Let f be a primitive holomorphic cusp form with even integral weight k≥2 for the full modular groupΓ=SL(2,Z)andλ_(sym^(j)f)(n)be the n-th coefficient of Dirichlet series of j-th symmetric L-function L(s,sym^(j)f)at...Let f be a primitive holomorphic cusp form with even integral weight k≥2 for the full modular groupΓ=SL(2,Z)andλ_(sym^(j)f)(n)be the n-th coefficient of Dirichlet series of j-th symmetric L-function L(s,sym^(j)f)attached to f.In this paper,we study the mean value distribution over a specific sparse sequence of positive integers of the following sum∑(a^(2)+b^(2)+c^(2)+d^(2)≤x(a,b,c,d)∈Z^(4))λ_(sym^(j))^(i)f(a^(2)+b^(2)+c^(2)+d^(2))where j≥2 is a given positive integer,i=2,3,4 andαis sufficiently large.We utilize Python programming to design algorithms for higher power conditions,combining Perron's formula,latest results of representations of natural integers as sums of squares,as well as analytic properties and subconvexity and convexity bounds of automorphic L-functions,to ensure the accuracy and verifiability of asymptotic formulas.The conclusion we obtained improves previous results and extends them to a more general settings.展开更多
VEXAS(vacuoles,E1 enzyme,X-linked,autoinflammatory,somatic)syndrome is a severe and progressive disease,characterized by clinical features that bridge rheumatologic and hematologic conditions.[1]VEXAS syndrome is a ra...VEXAS(vacuoles,E1 enzyme,X-linked,autoinflammatory,somatic)syndrome is a severe and progressive disease,characterized by clinical features that bridge rheumatologic and hematologic conditions.[1]VEXAS syndrome is a rare condition that was not reported until 2020.[2]Since then,interest among dermatologists,hematologists,and rheumatologists with published works has increased,[3]but none of them reported in the emergency setting,nor have any cases arisen following COVID-19 infection.展开更多
The article"Assessment of superior mesenteric vascular flow quantitation in children using four-dimensional flow magnetic resonance imaging"suggests to use of four-dimensional(4D)flow magnetic resonance imag...The article"Assessment of superior mesenteric vascular flow quantitation in children using four-dimensional flow magnetic resonance imaging"suggests to use of four-dimensional(4D)flow magnetic resonance imaging(MRI)which is also to measure the blood flow in the superior mesenteric vein(SMV)in pediatric patients over the traditional method.The study focuses on assessing the potential of SMV and superior mesenteric artery(SMA)flow quantification in children utilizing 4D flow MRI.It included 9 pediatric patients aged 18 years and below where 5 were male and 4 were female patients,on whom magnetic resonance enterorrhaphy(MRE)with 4D flow MRI protocol was used.Statistical analysis was performed using MedCalc.Measurements of SMV and SMA between two readers were calculated using Bland-Altman analysis.The results stated that six patients showed no MRE evidence of active inflammatory bowel disease,two patients showed unmarkable bowel appearance on MRI and one patient showed normal MRE without endoscopy performed at the same timeframe.The study utilized available 4D flow MRI sequences in this study aiming to show the feasibility of 4D flow quantitation of SMA and SMV flow in pediatric patients.The study also discovered good agreement for both peak velocity and peak speed measurements of SMA and SMV.展开更多
Objective:To evaluate laboratory findings that predict bacterial meningitis in emergency service and their diagnostic effectiveness.Methods:This retrospective cohort study analyzed data from patients presenting with m...Objective:To evaluate laboratory findings that predict bacterial meningitis in emergency service and their diagnostic effectiveness.Methods:This retrospective cohort study analyzed data from patients presenting with meningitis symptoms at a referral hospital in Mersin,Turkey,between January 2019 and January 2022.Clinical findings and laboratory results,including leukocyte count,C-reactive protein(CRP),and procalcitonin levels in blood,were examined.Logistic regression,Chi square test,and receiver operating characteristics(ROC)curve analyses assessed the predictive value of these parameters.Results:A total of 199 participants were included in the study;99 patients were diagnosed with meningitis after lumbar puncture and 100 served as controls.Patients with meningitis exhibited significantly higher leukocyte counts(median:11890×10^(3)/μL vs.7905×10^(3)/μL,P<0.001)and CRP levels(median:6.00 mg/dL vs.0.95 mg/dL,P<0.001)compared to controls.Procalcitonin levels were significantly elevated in meningitis patients(median:0.21 ng/mL vs.0.10 ng/mL,P<0.001).Logistic regression identified albumin(OR=0.16,95%CI=0.06-0.40),and CRP(OR=1.18,95%CI=1.08-1.28)as independent predictors of meningitis.ROC analysis for CRP demonstrated a sensitivity of 80.6%and specificity of 70.0%at a cut-off value of 2.23 mg/dL(AUC=0.792).Conclusions:Elevated albumin levels and CRP contents in the blood were significant predictors of meningitis in emergency service.Early identification of predictive markers may aid in timely lumbar puncture and management of atypical cases.展开更多
BACKGROUND Acute hemorrhagic leukoencephalitis(AHLE),also known as Weston-Hurst syndrome,is a very rare and fulminant form of demyelinating disorder.It is considered a hyperacute and severe variant of acute disseminat...BACKGROUND Acute hemorrhagic leukoencephalitis(AHLE),also known as Weston-Hurst syndrome,is a very rare and fulminant form of demyelinating disorder.It is considered a hyperacute and severe variant of acute disseminated encephalomyelitis.Clinically,patients present with fever,headache,seizures,and altered sensorium,which can rapidly progress to coma or death.Magnetic resonance imaging(MRI)is the investigation of choice and plays a pivotal role in diagnosing AHLE.The purpose of this article is to make readers familiar with the typical MRI features of AHLE and to discuss differentials.CASE SUMMARY This case series reports the clinical presentation and typical neuroimaging findings in four patients diagnosed with AHLE.All patients presented with acute neurological symptoms,such as severe headaches,seizures,and altered consciousness,often following a history of fever suggesting an infectious etiology.Additionally,laboratory investigations demonstrated elevated levels of serum inflammatory markers and neutrophilic pleocytosis on cerebrospinal fluid analysis,supporting a post-infectious etiology.MRI findings consistently revealed characteristic white matter lesions with hemorrhagic foci and vasogenic edema,indicative of widespread demyelination characteristic of AHLE.The outcomes varied,with two patients surviving but experiencing neurological sequelae,while two others unfortunately succumbed to the disease.The clinical data,laboratory results,and imaging findings from this case series were systematically compared with those from previously published studies.The key similarities and differences in clinical presentation,imaging characteristics,and outcomes are presented in a tabulated format.CONCLUSION AHLE is associated with high morbidity and mortality rates,emphasizing the need for early recognition,prompt intervention,and multidisciplinary management.Further research is needed to explain the pathophysiological mechanisms underlying AHLE,identify potential biomarkers for early diagnosis,and develop targeted therapies to improve patient outcomes.展开更多
Introduction: Foreign bodies (FB) in the lower airways (LAs) constitute a potentially life-threatening emergency requiring immediate management. The objective of our study was to describe the patient pathway and manag...Introduction: Foreign bodies (FB) in the lower airways (LAs) constitute a potentially life-threatening emergency requiring immediate management. The objective of our study was to describe the patient pathway and management of foreign bodies in the lower airways. Methodology: This was a descriptive study with retrospective data collection conducted over a 6-year period (January 1, 2014, to December 31, 2019) in the ENT and Head and Neck Surgery Department of Donka National Hospital. Results: We observed a prevalence of 1.79%. The average age was 5.71 years, with a sex ratio of 1.2. However, 82.61% of the cases originated from rural areas. We noted that 78.83% of patients were referred after visiting 1 to 2 healthcare facilities (75.36%). The consultation delay was 3 days. Penetration syndrome was present in 98.56% of cases. The foreign body incidents occurred during play in 54.84% and during meals in 29.09% of cases. Radiographs were performed in 93.9% of cases. Endoscopy was used for both diagnostic and therapeutic purposes in all patients. The foreign bodies were located in the trachea (37.68%), larynx (26.08%), and bronchi (21.73%). Non-organic foreign bodies were predominant (52.17%). Postoperative outcomes were uncomplicated in 95.98% of cases, and the lethality rate was 2.85%. Conclusion: The pathway of patients with foreign bodies in the airways remains unpredictable in our context due to parental hesitations. Early management reduces morbidity and mortality rates.展开更多
Bemisia tabaci is a polyphagous herbivore that feeds on a wide range of horticultural and ornamental crops cultivated under diverse ecological zones. In Sierra Leone, B. tabaci is found to infest a wide range of veget...Bemisia tabaci is a polyphagous herbivore that feeds on a wide range of horticultural and ornamental crops cultivated under diverse ecological zones. In Sierra Leone, B. tabaci is found to infest a wide range of vegetable crops by directly feeding on phloem sap thereby inducing physiological disorders, and also serve as a vector to gemini viruses. Invariably the destructive feeding of B. tabaci affects the productivity and aesthetic values of vegetables and other horticultural crops and hence is considered a serious economic pest. A bioassay experiment was carried out by rearing B. tabaci populations on four vegetable crops under controlled laboratory conditions to determine its life table and demographic parameters. Results showed that the intrinsic rate of growth which measures the population size and growth pattern was highest for populations reared on tomato crops with the following values: rm 0.145 female female−1 day−1, the gross reproduction rate (Ro), and finite growth rate λ were highest for population reared on tomato, correspondingly the development period from egg-adult emergence was shortest with a value of 26 d. Conversely, the computed demographical parameters rm, λ and Ro for the population reared on sweet pepper were 0.106 female female−1 day−1 respectively, with a corresponding development period egg-adult emergence as 36d. The computed biological parameters for okra and garden egg varied with intermediary values between tomato and pepper host materials. The survivorship rates were quite significant for the smaller instars (Instars 1-III) with over 80% surviving to pre-pupa and pupa stage for the populations reared for all the test materials. High mortality was noticed for the pre-pupa and pupa stages as their survival rates were significantly low compared to the high survival rates of the smaller instars. Less than 50% of pupae failed to emerge to adults except for populations reared on tomato test materials where 52% emerged to adults. The study indicated tomato as the most suitable host among the four vegetable crops. Although life table and demographic parameters are invaluable information for forecasting pest populations and help in designing pest management efforts, further investigations such as the economic threshold and economic injury levels of B. tabaci population are requisite decision tools for sound pest management decisions of B. tabaci on these vegetable crops. The information obtained from this investigation would be quite relevant for extension service and pest management practitioners where mixed vegetable farming is a common practice.展开更多
Phencyclidine(PCP,known as angel dust) is a nonbarbiturate,non-narcotic intravenous(IV) anesthetic with potent analgesic effects.However,its medical use was discontinued because of postoperative agitation,disorientati...Phencyclidine(PCP,known as angel dust) is a nonbarbiturate,non-narcotic intravenous(IV) anesthetic with potent analgesic effects.However,its medical use was discontinued because of postoperative agitation,disorientation,psychosis,cardiotoxicity,and hallucinogenic effects.Consequently,the PCP began to be illicitly distributed.The use methods include snorting,inhalation,IV,and subcutaneous(SC) injection.[1-5] The characteristic toxidrome of PCP includes altered mental status,tachycardia,and nystagmus.At higher doses,patients may become comatose and develop sympathomimetic effects such as tachycardia,hypertension,hypersalivation,urinary retention,and bronchospasm.In cases of intoxication,the pupillary light reflex remains intact,although the pupil size may vary.[1,3-6] PCP has a direct cardiotoxic effect and may induce arrhythmias.[2] Hyperreflexia,muscle rigidity,choreiform movements and muscle fasciculations may occur.[2,4,6] PCP-induced acute respiratory distress syndrome(ARDS) and alveolar hemorrhage(AH) are rare but potentially life-threatening complications.The main causes of non-traumatic death in patients with PCP intoxication include cardiopulmonary arrest,intracranial hemorrhage and rhabdomyolysis.[2,3,5] This case report aims to emphasize the management and potential benefits of inhaled N-acetylcysteine(NAC) and tranexamic acid(TXA)for PCP-induced ARDS and AH.展开更多
BACKGROUND Four-dimensional(4D)flow magnetic resonance imaging(MRI)is used as a noninvasive modality for assessing hemodynamic information with neurovascular and body applications.The application of 4D flow MRI for as...BACKGROUND Four-dimensional(4D)flow magnetic resonance imaging(MRI)is used as a noninvasive modality for assessing hemodynamic information with neurovascular and body applications.The application of 4D flow MRI for assessment of bowel disease in children has not been previously described.AIM To determine feasibility of superior mesenteric venous and arterial flow quantitation in pediatric patients using 4D flow MRI.METHODS Nine pediatric patients(7-14 years old,5 male and 4 female)with history or suspicion of bowel pathology,who underwent magnetic resonance(MR)enterography with 4D flow MR protocol from November 2022 to October 2023.Field strength/sequence:3T MRI using 4D flow MR protocol.Flow velocity and peak speed measurements were performed by two diagnostic radiologists placing the region of interest in perpendicular plane to blood flow on each cross section of superior mesenteric artery(SMA)and superior mesenteric vein(SMV)at three predetermined levels.Bland-Altman analysis,showed good agreement of flow velocity and peak speed measurements of SMV and SMA between two readers.RESULTS Mean SMV flow velocity increased from proximal to mid to distal(0.14 L/minute,0.17 L/minute,0.22 L/minute respectively).Mean SMA flow velocity decreased from proximal to mid to distal(0.35 L/minute,0.27 L/minute,0.21 L/minute respectively).Observed agreement was good for flow velocity measurements of SMV(mean bias-0.01 L/minute and 95%limits of agreement,-0.09 to 0.08 L/minute)and SMA(mean bias-0.03 L/minute and 95%limits of agreement,-0.23 to 0.17 L/minute)between two readers.Good agreement for peak speed measurements of SMV(mean bias-1.2 cm/second and 95%limits of agreement,-9.4 to 7.0 cm/second)and SMA(mean bias-3.2 cm/second and 95%limits of agreement,-31.4 to 24.9 cm/second).CONCLUSION Flow quantitation using 4D Flow is feasible to provide hemodynamic information for SMV and SMA in children.展开更多
BACKGROUND Postpancreatectomy hemorrhage is one of the most severe and life-threatening complications after pancreaticoduodenectomy.We present four cases of gastrointestinal bleeding patients to clarify its appropriat...BACKGROUND Postpancreatectomy hemorrhage is one of the most severe and life-threatening complications after pancreaticoduodenectomy.We present four cases of gastrointestinal bleeding patients to clarify its appropriate treatment and prevention.CASE SUMMARY The main symptoms included black stool,hematochezia,haematemesis,blood in the nasogastric tube,and hemorrhagic shock.The mean age was 66.25 years old and the median onset time was 340 d after the surgery.The bleeding location comprised gastrointestinal anastomosis,bile duct-jejunum anastomosis,and extraluminal bleeding.The possible causes included marginal ulcer,jejunal varix,and abdominal infection.Endoscopic hemostatic clips,as well as a covered stent using angiography,were utilized to stop the bleeding and three patients survived.Only one patient died of gastrointestinal bleeding,abdominal bleeding,abdominal infection,hypovolemic shock,and disseminated intravascular coagulation.CONCLUSION Early and effective endoscopic intervention is the key to successful hemostasis in patients with gastrointestinal bleeding after pancreatoduodenectomy.展开更多
Alga toxins have recently emerged as an environmental risk factor,especially to neurodegenerative diseases,such as Alzheimer's disease,Parkinson's disease and amyotrophic lateral sclerosis.However,the associat...Alga toxins have recently emerged as an environmental risk factor,especially to neurodegenerative diseases,such as Alzheimer's disease,Parkinson's disease and amyotrophic lateral sclerosis.However,the association between the alga toxinsβ-N-methylamino-L-alanine(BMAA),brevetoxin B,cyanoginosin LR,okadaic acid and neurodegenerative diseases remains inadequately investigated.Therefore,the aim of this study was to elucidate the potential associations.Four sets of differentially expressed genes related with BMAA,brevetoxin B,cyanoginosin LR and okadaic acid in Homo sapiens and genes linked to neurodegenerative disease development were respectively collected from the Comparative Toxicogenomic Database.Metascape analysis and cluster community analysis of four alga toxins highlighted protein-protein interaction enrichment and hub genes,while biological processes analysis showed that the dominant pathways involved in harmful effects triggered by four alga toxins were the apoptotic signaling pathway,regulation of amyloid protein formation,inflammatory response and endoplasmic reticulum stress.Genes related to the interactions between four alga toxins and neurodegenerative diseases were selected and analyzed,revealing that the relevant pathways and genes were those involved in apoptotic mitochondrial changes and neuroinflammatory response pathways.The adverse outcome pathway frameworks were constructed according to the analysis results for toxins and associated neurodegenerative diseases.These discoveries provide a new perspective for us to gain a deeper understanding of the neurotoxic effects of four alga toxins.展开更多
Introduction: Uterine rupture is certainly one of the most serious, as it immediately jeopardises the vital prognosis of the mother and foetus. It is a common obstetric tragedy in our delivery rooms in countries with ...Introduction: Uterine rupture is certainly one of the most serious, as it immediately jeopardises the vital prognosis of the mother and foetus. It is a common obstetric tragedy in our delivery rooms in countries with limited resources, reflecting the poor quality of obstetric care and, consequently, an unmet obstetric need. Methods: This was a descriptive and analytical cross-sectional study with prospective data collection over a four-year period from 1 January 2020 to 31 December 2023 at the University Hospital Centre (CHU) of Bouaké, in the Obstetrics and Gynaecology Department. The variables studied were epidemiological characteristics, therapeutic aspects and factors associated with maternal. Results: The prevalence of uterine rupture was 0.63%. The average age was 32, with patients aged 35 and over accounting for 33.68%, married 44.21% and 70% not in education. Patients with uterine rupture had been evacuated in 85.26% of cases. Uterine rupture was diagnosed in 97.89% of cases during labour. Maternal lethality due to rupture was 15.79%. The causes of maternal death were dominated by haemorrhagic shock (53.33%). Factors statistically associated with death were age ≥ 35 years (OR: 3.14), duration of labour ≥ 12 hours (OR: 5.8), multiparity (OR: 19.04), admission delay beyond 2 hours (OR: 4.36), haemoglobin level ≤ 7 g/dl (OR: 36.84), coma or obnubilation (OR: 71.82), haemorrhagic shock (OR: 243.94) and occurrence of post-operative complications (OR: 76.45). Conclusion: The frequency of uterine rupture remains significant in the department (0.63%), with maternal mortality still high (15.79%). The key to reducing uterine rupture and its consequences lies in timely referral and early, appropriate management.展开更多
Introduction: Uterine fibroids are benign tumors that develop from the connective and muscular tissues of the uterus. Common among African-American women, patients suffering from them often arrive late to the hospital...Introduction: Uterine fibroids are benign tumors that develop from the connective and muscular tissues of the uterus. Common among African-American women, patients suffering from them often arrive late to the hospital in our African regions. This study aimed to investigate the knowledge and perception of uterine fibroids among women who came to the gynecology-obstetrics department of the Regional Hospital Center (CHR) Tsévié. Methodology: It was a cross-sectional descriptive study, with data collection conducted from May 7th to 20th, 2024, using systematic sampling. The study included all women present in the Gynecology-Obstetrics Department of CHR Tsévié during the study period who willingly and informedly consented to participate in the survey. Results: 362 women participated in the study. Among them, 36.8% had a secondary level, and 72.9% were Christians. About 97.5% had heard of uterine fibroids. In 63.5% of cases, their entourage was the principal source of information. The diagnostic methods mentioned by the women were ultrasound in 94.6% of cases, while prayers and occultism were also cited in 28% and 33.3% of cases, respectively. While 91.9% of the women considered the hospital, the place for treatment, some indicated that treatment would require plant-based approaches (46.8%) and prayers (26%). The cost of treatment was an obstacle for 85.4% of women, and 61.3% expressed fear of dying during surgery. There was a statistically significant relationship between treatment choice and religion. Conclusion: The majority of women had heard of uterine fibroids but had incorrect information about the treatment.展开更多
Introduction: The therapeutic approach to benign prostatic hyperplasia (BPH) has evolved profoundly. Surgical treatment is reserved for complicated cases and the reference surgical technique is transurethral resection...Introduction: The therapeutic approach to benign prostatic hyperplasia (BPH) has evolved profoundly. Surgical treatment is reserved for complicated cases and the reference surgical technique is transurethral resection of the prostate (TURP). This work aims to study the epidemiological, clinical and therapeutic aspects of monopolar transurethral resection of the prostate in our department. Materials and Methods: We conducted a descriptive study with retrospective data collection over a 12-month period from November 1, 2023 to December 31, 2024. The urology unit, an integral part of the surgery department, of the Sino-Guinean Friendship Hospital in Conakry served as the setting for this study. It included 27 patients with benign prostatic hypertrophy treated surgically by monopolar transurethral resection and having a usable medical record. The parameters studied were epidemiological, clinics and therapeutic. Results: The mean age of the patients was 68.57 ± 5.7 years with extremes from 50 to 79 years. The peak frequency was observed between 70 and 79 years (48.15%). All our patients had lower urinary tract disorders, i.e. 100% of cases. On digital rectal examination, an increase in the volume of the prostate of benign appearance was observed in all cases. The mean prostate volume was 43.7 cc on ultrasound with extremes from 34 cc to 58 cc. The total PSA level was less than 4 ng/ml in the majority of cases. The postoperative course was generally uncomplicated (n = 26) with removal of the urinary catheter on the second postoperative day (D2). However, one peroperative complication was observed in one patient;it was a bladder breach, leading to the passage of glycine into the peritoneum. Conclusion: Transurethral resection of the prostate has reduced the length of hospital stay of our patients, as well as the comorbidities associated with the treatment. The complications associated with it are rare but potentially serious. Its performance requires in-depth mastery of the endoscopic anatomy of the lower urinary tract as well as technical operative expertise.展开更多
BACKGROUND Silver-Russell syndrome(SRS)is a clinically heterogeneous entity characterized by intrauterine and postnatal growth restriction,relative macrocephaly at birth,distinct facial features,and body asymmetry com...BACKGROUND Silver-Russell syndrome(SRS)is a clinically heterogeneous entity characterized by intrauterine and postnatal growth restriction,relative macrocephaly at birth,distinct facial features,and body asymmetry combined with other malformations.CASE SUMMARY Herein,we describe four individuals with SRS,focusing on their prenatal phenotype,postnatal presentation,diagnosis,and management.All cases had a typical phenotype,including postnatal growth failure,short stature(chronic malnutrition),and protruding forehead.Individually,they presented with feeding difficulties,leg length discrepancy,triangular face,or relative macrocephaly at birth,and each one exhibited distinct SRS features,including motor and/or speech delay,experiencing frequent hypoglycemic episodes.The fact that each patient exhibited a different combination of clinical findings underlines the heterogeneity of the syndrome.CONCLUSION SRS is diagnosed clinically.However,only 60%of cases are genetically confirmed,while most are sporadic.Although SRS is a well-described syndrome,a delayed diagnosis can have grave consequences on a child’s growth.Recombinant human growth hormone treatment is often initiated shortly after the diagnosis.The follow-up requires a multidisciplinary approach.展开更多
BACKGROUND Irritable bowel syndrome(IBS)symptoms are common in patients with inflammatory bowel disease(IBD),with systematic review reporting an overall pooled prevalence of 35-39%in patients with clinical remission.T...BACKGROUND Irritable bowel syndrome(IBS)symptoms are common in patients with inflammatory bowel disease(IBD),with systematic review reporting an overall pooled prevalence of 35-39%in patients with clinical remission.This subset of patients reports a reduced quality of life and increased anxiety and depression.A multistrain probiotic(Symprove™,Symprove Ltd,Farnham,United Kingdom)has been shown to improve overall symptom severity in patients with IBS and is associated with decreased intestinal inflammation in patients with ulcerative colitis(UC),but not in Crohn’s disease(CD).AIM To ascertain whether this multi-strain probiotic would be effective in an IBS/IBD overlap population.METHODS The treatment of symptoms in the absence of inflammation in inflammatory bowel diseases trial was a randomized,double-blind,placebo-controlled trial of a four-strain probiotic Symprove,containing Lactobacillus rhamnosus NCIMB 30174,Lactobacillus plantarum NCIMB 30173,Lactobacillus acidophilus NCIMB 30175 and Enterococcus faecium NCIMB 30176.The duration of the study was 3 months,at the end of which IBS-Symptom Severity Score(IBS-SSS)was repeated.Primary Endpoint was a 100-point reduction in IBS-SSS.RESULTS 61 participants were randomized into the intention-to-treat analysis.45%of patients receiving the active agent achieved the endpoint compared to 33%of those receiving placebo(P=0.42).In UC,50%of patients receiving placebo achieved the endpoint compared to 44%of those receiving the active agent(P=1.00).In CD 45%of those receiving the active agent achieved the endpoint compared to 29%of those receiving placebo(P=0.34).The mean change in IBS-SSS for patients receiving placebo was a reduction of 61 points,compared to a reduction in 90 points for patients receiving active agent(P=0.31).There was no difference between the groups with regard to IBD outcomes.CONCLUSION Probiotics may represent a safe and effective means of addressing the unmet clinical need for symptom relief in patients with overlapping IBS and IBD,especially in those with CD.展开更多
In science and technology,precision measurement of physical quantities is crucial,and the quantum Fisher information(QFI)plays a significant role in the study of quantum systems.In this work,we explore the dynamics of...In science and technology,precision measurement of physical quantities is crucial,and the quantum Fisher information(QFI)plays a significant role in the study of quantum systems.In this work,we explore the dynamics of QFI in a hybrid optomechanical system,which consists of a◇-type four-level atom interacting with a single-mode quantized field via a multi-photon process.We account for various sources of dissipation,including the decay rates of the atom,the cavity and the mechanical modes.Using an effective Hamiltonian,we analytically derive the explicit form of the state vector of the entire system via the time-dependent Schr?dinger equation.We then investigate the atomic QFI for the estimation precision of the decay rate of the mechanical oscillator.Furthermore,we examine how optomechanical and atom-field coupling strengths,dissipation parameters and multi-photon transition influence the dynamics of atomic QFI.Our numerical results suggest that the estimation precision of the decay rate of the mechanical oscillator can be controlled by these parameters.展开更多
Introduction: Urethral prolapse, a rare benign lesion of the female urethra, is considered unusual in children, but it is far from exceptional in girls aged 18 to 24. African origin. The diagnosis is clinical but can ...Introduction: Urethral prolapse, a rare benign lesion of the female urethra, is considered unusual in children, but it is far from exceptional in girls aged 18 to 24. African origin. The diagnosis is clinical but can be overlooked or confused with other pathologies. Treatment remains controversial. The aim of this work is to study the epidemiological, clinical and therapeutic data of urethral mucosal prolapse in young girls in our department. Materials and methods: Retrospective and descriptive study on urethral mucosal prolapse in little girls identified from the hospitalization records of the Sino-Guinean Friendship Hospital in Conakry. The study period was 5 years. Patients were selected randomly. Outcome assessment focused on the occurrence of recurrences and urinary incontinence. The mean follow-up duration was 24 months. The parameters studied were: Age, clinical and histological findings, therapeutic data and patient outcomes. Results: The incidence of urethral mucosal prolapse in girls in the urology department was 2.2 cases/year. The mean age of the patients was 6.7 years (with extremes of 5 months and 10 years). The age group of 7 to 10 years was the most represented, observed in 63.63% of patients. The most frequent reason for consultation was vulvar bleeding in 7 patients, or 63.63%. Malpighian hyperplasia with a congested chorion was the most observed histological type, in 4 patients. Surgical treatment consisting of complete excision of the prolapsed part had given excellent results. Conclusion: Urethral prolapse is a rare pathology, observed mainly in young black girls. Its diagnosis is based mainly on clinical examination. Surgical treatment gives satisfactory results, both clinically and aesthetically.展开更多
Introduction: Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS) is a sleep-related breathing disorder characterized by repeated episodes of partial obstruction of the upper airways (hypopnea) and/or intermittent compl...Introduction: Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS) is a sleep-related breathing disorder characterized by repeated episodes of partial obstruction of the upper airways (hypopnea) and/or intermittent complete obstruction (apnea). Our aim is to study the role of adeno-tonsillectomy in the management of OSAHS in children. Methodology: This was a prospective descriptive study conducted in the ENT-Head and Neck Surgery department of Ignace Deen National Hospital over a six-month period. We included in our study all patients aged 0 to 15 years, presenting with OSAHS of ENT etiology and who had undergone tonsillectomy/adenoidectomy. Results: The frequency of OSAHS was 13%. The mean age of our patients was 5.1 ± 3.8 years. There was a predominance of males (69.6%) with a sex ratio of 2.28. Snoring (98.6%), nasal obstruction (97.1%), and mouth breathing (96.6%) were the main reasons for consultation. Adeno-tonsillectomy (45.4%) was the primary surgical intervention. Almost all children (99.0%) had a simple postoperative course. Conclusion: OSAHS is a condition with a multifactorial etiology. Adeno-tonsillectomy remains the first-line surgical treatment to prevent severe complications and relieve the patient. Multidisciplinary collaboration is essential in the management of OSAHS.展开更多
Grapes are the main reason why the grapevine (Vitis vinifera L.) is cultivated. However, climate, soil conditions, vegetation and anthropogenic effects on the soil greatly affect grapevine production. The organoleptic...Grapes are the main reason why the grapevine (Vitis vinifera L.) is cultivated. However, climate, soil conditions, vegetation and anthropogenic effects on the soil greatly affect grapevine production. The organoleptic properties of grape-derived products, such as wine, are influenced by these factors, which are becoming increasingly popular in Africa. Thus, grapevines, which are commonly grown in warm regions, are acclimatized in Africa using grapevine varieties that can adjust to tropical conditions. This study, which was carried out in 2019, aimed to promote grapevine cultivation in Côte d’Ivoire by examining the influence of pedoclimatic factors on the agro-physiological characteristics of grapevines. In Côte d’Ivoire, there were four distinct agro-ecological zones (North, South, Southeast and West) where three grapevine varieties, Bequignol, Muscat Rouge and Aleatico, were grown. Grapevine plants could grow robustly in morpho-physiological ways because the soils had sufficient fertility, as revealed by the analysis of experimental sites. Grapevine varieties have successfully adapted to different terroirs, with the exception of Muscat Rouge, which only displayed favorable morphological characteristics in the Man zone (West). Regardless of the grape variety, the regions with the best grapevine-growing conditions were Man (West), followed by Aboisso (Southeast). Consequently, grapevine development was less favorable in Korhogo (North) and Abidjan (South) zones. Thus, the cultivation of grapevine varieties in Côte d’Ivoire was greatly influenced by terroir.展开更多
文摘Let f be a primitive holomorphic cusp form with even integral weight k≥2 for the full modular groupΓ=SL(2,Z)andλ_(sym^(j)f)(n)be the n-th coefficient of Dirichlet series of j-th symmetric L-function L(s,sym^(j)f)attached to f.In this paper,we study the mean value distribution over a specific sparse sequence of positive integers of the following sum∑(a^(2)+b^(2)+c^(2)+d^(2)≤x(a,b,c,d)∈Z^(4))λ_(sym^(j))^(i)f(a^(2)+b^(2)+c^(2)+d^(2))where j≥2 is a given positive integer,i=2,3,4 andαis sufficiently large.We utilize Python programming to design algorithms for higher power conditions,combining Perron's formula,latest results of representations of natural integers as sums of squares,as well as analytic properties and subconvexity and convexity bounds of automorphic L-functions,to ensure the accuracy and verifiability of asymptotic formulas.The conclusion we obtained improves previous results and extends them to a more general settings.
基金National High Level Hospital Clinical Research Funding(Scientific Research Seed Fund of Peking University First Hospital).
文摘VEXAS(vacuoles,E1 enzyme,X-linked,autoinflammatory,somatic)syndrome is a severe and progressive disease,characterized by clinical features that bridge rheumatologic and hematologic conditions.[1]VEXAS syndrome is a rare condition that was not reported until 2020.[2]Since then,interest among dermatologists,hematologists,and rheumatologists with published works has increased,[3]but none of them reported in the emergency setting,nor have any cases arisen following COVID-19 infection.
文摘The article"Assessment of superior mesenteric vascular flow quantitation in children using four-dimensional flow magnetic resonance imaging"suggests to use of four-dimensional(4D)flow magnetic resonance imaging(MRI)which is also to measure the blood flow in the superior mesenteric vein(SMV)in pediatric patients over the traditional method.The study focuses on assessing the potential of SMV and superior mesenteric artery(SMA)flow quantification in children utilizing 4D flow MRI.It included 9 pediatric patients aged 18 years and below where 5 were male and 4 were female patients,on whom magnetic resonance enterorrhaphy(MRE)with 4D flow MRI protocol was used.Statistical analysis was performed using MedCalc.Measurements of SMV and SMA between two readers were calculated using Bland-Altman analysis.The results stated that six patients showed no MRE evidence of active inflammatory bowel disease,two patients showed unmarkable bowel appearance on MRI and one patient showed normal MRE without endoscopy performed at the same timeframe.The study utilized available 4D flow MRI sequences in this study aiming to show the feasibility of 4D flow quantitation of SMA and SMV flow in pediatric patients.The study also discovered good agreement for both peak velocity and peak speed measurements of SMA and SMV.
文摘Objective:To evaluate laboratory findings that predict bacterial meningitis in emergency service and their diagnostic effectiveness.Methods:This retrospective cohort study analyzed data from patients presenting with meningitis symptoms at a referral hospital in Mersin,Turkey,between January 2019 and January 2022.Clinical findings and laboratory results,including leukocyte count,C-reactive protein(CRP),and procalcitonin levels in blood,were examined.Logistic regression,Chi square test,and receiver operating characteristics(ROC)curve analyses assessed the predictive value of these parameters.Results:A total of 199 participants were included in the study;99 patients were diagnosed with meningitis after lumbar puncture and 100 served as controls.Patients with meningitis exhibited significantly higher leukocyte counts(median:11890×10^(3)/μL vs.7905×10^(3)/μL,P<0.001)and CRP levels(median:6.00 mg/dL vs.0.95 mg/dL,P<0.001)compared to controls.Procalcitonin levels were significantly elevated in meningitis patients(median:0.21 ng/mL vs.0.10 ng/mL,P<0.001).Logistic regression identified albumin(OR=0.16,95%CI=0.06-0.40),and CRP(OR=1.18,95%CI=1.08-1.28)as independent predictors of meningitis.ROC analysis for CRP demonstrated a sensitivity of 80.6%and specificity of 70.0%at a cut-off value of 2.23 mg/dL(AUC=0.792).Conclusions:Elevated albumin levels and CRP contents in the blood were significant predictors of meningitis in emergency service.Early identification of predictive markers may aid in timely lumbar puncture and management of atypical cases.
文摘BACKGROUND Acute hemorrhagic leukoencephalitis(AHLE),also known as Weston-Hurst syndrome,is a very rare and fulminant form of demyelinating disorder.It is considered a hyperacute and severe variant of acute disseminated encephalomyelitis.Clinically,patients present with fever,headache,seizures,and altered sensorium,which can rapidly progress to coma or death.Magnetic resonance imaging(MRI)is the investigation of choice and plays a pivotal role in diagnosing AHLE.The purpose of this article is to make readers familiar with the typical MRI features of AHLE and to discuss differentials.CASE SUMMARY This case series reports the clinical presentation and typical neuroimaging findings in four patients diagnosed with AHLE.All patients presented with acute neurological symptoms,such as severe headaches,seizures,and altered consciousness,often following a history of fever suggesting an infectious etiology.Additionally,laboratory investigations demonstrated elevated levels of serum inflammatory markers and neutrophilic pleocytosis on cerebrospinal fluid analysis,supporting a post-infectious etiology.MRI findings consistently revealed characteristic white matter lesions with hemorrhagic foci and vasogenic edema,indicative of widespread demyelination characteristic of AHLE.The outcomes varied,with two patients surviving but experiencing neurological sequelae,while two others unfortunately succumbed to the disease.The clinical data,laboratory results,and imaging findings from this case series were systematically compared with those from previously published studies.The key similarities and differences in clinical presentation,imaging characteristics,and outcomes are presented in a tabulated format.CONCLUSION AHLE is associated with high morbidity and mortality rates,emphasizing the need for early recognition,prompt intervention,and multidisciplinary management.Further research is needed to explain the pathophysiological mechanisms underlying AHLE,identify potential biomarkers for early diagnosis,and develop targeted therapies to improve patient outcomes.
文摘Introduction: Foreign bodies (FB) in the lower airways (LAs) constitute a potentially life-threatening emergency requiring immediate management. The objective of our study was to describe the patient pathway and management of foreign bodies in the lower airways. Methodology: This was a descriptive study with retrospective data collection conducted over a 6-year period (January 1, 2014, to December 31, 2019) in the ENT and Head and Neck Surgery Department of Donka National Hospital. Results: We observed a prevalence of 1.79%. The average age was 5.71 years, with a sex ratio of 1.2. However, 82.61% of the cases originated from rural areas. We noted that 78.83% of patients were referred after visiting 1 to 2 healthcare facilities (75.36%). The consultation delay was 3 days. Penetration syndrome was present in 98.56% of cases. The foreign body incidents occurred during play in 54.84% and during meals in 29.09% of cases. Radiographs were performed in 93.9% of cases. Endoscopy was used for both diagnostic and therapeutic purposes in all patients. The foreign bodies were located in the trachea (37.68%), larynx (26.08%), and bronchi (21.73%). Non-organic foreign bodies were predominant (52.17%). Postoperative outcomes were uncomplicated in 95.98% of cases, and the lethality rate was 2.85%. Conclusion: The pathway of patients with foreign bodies in the airways remains unpredictable in our context due to parental hesitations. Early management reduces morbidity and mortality rates.
文摘Bemisia tabaci is a polyphagous herbivore that feeds on a wide range of horticultural and ornamental crops cultivated under diverse ecological zones. In Sierra Leone, B. tabaci is found to infest a wide range of vegetable crops by directly feeding on phloem sap thereby inducing physiological disorders, and also serve as a vector to gemini viruses. Invariably the destructive feeding of B. tabaci affects the productivity and aesthetic values of vegetables and other horticultural crops and hence is considered a serious economic pest. A bioassay experiment was carried out by rearing B. tabaci populations on four vegetable crops under controlled laboratory conditions to determine its life table and demographic parameters. Results showed that the intrinsic rate of growth which measures the population size and growth pattern was highest for populations reared on tomato crops with the following values: rm 0.145 female female−1 day−1, the gross reproduction rate (Ro), and finite growth rate λ were highest for population reared on tomato, correspondingly the development period from egg-adult emergence was shortest with a value of 26 d. Conversely, the computed demographical parameters rm, λ and Ro for the population reared on sweet pepper were 0.106 female female−1 day−1 respectively, with a corresponding development period egg-adult emergence as 36d. The computed biological parameters for okra and garden egg varied with intermediary values between tomato and pepper host materials. The survivorship rates were quite significant for the smaller instars (Instars 1-III) with over 80% surviving to pre-pupa and pupa stage for the populations reared for all the test materials. High mortality was noticed for the pre-pupa and pupa stages as their survival rates were significantly low compared to the high survival rates of the smaller instars. Less than 50% of pupae failed to emerge to adults except for populations reared on tomato test materials where 52% emerged to adults. The study indicated tomato as the most suitable host among the four vegetable crops. Although life table and demographic parameters are invaluable information for forecasting pest populations and help in designing pest management efforts, further investigations such as the economic threshold and economic injury levels of B. tabaci population are requisite decision tools for sound pest management decisions of B. tabaci on these vegetable crops. The information obtained from this investigation would be quite relevant for extension service and pest management practitioners where mixed vegetable farming is a common practice.
文摘Phencyclidine(PCP,known as angel dust) is a nonbarbiturate,non-narcotic intravenous(IV) anesthetic with potent analgesic effects.However,its medical use was discontinued because of postoperative agitation,disorientation,psychosis,cardiotoxicity,and hallucinogenic effects.Consequently,the PCP began to be illicitly distributed.The use methods include snorting,inhalation,IV,and subcutaneous(SC) injection.[1-5] The characteristic toxidrome of PCP includes altered mental status,tachycardia,and nystagmus.At higher doses,patients may become comatose and develop sympathomimetic effects such as tachycardia,hypertension,hypersalivation,urinary retention,and bronchospasm.In cases of intoxication,the pupillary light reflex remains intact,although the pupil size may vary.[1,3-6] PCP has a direct cardiotoxic effect and may induce arrhythmias.[2] Hyperreflexia,muscle rigidity,choreiform movements and muscle fasciculations may occur.[2,4,6] PCP-induced acute respiratory distress syndrome(ARDS) and alveolar hemorrhage(AH) are rare but potentially life-threatening complications.The main causes of non-traumatic death in patients with PCP intoxication include cardiopulmonary arrest,intracranial hemorrhage and rhabdomyolysis.[2,3,5] This case report aims to emphasize the management and potential benefits of inhaled N-acetylcysteine(NAC) and tranexamic acid(TXA)for PCP-induced ARDS and AH.
文摘BACKGROUND Four-dimensional(4D)flow magnetic resonance imaging(MRI)is used as a noninvasive modality for assessing hemodynamic information with neurovascular and body applications.The application of 4D flow MRI for assessment of bowel disease in children has not been previously described.AIM To determine feasibility of superior mesenteric venous and arterial flow quantitation in pediatric patients using 4D flow MRI.METHODS Nine pediatric patients(7-14 years old,5 male and 4 female)with history or suspicion of bowel pathology,who underwent magnetic resonance(MR)enterography with 4D flow MR protocol from November 2022 to October 2023.Field strength/sequence:3T MRI using 4D flow MR protocol.Flow velocity and peak speed measurements were performed by two diagnostic radiologists placing the region of interest in perpendicular plane to blood flow on each cross section of superior mesenteric artery(SMA)and superior mesenteric vein(SMV)at three predetermined levels.Bland-Altman analysis,showed good agreement of flow velocity and peak speed measurements of SMV and SMA between two readers.RESULTS Mean SMV flow velocity increased from proximal to mid to distal(0.14 L/minute,0.17 L/minute,0.22 L/minute respectively).Mean SMA flow velocity decreased from proximal to mid to distal(0.35 L/minute,0.27 L/minute,0.21 L/minute respectively).Observed agreement was good for flow velocity measurements of SMV(mean bias-0.01 L/minute and 95%limits of agreement,-0.09 to 0.08 L/minute)and SMA(mean bias-0.03 L/minute and 95%limits of agreement,-0.23 to 0.17 L/minute)between two readers.Good agreement for peak speed measurements of SMV(mean bias-1.2 cm/second and 95%limits of agreement,-9.4 to 7.0 cm/second)and SMA(mean bias-3.2 cm/second and 95%limits of agreement,-31.4 to 24.9 cm/second).CONCLUSION Flow quantitation using 4D Flow is feasible to provide hemodynamic information for SMV and SMA in children.
文摘BACKGROUND Postpancreatectomy hemorrhage is one of the most severe and life-threatening complications after pancreaticoduodenectomy.We present four cases of gastrointestinal bleeding patients to clarify its appropriate treatment and prevention.CASE SUMMARY The main symptoms included black stool,hematochezia,haematemesis,blood in the nasogastric tube,and hemorrhagic shock.The mean age was 66.25 years old and the median onset time was 340 d after the surgery.The bleeding location comprised gastrointestinal anastomosis,bile duct-jejunum anastomosis,and extraluminal bleeding.The possible causes included marginal ulcer,jejunal varix,and abdominal infection.Endoscopic hemostatic clips,as well as a covered stent using angiography,were utilized to stop the bleeding and three patients survived.Only one patient died of gastrointestinal bleeding,abdominal bleeding,abdominal infection,hypovolemic shock,and disseminated intravascular coagulation.CONCLUSION Early and effective endoscopic intervention is the key to successful hemostasis in patients with gastrointestinal bleeding after pancreatoduodenectomy.
基金supported by the Natural Science Foundation of Shandong province(Nos.ZR2019MH048 and ZR2022QC149)the Double First-class Disciplines Construction Fund Project from Harbin Institute of Technology at Weihai(No.2023SYLHY18)Weihai Science and Technology Development Program。
文摘Alga toxins have recently emerged as an environmental risk factor,especially to neurodegenerative diseases,such as Alzheimer's disease,Parkinson's disease and amyotrophic lateral sclerosis.However,the association between the alga toxinsβ-N-methylamino-L-alanine(BMAA),brevetoxin B,cyanoginosin LR,okadaic acid and neurodegenerative diseases remains inadequately investigated.Therefore,the aim of this study was to elucidate the potential associations.Four sets of differentially expressed genes related with BMAA,brevetoxin B,cyanoginosin LR and okadaic acid in Homo sapiens and genes linked to neurodegenerative disease development were respectively collected from the Comparative Toxicogenomic Database.Metascape analysis and cluster community analysis of four alga toxins highlighted protein-protein interaction enrichment and hub genes,while biological processes analysis showed that the dominant pathways involved in harmful effects triggered by four alga toxins were the apoptotic signaling pathway,regulation of amyloid protein formation,inflammatory response and endoplasmic reticulum stress.Genes related to the interactions between four alga toxins and neurodegenerative diseases were selected and analyzed,revealing that the relevant pathways and genes were those involved in apoptotic mitochondrial changes and neuroinflammatory response pathways.The adverse outcome pathway frameworks were constructed according to the analysis results for toxins and associated neurodegenerative diseases.These discoveries provide a new perspective for us to gain a deeper understanding of the neurotoxic effects of four alga toxins.
文摘Introduction: Uterine rupture is certainly one of the most serious, as it immediately jeopardises the vital prognosis of the mother and foetus. It is a common obstetric tragedy in our delivery rooms in countries with limited resources, reflecting the poor quality of obstetric care and, consequently, an unmet obstetric need. Methods: This was a descriptive and analytical cross-sectional study with prospective data collection over a four-year period from 1 January 2020 to 31 December 2023 at the University Hospital Centre (CHU) of Bouaké, in the Obstetrics and Gynaecology Department. The variables studied were epidemiological characteristics, therapeutic aspects and factors associated with maternal. Results: The prevalence of uterine rupture was 0.63%. The average age was 32, with patients aged 35 and over accounting for 33.68%, married 44.21% and 70% not in education. Patients with uterine rupture had been evacuated in 85.26% of cases. Uterine rupture was diagnosed in 97.89% of cases during labour. Maternal lethality due to rupture was 15.79%. The causes of maternal death were dominated by haemorrhagic shock (53.33%). Factors statistically associated with death were age ≥ 35 years (OR: 3.14), duration of labour ≥ 12 hours (OR: 5.8), multiparity (OR: 19.04), admission delay beyond 2 hours (OR: 4.36), haemoglobin level ≤ 7 g/dl (OR: 36.84), coma or obnubilation (OR: 71.82), haemorrhagic shock (OR: 243.94) and occurrence of post-operative complications (OR: 76.45). Conclusion: The frequency of uterine rupture remains significant in the department (0.63%), with maternal mortality still high (15.79%). The key to reducing uterine rupture and its consequences lies in timely referral and early, appropriate management.
文摘Introduction: Uterine fibroids are benign tumors that develop from the connective and muscular tissues of the uterus. Common among African-American women, patients suffering from them often arrive late to the hospital in our African regions. This study aimed to investigate the knowledge and perception of uterine fibroids among women who came to the gynecology-obstetrics department of the Regional Hospital Center (CHR) Tsévié. Methodology: It was a cross-sectional descriptive study, with data collection conducted from May 7th to 20th, 2024, using systematic sampling. The study included all women present in the Gynecology-Obstetrics Department of CHR Tsévié during the study period who willingly and informedly consented to participate in the survey. Results: 362 women participated in the study. Among them, 36.8% had a secondary level, and 72.9% were Christians. About 97.5% had heard of uterine fibroids. In 63.5% of cases, their entourage was the principal source of information. The diagnostic methods mentioned by the women were ultrasound in 94.6% of cases, while prayers and occultism were also cited in 28% and 33.3% of cases, respectively. While 91.9% of the women considered the hospital, the place for treatment, some indicated that treatment would require plant-based approaches (46.8%) and prayers (26%). The cost of treatment was an obstacle for 85.4% of women, and 61.3% expressed fear of dying during surgery. There was a statistically significant relationship between treatment choice and religion. Conclusion: The majority of women had heard of uterine fibroids but had incorrect information about the treatment.
文摘Introduction: The therapeutic approach to benign prostatic hyperplasia (BPH) has evolved profoundly. Surgical treatment is reserved for complicated cases and the reference surgical technique is transurethral resection of the prostate (TURP). This work aims to study the epidemiological, clinical and therapeutic aspects of monopolar transurethral resection of the prostate in our department. Materials and Methods: We conducted a descriptive study with retrospective data collection over a 12-month period from November 1, 2023 to December 31, 2024. The urology unit, an integral part of the surgery department, of the Sino-Guinean Friendship Hospital in Conakry served as the setting for this study. It included 27 patients with benign prostatic hypertrophy treated surgically by monopolar transurethral resection and having a usable medical record. The parameters studied were epidemiological, clinics and therapeutic. Results: The mean age of the patients was 68.57 ± 5.7 years with extremes from 50 to 79 years. The peak frequency was observed between 70 and 79 years (48.15%). All our patients had lower urinary tract disorders, i.e. 100% of cases. On digital rectal examination, an increase in the volume of the prostate of benign appearance was observed in all cases. The mean prostate volume was 43.7 cc on ultrasound with extremes from 34 cc to 58 cc. The total PSA level was less than 4 ng/ml in the majority of cases. The postoperative course was generally uncomplicated (n = 26) with removal of the urinary catheter on the second postoperative day (D2). However, one peroperative complication was observed in one patient;it was a bladder breach, leading to the passage of glycine into the peritoneum. Conclusion: Transurethral resection of the prostate has reduced the length of hospital stay of our patients, as well as the comorbidities associated with the treatment. The complications associated with it are rare but potentially serious. Its performance requires in-depth mastery of the endoscopic anatomy of the lower urinary tract as well as technical operative expertise.
文摘BACKGROUND Silver-Russell syndrome(SRS)is a clinically heterogeneous entity characterized by intrauterine and postnatal growth restriction,relative macrocephaly at birth,distinct facial features,and body asymmetry combined with other malformations.CASE SUMMARY Herein,we describe four individuals with SRS,focusing on their prenatal phenotype,postnatal presentation,diagnosis,and management.All cases had a typical phenotype,including postnatal growth failure,short stature(chronic malnutrition),and protruding forehead.Individually,they presented with feeding difficulties,leg length discrepancy,triangular face,or relative macrocephaly at birth,and each one exhibited distinct SRS features,including motor and/or speech delay,experiencing frequent hypoglycemic episodes.The fact that each patient exhibited a different combination of clinical findings underlines the heterogeneity of the syndrome.CONCLUSION SRS is diagnosed clinically.However,only 60%of cases are genetically confirmed,while most are sporadic.Although SRS is a well-described syndrome,a delayed diagnosis can have grave consequences on a child’s growth.Recombinant human growth hormone treatment is often initiated shortly after the diagnosis.The follow-up requires a multidisciplinary approach.
文摘BACKGROUND Irritable bowel syndrome(IBS)symptoms are common in patients with inflammatory bowel disease(IBD),with systematic review reporting an overall pooled prevalence of 35-39%in patients with clinical remission.This subset of patients reports a reduced quality of life and increased anxiety and depression.A multistrain probiotic(Symprove™,Symprove Ltd,Farnham,United Kingdom)has been shown to improve overall symptom severity in patients with IBS and is associated with decreased intestinal inflammation in patients with ulcerative colitis(UC),but not in Crohn’s disease(CD).AIM To ascertain whether this multi-strain probiotic would be effective in an IBS/IBD overlap population.METHODS The treatment of symptoms in the absence of inflammation in inflammatory bowel diseases trial was a randomized,double-blind,placebo-controlled trial of a four-strain probiotic Symprove,containing Lactobacillus rhamnosus NCIMB 30174,Lactobacillus plantarum NCIMB 30173,Lactobacillus acidophilus NCIMB 30175 and Enterococcus faecium NCIMB 30176.The duration of the study was 3 months,at the end of which IBS-Symptom Severity Score(IBS-SSS)was repeated.Primary Endpoint was a 100-point reduction in IBS-SSS.RESULTS 61 participants were randomized into the intention-to-treat analysis.45%of patients receiving the active agent achieved the endpoint compared to 33%of those receiving placebo(P=0.42).In UC,50%of patients receiving placebo achieved the endpoint compared to 44%of those receiving the active agent(P=1.00).In CD 45%of those receiving the active agent achieved the endpoint compared to 29%of those receiving placebo(P=0.34).The mean change in IBS-SSS for patients receiving placebo was a reduction of 61 points,compared to a reduction in 90 points for patients receiving active agent(P=0.31).There was no difference between the groups with regard to IBD outcomes.CONCLUSION Probiotics may represent a safe and effective means of addressing the unmet clinical need for symptom relief in patients with overlapping IBS and IBD,especially in those with CD.
文摘In science and technology,precision measurement of physical quantities is crucial,and the quantum Fisher information(QFI)plays a significant role in the study of quantum systems.In this work,we explore the dynamics of QFI in a hybrid optomechanical system,which consists of a◇-type four-level atom interacting with a single-mode quantized field via a multi-photon process.We account for various sources of dissipation,including the decay rates of the atom,the cavity and the mechanical modes.Using an effective Hamiltonian,we analytically derive the explicit form of the state vector of the entire system via the time-dependent Schr?dinger equation.We then investigate the atomic QFI for the estimation precision of the decay rate of the mechanical oscillator.Furthermore,we examine how optomechanical and atom-field coupling strengths,dissipation parameters and multi-photon transition influence the dynamics of atomic QFI.Our numerical results suggest that the estimation precision of the decay rate of the mechanical oscillator can be controlled by these parameters.
文摘Introduction: Urethral prolapse, a rare benign lesion of the female urethra, is considered unusual in children, but it is far from exceptional in girls aged 18 to 24. African origin. The diagnosis is clinical but can be overlooked or confused with other pathologies. Treatment remains controversial. The aim of this work is to study the epidemiological, clinical and therapeutic data of urethral mucosal prolapse in young girls in our department. Materials and methods: Retrospective and descriptive study on urethral mucosal prolapse in little girls identified from the hospitalization records of the Sino-Guinean Friendship Hospital in Conakry. The study period was 5 years. Patients were selected randomly. Outcome assessment focused on the occurrence of recurrences and urinary incontinence. The mean follow-up duration was 24 months. The parameters studied were: Age, clinical and histological findings, therapeutic data and patient outcomes. Results: The incidence of urethral mucosal prolapse in girls in the urology department was 2.2 cases/year. The mean age of the patients was 6.7 years (with extremes of 5 months and 10 years). The age group of 7 to 10 years was the most represented, observed in 63.63% of patients. The most frequent reason for consultation was vulvar bleeding in 7 patients, or 63.63%. Malpighian hyperplasia with a congested chorion was the most observed histological type, in 4 patients. Surgical treatment consisting of complete excision of the prolapsed part had given excellent results. Conclusion: Urethral prolapse is a rare pathology, observed mainly in young black girls. Its diagnosis is based mainly on clinical examination. Surgical treatment gives satisfactory results, both clinically and aesthetically.
文摘Introduction: Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS) is a sleep-related breathing disorder characterized by repeated episodes of partial obstruction of the upper airways (hypopnea) and/or intermittent complete obstruction (apnea). Our aim is to study the role of adeno-tonsillectomy in the management of OSAHS in children. Methodology: This was a prospective descriptive study conducted in the ENT-Head and Neck Surgery department of Ignace Deen National Hospital over a six-month period. We included in our study all patients aged 0 to 15 years, presenting with OSAHS of ENT etiology and who had undergone tonsillectomy/adenoidectomy. Results: The frequency of OSAHS was 13%. The mean age of our patients was 5.1 ± 3.8 years. There was a predominance of males (69.6%) with a sex ratio of 2.28. Snoring (98.6%), nasal obstruction (97.1%), and mouth breathing (96.6%) were the main reasons for consultation. Adeno-tonsillectomy (45.4%) was the primary surgical intervention. Almost all children (99.0%) had a simple postoperative course. Conclusion: OSAHS is a condition with a multifactorial etiology. Adeno-tonsillectomy remains the first-line surgical treatment to prevent severe complications and relieve the patient. Multidisciplinary collaboration is essential in the management of OSAHS.
文摘Grapes are the main reason why the grapevine (Vitis vinifera L.) is cultivated. However, climate, soil conditions, vegetation and anthropogenic effects on the soil greatly affect grapevine production. The organoleptic properties of grape-derived products, such as wine, are influenced by these factors, which are becoming increasingly popular in Africa. Thus, grapevines, which are commonly grown in warm regions, are acclimatized in Africa using grapevine varieties that can adjust to tropical conditions. This study, which was carried out in 2019, aimed to promote grapevine cultivation in Côte d’Ivoire by examining the influence of pedoclimatic factors on the agro-physiological characteristics of grapevines. In Côte d’Ivoire, there were four distinct agro-ecological zones (North, South, Southeast and West) where three grapevine varieties, Bequignol, Muscat Rouge and Aleatico, were grown. Grapevine plants could grow robustly in morpho-physiological ways because the soils had sufficient fertility, as revealed by the analysis of experimental sites. Grapevine varieties have successfully adapted to different terroirs, with the exception of Muscat Rouge, which only displayed favorable morphological characteristics in the Man zone (West). Regardless of the grape variety, the regions with the best grapevine-growing conditions were Man (West), followed by Aboisso (Southeast). Consequently, grapevine development was less favorable in Korhogo (North) and Abidjan (South) zones. Thus, the cultivation of grapevine varieties in Côte d’Ivoire was greatly influenced by terroir.
