The traditional view of the decompensated stage as a point of no return in the natural history of liver cirrhosis(LC)is currently being questioned.This is due to the appearance of data indicating the possibility of re...The traditional view of the decompensated stage as a point of no return in the natural history of liver cirrhosis(LC)is currently being questioned.This is due to the appearance of data indicating the possibility of restoring the structure and function of the liver,reducing the portal pressure with a positive effect on complications associated with portal hypertension and decreasing the risk of developing hepatocellular carcinoma after elimination of the etiological factor.To create a unified understanding the recompensation of decompensated LC,at the Baveno VII consensus workshop were developed criteria confirming it.At the moment,the efficacy of etiological therapy in achieving established criteria for recompensation has been evaluated only in patients with alcohol-related,as well as hepatitis B virus-related and hepatitis C virus-related decompensated LC.The purpose of the review is to provide up–to-date information on the role of etiological therapy in achieving recompensation of decompensated LC according to Baveno VII criteria.So far,only the first steps have been taken in studying this problem.To further understand it,research is needed to identify pathophysiological mechanisms,modifying factors,predictors,and potential noninvasive biomarkers of recompensation of decompensated LC.展开更多
Porcine respiratory coronavirus （PRCV）, a spike （S） gene natural deletion mutant of transmissible gastroenteritis virus （TGEV）, causes porcine respiratory disease complex. Research advances on porcine respirator...Porcine respiratory coronavirus （PRCV）, a spike （S） gene natural deletion mutant of transmissible gastroenteritis virus （TGEV）, causes porcine respiratory disease complex. Research advances on porcine respiratory coronavirus were reviewed from four aspects of biological character, the model fimction for SARS-CoV research, contribution of the immunity to PRCV to protection against TGEV challenge exposure and other etiological significance展开更多
Introduction: The dilatation of the upper urinary tract, signs in the vast majority of cases the presence of a ureteral obstacle. The etiologies are diverse. Mali is a country where urinary schistosomiasis is endemic....Introduction: The dilatation of the upper urinary tract, signs in the vast majority of cases the presence of a ureteral obstacle. The etiologies are diverse. Mali is a country where urinary schistosomiasis is endemic. Repeated infestation may result in long-term ureteropelastic dilatation secondary to stenotic sequelae. The objective is to study the causes of dilatations of the upper urinary tract. Materials and Methods: This is a prospective study of 12 months, from October 2010 to September 2011, performed in the urology department of Gabriel Toure University Hospital in Bamako. The parameters studied were: age, sex, reason for consultation, medical history, urinary analysis, etiological diagnosis, management, evaluation of renal failure. Result: In 12 months, we collected 50 cases of dilatations of the upper urinary tract representing 0.66% of all consultations. The average age of our patients was 35 years old. The sex ratio was 2.13 in favor of men. A history of urinary schistosomiasis was found in 25 patients or 50%. Low back pain was the most common reason for consultation, 76%. The renal and bladder ultrasonography performed in all 50 patients in our series found bilateral dilatation in 68% of patients and unilateral dilation in 32% of cases. Urinary tract infection with Escherichia coli was found in 53% of cases. Ureterovesical reimplantation was performed in 40% of cases. Conclusion: The dilatation of the upper urinary tract, consequence of an anatomical or functional obstruction, constitutes a rather frequent pathology and constituted 10% of the surgical acts of our service. Etiologies are diverse: congenital and acquired. Open surgery gives good results, but the introduction of innovative minimally invasive surgical technique is necessary.展开更多
Background: Non-traumatic coma is the most common pediatric medical emergency. Its clinical diagnosis is easy. The difficulty lies in finding the etiology. Objective: To determine the prevalence and clinical profiles ...Background: Non-traumatic coma is the most common pediatric medical emergency. Its clinical diagnosis is easy. The difficulty lies in finding the etiology. Objective: To determine the prevalence and clinical profiles of non-traumatic Coma at the Centre Hospitalier Universitaire Pédiatrique de Bangui (CHUPB). Methodology: This was a descriptive and analytical cross-sectional study conducted between January 1 and June 31, 2021, at CHUPB. Children aged 1 month to 15 years, admitted to the emergency room with a Glasgow score less than or equal to 8 without any traumatism were included. The variables studied were sociodemographic, clinical and paraclinical. Data were entered and analyzed using SPSS 20.0 statistical software. The statistical test used was Pearson’s chi<sup>2</sup>, any p-value Results: Of 8551 children hospitalized during the study period, 370 were hospitalized for non-traumatic coma: 4.32%. They were divided into 57.5% (n = 213) boys and 42.44% (n = 157) girls, giving a sex ratio of 1.35. Their mean age was 35.95 ± 27.21 months. Children aged 1 to 24 months represented 54.59% (n = 202) of cases. The mean time to the consultation was 2.91 days ± 1.8. Fever 86.48% (n = 320) and convulsions 80% (n = 296) were the main reasons for consultation. Coma stages II - III and IV represented 52.44% (n = 194), 42.97% (n = 159) and 4.59% (n = 17) respectively. Neuromalaria (29.72%;n = 110), meningitis-meningoencephalitis-encephalitis (30%;n = 111), sepsis (19.72%;n = 73) and acidosis Coma (5.40%;n = 20) were the main etiologies. Conclusion: Non-traumatic coma is common at CHUPB. Infections were the main etiology, particularly cerebral malaria. The reduction of its frequency requires, among others, the strengthening of the national monitoring malaria program. The strengthening of the technical platform for a good etiological diagnosis constitutes the other axis of prevention.展开更多
Introduction: Studies showed a high prevalence of metabolic abnormalities including dyslipidemia, type 2 diabetes in cases of low testosterone in men and which are associated with increased cardiovascular risk. Hypogo...Introduction: Studies showed a high prevalence of metabolic abnormalities including dyslipidemia, type 2 diabetes in cases of low testosterone in men and which are associated with increased cardiovascular risk. Hypogonadism represents the second cause of endocrine osteoporosis. Objectives: The objectives of our work were: to determine the main causes of hypogonadism in women and men;to assess the frequency of metabolic and osteosdensitometric abnormalities in the hypogonadal population. Patients and methods: A retrospective descriptive study was carried out over 7 years on 120 patients, hospitalized in the Endocrinology department of the Hassan II University Hospital of Fez-Morocco for hypogonadism. The patients selected were those who had symptoms of hypogonadism confirmed in men by: low total testosterone for Tanner stage in adolescents, ng/ml or lower limit of normal for adults;in women, hypoestrogenia 30 pg/l. Gonadotropin dosage, karyotype, pelvic or testicular ultrasound and pituitary MRI, for etiological diagnosis, were performed. Bone densitometry was performed for bone impact and lipid profile for metabolic profile. Results: Out of 120 patients, there were 77 women and 43 men. The average age was 31.51 years. In men, the main causes were central hypogonadism in 67.4% and primary testicular failure in 32.6%. In women, central hypogonadism was also the most common cause noted in 63.7% and premature ovarian failure was observed in 36.4%. HypoHDL was significantly more frequent p (0.005) in women, osteopenia and osteoporosis were significantly more frequent in women than in men p (0.046). Conclusion: Central causes represent the most common etiology of hypogonadism in both sexes;abnormalities of bone mineralization and metabolic disorders were predominant in women.展开更多
Introduction The number of elderly persons is increasing all over the world. This strong demographic trend will affect our societies profoundly. Since the largest relative increase is expected to occur in the group of...Introduction The number of elderly persons is increasing all over the world. This strong demographic trend will affect our societies profoundly. Since the largest relative increase is expected to occur in the group of very old persons, over 80 years of age, the demands on the society and on relatives in terms of health- and social care are considerable. The influence of ageing on the auditory function is pronounced. Age-related hearing loss (ARHL), or presbyacusis, belongs to one of the three most frequently reported chronic health problems in old age, and is also the most prevalent cause of hearing loss. Communication with other people, and the auditory system is the most important link in communication. ARHL has often a devastating effect on the social contacts and quality of life of many elderly people.展开更多
Introduction: In emerging countries where studies are rarer, the epidemiological profile of infective endocarditis resembles that of developed countries at the beginning of the antibiotic era. There is little data ava...Introduction: In emerging countries where studies are rarer, the epidemiological profile of infective endocarditis resembles that of developed countries at the beginning of the antibiotic era. There is little data available in Mali on this subject, motivating this study, the aim of which was to study the etiological factors of infective endocarditis in children aged between 1 month and 15 years hospitalised in the paediatric department of the CHU Gabriel Touré. Patients and Methods: We conducted a cross-sectional and descriptive study, which took place from August 2018 to August 2019 (13 months), in children aged between 1 month and 15 years hospitalised in the paediatric department of the Gabriel Touré University Hospital with an ultrasound- confirmed cardiac disease and a temperature above 38°C. Results: The hospitalization rate was 0.4%. The average age was 11 months, the sex ratio was 1.35. Respiratory distress (63.6%) and fever (30.3%) were the most common reasons for referral. Congenital heart disease (87.9%) and dyspnoea on feeding (24.2%) were the most common medical histories. IVC was the most frequent congenital heart disease (36.4%). The mean temperature was 39.1°C. Blood cultures were taken in 24 patients (72.7%) and were positive in 27.3%. Staphylococcus aureus was found in 55.6% of cases. Trans-thoracic ultrasound found vegetations in 03 cases. According to the modified DUKE criteria, the diagnosis of endocarditis was retained in 27.30%. The evolution was marked by a high case fatality rate (45.45%). Conclusion: Endocarditis is an uncommon disease in children with a pulmonary portal of entry and Staphylococcus aureus as the main germ. Its mortality remains high.展开更多
“Treatment in accordance with three categories of etiologic factors”(consideration of the climatic and seasonal conditions,environment and individual’s constitution in the treatment of diseases),that is,treatment f...“Treatment in accordance with three categories of etiologic factors”(consideration of the climatic and seasonal conditions,environment and individual’s constitution in the treatment of diseases),that is,treatment following time,place and individual,is one of the basic principles followed by Chinese medicine in the clinical treatment of diseases.This paper analyzes the similarities and differences in traditional Chinese medicine treatment of patients with epidemic diseases in different regions and periods since the Ming(1368-1644 C.E.)and Qing(1636-1912 C.E.)Dynasties.In addition,the theory of epidemic disease prevention and control based on the application of“treatment in accordance with three categories of etiologic factors”was discussed to inspire and guide the prevention and treatment of COVID-19.展开更多
<strong>Objective: </strong>To explore the value of real-time bedside ultrasonography in the etiologic diagnosis of acute dyspnea.<strong> Methods:</strong> Sixty-two patients with acute dyspne...<strong>Objective: </strong>To explore the value of real-time bedside ultrasonography in the etiologic diagnosis of acute dyspnea.<strong> Methods:</strong> Sixty-two patients with acute dyspnea who were treated in our hospital from January 2016 to December 2020 were randomly selected and their clinical data were retrospectively analyzed. All patients were randomly divided into a control group for routine examinations (n = 31) and an observation group for real-time beside ultrasonography (n = 31). The costs of medical examinations, examination duration, and diagnostic results of severe pneumonia, acute cardiogenic pulmonary edema, pulmonary embolism, chronic obstructive pulmonary disease, and pneumothorax (including sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy) of the two groups of patients were compared and analyzed. <strong>Results:</strong> Compared with the control group, the observation group had significantly shorter examinations (P < 0.05). Although the cost of medical examinations of the observation group tended to be higher, the difference between groups was not significant (P > 0.05). Moreover, there were no significant differences in left ventricular ejection fraction, left ventricular end-diastolic diameter, or brain natriuretic peptide between the two groups (P > 0.05). Comparison of the etiologic diagnosis results between the two groups showed that the observation group had significantly higher diagnostic sensitivity, specificity, positive and negative predictive values, and diagnostic accuracy for various causes compared with the control group (P < 0.05). <strong>Conclusion:</strong> Real-time bedside ultrasonography for the etiologic diagnosis of patients with acute dyspnea was quicker and had higher diagnostic accuracy;thus providing accurate guidance for the disease treatment, and having a higher promotional value in clinical practice compared with routine examinations.展开更多
To study the relationship between bacterial infection and the etiology of cystitis glandularis, 36 female Wistar rats were divided into 3 groups. No intervention was given to the rats in the blank group. NS was infuse...To study the relationship between bacterial infection and the etiology of cystitis glandularis, 36 female Wistar rats were divided into 3 groups. No intervention was given to the rats in the blank group. NS was infused into the bladder of the rats of the control group, and solution containing E. coil was injected into the bladder of experimental group. Three months later, tissue samples of bladder were collected and observed visually and under light microscope. The results showed that tissues of the blank group were normal＇, one sample in the control group showed Brunn＇s nests and cystitis cystica, and 10 in the experimental group had the change of cystitis glandularis. Compared to the blank and control group, samples in the experimental group showed significant change （P〈0.05）. There were no significant difference between blank group and control group （P〉0.05）. It is concluded that bladder instillation of E. coil can induce cystitis glandularis, which confirms that infection is the cause of cystitis glandularis.展开更多
The inability to procreate is frequently considered a personal tragedy and a hardship for couples, impacting on the entire family and even the local community. In Gaza strip, Palestine, there has been no study on etio...The inability to procreate is frequently considered a personal tragedy and a hardship for couples, impacting on the entire family and even the local community. In Gaza strip, Palestine, there has been no study on etiological risk factors for subfertility. The present study aimed to identify risk factors associated with subfertility among women in Gaza, Palestine. One hundred and sixty-nine women in the study group and 115 women in the control group were included. Cases were selected randomly from those referred to the A1 Basma Fertility Center, Gaza, Palestine. Data were collected through close-ended questionnaire, sonography, hormonal analysis and thrombophilia profile that included the methylenetetrahydrofolate reductase （MTHFR 677 C 〉 T）, factor V leiden （1691 G 〉 A） and pro- thrombin （20210 G 〉 A） genes. By using univariate analyses, the effects of different patient-related variables on the presence of subfertility were evaluated. A multiple logistic regression model was constructed, crude and adjusted odds ratios （OR） and 95% confidence intervals （95% CI） were calculated. The findings showed that 73.5 % （169/230） of the women referred to the A1 Basma Center sought treatment for subfertility. Different etiological risk factors were associated with subfertility, the most frequent of which in descending order were： thrombophilic disorders, fallopian tube problems, sex hormone abnormalities and polycystic ovary syndrome with an adjusted OR of 21.42, 13.63, 11.69 and 10.29, respectively. In conclusion, several etiological risk factors are responsible for subfertility among women in Gaza. Comprehensive evaluation of infertile women should be considered in the course of treatment; otherwise, the duration of sterility may be extended.展开更多
AIM To investigate the etiologic association of pancreas divisum (PD) with chronic pancreatitis and to clarify its pathogenesis. METHODS A PD canine model was established in 32 dogs. The dogs were randomly divided ...AIM To investigate the etiologic association of pancreas divisum (PD) with chronic pancreatitis and to clarify its pathogenesis. METHODS A PD canine model was established in 32 dogs. The dogs were randomly divided into 4 groups ( n =8). Group Ⅰ: The communicating branch between the dorsal and ventral pancreatic ducts was partly ligated. Group Ⅱa: The communicating branch was amputated and completely ligated. Group Ⅱb: The dorsal duct was amputated and ligated at 2mm distance to the minor papilla. Group Ⅲ: A sham operation without any amputation or ligation was performed. Before and after operation, the activities of serum phospholipase A2 (PLA2) and amylase (Ams) were assayed and the basal pressures of the ducts were measured when secretin was injected. Pancreatic ductography and the pathologic examination were made. RESULTS The activities of serum PLA2 and Ams in Group Ⅰ,Ⅱa and Ⅱb were significantly increased 5-80 days after operation. At sacrifice, the basal pressures of the ventral duct were significantly higher 30min-60min after provocation in Group Ⅰ, Ⅱa and Ⅱb. The pressures of the dorsal duct were significantly increased in Group Ⅱb but no difference in Group Ⅰ and Ⅱa. Under light microscopy the fibrosis of interlobus and periducts, the destruction of acini and infiltration of inflammatory cell in dorsal and ventral pancreas were found in Group Ⅱb. But in Group Ⅰ and Ⅱa, these findings were present only in ventral pancreas. The electron microscopy showed that in ventral pancreas of Groups Ⅰ and Ⅱa and the dorsal and ventral pancreas of Group Ⅱb, the rough endoplasmic reticulum of the acinar cells showed granules scaling, fusion and dilatation. The zymogen granules decreased and the mitochondria was swollen. CONCLUSION PD is one of etiologic factors in chronic pancreatitis. The pathogenesis is the functional obstruction of the minor papilla at the peak stage of secretion.展开更多
BACKGROUND: This study was to clarify the high riskfactors for subphrenic infection (SI) after liver resection forpatients with hepatic malignancy.METHODS: Three hundred and sixty-eight patients whohad undergone hepat...BACKGROUND: This study was to clarify the high riskfactors for subphrenic infection (SI) after liver resection forpatients with hepatic malignancy.METHODS: Three hundred and sixty-eight patients whohad undergone hepatectomy from January 1985 throughJune 2002 were randomly divided into 2 groups accordingto resection of liver parenchyma, hepatic cirrhosis, primaryliver cancer, intraoperative blood loss, and subphrenicdrainage. The chi-square was used for statistical analysis.RESULTS: Thirteen patients (3.53%) of the 368 patientshad SI. The high-risk factors for SI after hepatectomy wererelated to resection of liver parenchyma and hepatic cirrho-sis ; but the course or stage of primary liver cancer was notrelated to the incidence of SI. Intraoperative blood loss ofover 1500 ml was found to be a significant risk factor forpostoperative SI. Adequate drainage of the subdiaphragmand the raw surface of the liver after operation was essentialto decreasing SI after liver resection.CONCLUSION: Inadequate subphrenic drainage maylargely contribute to SI in patients with hepatic malignancyundergoing hepatectomy apart from other factors. Com-prehensive measures should be taken to prevent the infec-tion after hepatectomy.展开更多
The objective of our study was to study the epidemiological, etiological and contributory factors of maternal deaths in the obstetrics and gynecology department of the regional hospital center (RHC) of Ouahigouya from...The objective of our study was to study the epidemiological, etiological and contributory factors of maternal deaths in the obstetrics and gynecology department of the regional hospital center (RHC) of Ouahigouya from 2013 to 2015. We carried out a descriptive and analytical study on maternal deaths in maternity of the RHC of Ouahigouya, including all patients who died in the obstetrics and gynecology department of the RHC of Ouahigouya from 1 January 2013 to 31 December 2015, which meets WHO’s definition of maternal death. We recorded 151 maternal deaths and 5481 live births, a maternal mortality ratio of 2755 per 100,000 live births. The most affected women were women aged 20 - 24 years (27.8%), multiparous (25.5%), married women (88.7%) and those without income-generating activities (85.4%). The main causes of death from direct obstetrical complications were hemorrhage (38.3%), infections (21.5%), abortions (16.8%) and complications of hypertension disorders (15.8%) and for indirect obstetrical complications, malaria (36.6%), anemia (29.5%), and HIV/AIDS (9.1%). Contributing factors to maternal deaths prior to admission were delay in referral (33.3%) and delay in transfer (31.5%) and delay in admission (32.8%) and delay in diagnosis (23.4). From our study, it appears elsewhere as well as that most maternal deaths are preventable, hence the need for coordinated actions to effectively fight against maternal mortality.展开更多
Aim: To study common cause of digestive tract hemorrhage and the relationship between etiology and age. Methods: Retrospective analysis about the data of 419 cases of digestive tract hemorrhage in digestive internal m...Aim: To study common cause of digestive tract hemorrhage and the relationship between etiology and age. Methods: Retrospective analysis about the data of 419 cases of digestive tract hemorrhage in digestive internal medicine from January 2016 to January 2018 in Jingzhou Central Hospital. Results: 419 cases of digestive tract hemorrhage include 305 cases of hemorrhage in upper digestive tract and 114 cases of hemorrhage in lower digestive tract. The first 5 causes of upper digestive tract hemorrhage in middle-aged and young group were: duodenal bulb ulcer, gastric ulcer, esophageal and stomach bottom varices bleeding in cirrhosis of schistosomiasis, compound ulcer, esophageal and stomach bottom varices bleeding in hepatitis B cirrhosis. The first 5 causes of upper digestive tract hemorrhage in elderly group were: gastric ulcer, duodenal bulb ulcer, esophageal and stomach bottom varices bleeding in hepatitis B cirrhosis, esophageal and stomach bottom varices bleeding in cirrhosis of schistosomiasis, gastric cancer. The first 5 causes of lower digestive tract hemorrhage in middle-aged and young group were: ulcerative colitis, colorectal polyps, hemorrhoids, crohn’s disease, ischemic bowel disease. The first 5 causes of lower digestive tract hemorrhage in elderly group were: colorectal polyps, colon cancer, ulcerative colitis, ischemic bowel disease, hemorrhoids. Conclusion: In the cases of upper digestive tract hemorrhage, peptic ulcer should be paid attention to in middle-aged and young people, and elderly should be noted in gastric cancer. Ulcerative colitis should be paid attention to in middle-aged and young people with lower digestive tract hemorrhage, and elderly should be noted in colorectal polyps and colon cancer.展开更多
Etiologies of benign esophageal dysphagia are diverse and a panel of clinical and laboratory investigations should be taken to make the right diagnosis. We report herein two cases of benign esophageal dysphagia of non...Etiologies of benign esophageal dysphagia are diverse and a panel of clinical and laboratory investigations should be taken to make the right diagnosis. We report herein two cases of benign esophageal dysphagia of non-infectious origin. Imaging tests identified changes similar to malignancies, while only inflamed granulation tissue was discovered in biopsy specimens. Surgical resection was finally applied due to severe symptoms and the histological study revealed only granulation tissue. They were diagnosed as idiopathic cases when all the known non-infectious pathogenesis were carefully ruled out by sound examination results. The differetail diagnosis of benign esophageal dysphagia is quite important as observational data shows that medical therapy should be applied in certain pathogenesis, while esophagectomy might be the most effective solution for other etiologies. Subsequently a comparison of the manifestations of the two cases and those of esophageal dysphagia induced by other non-infectious etiologies was done to shine some light on the differencial diagnosis of benign esophageal dysphagia.展开更多
Introduction: Nocturia is categorized into many categories. Each category requires different approaches and treatment. We aimed to obtain data regarding nocturia, classified into categories according to its pathogenes...Introduction: Nocturia is categorized into many categories. Each category requires different approaches and treatment. We aimed to obtain data regarding nocturia, classified into categories according to its pathogenesis, in Thai patients. Methods: We reviewed 133 medical records and voiding diaries of the patients who attended a urologic clinic in a tertiary teaching hospital during year 2009-2010 with nocturia problems. Those data were analyzed to sort these nocturia patients into the appropriate categories. Results: There were a total of 133 patients, consisting of 94 males (70.1%) and 39 females (29.9%). Overall mean age was 64.74 ± 25.85 years. There was no statistically difference between the two genders (Male 65.94 ± 24.56 years vs. Female 61.87 ± 28.24 years, p = 0.10). Among these, 71 patients (53.4%) had nocturnal polyuria. Almost all patients (132 patients, 99.2%) met the criteria for diminished global/nocturnal bladder capacity. The younger patients (less than 40 years) were found to have more severe clinical symptoms than the older patients (6 from 8 or 75% vs. 46 from 125 or 36%, p = 0.032). Seventy patients (52.6%) met the criteria of Mixed NP and Diminished. There were 32 patients (24.1%) found in the group of Global polyuria. Only one patient was classified as isolated nocturnal polyuria and none as isolated global polyuria. Conclusion: Nocturnal polyuria and global polyuria are not uncommon conditions and most of these patients might have concomitant diminished bladder capacity for which investigation or simultaneous treatment may be needed to gain the best treatment result.展开更多
文摘The traditional view of the decompensated stage as a point of no return in the natural history of liver cirrhosis(LC)is currently being questioned.This is due to the appearance of data indicating the possibility of restoring the structure and function of the liver,reducing the portal pressure with a positive effect on complications associated with portal hypertension and decreasing the risk of developing hepatocellular carcinoma after elimination of the etiological factor.To create a unified understanding the recompensation of decompensated LC,at the Baveno VII consensus workshop were developed criteria confirming it.At the moment,the efficacy of etiological therapy in achieving established criteria for recompensation has been evaluated only in patients with alcohol-related,as well as hepatitis B virus-related and hepatitis C virus-related decompensated LC.The purpose of the review is to provide up–to-date information on the role of etiological therapy in achieving recompensation of decompensated LC according to Baveno VII criteria.So far,only the first steps have been taken in studying this problem.To further understand it,research is needed to identify pathophysiological mechanisms,modifying factors,predictors,and potential noninvasive biomarkers of recompensation of decompensated LC.
文摘Porcine respiratory coronavirus （PRCV）, a spike （S） gene natural deletion mutant of transmissible gastroenteritis virus （TGEV）, causes porcine respiratory disease complex. Research advances on porcine respiratory coronavirus were reviewed from four aspects of biological character, the model fimction for SARS-CoV research, contribution of the immunity to PRCV to protection against TGEV challenge exposure and other etiological significance
文摘Introduction: The dilatation of the upper urinary tract, signs in the vast majority of cases the presence of a ureteral obstacle. The etiologies are diverse. Mali is a country where urinary schistosomiasis is endemic. Repeated infestation may result in long-term ureteropelastic dilatation secondary to stenotic sequelae. The objective is to study the causes of dilatations of the upper urinary tract. Materials and Methods: This is a prospective study of 12 months, from October 2010 to September 2011, performed in the urology department of Gabriel Toure University Hospital in Bamako. The parameters studied were: age, sex, reason for consultation, medical history, urinary analysis, etiological diagnosis, management, evaluation of renal failure. Result: In 12 months, we collected 50 cases of dilatations of the upper urinary tract representing 0.66% of all consultations. The average age of our patients was 35 years old. The sex ratio was 2.13 in favor of men. A history of urinary schistosomiasis was found in 25 patients or 50%. Low back pain was the most common reason for consultation, 76%. The renal and bladder ultrasonography performed in all 50 patients in our series found bilateral dilatation in 68% of patients and unilateral dilation in 32% of cases. Urinary tract infection with Escherichia coli was found in 53% of cases. Ureterovesical reimplantation was performed in 40% of cases. Conclusion: The dilatation of the upper urinary tract, consequence of an anatomical or functional obstruction, constitutes a rather frequent pathology and constituted 10% of the surgical acts of our service. Etiologies are diverse: congenital and acquired. Open surgery gives good results, but the introduction of innovative minimally invasive surgical technique is necessary.
文摘Background: Non-traumatic coma is the most common pediatric medical emergency. Its clinical diagnosis is easy. The difficulty lies in finding the etiology. Objective: To determine the prevalence and clinical profiles of non-traumatic Coma at the Centre Hospitalier Universitaire Pédiatrique de Bangui (CHUPB). Methodology: This was a descriptive and analytical cross-sectional study conducted between January 1 and June 31, 2021, at CHUPB. Children aged 1 month to 15 years, admitted to the emergency room with a Glasgow score less than or equal to 8 without any traumatism were included. The variables studied were sociodemographic, clinical and paraclinical. Data were entered and analyzed using SPSS 20.0 statistical software. The statistical test used was Pearson’s chi<sup>2</sup>, any p-value Results: Of 8551 children hospitalized during the study period, 370 were hospitalized for non-traumatic coma: 4.32%. They were divided into 57.5% (n = 213) boys and 42.44% (n = 157) girls, giving a sex ratio of 1.35. Their mean age was 35.95 ± 27.21 months. Children aged 1 to 24 months represented 54.59% (n = 202) of cases. The mean time to the consultation was 2.91 days ± 1.8. Fever 86.48% (n = 320) and convulsions 80% (n = 296) were the main reasons for consultation. Coma stages II - III and IV represented 52.44% (n = 194), 42.97% (n = 159) and 4.59% (n = 17) respectively. Neuromalaria (29.72%;n = 110), meningitis-meningoencephalitis-encephalitis (30%;n = 111), sepsis (19.72%;n = 73) and acidosis Coma (5.40%;n = 20) were the main etiologies. Conclusion: Non-traumatic coma is common at CHUPB. Infections were the main etiology, particularly cerebral malaria. The reduction of its frequency requires, among others, the strengthening of the national monitoring malaria program. The strengthening of the technical platform for a good etiological diagnosis constitutes the other axis of prevention.
文摘Introduction: Studies showed a high prevalence of metabolic abnormalities including dyslipidemia, type 2 diabetes in cases of low testosterone in men and which are associated with increased cardiovascular risk. Hypogonadism represents the second cause of endocrine osteoporosis. Objectives: The objectives of our work were: to determine the main causes of hypogonadism in women and men;to assess the frequency of metabolic and osteosdensitometric abnormalities in the hypogonadal population. Patients and methods: A retrospective descriptive study was carried out over 7 years on 120 patients, hospitalized in the Endocrinology department of the Hassan II University Hospital of Fez-Morocco for hypogonadism. The patients selected were those who had symptoms of hypogonadism confirmed in men by: low total testosterone for Tanner stage in adolescents, ng/ml or lower limit of normal for adults;in women, hypoestrogenia 30 pg/l. Gonadotropin dosage, karyotype, pelvic or testicular ultrasound and pituitary MRI, for etiological diagnosis, were performed. Bone densitometry was performed for bone impact and lipid profile for metabolic profile. Results: Out of 120 patients, there were 77 women and 43 men. The average age was 31.51 years. In men, the main causes were central hypogonadism in 67.4% and primary testicular failure in 32.6%. In women, central hypogonadism was also the most common cause noted in 63.7% and premature ovarian failure was observed in 36.4%. HypoHDL was significantly more frequent p (0.005) in women, osteopenia and osteoporosis were significantly more frequent in women than in men p (0.046). Conclusion: Central causes represent the most common etiology of hypogonadism in both sexes;abnormalities of bone mineralization and metabolic disorders were predominant in women.
文摘Introduction The number of elderly persons is increasing all over the world. This strong demographic trend will affect our societies profoundly. Since the largest relative increase is expected to occur in the group of very old persons, over 80 years of age, the demands on the society and on relatives in terms of health- and social care are considerable. The influence of ageing on the auditory function is pronounced. Age-related hearing loss (ARHL), or presbyacusis, belongs to one of the three most frequently reported chronic health problems in old age, and is also the most prevalent cause of hearing loss. Communication with other people, and the auditory system is the most important link in communication. ARHL has often a devastating effect on the social contacts and quality of life of many elderly people.
文摘Introduction: In emerging countries where studies are rarer, the epidemiological profile of infective endocarditis resembles that of developed countries at the beginning of the antibiotic era. There is little data available in Mali on this subject, motivating this study, the aim of which was to study the etiological factors of infective endocarditis in children aged between 1 month and 15 years hospitalised in the paediatric department of the CHU Gabriel Touré. Patients and Methods: We conducted a cross-sectional and descriptive study, which took place from August 2018 to August 2019 (13 months), in children aged between 1 month and 15 years hospitalised in the paediatric department of the Gabriel Touré University Hospital with an ultrasound- confirmed cardiac disease and a temperature above 38°C. Results: The hospitalization rate was 0.4%. The average age was 11 months, the sex ratio was 1.35. Respiratory distress (63.6%) and fever (30.3%) were the most common reasons for referral. Congenital heart disease (87.9%) and dyspnoea on feeding (24.2%) were the most common medical histories. IVC was the most frequent congenital heart disease (36.4%). The mean temperature was 39.1°C. Blood cultures were taken in 24 patients (72.7%) and were positive in 27.3%. Staphylococcus aureus was found in 55.6% of cases. Trans-thoracic ultrasound found vegetations in 03 cases. According to the modified DUKE criteria, the diagnosis of endocarditis was retained in 27.30%. The evolution was marked by a high case fatality rate (45.45%). Conclusion: Endocarditis is an uncommon disease in children with a pulmonary portal of entry and Staphylococcus aureus as the main germ. Its mortality remains high.
文摘“Treatment in accordance with three categories of etiologic factors”(consideration of the climatic and seasonal conditions,environment and individual’s constitution in the treatment of diseases),that is,treatment following time,place and individual,is one of the basic principles followed by Chinese medicine in the clinical treatment of diseases.This paper analyzes the similarities and differences in traditional Chinese medicine treatment of patients with epidemic diseases in different regions and periods since the Ming(1368-1644 C.E.)and Qing(1636-1912 C.E.)Dynasties.In addition,the theory of epidemic disease prevention and control based on the application of“treatment in accordance with three categories of etiologic factors”was discussed to inspire and guide the prevention and treatment of COVID-19.
文摘<strong>Objective: </strong>To explore the value of real-time bedside ultrasonography in the etiologic diagnosis of acute dyspnea.<strong> Methods:</strong> Sixty-two patients with acute dyspnea who were treated in our hospital from January 2016 to December 2020 were randomly selected and their clinical data were retrospectively analyzed. All patients were randomly divided into a control group for routine examinations (n = 31) and an observation group for real-time beside ultrasonography (n = 31). The costs of medical examinations, examination duration, and diagnostic results of severe pneumonia, acute cardiogenic pulmonary edema, pulmonary embolism, chronic obstructive pulmonary disease, and pneumothorax (including sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy) of the two groups of patients were compared and analyzed. <strong>Results:</strong> Compared with the control group, the observation group had significantly shorter examinations (P < 0.05). Although the cost of medical examinations of the observation group tended to be higher, the difference between groups was not significant (P > 0.05). Moreover, there were no significant differences in left ventricular ejection fraction, left ventricular end-diastolic diameter, or brain natriuretic peptide between the two groups (P > 0.05). Comparison of the etiologic diagnosis results between the two groups showed that the observation group had significantly higher diagnostic sensitivity, specificity, positive and negative predictive values, and diagnostic accuracy for various causes compared with the control group (P < 0.05). <strong>Conclusion:</strong> Real-time bedside ultrasonography for the etiologic diagnosis of patients with acute dyspnea was quicker and had higher diagnostic accuracy;thus providing accurate guidance for the disease treatment, and having a higher promotional value in clinical practice compared with routine examinations.
基金the Hubei Prov-ince Natural Sciences Foundation (No.2005ABA164).
文摘To study the relationship between bacterial infection and the etiology of cystitis glandularis, 36 female Wistar rats were divided into 3 groups. No intervention was given to the rats in the blank group. NS was infused into the bladder of the rats of the control group, and solution containing E. coil was injected into the bladder of experimental group. Three months later, tissue samples of bladder were collected and observed visually and under light microscope. The results showed that tissues of the blank group were normal＇, one sample in the control group showed Brunn＇s nests and cystitis cystica, and 10 in the experimental group had the change of cystitis glandularis. Compared to the blank and control group, samples in the experimental group showed significant change （P〈0.05）. There were no significant difference between blank group and control group （P〉0.05）. It is concluded that bladder instillation of E. coil can induce cystitis glandularis, which confirms that infection is the cause of cystitis glandularis.
文摘The inability to procreate is frequently considered a personal tragedy and a hardship for couples, impacting on the entire family and even the local community. In Gaza strip, Palestine, there has been no study on etiological risk factors for subfertility. The present study aimed to identify risk factors associated with subfertility among women in Gaza, Palestine. One hundred and sixty-nine women in the study group and 115 women in the control group were included. Cases were selected randomly from those referred to the A1 Basma Fertility Center, Gaza, Palestine. Data were collected through close-ended questionnaire, sonography, hormonal analysis and thrombophilia profile that included the methylenetetrahydrofolate reductase （MTHFR 677 C 〉 T）, factor V leiden （1691 G 〉 A） and pro- thrombin （20210 G 〉 A） genes. By using univariate analyses, the effects of different patient-related variables on the presence of subfertility were evaluated. A multiple logistic regression model was constructed, crude and adjusted odds ratios （OR） and 95% confidence intervals （95% CI） were calculated. The findings showed that 73.5 % （169/230） of the women referred to the A1 Basma Center sought treatment for subfertility. Different etiological risk factors were associated with subfertility, the most frequent of which in descending order were： thrombophilic disorders, fallopian tube problems, sex hormone abnormalities and polycystic ovary syndrome with an adjusted OR of 21.42, 13.63, 11.69 and 10.29, respectively. In conclusion, several etiological risk factors are responsible for subfertility among women in Gaza. Comprehensive evaluation of infertile women should be considered in the course of treatment; otherwise, the duration of sterility may be extended.
文摘AIM To investigate the etiologic association of pancreas divisum (PD) with chronic pancreatitis and to clarify its pathogenesis. METHODS A PD canine model was established in 32 dogs. The dogs were randomly divided into 4 groups ( n =8). Group Ⅰ: The communicating branch between the dorsal and ventral pancreatic ducts was partly ligated. Group Ⅱa: The communicating branch was amputated and completely ligated. Group Ⅱb: The dorsal duct was amputated and ligated at 2mm distance to the minor papilla. Group Ⅲ: A sham operation without any amputation or ligation was performed. Before and after operation, the activities of serum phospholipase A2 (PLA2) and amylase (Ams) were assayed and the basal pressures of the ducts were measured when secretin was injected. Pancreatic ductography and the pathologic examination were made. RESULTS The activities of serum PLA2 and Ams in Group Ⅰ,Ⅱa and Ⅱb were significantly increased 5-80 days after operation. At sacrifice, the basal pressures of the ventral duct were significantly higher 30min-60min after provocation in Group Ⅰ, Ⅱa and Ⅱb. The pressures of the dorsal duct were significantly increased in Group Ⅱb but no difference in Group Ⅰ and Ⅱa. Under light microscopy the fibrosis of interlobus and periducts, the destruction of acini and infiltration of inflammatory cell in dorsal and ventral pancreas were found in Group Ⅱb. But in Group Ⅰ and Ⅱa, these findings were present only in ventral pancreas. The electron microscopy showed that in ventral pancreas of Groups Ⅰ and Ⅱa and the dorsal and ventral pancreas of Group Ⅱb, the rough endoplasmic reticulum of the acinar cells showed granules scaling, fusion and dilatation. The zymogen granules decreased and the mitochondria was swollen. CONCLUSION PD is one of etiologic factors in chronic pancreatitis. The pathogenesis is the functional obstruction of the minor papilla at the peak stage of secretion.
文摘BACKGROUND: This study was to clarify the high riskfactors for subphrenic infection (SI) after liver resection forpatients with hepatic malignancy.METHODS: Three hundred and sixty-eight patients whohad undergone hepatectomy from January 1985 throughJune 2002 were randomly divided into 2 groups accordingto resection of liver parenchyma, hepatic cirrhosis, primaryliver cancer, intraoperative blood loss, and subphrenicdrainage. The chi-square was used for statistical analysis.RESULTS: Thirteen patients (3.53%) of the 368 patientshad SI. The high-risk factors for SI after hepatectomy wererelated to resection of liver parenchyma and hepatic cirrho-sis ; but the course or stage of primary liver cancer was notrelated to the incidence of SI. Intraoperative blood loss ofover 1500 ml was found to be a significant risk factor forpostoperative SI. Adequate drainage of the subdiaphragmand the raw surface of the liver after operation was essentialto decreasing SI after liver resection.CONCLUSION: Inadequate subphrenic drainage maylargely contribute to SI in patients with hepatic malignancyundergoing hepatectomy apart from other factors. Com-prehensive measures should be taken to prevent the infec-tion after hepatectomy.
文摘The objective of our study was to study the epidemiological, etiological and contributory factors of maternal deaths in the obstetrics and gynecology department of the regional hospital center (RHC) of Ouahigouya from 2013 to 2015. We carried out a descriptive and analytical study on maternal deaths in maternity of the RHC of Ouahigouya, including all patients who died in the obstetrics and gynecology department of the RHC of Ouahigouya from 1 January 2013 to 31 December 2015, which meets WHO’s definition of maternal death. We recorded 151 maternal deaths and 5481 live births, a maternal mortality ratio of 2755 per 100,000 live births. The most affected women were women aged 20 - 24 years (27.8%), multiparous (25.5%), married women (88.7%) and those without income-generating activities (85.4%). The main causes of death from direct obstetrical complications were hemorrhage (38.3%), infections (21.5%), abortions (16.8%) and complications of hypertension disorders (15.8%) and for indirect obstetrical complications, malaria (36.6%), anemia (29.5%), and HIV/AIDS (9.1%). Contributing factors to maternal deaths prior to admission were delay in referral (33.3%) and delay in transfer (31.5%) and delay in admission (32.8%) and delay in diagnosis (23.4). From our study, it appears elsewhere as well as that most maternal deaths are preventable, hence the need for coordinated actions to effectively fight against maternal mortality.
文摘Aim: To study common cause of digestive tract hemorrhage and the relationship between etiology and age. Methods: Retrospective analysis about the data of 419 cases of digestive tract hemorrhage in digestive internal medicine from January 2016 to January 2018 in Jingzhou Central Hospital. Results: 419 cases of digestive tract hemorrhage include 305 cases of hemorrhage in upper digestive tract and 114 cases of hemorrhage in lower digestive tract. The first 5 causes of upper digestive tract hemorrhage in middle-aged and young group were: duodenal bulb ulcer, gastric ulcer, esophageal and stomach bottom varices bleeding in cirrhosis of schistosomiasis, compound ulcer, esophageal and stomach bottom varices bleeding in hepatitis B cirrhosis. The first 5 causes of upper digestive tract hemorrhage in elderly group were: gastric ulcer, duodenal bulb ulcer, esophageal and stomach bottom varices bleeding in hepatitis B cirrhosis, esophageal and stomach bottom varices bleeding in cirrhosis of schistosomiasis, gastric cancer. The first 5 causes of lower digestive tract hemorrhage in middle-aged and young group were: ulcerative colitis, colorectal polyps, hemorrhoids, crohn’s disease, ischemic bowel disease. The first 5 causes of lower digestive tract hemorrhage in elderly group were: colorectal polyps, colon cancer, ulcerative colitis, ischemic bowel disease, hemorrhoids. Conclusion: In the cases of upper digestive tract hemorrhage, peptic ulcer should be paid attention to in middle-aged and young people, and elderly should be noted in gastric cancer. Ulcerative colitis should be paid attention to in middle-aged and young people with lower digestive tract hemorrhage, and elderly should be noted in colorectal polyps and colon cancer.
基金Supported by Scientific and Technological Project of Shaanxi Province (2011K12-05-10)
文摘Etiologies of benign esophageal dysphagia are diverse and a panel of clinical and laboratory investigations should be taken to make the right diagnosis. We report herein two cases of benign esophageal dysphagia of non-infectious origin. Imaging tests identified changes similar to malignancies, while only inflamed granulation tissue was discovered in biopsy specimens. Surgical resection was finally applied due to severe symptoms and the histological study revealed only granulation tissue. They were diagnosed as idiopathic cases when all the known non-infectious pathogenesis were carefully ruled out by sound examination results. The differetail diagnosis of benign esophageal dysphagia is quite important as observational data shows that medical therapy should be applied in certain pathogenesis, while esophagectomy might be the most effective solution for other etiologies. Subsequently a comparison of the manifestations of the two cases and those of esophageal dysphagia induced by other non-infectious etiologies was done to shine some light on the differencial diagnosis of benign esophageal dysphagia.
文摘Introduction: Nocturia is categorized into many categories. Each category requires different approaches and treatment. We aimed to obtain data regarding nocturia, classified into categories according to its pathogenesis, in Thai patients. Methods: We reviewed 133 medical records and voiding diaries of the patients who attended a urologic clinic in a tertiary teaching hospital during year 2009-2010 with nocturia problems. Those data were analyzed to sort these nocturia patients into the appropriate categories. Results: There were a total of 133 patients, consisting of 94 males (70.1%) and 39 females (29.9%). Overall mean age was 64.74 ± 25.85 years. There was no statistically difference between the two genders (Male 65.94 ± 24.56 years vs. Female 61.87 ± 28.24 years, p = 0.10). Among these, 71 patients (53.4%) had nocturnal polyuria. Almost all patients (132 patients, 99.2%) met the criteria for diminished global/nocturnal bladder capacity. The younger patients (less than 40 years) were found to have more severe clinical symptoms than the older patients (6 from 8 or 75% vs. 46 from 125 or 36%, p = 0.032). Seventy patients (52.6%) met the criteria of Mixed NP and Diminished. There were 32 patients (24.1%) found in the group of Global polyuria. Only one patient was classified as isolated nocturnal polyuria and none as isolated global polyuria. Conclusion: Nocturnal polyuria and global polyuria are not uncommon conditions and most of these patients might have concomitant diminished bladder capacity for which investigation or simultaneous treatment may be needed to gain the best treatment result.
