatic patients with coronavirus disease 2019(COVID-19)at 6 and 10 months after disease onset.Methods Blood samples were collected at three different time points from 27 asymptomatic individuals and 69 symptomatic patients infected with severe acute respiratory syndrome coronavirus 2(SARS-Co V-2).Virus-neutralizing antibody titers against SARS-CoV-2 in both groups were measured and statistically analyzed.Results The symptomatic and asymptomatic groups had higher neutralizing antibodies at 3 months and 1–2 months post polymerase chain reaction confirmation,respectively.However,neutralizing antibodies in both groups dropped significantly to lower levels at 6 months post-PCR confirmation.Conclusion Continued monitoring of symptomatic and asymptomatic individuals with COVID-19 is key to controlling the infection.展开更多
AIM: To clarify the pathogenesis of gastroesophageal reflux disease symptoms in non-erosive reflux disease(NERD) patients.METHODS: Thirty-five NERD patients with persistent symptoms, despite taking rabeprazole 10 mg t...AIM: To clarify the pathogenesis of gastroesophageal reflux disease symptoms in non-erosive reflux disease(NERD) patients.METHODS: Thirty-five NERD patients with persistent symptoms, despite taking rabeprazole 10 mg twice daily for at least 8 wk, were included in this study. All patients underwent 24 h combined impedance- p H on rabeprazole. The symptom index(SI) was considered to be positive if ≥ 50%, and proximal reflux episodes were determined when reflux reached 15 cm above the proximal margin of the lower esophageal sphincter.RESULTS: In 14(40%) SI-positive patients, with liquid weakly acid reflux, the occurrence rate of reflux symptoms was significantly more frequent in proximal reflux episodes(46.7%) than in distal ones(5.7%)(P < 0.001). With liquid acid reflux, there were no significant differences in the occurrence rate of reflux symptoms between proximal reflux episodes(38.5%) and distal ones(20.5%)(NS). With mixed liquid-gas weakly acid reflux, the occurrence rate of reflux symptoms in proximal reflux episodes was significantly more frequent(31.0%) than in distal reflux ones(3.3%)(P < 0.001). With mixed liquid-gas acid reflux, there were no significant differences in the occurrence rate of reflux symptoms between proximal reflux episodes(29.4%) and distal ones(14.3%)(NS).CONCLUSION: The proximal extent of weakly acidic liquid and mixed liquid-gas reflux is a major factor associated with reflux perception in SI-positive patients on proton pump inhibitor therapy.展开更多
AIM To determine the role of cartilage oligomeric matrix protein(COMP), interleukin(IL)-6, IL-10 and ratio of IL-6/IL-10 as risk factors of symptomatic lumbar osteoarthritis(OA) in postmenopausal women with estrogen d...AIM To determine the role of cartilage oligomeric matrix protein(COMP), interleukin(IL)-6, IL-10 and ratio of IL-6/IL-10 as risk factors of symptomatic lumbar osteoarthritis(OA) in postmenopausal women with estrogen deficiency.METHODS Case-control study had been conducted in Sanglah General Hospital from October 2015 until March 2016. The blood samples were obtained and analyzed by enzyme-linked immunosorbent assay(ELISA).RESULTS From 44 pairs of samples which divided into 44 samples as case group and 44 samples as control group showed that high level of COMP in estrogen deficiency postmenopausal women were not at risk(OR = 0.7; 95%CI: 0.261-1.751; P = 0.393) for symptomatic lumbar OA(cut-off point 0.946). Estrogen deficiency in postmenopausal women with the high level of IL-6 had 2.7 times risk(OR = 2.7; 95%CI: 0.991-8.320; P = 0.033) for symptomatic lumbar OA from the low level of IL-6(cut-off point 2.264). At lower level of IL-10, there was no risk for symptomatic lumbar OA(OR = 0.6; 95%CI: 0.209-1.798; P = 0.345) than with the higher level of IL-10(cut-off point 6.049). While the high ratio of IL-6/IL-10 level in estrogen deficiency postmenopausal women gave 3.4 times risk(OR = 3.4; 95%CI: 1.204-11.787; P = 0.011)for symptomatic lumbar OA than the low ratio of IL-6/IL-10 level(cut-off point 0.364).CONCLUSION High ratio of IL-6/IL-10 plasma level was the highest risk factor for causing symptomatic lumbar OA in postmenopausal women with estrogen deficiency.展开更多
Dear Sir,Iam Yonca A.Akova,MD-from the Department of Ophthalmology,Bayindir Kavaklidere Hospital,Turkey.I wrote this letter to evaluate the efficacy of 0.05%topical cyclosporine A(CsA)eye drops(Restasis Allergan,Irvin...Dear Sir,Iam Yonca A.Akova,MD-from the Department of Ophthalmology,Bayindir Kavaklidere Hospital,Turkey.I wrote this letter to evaluate the efficacy of 0.05%topical cyclosporine A(CsA)eye drops(Restasis Allergan,Irvine,USA)in symptomatic patients with recurrent subepithelial infiltrates(SEIs)due to adenoviral keratoconjunctivitis following steroid eye drops tapering or discontinuation.展开更多
AIM:To compare the laparoscopic and the open gastrectomy approaches for short term morbidity,length of hospital stay and also long term gastrointestinal symptoms.METHODS:Patients who have undergone gastrectomy had the...AIM:To compare the laparoscopic and the open gastrectomy approaches for short term morbidity,length of hospital stay and also long term gastrointestinal symptoms.METHODS:Patients who have undergone gastrectomy had their medical records reviewed for demographic data,type of gastrectomy,short term morbidity,and length of hospital stay.Patients were contacted and asked to complete the Gastrointestinal Symptom Rating Scale(GSRS).The GSRS measures three domains of GI symptoms:Dyspepsia Syndrome(DS) for the foregut(best score 0,worse score 15),indigestion syndrome(IS) for the midgut(best score 0,worse score 12),and bowel dysfunction syndrome(BDS) for the hindgut(best score 0,worse score 16).Statistical analysis was done using the Mann-Whitney U-test.RESULTS:We had complete data on 32 patients:7 laparoscopic and 25 open.Of these,25 had a gastroenteric anastomosis and 6 did not.The table shows the results as medians with interquartile range.Laparoscopic gastrectomy had a better score than open gastrectomy in the DS domain(0 vs 1,P = 0.02),while gastrectomy without anastomosis had a better score than gastrectomy with anastomosis in the IS domain(0 vs 1,P = 0.05).CONCLUSION:Patients have little adverse gastroin-testinal symptoms and preserve good gastrointestinal function after undergoing any type of gastrectomy.Laparoscopic approach had better dyspepsia and foregut symptoms.Performing an anastomosis led to mild adverse midgut and indigestion展开更多
1 Transcatheter aortic valve implantation in symptomatic severe aortic stenosis: where do we stand? Aortic stenosis occurs in 2%-9% of patients over the age of 65, the most common cause being degenerative.^([1,2]) The...1 Transcatheter aortic valve implantation in symptomatic severe aortic stenosis: where do we stand? Aortic stenosis occurs in 2%-9% of patients over the age of 65, the most common cause being degenerative.^([1,2]) The preferred treatment in symptomatic severe aortic stenosis(SAS) is surgical aortic valve replacement(SAVR), but in the elderly, the surgical risk can be greater than the benefit.([3]).展开更多
Introduction: The epidemic of atherosclerotic cardiovascular disease in the Western World accounts for the majority of morbidity and mortality in adults. This disease is on the increase, and previous recommendations u...Introduction: The epidemic of atherosclerotic cardiovascular disease in the Western World accounts for the majority of morbidity and mortality in adults. This disease is on the increase, and previous recommendations using “risk equations” to prescribe preventive treatment have not been successful in reducing the prevalence of cardiovascular disease. Furthermore, compliance with statin medication has been limited, with approximately 50% of individuals being non-compliant within five years. This situation is unacceptable since atherosclerosis is both preventable and reversible. Methods: The guidelines presented in this article utilize coronary artery calcium scanning as the basis for preventative therapeutic decisions and identifying the presence of asymptomatic cardiovascular disease. This radiographic technique is superior to “risk equations” in predicting future cardiovascular events. It provides a comprehensive assessment of the lifelong insults to the coronary artery vascular endothelium and the resulting inflammation. Coronary artery calcium scanning is widely available, inexpensive, safe, and reproducible. It has the major advantage of increasing treatment compliance in patients with positive coronary artery calcium scores. Results: All suggested guidelines are supported by published scientific data. Citations are provided to allow the reader to obtain further information. The authors are available for further consultation. Each guideline provides specific recommendations that the primary caregiver can discuss with the patient. Patient involvement in decision-making is strongly recommended. Both treatment costs and adverse effects are minimal. Conclusion: It is anticipated that the early identification of asymptomatic cardiovascular disease and its aggressive treatment will result in regression of subclinical atherosclerosis. Adoption of these guidelines will stop the epidemic of symptomatic heart disease and result in healthier and more satisfied patients.展开更多
<span style="font-family:;" "=""><span style="font-family:Verdana;">The uropathogenic </span><i><span style="font-family:Verdana;">Staphylococ...<span style="font-family:;" "=""><span style="font-family:Verdana;">The uropathogenic </span><i><span style="font-family:Verdana;">Staphylococcus</span></i></span><i><span style="font-family:;" "=""> </span></i><i><span style="font-family:Verdana;">saprophyticus</span></i><span style="font-family:;" "=""><span style="font-family:Verdana;"> is reported severally to be resistant to the drugs often used empirically for treatment of urinary tract infections (UTIs). Their ability to exhibit resistance to multiple drugs is a great de</span><span style="font-family:Verdana;">al of threat to successes recorded in the management of UTIs cause</span><span style="font-family:Verdana;">d by this pathogen. Lactic acid bacteria (LAB) have been demonstrated to exhibit an</span><span style="font-family:Verdana;">timicrobial activities but studies about their prospect against multi</span><span style="font-family:Verdana;">-drug resistant </span><i><span style="font-family:Verdana;">S.</span></i> <i><span style="font-family:Verdana;">saprophyticus</span></i><span style="font-family:Verdana;"> are quite few. This study therefore investigated acti</span><span><span style="font-family:Verdana;">vities of LAB against the multi-drug resistant </span><i><span style="font-family:Verdana;">S</span></i><span style="font-family:Verdana;">. </span><i><span style="font-family:Verdana;">saprophyticus</span></i><span style="font-family:Verdana;"> recover</span></span><span style="font-family:Verdana;">ed fro</span><span style="font-family:Verdana;">m urine samples of symptomatic women. The three differ</span><span style="font-family:Verdana;">ent species of LAB </span><span><span style="font-family:Verdana;">(</span><i><span style="font-family:Verdana;">Lactobacillus</span></i></span></span><i><span style="font-family:;" "=""> </span></i><i><span style="font-family:Verdana;">fermentum</span></i><span style="font-family:;" "=""><span style="font-family:Verdana;"> BTA 62, </span><i><span style="font-family:Verdana;">Lactobacillus</span></i></span><i><span style="font-family:;" "=""> </span></i><i><span style="font-family:Verdana;">johnsonii</span></i><span style="font-family:;" "=""><span style="font-family:Verdana;"> BTA 86 and </span><i><span style="font-family:Verdana;">Weis</span></i></span><i><span style="font-family:Verdana;">sella</span></i><i><span style="font-family:;" "=""> </span></i><i><span style="font-family:Verdana;">confusa</span></i><span style="font-family:Verdana;"> BTA 40) previously isolated and identified by 16S rRNA s</span><span style="font-family:;" "=""><span style="font-family:Verdana;">e</span><span style="font-family:Verdana;">quencing were selected based on their history of antimicrobial activities. Their</span><span style="font-family:Verdana;"> m</span><span style="font-family:Verdana;">etabolites were employed in the antagonistic assays against six (6) mu</span><span style="font-family:Verdana;">lti-drug resista</span><span style="font-family:Verdana;">nt test pathogens recovered fro</span><span style="font-family:Verdana;">m urine samples of symptomatic, non-pregnant women attending clinics in Lagos, Nigeria and the control (</span><i><span style="font-family:Verdana;">S</span></i><span style="font-family:Verdana;">. </span><i><span style="font-family:Verdana;">saprophyticus</span></i><span style="font-family:Verdana;"> subs bovis strain DSM 18669) following standard procedures. </span><span style="font-family:Verdana;">The pathogens showed resistances to almost all the antibiotics except</span><span style="font-family:Verdana;"> levofloxaci</span><span style="font-family:Verdana;">n, ciprofloxacin, imipenem while the control showed resistance to thr</span><span style="font-family:Verdana;">ee. The LAB, </span><i><span style="font-family:Verdana;">L.</span></i></span><i><span style="font-family:;" "=""> </span></i><i><span style="font-family:Verdana;">fermentum</span></i><span style="font-family:;" "=""><span style="font-family:Verdana;"> inhibited five (83.3%) of the pathogens with zone diameter of 12 - 17 mm, followed by </span><i><span style="font-family:Verdana;">W</span></i><span style="font-family:Verdana;">. </span><i><span style="font-family:Verdana;">confusa</span></i><span style="font-family:Verdana;"> inhibiting three (50%) with 15 - 17 mm. </span><i><span style="font-family:Verdana;">Lactobacillus</span></i></span><i><span style="font-family:;" "=""> </span></i><i><span style="font-family:Verdana;">johnsonii</span></i><span style="font-family:;" "=""><span style="font-family:Verdana;"> on the other hand, inhibited a pathogen and the control with zones of 13 mm and 14 mm respectively. In conclusion, the extracted metabolites of LAB inhibited the growth of multi-drug resistant clinical isolates of uropathogenic </span><i><span style="font-family:Verdana;">S</span></i><span style="font-family:Verdana;">. </span><i><span style="font-family:Verdana;">saprophyticus</span></i><span style="font-family:Verdana;"> and may therefore be potent alternatives to antibiotics.</span></span>展开更多
Serous cystadenoma(SC) is a benign pancreatic cystic tumor. Surgical resection is recommended for symptomatic forms, but laparoscopic fenestration of large symptomatic macrocystic SC was not yet described in the liter...Serous cystadenoma(SC) is a benign pancreatic cystic tumor. Surgical resection is recommended for symptomatic forms, but laparoscopic fenestration of large symptomatic macrocystic SC was not yet described in the literature. In this study, 3 female patients underwent laparoscopic fenestration for macrocystic SC(12-14 cm). Diagnosis was established via magnetic resonance imaging and endoscopic ultrasound, with intra-cystic dosage of tumors markers(ACE and CA19-9) in 2 patients. All patients were symptomatic and operated on 15-60 mo after diagnosis.Radiological evaluation showed constant cyst growth.Patients were informed about this new surgical modality that can avoid pancreatic resection. The mean operative time was 103 min(70-150 min) with one conversion.The post-operative course was marked by a grade A pancreatic fistula in one patient and was uneventful in the other two. The hospital stay was 3, 10, and 18 d, respectively. The diagnosis of macrocystic SC was histologically-confirmed in all cases. At the last followup(13-26 mo), all patients were symptom-free, and radiological evaluation showed complete disappearance of the cyst. Laparoscopic fenestration, as opposed to resection, should be considered for large symptomatic macrocystic SC, thereby avoiding pancreatic resection morbidity and mortality.展开更多
AIM:To investigate the depressive state among the patients with symptomatic vitreous floaters(SVF),as well as its change after SVF removal via vitrectomy surgery.METHODS:Twenty-eight eyes of 28 patients who underwent ...AIM:To investigate the depressive state among the patients with symptomatic vitreous floaters(SVF),as well as its change after SVF removal via vitrectomy surgery.METHODS:Twenty-eight eyes of 28 patients who underwent 27-gauge pars plana vitrectomy(PPV)for SVF were included.Thirty-nine eyes of 39 age-and gendermatched healthy volunteers without SVF were also recruited as a healthy control.Center for Epidemiologic Studies Depression(CES-D)was used to assess volunteers and patients’depression(before and 1 wk after PPV).RESULTS:The CES-D score was 18.3±8.6 for patients,and was 12.4±6.0 for healthy control(P=0.003).Patients were significantly more likely to be in a depressive state(53.6%,defined as CES-D score≥16)than the healthy control(20.5%,P=0.005).For patients with SVF,the CES-D score was negatively correlated with their age(rs=-0.42,P=0.025).After PPV,both the CES-D score(11.9±5.4 vs 18.3±8.6,P<0.001)and proportion of depressive state(18.5%vs 53.6%,P=0.005)were significantly decreased.CONCLUSION:This study suggests that symptoms of vitreous floaters have an apparently negative impact on patients’psychological state.The PPV can effectively relieve the depressive state for patients with SVF.展开更多
COVID-19 is one of themost highly infectious diseases ever emerged and caused by newly discovered severe acute respiratory syndrome coronavirus 2(SARS-CoV-2).It has already led the entire world to health and economic ...COVID-19 is one of themost highly infectious diseases ever emerged and caused by newly discovered severe acute respiratory syndrome coronavirus 2(SARS-CoV-2).It has already led the entire world to health and economic crisis.It has invaded the whole universe all most every way.The present study demonstrates with a nine mutually exclusive compartmental model on transmission dynamics of this pandemic disease(COVID-19),with special focus on the transmissibility of symptomatic and asymptomatic infection from susceptible individuals.Herein,the compartmental model has been investigated with mathematical analysis and computer simulations in order to understand the dynamics of COVID-19 transmission.Initially,mathematical analysis of the model has been carried out in broadly by illustrating some well-known methods including exactness,equilibrium and stability analysis in terms of basic reproduction number.We investigate the sensitivity of the model with respect to the variation of the parameters’values.Furthermore,computer simulations are performed to illustrate the results.Our analysis reveals that the death rate from coronavirus disease increases as the infection rate increases,whereas infection rate extensively decreases with the increase of quarantined individuals.The quarantined individuals also lead to increase the concentration of recovered individuals.However,the infection rate of COVID-19 increases more surprisingly as the rate of asymptomatic individuals increases than that of the symptomatic individuals.Moreover,the infection rate decreases significantly due to increase of self-immunity rate.展开更多
BACKGROUND Delayed arterial symptomatic epidural hematoma(SEH)on the 14th day after posterior lumbar interbody fusion(PLIF)is rare but it may lead to severe complications if not identified and treated in a timely mann...BACKGROUND Delayed arterial symptomatic epidural hematoma(SEH)on the 14th day after posterior lumbar interbody fusion(PLIF)is rare but it may lead to severe complications if not identified and treated in a timely manner.After diagnosis of the current case,early surgical removal of the hematoma and strict hemostasis treatment was accomplished.This case report highlights the importance of swift diagnosis and treatment in SEH patients.CASE SUMMARY A 41-year-old male patient with a single-segment lumbar disc herniation underwent left-side PLIF.On the 14th post-operative day,the patient complained of lumbar incision pain with sudden onset accompanied by left limb radiation pain and aggravated cauda equina symptoms.Magnetic resonance imaging examination and a puncture blood draw at the incision site confirmed a delayed arterial SEH.Emergency surgical removal of the hematoma and hemostasis was performed.About 70 mL of hematoma was found in the left incision.Continuous bleeding was found in the anterior branch of the transverse process of the 4th lumbar artery in the muscle area about 2 cm below the transverse process of the 4th lumbar vertebra.A blood jet of about 10 cm in height was observed and bipolar electrocoagulation was used to stop the bleeding.Post-operative lumbar incision pain and left lower limb pain were relieved immediately and gradually disappeared.There was no recurrence during the 12-mo follow-up.CONCLUSION For delayed arterial SEH on the 14th day after PLIF,preventive measures including pre-,intra-and post-operative prevention should be implemented.展开更多
Study Design: Prospective analytical study. Objectives: The aim was to determine the association between mental depression and symptomatic Lumbar Degenerative Disc Disease (LDDD) in patients with no previous backgroun...Study Design: Prospective analytical study. Objectives: The aim was to determine the association between mental depression and symptomatic Lumbar Degenerative Disc Disease (LDDD) in patients with no previous background of mental disorder. We also aimed at determining the incidence of mental depressions in patients with LDDD and the effects of the treatment on the mental depression. Methodology: One hundred and sixty patients with no prior history of mental or behavioral disorders who presented with low back pains arising from LDDD and met inclusion criteria were studied. The clinical findings and Depression Screening Test pro-forma were completed for each. The extracted information was analyzed using Statistical Package for Social Science (SPSS) version 24.0. The statistical significance was set at P Results: One hundred and fifty-three patients completed the study, with a male to female ratio of 1:1.5 and the mean age of the patients was 48.5 years. The marital status was 4.4% single, 86.9% married, 3.8% divorce/separate and 5% widow/widower. Their levels of education were: no formal education (10.00%), primary school level (8.10%), secondary level (27.50%) and Tertiary level (54.40%). Conclusions: This study showed the incidence of mental depression in 32% of the patients with LDDD. We also noted a statistically significant relationship between symptomatic LDDD and level of mental depression with significant improvement in the level of depression at 6th month after treatment. Hence, assessment of the patients’ mental health is important in the management of LDDD.展开更多
A randomized, double blind, and active reference-controlled study was carried out among 116 patients suffering from idiopathic Parkinson’s disease (PD). The aim of the study was to compare the safety and efficacy of ...A randomized, double blind, and active reference-controlled study was carried out among 116 patients suffering from idiopathic Parkinson’s disease (PD). The aim of the study was to compare the safety and efficacy of alpha-dihydroergocryptine (DHEC) vs. pramipexole (PRAM) as an adjunct symptomatic therapy to levodopa in PD patients. The motor symptoms, assessed by the Unified Parkinson’s Disease Rating Scale (UPDRS) III subscale, was identified as efficacy target. Fifty-six patients were randomized to DHEC and 60 to PRAM. Patients included were under constant levodopa dose for at least 3 months before entering the study, with baseline UPDRS III ≥14. They underwent a 16-week treatment. Out of the 116 included patients, 85 (39 in DHEC group and 46 in PRAM group, respectively) completed the study protocol. In DHEC group, UPDRS III decreased by 24.2% from baseline at week 10 and by 28.1% at week 16. In PRAM group, UPDRS III decreased by 27.1% from baseline at week 10 and by 29.2% at week 16. The data were highly significant展开更多
Carpal coalitions are uncommon and are frequently asymptomatic. 15 Patients with persistent symptomatic scaphotrapeziotrapezoid (STT) carpal coalitions unresponsive to six months of conservative treatment with no hist...Carpal coalitions are uncommon and are frequently asymptomatic. 15 Patients with persistent symptomatic scaphotrapeziotrapezoid (STT) carpal coalitions unresponsive to six months of conservative treatment with no history of trauma went for further investigations. CT scans and bone scans revealed that coalition was the only abnormality to account for the patient’s ongoing problems. The senior authors explored the carpal coalition surgically excising the affected region and interposing capsular fibrous tissue. Histologically partial bony and cartilaginous bridging was evident with no features of degenerative arthritis being noted. Good or excellent subjective results were achieved in all patients at final review an average of 2.7 (1.0 - 4.2) years after surgery. All patients described significant reduction in visual analogue pain scores from an average of 71.5 to 18.4 points. The Green and O’Brien wrist scores improved from a mean of 58.2 to 94.2, with all patients returning to work with improved function. Normally carpal coalition is treated with arthrodesis or excision of part of the carpus. A further treatment option is outlined here with recreation of the joint space in symptomatic, isolated, nonsyndromic scaphotrapezio-trapezoidal coalition.展开更多
文摘BACKGROUND Several studies have explored the long-term prognosis of patients with asymp-tomatic gallbladder stones.These reports were primarily conducted in facilities equipped with beds for addressing symptomatic cases.AIM To report the long-term prognosis of patients with asymptomatic gallbladder stones in clinics without bed facilities.METHODS We investigated the prognoses of 237 patients diagnosed with asymptomatic gallbladder stones in clinics without beds between March 2010 and October 2022.When symptoms developed,patients were transferred to hospitals where appropriate treatment was possible.We investigated the asymptomatic and survival periods during the follow-up.RESULTS Among the 237 patients,214(90.3%)remained asymptomatic,with a mean asymptomatic period of 3898.9279±46.871 d(50-4111 d,10.7 years on average).Biliary complications developed in 23 patients(9.7%),with a mean survival period of 4010.0285±31.2788 d(53-4112 d,10.9 years on average).No patient died of biliary complications.CONCLUSION The long-term prognosis of asymptomatic gallbladder stones in clinics without beds was favorable.When the condition became symptomatic,the patients were transferred to hospitals with beds that could address it;thus,no deaths related to biliary complications were reported.This finding suggests that follow-up care in clinics without beds is possible.
文摘Objective:To investigate the clinical profile and risk factors of symptomatic and asymptomatic hypoglycemia in neonates admitted to a neonatal intensive care unit in a tertiary care center.Methods:The prospective observational study was conducted in a tertiary care center in the Specialty Department of Pediatric.196 Newborn babies with blood glucose levels<45 mg/dL were examined with a simple random sampling method between December 2019 and November 2021.Maternal and neonatal risk factors and clinical signs were recorded and compared between symptomatic and asymptomatic cases.Results:The proportion of symptomatic hypoglycemia neonates born to gestational diabetes mellitus mothers was significantly higher(23.4%vs.8.4%)(P<0.05).Small for gestational age,low birth weight,respiratory distress syndrome,hypothermia,and endocrine disorders were risk factors.The death rate in asymptomatic hypoglycemia neonates was significantly higher(58%vs.39%)(P<0.05).Conclusions:The study indicates that maternal gestational diabetes mellitus is associated with symptomatic hypoglycemia and asymptomatic hypoglycemia is associated with neonatal mortality.It is important to take vigilance and timely interventions to address associated symptoms,particularly poor feeding,in the management of neonatal hypoglycemia.
文摘It is known that the pathogenicity of Plasmodium induces the breakdown of haemoglobin, which leads to the induction of oxidative stress. This study aimed to identify the possible effects of oxidative stress and antioxidant defence systems in symptomatic and asymptomatic Plasmodium falciparum malaria infection in children (1 - 15 years old) in the Mount Cameroon vicinity. This cross-sectional study involved blood samples collected from 473 children and examined for malaria parasitaemia. Full blood counts were performed using an automated haemoanalyser. Serum oxidative stress status (malondialdehyde (MDA), nitric oxide (NO), reduced glutathione (GSH), catalase (CAT), superoxide dismutase (SOD) and vitamin C (Vit C)) were each determined by colorimetric enzymatic assays. The prevalence of malaria parasite infection was 32.1% among the participants. Out of that, 62.5% of patients with parasitaemia were symptomatic. Anaemia prevalence increased significantly with parasite density. MDA levels were significantly higher in patients with malaria symptoms than in those without symptoms. A significant and positive correlation was detected between MDA (r = 0.831, P < 0.05), NO (r = 0.779, P < 0.05), and malaria parasite density while, a significant and negative relationship occurred between parasite density and GSH (r = ?0.763, P < 0.05) and Vit C (r = ?0.826, P < 0.05) levels, SOD (r = ?0.621, P < 0.05) and CAT (r = ?0.817, P < 0.05) activities. The SOD activity and GSH level significantly decreased (P < 0.05) with an increase in the MDA levels. These findings showed that MDA and nitric oxide levels increased both in malaria participants with or without symptoms. A similar decrease in the antioxidant defence system was observed in both symptomatic and asymptomatic patients. Therefore, there is a need to develop public health policies that encourage routine diagnosis and treatment of malaria in seemingly healthy people (asymptomatic cases), and this will play an essential role in controlling malaria in tropical countries.
文摘Neuromyelitis optica spectrum disorder(NMOSD)is a humoral immune-mediated inflammatory demyelinating disease of the central nervous system with an unclear pathogenesis,often associated with autoimmune diseases such as systemic lupus erythematosus and dry syndrome.The pathology of the disease shows demyelinating changes and axonal damage,and the lesions mostly involve the optic nerve and spinal cord,and the last region of the medulla oblongata,thalamus,paraventricular,and other sites with high aquaporin-4 expression can also be involved.The clinical manifestations are closely related to the location of the lesion,with common symptoms such as optic neuritis,acute myelitis,and intractable eruption,and most patients have recurrent episodes that can leave sequelae such as visual impairment and urinary and bowel disorders.However,a few patients present with less common symptoms,which can easily be missed or misdiagnosed,delaying the diagnosis and treatment of the disease.In this paper,we report the case of a middle-aged female patient with the first symptoms of optic neuritis who developed seizures after 2 months.After completing relevant tests,cerebrospinal fluid and serum anti-aquaporin-4 antibodies were positive,and NMOSD with symptomatic epilepsy was considered.Seizures did not recur after hormone therapy was given again.The purpose of this report is to improve awareness and diagnosis of NMOSD among clinicians.
文摘Objective The aim of this study was to assess quality of results of elderly patients with coronary disease after medical or revascularisation therapy. Methods In this study, we enrolled 103 patients aged 75 years or older with chronic angina in which 47 patients were assigned coronary angiography and revascularisation and 56 patients with optimised medical therapy. The primary endpoint was quality of life after 6 months, as assessed by questionnaire and the presence of major adverse cardiac events (death, non fatal myocardial infarction, or hospital admission for acute coronary syndrome with or without the need for revascularisation). Results After 6 months follow up, angina severity decreased and measures of quality of life increased in both treatment groups( P <0.05 ); however, these improvements were significantly greater after revascularisation( P <0.01 ). Major adverse cardiac events occurred in 30 ( 53.6% ) of patients in the medical group and 9 ( 19.1% ) in the invasive group ( P <0.01 ).Conclusions Patients aged 75 years or older with angina benefit more from revascularisation than from optimised medical therapy in terms of symptom relief and quality of life. Therefore, these patients should be offered invasive assessment despite their high risk profile followed by revascularisation if feasible.
基金supported by the National Natural Science Foundation of China[82041027]National Key R&D Program of China[2021ZD0114100,2021ZD0114103]+2 种基金The Capital Health Development and Research of Special[2022-1G-3014]Beijing Science and Technology Planning Project of Beijing Science and Technology Commission[Z211100002521015,Z211100002521019]Cooperation project[2022-jk-cd-009]。
文摘Objective To investigate neutralizing antibody levels in symptomatic and asymptomatic patients with coronavirus disease 2019(COVID-19)at 6 and 10 months after disease onset.Methods Blood samples were collected at three different time points from 27 asymptomatic individuals and 69 symptomatic patients infected with severe acute respiratory syndrome coronavirus 2(SARS-Co V-2).Virus-neutralizing antibody titers against SARS-CoV-2 in both groups were measured and statistically analyzed.Results The symptomatic and asymptomatic groups had higher neutralizing antibodies at 3 months and 1–2 months post polymerase chain reaction confirmation,respectively.However,neutralizing antibodies in both groups dropped significantly to lower levels at 6 months post-PCR confirmation.Conclusion Continued monitoring of symptomatic and asymptomatic individuals with COVID-19 is key to controlling the infection.
文摘AIM: To clarify the pathogenesis of gastroesophageal reflux disease symptoms in non-erosive reflux disease(NERD) patients.METHODS: Thirty-five NERD patients with persistent symptoms, despite taking rabeprazole 10 mg twice daily for at least 8 wk, were included in this study. All patients underwent 24 h combined impedance- p H on rabeprazole. The symptom index(SI) was considered to be positive if ≥ 50%, and proximal reflux episodes were determined when reflux reached 15 cm above the proximal margin of the lower esophageal sphincter.RESULTS: In 14(40%) SI-positive patients, with liquid weakly acid reflux, the occurrence rate of reflux symptoms was significantly more frequent in proximal reflux episodes(46.7%) than in distal ones(5.7%)(P < 0.001). With liquid acid reflux, there were no significant differences in the occurrence rate of reflux symptoms between proximal reflux episodes(38.5%) and distal ones(20.5%)(NS). With mixed liquid-gas weakly acid reflux, the occurrence rate of reflux symptoms in proximal reflux episodes was significantly more frequent(31.0%) than in distal reflux ones(3.3%)(P < 0.001). With mixed liquid-gas acid reflux, there were no significant differences in the occurrence rate of reflux symptoms between proximal reflux episodes(29.4%) and distal ones(14.3%)(NS).CONCLUSION: The proximal extent of weakly acidic liquid and mixed liquid-gas reflux is a major factor associated with reflux perception in SI-positive patients on proton pump inhibitor therapy.
文摘AIM To determine the role of cartilage oligomeric matrix protein(COMP), interleukin(IL)-6, IL-10 and ratio of IL-6/IL-10 as risk factors of symptomatic lumbar osteoarthritis(OA) in postmenopausal women with estrogen deficiency.METHODS Case-control study had been conducted in Sanglah General Hospital from October 2015 until March 2016. The blood samples were obtained and analyzed by enzyme-linked immunosorbent assay(ELISA).RESULTS From 44 pairs of samples which divided into 44 samples as case group and 44 samples as control group showed that high level of COMP in estrogen deficiency postmenopausal women were not at risk(OR = 0.7; 95%CI: 0.261-1.751; P = 0.393) for symptomatic lumbar OA(cut-off point 0.946). Estrogen deficiency in postmenopausal women with the high level of IL-6 had 2.7 times risk(OR = 2.7; 95%CI: 0.991-8.320; P = 0.033) for symptomatic lumbar OA from the low level of IL-6(cut-off point 2.264). At lower level of IL-10, there was no risk for symptomatic lumbar OA(OR = 0.6; 95%CI: 0.209-1.798; P = 0.345) than with the higher level of IL-10(cut-off point 6.049). While the high ratio of IL-6/IL-10 level in estrogen deficiency postmenopausal women gave 3.4 times risk(OR = 3.4; 95%CI: 1.204-11.787; P = 0.011)for symptomatic lumbar OA than the low ratio of IL-6/IL-10 level(cut-off point 0.364).CONCLUSION High ratio of IL-6/IL-10 plasma level was the highest risk factor for causing symptomatic lumbar OA in postmenopausal women with estrogen deficiency.
文摘Dear Sir,Iam Yonca A.Akova,MD-from the Department of Ophthalmology,Bayindir Kavaklidere Hospital,Turkey.I wrote this letter to evaluate the efficacy of 0.05%topical cyclosporine A(CsA)eye drops(Restasis Allergan,Irvine,USA)in symptomatic patients with recurrent subepithelial infiltrates(SEIs)due to adenoviral keratoconjunctivitis following steroid eye drops tapering or discontinuation.
文摘AIM:To compare the laparoscopic and the open gastrectomy approaches for short term morbidity,length of hospital stay and also long term gastrointestinal symptoms.METHODS:Patients who have undergone gastrectomy had their medical records reviewed for demographic data,type of gastrectomy,short term morbidity,and length of hospital stay.Patients were contacted and asked to complete the Gastrointestinal Symptom Rating Scale(GSRS).The GSRS measures three domains of GI symptoms:Dyspepsia Syndrome(DS) for the foregut(best score 0,worse score 15),indigestion syndrome(IS) for the midgut(best score 0,worse score 12),and bowel dysfunction syndrome(BDS) for the hindgut(best score 0,worse score 16).Statistical analysis was done using the Mann-Whitney U-test.RESULTS:We had complete data on 32 patients:7 laparoscopic and 25 open.Of these,25 had a gastroenteric anastomosis and 6 did not.The table shows the results as medians with interquartile range.Laparoscopic gastrectomy had a better score than open gastrectomy in the DS domain(0 vs 1,P = 0.02),while gastrectomy without anastomosis had a better score than gastrectomy with anastomosis in the IS domain(0 vs 1,P = 0.05).CONCLUSION:Patients have little adverse gastroin-testinal symptoms and preserve good gastrointestinal function after undergoing any type of gastrectomy.Laparoscopic approach had better dyspepsia and foregut symptoms.Performing an anastomosis led to mild adverse midgut and indigestion
文摘1 Transcatheter aortic valve implantation in symptomatic severe aortic stenosis: where do we stand? Aortic stenosis occurs in 2%-9% of patients over the age of 65, the most common cause being degenerative.^([1,2]) The preferred treatment in symptomatic severe aortic stenosis(SAS) is surgical aortic valve replacement(SAVR), but in the elderly, the surgical risk can be greater than the benefit.([3]).
文摘Introduction: The epidemic of atherosclerotic cardiovascular disease in the Western World accounts for the majority of morbidity and mortality in adults. This disease is on the increase, and previous recommendations using “risk equations” to prescribe preventive treatment have not been successful in reducing the prevalence of cardiovascular disease. Furthermore, compliance with statin medication has been limited, with approximately 50% of individuals being non-compliant within five years. This situation is unacceptable since atherosclerosis is both preventable and reversible. Methods: The guidelines presented in this article utilize coronary artery calcium scanning as the basis for preventative therapeutic decisions and identifying the presence of asymptomatic cardiovascular disease. This radiographic technique is superior to “risk equations” in predicting future cardiovascular events. It provides a comprehensive assessment of the lifelong insults to the coronary artery vascular endothelium and the resulting inflammation. Coronary artery calcium scanning is widely available, inexpensive, safe, and reproducible. It has the major advantage of increasing treatment compliance in patients with positive coronary artery calcium scores. Results: All suggested guidelines are supported by published scientific data. Citations are provided to allow the reader to obtain further information. The authors are available for further consultation. Each guideline provides specific recommendations that the primary caregiver can discuss with the patient. Patient involvement in decision-making is strongly recommended. Both treatment costs and adverse effects are minimal. Conclusion: It is anticipated that the early identification of asymptomatic cardiovascular disease and its aggressive treatment will result in regression of subclinical atherosclerosis. Adoption of these guidelines will stop the epidemic of symptomatic heart disease and result in healthier and more satisfied patients.
文摘<span style="font-family:;" "=""><span style="font-family:Verdana;">The uropathogenic </span><i><span style="font-family:Verdana;">Staphylococcus</span></i></span><i><span style="font-family:;" "=""> </span></i><i><span style="font-family:Verdana;">saprophyticus</span></i><span style="font-family:;" "=""><span style="font-family:Verdana;"> is reported severally to be resistant to the drugs often used empirically for treatment of urinary tract infections (UTIs). Their ability to exhibit resistance to multiple drugs is a great de</span><span style="font-family:Verdana;">al of threat to successes recorded in the management of UTIs cause</span><span style="font-family:Verdana;">d by this pathogen. Lactic acid bacteria (LAB) have been demonstrated to exhibit an</span><span style="font-family:Verdana;">timicrobial activities but studies about their prospect against multi</span><span style="font-family:Verdana;">-drug resistant </span><i><span style="font-family:Verdana;">S.</span></i> <i><span style="font-family:Verdana;">saprophyticus</span></i><span style="font-family:Verdana;"> are quite few. This study therefore investigated acti</span><span><span style="font-family:Verdana;">vities of LAB against the multi-drug resistant </span><i><span style="font-family:Verdana;">S</span></i><span style="font-family:Verdana;">. </span><i><span style="font-family:Verdana;">saprophyticus</span></i><span style="font-family:Verdana;"> recover</span></span><span style="font-family:Verdana;">ed fro</span><span style="font-family:Verdana;">m urine samples of symptomatic women. The three differ</span><span style="font-family:Verdana;">ent species of LAB </span><span><span style="font-family:Verdana;">(</span><i><span style="font-family:Verdana;">Lactobacillus</span></i></span></span><i><span style="font-family:;" "=""> </span></i><i><span style="font-family:Verdana;">fermentum</span></i><span style="font-family:;" "=""><span style="font-family:Verdana;"> BTA 62, </span><i><span style="font-family:Verdana;">Lactobacillus</span></i></span><i><span style="font-family:;" "=""> </span></i><i><span style="font-family:Verdana;">johnsonii</span></i><span style="font-family:;" "=""><span style="font-family:Verdana;"> BTA 86 and </span><i><span style="font-family:Verdana;">Weis</span></i></span><i><span style="font-family:Verdana;">sella</span></i><i><span style="font-family:;" "=""> </span></i><i><span style="font-family:Verdana;">confusa</span></i><span style="font-family:Verdana;"> BTA 40) previously isolated and identified by 16S rRNA s</span><span style="font-family:;" "=""><span style="font-family:Verdana;">e</span><span style="font-family:Verdana;">quencing were selected based on their history of antimicrobial activities. Their</span><span style="font-family:Verdana;"> m</span><span style="font-family:Verdana;">etabolites were employed in the antagonistic assays against six (6) mu</span><span style="font-family:Verdana;">lti-drug resista</span><span style="font-family:Verdana;">nt test pathogens recovered fro</span><span style="font-family:Verdana;">m urine samples of symptomatic, non-pregnant women attending clinics in Lagos, Nigeria and the control (</span><i><span style="font-family:Verdana;">S</span></i><span style="font-family:Verdana;">. </span><i><span style="font-family:Verdana;">saprophyticus</span></i><span style="font-family:Verdana;"> subs bovis strain DSM 18669) following standard procedures. </span><span style="font-family:Verdana;">The pathogens showed resistances to almost all the antibiotics except</span><span style="font-family:Verdana;"> levofloxaci</span><span style="font-family:Verdana;">n, ciprofloxacin, imipenem while the control showed resistance to thr</span><span style="font-family:Verdana;">ee. The LAB, </span><i><span style="font-family:Verdana;">L.</span></i></span><i><span style="font-family:;" "=""> </span></i><i><span style="font-family:Verdana;">fermentum</span></i><span style="font-family:;" "=""><span style="font-family:Verdana;"> inhibited five (83.3%) of the pathogens with zone diameter of 12 - 17 mm, followed by </span><i><span style="font-family:Verdana;">W</span></i><span style="font-family:Verdana;">. </span><i><span style="font-family:Verdana;">confusa</span></i><span style="font-family:Verdana;"> inhibiting three (50%) with 15 - 17 mm. </span><i><span style="font-family:Verdana;">Lactobacillus</span></i></span><i><span style="font-family:;" "=""> </span></i><i><span style="font-family:Verdana;">johnsonii</span></i><span style="font-family:;" "=""><span style="font-family:Verdana;"> on the other hand, inhibited a pathogen and the control with zones of 13 mm and 14 mm respectively. In conclusion, the extracted metabolites of LAB inhibited the growth of multi-drug resistant clinical isolates of uropathogenic </span><i><span style="font-family:Verdana;">S</span></i><span style="font-family:Verdana;">. </span><i><span style="font-family:Verdana;">saprophyticus</span></i><span style="font-family:Verdana;"> and may therefore be potent alternatives to antibiotics.</span></span>
文摘Serous cystadenoma(SC) is a benign pancreatic cystic tumor. Surgical resection is recommended for symptomatic forms, but laparoscopic fenestration of large symptomatic macrocystic SC was not yet described in the literature. In this study, 3 female patients underwent laparoscopic fenestration for macrocystic SC(12-14 cm). Diagnosis was established via magnetic resonance imaging and endoscopic ultrasound, with intra-cystic dosage of tumors markers(ACE and CA19-9) in 2 patients. All patients were symptomatic and operated on 15-60 mo after diagnosis.Radiological evaluation showed constant cyst growth.Patients were informed about this new surgical modality that can avoid pancreatic resection. The mean operative time was 103 min(70-150 min) with one conversion.The post-operative course was marked by a grade A pancreatic fistula in one patient and was uneventful in the other two. The hospital stay was 3, 10, and 18 d, respectively. The diagnosis of macrocystic SC was histologically-confirmed in all cases. At the last followup(13-26 mo), all patients were symptom-free, and radiological evaluation showed complete disappearance of the cyst. Laparoscopic fenestration, as opposed to resection, should be considered for large symptomatic macrocystic SC, thereby avoiding pancreatic resection morbidity and mortality.
基金Supported by Zhejiang Provincial Natural Science Foundation of China(No.LQ18H120004)the Innovation Research Project of the Eye Hospital of Wenzhou Medical University(No.YNCX201308).
文摘AIM:To investigate the depressive state among the patients with symptomatic vitreous floaters(SVF),as well as its change after SVF removal via vitrectomy surgery.METHODS:Twenty-eight eyes of 28 patients who underwent 27-gauge pars plana vitrectomy(PPV)for SVF were included.Thirty-nine eyes of 39 age-and gendermatched healthy volunteers without SVF were also recruited as a healthy control.Center for Epidemiologic Studies Depression(CES-D)was used to assess volunteers and patients’depression(before and 1 wk after PPV).RESULTS:The CES-D score was 18.3±8.6 for patients,and was 12.4±6.0 for healthy control(P=0.003).Patients were significantly more likely to be in a depressive state(53.6%,defined as CES-D score≥16)than the healthy control(20.5%,P=0.005).For patients with SVF,the CES-D score was negatively correlated with their age(rs=-0.42,P=0.025).After PPV,both the CES-D score(11.9±5.4 vs 18.3±8.6,P<0.001)and proportion of depressive state(18.5%vs 53.6%,P=0.005)were significantly decreased.CONCLUSION:This study suggests that symptoms of vitreous floaters have an apparently negative impact on patients’psychological state.The PPV can effectively relieve the depressive state for patients with SVF.
基金The authors greatly acknowledge the partial financial support provided by the Ministry of Science and Technology,Government of the People’s Republic of Bangladesh under special allocation in 2019–2020 with the research Grant Ref.No.39.00.0000.009.06.024.19-12/410(EAS).Supports with Ref.:17-392RG/MATHS/AS_I-FR3240297753 funded by TWAS,Italy and Ref.No.6(74)UGC/ST/Physical-17/2017/3169 funded by the UGC,Bangladesh are also acknowledged.
文摘COVID-19 is one of themost highly infectious diseases ever emerged and caused by newly discovered severe acute respiratory syndrome coronavirus 2(SARS-CoV-2).It has already led the entire world to health and economic crisis.It has invaded the whole universe all most every way.The present study demonstrates with a nine mutually exclusive compartmental model on transmission dynamics of this pandemic disease(COVID-19),with special focus on the transmissibility of symptomatic and asymptomatic infection from susceptible individuals.Herein,the compartmental model has been investigated with mathematical analysis and computer simulations in order to understand the dynamics of COVID-19 transmission.Initially,mathematical analysis of the model has been carried out in broadly by illustrating some well-known methods including exactness,equilibrium and stability analysis in terms of basic reproduction number.We investigate the sensitivity of the model with respect to the variation of the parameters’values.Furthermore,computer simulations are performed to illustrate the results.Our analysis reveals that the death rate from coronavirus disease increases as the infection rate increases,whereas infection rate extensively decreases with the increase of quarantined individuals.The quarantined individuals also lead to increase the concentration of recovered individuals.However,the infection rate of COVID-19 increases more surprisingly as the rate of asymptomatic individuals increases than that of the symptomatic individuals.Moreover,the infection rate decreases significantly due to increase of self-immunity rate.
文摘BACKGROUND Delayed arterial symptomatic epidural hematoma(SEH)on the 14th day after posterior lumbar interbody fusion(PLIF)is rare but it may lead to severe complications if not identified and treated in a timely manner.After diagnosis of the current case,early surgical removal of the hematoma and strict hemostasis treatment was accomplished.This case report highlights the importance of swift diagnosis and treatment in SEH patients.CASE SUMMARY A 41-year-old male patient with a single-segment lumbar disc herniation underwent left-side PLIF.On the 14th post-operative day,the patient complained of lumbar incision pain with sudden onset accompanied by left limb radiation pain and aggravated cauda equina symptoms.Magnetic resonance imaging examination and a puncture blood draw at the incision site confirmed a delayed arterial SEH.Emergency surgical removal of the hematoma and hemostasis was performed.About 70 mL of hematoma was found in the left incision.Continuous bleeding was found in the anterior branch of the transverse process of the 4th lumbar artery in the muscle area about 2 cm below the transverse process of the 4th lumbar vertebra.A blood jet of about 10 cm in height was observed and bipolar electrocoagulation was used to stop the bleeding.Post-operative lumbar incision pain and left lower limb pain were relieved immediately and gradually disappeared.There was no recurrence during the 12-mo follow-up.CONCLUSION For delayed arterial SEH on the 14th day after PLIF,preventive measures including pre-,intra-and post-operative prevention should be implemented.
文摘Study Design: Prospective analytical study. Objectives: The aim was to determine the association between mental depression and symptomatic Lumbar Degenerative Disc Disease (LDDD) in patients with no previous background of mental disorder. We also aimed at determining the incidence of mental depressions in patients with LDDD and the effects of the treatment on the mental depression. Methodology: One hundred and sixty patients with no prior history of mental or behavioral disorders who presented with low back pains arising from LDDD and met inclusion criteria were studied. The clinical findings and Depression Screening Test pro-forma were completed for each. The extracted information was analyzed using Statistical Package for Social Science (SPSS) version 24.0. The statistical significance was set at P Results: One hundred and fifty-three patients completed the study, with a male to female ratio of 1:1.5 and the mean age of the patients was 48.5 years. The marital status was 4.4% single, 86.9% married, 3.8% divorce/separate and 5% widow/widower. Their levels of education were: no formal education (10.00%), primary school level (8.10%), secondary level (27.50%) and Tertiary level (54.40%). Conclusions: This study showed the incidence of mental depression in 32% of the patients with LDDD. We also noted a statistically significant relationship between symptomatic LDDD and level of mental depression with significant improvement in the level of depression at 6th month after treatment. Hence, assessment of the patients’ mental health is important in the management of LDDD.
文摘A randomized, double blind, and active reference-controlled study was carried out among 116 patients suffering from idiopathic Parkinson’s disease (PD). The aim of the study was to compare the safety and efficacy of alpha-dihydroergocryptine (DHEC) vs. pramipexole (PRAM) as an adjunct symptomatic therapy to levodopa in PD patients. The motor symptoms, assessed by the Unified Parkinson’s Disease Rating Scale (UPDRS) III subscale, was identified as efficacy target. Fifty-six patients were randomized to DHEC and 60 to PRAM. Patients included were under constant levodopa dose for at least 3 months before entering the study, with baseline UPDRS III ≥14. They underwent a 16-week treatment. Out of the 116 included patients, 85 (39 in DHEC group and 46 in PRAM group, respectively) completed the study protocol. In DHEC group, UPDRS III decreased by 24.2% from baseline at week 10 and by 28.1% at week 16. In PRAM group, UPDRS III decreased by 27.1% from baseline at week 10 and by 29.2% at week 16. The data were highly significant
文摘Carpal coalitions are uncommon and are frequently asymptomatic. 15 Patients with persistent symptomatic scaphotrapeziotrapezoid (STT) carpal coalitions unresponsive to six months of conservative treatment with no history of trauma went for further investigations. CT scans and bone scans revealed that coalition was the only abnormality to account for the patient’s ongoing problems. The senior authors explored the carpal coalition surgically excising the affected region and interposing capsular fibrous tissue. Histologically partial bony and cartilaginous bridging was evident with no features of degenerative arthritis being noted. Good or excellent subjective results were achieved in all patients at final review an average of 2.7 (1.0 - 4.2) years after surgery. All patients described significant reduction in visual analogue pain scores from an average of 71.5 to 18.4 points. The Green and O’Brien wrist scores improved from a mean of 58.2 to 94.2, with all patients returning to work with improved function. Normally carpal coalition is treated with arthrodesis or excision of part of the carpus. A further treatment option is outlined here with recreation of the joint space in symptomatic, isolated, nonsyndromic scaphotrapezio-trapezoidal coalition.
