Obesity is a chronic,multifactorial disease closely linked to a spectrum of cardiometabolic disorders,with its global prevalence rising at an alarming rate.In recent years,minimally invasive,safe,and effective endosco...Obesity is a chronic,multifactorial disease closely linked to a spectrum of cardiometabolic disorders,with its global prevalence rising at an alarming rate.In recent years,minimally invasive,safe,and effective endoscopic bariatric therapies have gained significant attention as alternatives to conventional surgical interventions.This review provides a comprehensive overview of various endoscopic weight-loss procedures,evaluating their advantages and limitations in comparison to surgical approaches to assist clinicians in optimizing patientspecific treatment strategies.Endoscopic bariatric therapies,including intragastric balloons,duodenal-jejunal bypass sleeves,endoscopic sleeve gastroplasty,gastric remodeling procedures,and interventions aimed at delaying gastric emptying are systematically reviewed.The efficacy,safety profiles,and clinical applicability are all synthesized.Endoscopic bariatric therapies exhibit distinct advantages and limitations,with varying indications and contraindications.As part of a multidisciplinary approach to obesity management,these procedures should be integrated with lifestyle modifications and nutritional counseling to maximize therapeutic benefits.Future research should focus on the long-term efficacy,safety,and patient-reported outcomes to refine clinical practice and optimize the role of endoscopic interventions in obesity treatment.展开更多
This study is a retrospective analysis of demographic, clinical, radiological and outcome data of surgically treated acute traumatic epidural hematomas. Forty-six consecutive cases of epidural hematomas were operated ...This study is a retrospective analysis of demographic, clinical, radiological and outcome data of surgically treated acute traumatic epidural hematomas. Forty-six consecutive cases of epidural hematomas were operated at the University Hospital Center of Yaoundé, Cameroon, between February 2006 and December 2013. The mean age was 29.56 years and63.04% of patients were between 21 and 30 years. Almost 94% of patients were males. Thirty-five percent of patients were motorcycle riders. Road traffic accident was the cause in 70% of cases. Mean time between head trauma and surgical evacuation was 78 hours. Head trauma was moderate in 52.17%. Initial loss of consciousness was found in 78.26% and lucid interval in 65.23%. Seventy-four percent of patients had signs of intracranial hypertension on admission, 35% had at least one neurologic focal sign and 50% had a scalp wound. Eight patients (17.39%) presented with unilateral or bilateral mydriasis. On computed tomography, the hematoma was on the left side in 60.86% of patients and frontal-parietal location was the most frequent. Computed tomography showed mass effect in 97.82% of patients. The most frequent surgical procedure was craniotomy. Six (13.04%) patients died, but 82.60% recovered fully (GOS 5). In Cameroon, traumatic acute epidural hematoma affects primarily healthy young men in their twenties and thirties. Road traffic accidents are the main etiology. Most patients had moderate head trauma and presented with intracranial hypertension. Early surgery is rarely done. Nevertheless, even with delayed surgery, most patients have good outcome.展开更多
<strong>Background</strong>:<span style="font-family:;" "=""><span style="font-family:Verdana;"> Pediatric abdominal surgical emergencies are major causes of ...<strong>Background</strong>:<span style="font-family:;" "=""><span style="font-family:Verdana;"> Pediatric abdominal surgical emergencies are major causes of morbidity and mortality. The goal was to identify the main determinants of their management and access to assess their evolution. </span><b><span style="font-family:Verdana;">Patients and methods:</span></b><span style="font-family:Verdana;"> This is a prospective, descriptive and analytical study performed at Parakou teaching hospital and Tanguieta district hospital. It has been conducted from January 1st to July 31st 2016. All children were included aged 0 to 15 years and admitted for an abdominal surgical emergency with a Clinical Classification of Emergency Patients listed from 3 to 5. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> Pediatric abdominal surgical emergencies accounted for 42.8% of pediatric surgical emergencies. The average age was 9.3 ± 3.5 years old. The sex ratio was 1.7. The most encountered etiologies were peritonitis (36.76%), abdominal trauma (16.17%) and anorectal malformations (14.71%). The comparison of the delay in operative treatment with the World Society of Emergency Surgery shows a delay in 82.35% of cases. Mortality was high preoperatively and was related to the neonatal period (p = 0.027) and to a resuscitation length of stay higher than 36 hours (p = 0.035). </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> Surgical care was delayed, mainly due to the lack of technical capacities. Morbidity and mortality were relatively low.</span></span>展开更多
基金Supported by National Natural Science Foundation of China,No.81602056 and No.82273393the Young Talents Promotion Project of Shandong Medical Association in 2023,No.2023-GJ-0087.
文摘Obesity is a chronic,multifactorial disease closely linked to a spectrum of cardiometabolic disorders,with its global prevalence rising at an alarming rate.In recent years,minimally invasive,safe,and effective endoscopic bariatric therapies have gained significant attention as alternatives to conventional surgical interventions.This review provides a comprehensive overview of various endoscopic weight-loss procedures,evaluating their advantages and limitations in comparison to surgical approaches to assist clinicians in optimizing patientspecific treatment strategies.Endoscopic bariatric therapies,including intragastric balloons,duodenal-jejunal bypass sleeves,endoscopic sleeve gastroplasty,gastric remodeling procedures,and interventions aimed at delaying gastric emptying are systematically reviewed.The efficacy,safety profiles,and clinical applicability are all synthesized.Endoscopic bariatric therapies exhibit distinct advantages and limitations,with varying indications and contraindications.As part of a multidisciplinary approach to obesity management,these procedures should be integrated with lifestyle modifications and nutritional counseling to maximize therapeutic benefits.Future research should focus on the long-term efficacy,safety,and patient-reported outcomes to refine clinical practice and optimize the role of endoscopic interventions in obesity treatment.
文摘This study is a retrospective analysis of demographic, clinical, radiological and outcome data of surgically treated acute traumatic epidural hematomas. Forty-six consecutive cases of epidural hematomas were operated at the University Hospital Center of Yaoundé, Cameroon, between February 2006 and December 2013. The mean age was 29.56 years and63.04% of patients were between 21 and 30 years. Almost 94% of patients were males. Thirty-five percent of patients were motorcycle riders. Road traffic accident was the cause in 70% of cases. Mean time between head trauma and surgical evacuation was 78 hours. Head trauma was moderate in 52.17%. Initial loss of consciousness was found in 78.26% and lucid interval in 65.23%. Seventy-four percent of patients had signs of intracranial hypertension on admission, 35% had at least one neurologic focal sign and 50% had a scalp wound. Eight patients (17.39%) presented with unilateral or bilateral mydriasis. On computed tomography, the hematoma was on the left side in 60.86% of patients and frontal-parietal location was the most frequent. Computed tomography showed mass effect in 97.82% of patients. The most frequent surgical procedure was craniotomy. Six (13.04%) patients died, but 82.60% recovered fully (GOS 5). In Cameroon, traumatic acute epidural hematoma affects primarily healthy young men in their twenties and thirties. Road traffic accidents are the main etiology. Most patients had moderate head trauma and presented with intracranial hypertension. Early surgery is rarely done. Nevertheless, even with delayed surgery, most patients have good outcome.
文摘<strong>Background</strong>:<span style="font-family:;" "=""><span style="font-family:Verdana;"> Pediatric abdominal surgical emergencies are major causes of morbidity and mortality. The goal was to identify the main determinants of their management and access to assess their evolution. </span><b><span style="font-family:Verdana;">Patients and methods:</span></b><span style="font-family:Verdana;"> This is a prospective, descriptive and analytical study performed at Parakou teaching hospital and Tanguieta district hospital. It has been conducted from January 1st to July 31st 2016. All children were included aged 0 to 15 years and admitted for an abdominal surgical emergency with a Clinical Classification of Emergency Patients listed from 3 to 5. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> Pediatric abdominal surgical emergencies accounted for 42.8% of pediatric surgical emergencies. The average age was 9.3 ± 3.5 years old. The sex ratio was 1.7. The most encountered etiologies were peritonitis (36.76%), abdominal trauma (16.17%) and anorectal malformations (14.71%). The comparison of the delay in operative treatment with the World Society of Emergency Surgery shows a delay in 82.35% of cases. Mortality was high preoperatively and was related to the neonatal period (p = 0.027) and to a resuscitation length of stay higher than 36 hours (p = 0.035). </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> Surgical care was delayed, mainly due to the lack of technical capacities. Morbidity and mortality were relatively low.</span></span>
