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Overview of the immunological mechanisms in hepatitis B virus reactivation:Implications for disease progression and management strategies 被引量:1
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作者 Hui Ma Qing-Zhu Yan +2 位作者 Jing-Ru Ma Dong-Fu Li Jun-Ling Yang 《World Journal of Gastroenterology》 SCIE CAS 2024年第10期1295-1312,共18页
Hepatitis B virus(HBV)reactivation is a clinically significant challenge in disease management.This review explores the immunological mechanisms underlying HBV reactivation,emphasizing disease progression and manageme... Hepatitis B virus(HBV)reactivation is a clinically significant challenge in disease management.This review explores the immunological mechanisms underlying HBV reactivation,emphasizing disease progression and management.It delves into host immune responses and reactivation’s delicate balance,spanning innate and adaptive immunity.Viral factors’disruption of this balance,as are interac-tions between viral antigens,immune cells,cytokine networks,and immune checkpoint pathways,are examined.Notably,the roles of T cells,natural killer cells,and antigen-presenting cells are discussed,highlighting their influence on disease progression.HBV reactivation’s impact on disease severity,hepatic flares,liver fibrosis progression,and hepatocellular carcinoma is detailed.Management strategies,including anti-viral and immunomodulatory approaches,are critically analyzed.The role of prophylactic anti-viral therapy during immunosuppressive treatments is explored alongside novel immunotherapeutic interventions to restore immune control and prevent reactivation.In conclusion,this compre-hensive review furnishes a holistic view of the immunological mechanisms that propel HBV reactivation.With a dedicated focus on understanding its implic-ations for disease progression and the prospects of efficient management stra-tegies,this article contributes significantly to the knowledge base.The more profound insights into the intricate interactions between viral elements and the immune system will inform evidence-based approaches,ultimately enhancing disease management and elevating patient outcomes.The dynamic landscape of management strategies is critically scrutinized,spanning anti-viral and immunomodulatory approaches.The role of prophylactic anti-viral therapy in preventing reactivation during immunosuppressive treatments and the potential of innovative immunotherapeutic interventions to restore immune control and proactively deter reactivation. 展开更多
关键词 Hepatitis B virus reactivation Immunological mechanisms Disease progression management strategies Immune response
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Establishment and characterization of a canine chondrosarcoma cell line:Mango
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作者 Meilin Wang Xiao Wang +8 位作者 Lixin He Hongbo Gao Wenxuan Li Huili Feng Qingyuan Zhao Wenwen Zhang Chengzong Li Bohan Zhang Changwei Qiu 《Animal Diseases》 CAS 2024年第3期186-197,共12页
In the global progress of bone tumor research,established stable and long-lasting transgenic chondrosarcoma(CSA)cell lines are rare,mainly of murine and human origin,while the establishment of canine CSA cell lines ha... In the global progress of bone tumor research,established stable and long-lasting transgenic chondrosarcoma(CSA)cell lines are rare,mainly of murine and human origin,while the establishment of canine CSA cell lines has yet to be reported.This study established a canine CSA cell line to facilitate the basic clinical study of canine CSA.Fifty fve cases of canine osteolytic disease were collected,and more than 10 bone tumor samples from dogs with typical clinical signs were used for primary cell culture.A cell line with stable passaging for more than 100 generations and mouse tumorigenic ability was successfully cultured.According to the clinical characteristics of the dog and the histopathological results of the primary tumor,CSA was diagnosed,and the CSA cell line was designated Mango.Immunohistochemical(IHC)results showed that the immunoreactivity of bone gamma-carboxyglutamate protein(BGLAP),secreted protein acidic and rich in cysteine(SPARC),alkaline phosphatase(ALPL),vimentin(VIM)and S100 were positive.However,the immunoreactivity of pan-cytokeratin(PCK),chromogranin A(CGA),and platelet endothelial cell adhesion molecule-1(CD31)was negative.Immunofuorescence(IF)results showed that the protein expressions in the Mango cell line were consistent with the IHC identifcation of the primary tumor.The Mango cell line’s doubling time was 43.92 h,and the cell formation rate exceeded 20%.There were abnormal chromosome numbers,hetero staining with toluidine blue,and certain calcifcation abilities.It could be passaged stably and continuously without changing the cell morphology and characteristics.In vivo,the cells were successfully injected into the nude mice model with a tumorigenic rate of 100%.The immunophenotype of the xenograft tumor was consistent with that of the primary tumor.Therefore,we efectively established a canine CSA cell line.As a promising cell material,this cell line can be used to construct a tumor-bearing model conducive to the subsequent basic research of canine CSA.Moreover,because of its similarity to human CSA,the animal model of CSA is also indispensable for investigating human CSA. 展开更多
关键词 Canine chondrosarcoma Cell line establishment CHARACTERIZATION Tumorigenicity
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The Chinese guideline for management of snakebites
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作者 Rongde Lai Shijiao Yan +19 位作者 Shijun Wang Shuqing Yang Zhangren Yan Pin Lan Yonggao Wang Qi Li Jinlong Wang Wei Wang Yuefeng Ma Zijing Liang Jianfeng Zhang Ning Zhou Xiaotong Han Xinchao Zhang Mao Zhang Xiaodong Zhao Guoqiang Zhang Huadong Zhu Xuezhong Yu Chuanzhu Lyu 《World Journal of Emergency Medicine》 SCIE CAS CSCD 2024年第5期333-355,共23页
In 2009,the World Health Organization included snakebite on the list of neglected tropical diseases,acknowledging it as a common occupational hazard for farmers,plantation workers,and others,causing tens of thousands ... In 2009,the World Health Organization included snakebite on the list of neglected tropical diseases,acknowledging it as a common occupational hazard for farmers,plantation workers,and others,causing tens of thousands of deaths and chronic physical disabilities every year.This guideline aims to provide practical information to help clinical professionals evaluate and treat snakebite victims.These recommendations are based on clinical experience and clinical research evidence.This guideline focuses on the following topics:snake venom,clinical manifestations,auxiliary examination,diagnosis,treatments,and prevention. 展开更多
关键词 SNAKEBITE ENVENOMATION management PREVENTION
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Estimation of the Direct Cost of Management of Venous Thromboembolism in Three Reference Hospitals in the City of Yaoundé: A Retrospective Study over a Three-Year Period
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作者 Hamadou Ba Nganou-Ngnindjio Chris Nadège +5 位作者 Tatchim Samuel Aimé Kamdem Félicité Tchoukoua Serge Honoré Ahmadou Jingi Danwe Dieudonne Kingue Samuel 《World Journal of Cardiovascular Diseases》 CAS 2024年第2期99-114,共16页
Background: Venous thromboembolism (VTE) is a major public health problem due to its increasing frequency, mortality and management cost. This cost may require major financial efforts from patients, especially in deve... Background: Venous thromboembolism (VTE) is a major public health problem due to its increasing frequency, mortality and management cost. This cost may require major financial efforts from patients, especially in developing countries like ours where less than 7% of the population has health insurance. This study aimed to estimate the direct cost of managing VTE in three reference hospitals in Yaoundé. Methods: This was a cross-sectional retrospective study over a three-year period (from January 1st 2018 to December 31 2020) carried out in the Cardiology departments of the Central and General Hospitals, and the Emergency Centre of the city of Yaoundé. All patients managed during the study period for deep vein thrombosis and pulmonary embolism confirmed by venous ultrasound coupled with Doppler and computed tomography pulmonary angiography respectively were included. For each patient, we collected sociodemographic and clinical data as well as data on the cost of consultation, hospital stay, workups and medications. These data were analysed using SPSS version 23.0. Results: A total of 92 patient’s records were analysed. The median age was 60 years [48 - 68] with a sex ratio of 0.53. The median direct cost of management of venous thromboembolism was 766,375 CFAF [536,455 - 1,029,745] or $1415 USD. Management of pulmonary embolism associated with deep vein thrombosis was more costly than isolated pulmonary embolism or deep vein thrombosis. Factors influencing the direct cost of management of venous thromboembolism were: hospital structure (p = 0.015), health insurance (p 0.001), type of pulmonary embolism (p = 0.021), and length of hospital stay (p = 0.001). Conclusion: Management of VTE is a major financial burden for our patients and this burden is influenced by the hospital structure, health insurance, type of pulmonary embolism and length of hospital stay. 展开更多
关键词 COST management Venous Thromboembolism Yaoundé
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On Designs of Decentralized Reputation Management for Permissioned Blockchain Networks
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作者 Jinyu Chen Long Shi +2 位作者 Qisheng Huang Taotao Wang Daojing He 《Computer Modeling in Engineering & Sciences》 SCIE EI 2024年第5期1755-1773,共19页
In permissioned blockchain networks,the Proof of Authority(PoA)consensus,which uses the election of authorized nodes to validate transactions and blocks,has beenwidely advocated thanks to its high transaction throughp... In permissioned blockchain networks,the Proof of Authority(PoA)consensus,which uses the election of authorized nodes to validate transactions and blocks,has beenwidely advocated thanks to its high transaction throughput and fault tolerance.However,PoA suffers from the drawback of centralization dominated by a limited number of authorized nodes and the lack of anonymity due to the round-robin block proposal mechanism.As a result,traditional PoA is vulnerable to a single point of failure that compromises the security of the blockchain network.To address these issues,we propose a novel decentralized reputation management mechanism for permissioned blockchain networks to enhance security,promote liveness,and mitigate centralization while retaining the same throughput as traditional PoA.This paper aims to design an off-chain reputation evaluation and an on-chain reputation-aided consensus.First,we evaluate the nodes’reputation in the context of the blockchain networks and make the reputation globally verifiable through smart contracts.Second,building upon traditional PoA,we propose a reputation-aided PoA(rPoA)consensus to enhance securitywithout sacrificing throughput.In particular,rPoA can incentivize nodes to autonomously form committees based on reputation authority,which prevents block generation from being tracked through the randomness of reputation variation.Moreover,we develop a reputation-aided fork-choice rule for rPoA to promote the network’s liveness.Finally,experimental results show that the proposed rPoA achieves higher security performance while retaining transaction throughput compared to traditional PoA. 展开更多
关键词 Blockchain reputation management POA THROUGHPUT SECURITY DECENTRALIZATION
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Etiology and management of urethral calculi:A systematic review of contemporary series
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作者 Andrew Morton Arsalan Tariq +2 位作者 Nigel Dunglison Rachel Esler Matthew J.Roberts 《Asian Journal of Urology》 CSCD 2024年第1期10-18,共9页
Objective:To conduct a systematic literature review on urethral calculi in a contemporary cohort describing etiology,investigation,and management patterns.Methods:A systematic search of MEDLINE and Cochrane Central Re... Objective:To conduct a systematic literature review on urethral calculi in a contemporary cohort describing etiology,investigation,and management patterns.Methods:A systematic search of MEDLINE and Cochrane Central Register of Controlled Trials(CENTRAL)databases was performed.Articles,including case reports and case series on urethral calculi published between January 2000 and December 2019,were included.Full-text manuscripts were reviewed for clinical parameters including symptomatology,etiology,medical history,investigations,treatment,and outcomes.Data were collated and analyzed with univariate methods.Results:Seventy-four publications met inclusion criteria,reporting on 95 cases.Voiding symptoms(41.1%),pain(40.0%),and acute urinary retention(32.6%)were common presenting features.Urethral calculi were most often initially investigated using plain X-ray(63.2%),with almost all radio-opaque(98.3%).Urethral calculi were frequently associated with coexistent bladder or upper urinary tract calculi(16.8%)and underlying urethral pathology(53.7%)including diverticulum(33.7%)or stricture(13.7%).Urethral calculi were most commonly managed with external urethrolithotomy(31.6%),retrograde manipulation(22.1%),and endoscopic in situ lithotripsy(17.9%).Conclusion:This unique systematic review of urethral calculi provided a summary of clinical features and treatment trends with a suggested treatment algorithm.Management in contemporary urological practice should be according to calculus size,shape,anatomical location,and presence of urethral pathology. 展开更多
关键词 Urinary calculi URETHRA Urethral calculi management algorithm
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Management of Acute Malnutrition in Children Aged 0 to 24 Months Boulbinet Health Center
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作者 Mohamed Lamine Diallo Mamadou Ciré Barry +4 位作者 M’mah Aminata Bangoura Louis Philippe Diffo Mamadouba Bangoura Fatoumata Sacko Telly Sy 《Open Journal of Pediatrics》 2024年第1期122-131,共10页
Introduction: Malnutrition is a pathological state resulting from the relative deficiency or excess of one or more essential nutrients, whether manifested clinically or detected only by biochemical, anthropometric or ... Introduction: Malnutrition is a pathological state resulting from the relative deficiency or excess of one or more essential nutrients, whether manifested clinically or detected only by biochemical, anthropometric or physiological analyses. The overall objective was to assess the quality of management of acute malnutrition in children aged 0 - 24 months at the Boulbinet health center. Methodology: This was a prospective descriptive study lasting six (06) months from May 5 to October 5, 2018. The study included all children aged 0 to 24 months. Results: Acute malnutrition in children aged 0 - 24 months accounted for 2.11% of cases. The sex ratio was 1.41 in favor of males. The mean age of our patients was 5 months 7 days, with extremes of 1 month and 6 months. The majority came from Ra toma (40.24%). Exclusive breastfeeding was most common (54.02%). The main clinical signs were: pallor 49.42%, diarrhea 46.67, oral lesions37.96%. SAM represented 89.66% and MAM 10.34%. Most associated pathologies: anemia 49.42% and oral candidiasis 37.93%. In terms of outcome, we recorded 56.32% cures, 20.69% deaths, 18.39% dropouts and 4.60% cures. Conclusion: Improving the quality of care for malnourished children aged 0 - 24 months requires raising awareness among mothers and the general public of the consequences of malnutrition. 展开更多
关键词 management Acute Malnutrition CENTER Boulbinet
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Principle for the Installation of Accommodation for Sick guards in Public Health Establishments in Brazzaville in the Republic of Congo
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作者 Alain Symphorien Ndongo Destin Gemetone Etou Christian Tathy 《Journal of Environmental Science and Engineering(B)》 CAS 2024年第2期70-79,共10页
The results of scientific studies of human social facts in the field of health show that the management of a patient should involve the patient’s entourage,whatever the status or size of the health establishment.In h... The results of scientific studies of human social facts in the field of health show that the management of a patient should involve the patient’s entourage,whatever the status or size of the health establishment.In healthcare establishments in the Congo,the following are recognised as being responsible for medical care:specialist doctors,doctors,midwives,nurses and care assistants.The patient’s family and close friends are responsible for looking after the patient and financing care.The hospital infrastructure does not provide any space for the patient warden who accompany the patient during reception and hospitalisation.This makes Congolese hospitals inefficient for patient care.How can we integrate the function of the Sick guard and the assistance of the family,in order to reduce the mortality rate and repair the harm caused to patients requiring the presence of relatives during their stay in hospital,which is considered to be a dangerous place?This article examines the functional principles for configuring the space that patient warden would occupy in the patient care system.On the basis of a documentary analysis of sociological and architectural studies of existing facilities,this article proposes a typical accommodation model with the spaces needed to ensure the well-being and effectiveness of the patient warden with the patient.These are rooms with minimum space for 2 to 4 individual beds,equipped with toilets and showers.The accommodation has a dining area,kitchen and laundry facilities.In the future,this accommodation will become part of the hospital estate and may be occupied by orderlies and patient warden recruited by the hospital administration. 展开更多
关键词 Sick guard patient public health establishment ACCOMMODATION Republic of Congo
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Diagnosis and Management of Childhood Tuberculosis: A Cross-Sectional Study of Practices in Gilgit Baltistan, Pakistan
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作者 Khalid Mahmood Razia Fatima +3 位作者 Aashifa Yaqoob Faheem Jan Zia Samad Mahboob Ul Haq 《Journal of Tuberculosis Research》 2024年第2期57-72,共16页
Background: Tuberculosis (TB) is one of the major killer diseases among infectious diseases. The success of TB control depends on the capability of the health care system to detect and accurately manage TB cases. Tube... Background: Tuberculosis (TB) is one of the major killer diseases among infectious diseases. The success of TB control depends on the capability of the health care system to detect and accurately manage TB cases. Tuberculosis in children remained a low public health priority with limited epidemiologic studies. Struggles for TB control in children need to be enhanced as children are providing the reservoir for future cases to develop. Objectives: The study evaluated diagnostic and treatment practices related to childhood pulmonary tuberculosis in Gilgit Baltistan (GB), Pakistan. Methods: A descriptive, cross-sectional study based on retrospective record review of childhood Pulmonary Tuberculosis patients registered in the year 2020 with self-administered questionnaire. Results: Data of 557 childhood cases were collected. Most childhood cases were in age group 1 - 4 years (54%) with male predominance. More than 90% were diagnosed and treated at public sector facilities. 99% of the cases were clinically diagnosed with passive case finding. Cough was considered as a symptom of childhood Tuberculosis (TB) by 94% of physicians. Other important features included failure to thrive (13%), contact with a family history of TB (15%), Malnutrition(24%) and respiratory signs (21%). 99% physicians advised chest X-ray, Complete blood count (CBC) (95%) and Erythrocytes sedimentation rate (ESR) (72%) for diagnosis and fewer physicians (2%) used sputum smear microscopy and induced sputum (0.1%). Combining data on dosage, frequency and duration for drugs, 99% of the cases were found receiving correct regimen. The treatment outcomes of the cases were cured 4 (0.8%), treatment completed 551 (99.3%) and died 2 (0.4%) with no lost to follow up. Conclusions: The study highlights inappropriate diagnostic and treatment practices for managing childhood pulmonary TB among physicians in public and private sectors of Gilgit Baltistan. Most of the cases are managed by general practitioners with no post graduate qualification in medicine or pediatrics. The deviations from the guidelines for TB control cannot be negated in the region. 展开更多
关键词 CHILDHOOD TUBERCULOSIS management Respiratory Signs
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Uncovering the Challenges of Faecal Sludge Management in Benin’s Urban Hubs: The Cases of Abomey-Calavi and Natitingou
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作者 Nikita Topanou Blaise Agbatchi +2 位作者 Gouvidé Jean Gbaguidi Jacques Fatombi Fidèle Paul Tchobo 《Journal of Environmental Protection》 2024年第7期767-780,共14页
The issue of faecal sludge management in developing countries remains a significant challenge due to the indiscriminate discharge of sludge into the environment. This practice generates more environmental problems tha... The issue of faecal sludge management in developing countries remains a significant challenge due to the indiscriminate discharge of sludge into the environment. This practice generates more environmental problems than it solves. This study aims to assess the management of household faecal sludge in the communes of Abomey-Calavi and Natitingou, Benin, in order to optimise the best storage conditions for subsequent more effective treatment. To this end, a sociological survey was conducted among households in Abomey-Calavi and Natitingou, as well as among manual emptiers. The results of our studies revealed that two types of latrines are used in households. 20.55% of households use traditional latrines, while 59.83% use ordinary latrines. 7.97% of households use both types of latrine. Moreover, the depth of the latrines varies from 2.5 m to 7 m in Abomey-Calavi and from 2.5 m to 8 m in Natitingou. Among households with a latrine, 28.26% empty their pit at least once, while 71.74% have never emptied it. The emptying cost varies between 35,000 FCFA and 90,000 FCFA. The mixing of faecal sludge with solid waste, including plastic materials, makes emptying difficult due to the obstruction of the vacuum pump. The results obtained will serve as a reliable database to facilitate decision-making in the context of faecal sludge management. 展开更多
关键词 management Faecal Sludge VALORIZATION BENIN
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Role of outdoor trees on pedestrian wind and thermal conditions around a pre-education building for sustainable energy management
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作者 LI Xiao-jie TANG Hui-li 《Journal of Central South University》 SCIE EI CAS CSCD 2024年第6期2039-2053,共15页
Finding sustainable energy resources is essential to face the increasing energy demand.Trees are an important part of ancient architecture but are becoming rare in urban areas.Trees can control and tune the pedestrian... Finding sustainable energy resources is essential to face the increasing energy demand.Trees are an important part of ancient architecture but are becoming rare in urban areas.Trees can control and tune the pedestrian-level wind velocity and thermal condition.In this study,a numerical investigation is employed to assess the role of trees planted in the windward direction of the building complex on the thermal and pedestrian wind velocity conditions around/inside a pre-education building located in the center of the complex.Compared to the previous studies(which considered only outside buildings),this work considers the effects of trees on microclimate change both inside/outside buildings.Effects of different parameters including the leaf area density and number of trees,number of rows,far-field velocity magnitude,and thermal condition around the main building are assessed.The results show that the flow velocity in the spacing between the first-row buildings is reduced by 30%-40% when the one-row trees with 2 m height are planted 15 m farther than the buildings.Furthermore,two rows of trees are more effective in higher velocities and reduce the maximum velocity by about 50%.The investigation shows that trees also could reduce the temperature by about 1℃around the building. 展开更多
关键词 sustainable management energy trees urban area thermal condition building
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Evaluation of Colorectal Cancer Management in Eastern DR Congo. About 55 Cases Were Collected from January 2002 to December 2016 Panzi General Referral Hospital
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作者 Bafunyembaka Muka Alain Kitumaini Munyahali John +6 位作者 Ciruza Balegana Jean-Claude Lobe Lottin Michel Luhiriri Ndanda Levi Kavira Isse Somo Prisca Amisi Mangaza Emilie Alumeti Munyali Desire Ahuka Ona Longombe Albert 《Journal of Cancer Therapy》 2024年第4期179-189,共11页
A retrospective study was conducted at the HGR de Panzi in eastern DR Congo to determine the profile of colorectal cancer (CRC) management based on 55 cases out of 129 digestive cancers diagnosed in the digestive surg... A retrospective study was conducted at the HGR de Panzi in eastern DR Congo to determine the profile of colorectal cancer (CRC) management based on 55 cases out of 129 digestive cancers diagnosed in the digestive surgery, endoscopy, and pathology department of the HGR de Panzi from January 2002 to December 2016. The prevalence of CRC was 42.6%. The mean age of patients was 50.8 years, with a range of 20 to 81 years. The male to female ratio was 2.2. In 69.1% of cases, the patients had a low socioeconomic status, and 52.7% had a history of hemorrhoids. Rectorrhagia revealed CCR in 49.1% of cases. The mode of discovery was predominantly emergency in 69.1% of cases, and 58.20% of CRCs were diagnosed by an initial endoscopy of the lower colon. Adenocarcinoma was found in 94.5% of cases, and 45% of cases required abdominoperineal amputation. Various postoperative complications were experienced by 54.5% of patients, and 25.5% of patients died. To decrease the occurrence of these types of cancers, it is necessary to focus on early detection in the population and enhance access to primary healthcare for everyone. 展开更多
关键词 Assessment management Colorectal Cancer
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Surgical management of adult hand macrodactyly in a 49-year-old patient:A case report
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作者 Chao-Jian Pang Xiao-Yan Huo +4 位作者 Yuan Liu Zong-You Yang Lu Liu Xiao-Bo Fan Shang-Wen Xu 《World Journal of Clinical Cases》 SCIE 2024年第22期5236-5244,共9页
BACKGROUND Macrodactyly is a rare congenital malformation characterized by an increase in the size of all structures of a digit,accounting for less than 1%of all congenital upper extremity conditions.CASE SUMMARY We r... BACKGROUND Macrodactyly is a rare congenital malformation characterized by an increase in the size of all structures of a digit,accounting for less than 1%of all congenital upper extremity conditions.CASE SUMMARY We report a case involving a 49-year-old woman who presented for the first time with untreated,radial-sided hand macrodactyly.We performed soft tissue debulking,amputation,median nerve neurotomy and coaptation,and carpal tunnel release.At the 6-year follow-up,no significant growth was observed in the bone or soft tissue of the affected area.CONCLUSION Tissue overgrowth in patients with progressive macrodactyly can continue and progress excessively with age.Median nerve neurotomy and coaptation play a crucial role in preventing recurrence of the deformity. 展开更多
关键词 Macrodactyly Surgery management HAND Case report
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Recent Advances for Global Perspectives on Etiology, Pathophysiology, Clinical Presentations, and Management of Moyamoya Disease
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作者 Maiko Charles Mkwambe Dongchi Zhao Youping Deng 《World Journal of Neuroscience》 CAS 2024年第1期6-23,共18页
Moyamoya disease (MMD) is a condition characterized by the gradual narrowing and blockage of blood vessels in the brain, specifically those in the circle of Willis and the arteries that supply it. This results in redu... Moyamoya disease (MMD) is a condition characterized by the gradual narrowing and blockage of blood vessels in the brain, specifically those in the circle of Willis and the arteries that supply it. This results in reduced blood flow and oxygen to the brain, leading to progressive symptoms and potential complications. The underlying pathophysiological mechanism remains elucidated. However, recent studies have highlighted numerous etiologic factors: abnormal immune complex responses, susceptibility genes, branched-chain amino acids, antibodies, heritable diseases, and acquired diseases, which may be the great potential triggers for the development of moyamoya disease. Its clinical presentation has varying degrees from transient asymptomatic events to significant neurological deficits. Moyamoya disease (MMD) shows different patterns in children and adults. Children with MMD are more susceptible to ischemic events due to decreased blood flow to the brain. Conversely, adults with MMD are more prone to hemorrhagic events involving brain bleeding. Children with MMD may experience a range of symptoms including motor impairments, sensory issues, seizures, headaches, dizziness, cognitive delays, or ongoing neurological problems. Although adults may present with similar clinical symptoms as children, they are more prone to experiencing sudden onset intraventricular, subarachnoid, or intracerebral hemorrhages. One of the challenges in moyamoya disease is the potential for misdiagnosis or delayed diagnosis, particularly when physicians fail to consider MMD as a possible cause in stroke patients. This review aims to provide a comprehensive overview of recent global studies on the pathophysiology of MMD, along with advancements in its management. Additionally, the review will delve into various surgical treatment options for MMD, as well as its rare occurrence alongside atrioventricular malformations. Exciting prospects include the use of autologous bone marrow transplant and the potential role of Connexin 43 protein treatment in the development of moyamoya disease. 展开更多
关键词 Moyamoya Disease (MMD) ETIOLOGY PATHOPHYSIOLOGY Clinical Presentations management Future Promising Avenues
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Management of Spontaneous Intracerebral Haemorrhage (sICH) at the University Hospital of Brazzaville (CONGO)
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作者 Ekouele Mbaki Hugues Brieux Ngoma Niangui Léocia Exaucée +5 位作者 Diatewa Josué Euberma Boukaka Kala Rel Gerald Ngackosso Olivier Brice Mpandzou Ghislain Armel Boukassa Léon Ossou-Nguiet Paul Macaire 《Neuroscience & Medicine》 2024年第1期23-38,共16页
Spontaneous intracerebral haemorrhage (sICH) is characterised by bleeding within the brain parenchyma, without any accompanying vascular malformation, parenchymal abnormality or coagulation disorder. The study aimed t... Spontaneous intracerebral haemorrhage (sICH) is characterised by bleeding within the brain parenchyma, without any accompanying vascular malformation, parenchymal abnormality or coagulation disorder. The study aimed to depict the management of sICH at the University Hospital of Brazzaville (UHB). It was an observational, descriptive, and cross-sectional analysis. Data collection was conducted retrospectively, covering the period from January 1, 2020 to August 31, 2022, spanning two years and eight months. The study examined socio-demographic, diagnostic, therapeutic, and evolutionary variables. We included 274 cases. We observed 160 men (58.4%) and 114 women (41.6%), resulting in a sex ratio of 1.4. The mean age was 55.3 ± 11.4 years, with ages ranging from 31 to 93 years. The detection of sICH was typically a result of experiencing motor deficits (59.5%) or disorders of consciousness (37.2%). The weightiness of one half of the body was the most common reason for seeking medical advice. Hematoma was capsulo-lenticular in 159 cases (58%) and capsulo-thalamic in 63 cases (23%). Hematomas were <30 ml in 162 cases (59.1%) and >30 ml in 112 cases (40.9%), and associated with hydrocephalus in 11.7% of cases. Conservative medical treatment was administered in 257 cases (94.2%) while surgical treatment was performed in 16 cases (5.8%). The surgical techniques used were external ventricular drainage (EVD) in 2 cases, ventriculo-peritoneal shunt in 5 cases, and hematoma evacuation in 10 cases. Death occurred before the 7th day of hospitalisation in 73 cases (57.8%) and after in 46 cases (42.2%). The median time to death was four days (Q1 = 2 days;Q3 = 7 days), with extremes of 0 and 216 days. . 展开更多
关键词 Spontaneous Intracerebral haemorrhage management BRAZZAVILLE
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Ethics of Human Resources Management in the Cameroonian Health System, Medical Nomadism and the Ineffectiveness of the Fight against High Blood Pressure
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作者 Jean Ndibi Abanda Anicet Onana Akoa +2 位作者 Désiré Tchoffo Ulrich Dama Pierre Yassa Yoniene 《Health》 2024年第1期9-21,共13页
Context/objectives: The fight against Chronic Non-Communicable Diseases (NCDs) is a long-term undertaking, which requires available, motivated and well-managed human resources (HR). The administrative management of sk... Context/objectives: The fight against Chronic Non-Communicable Diseases (NCDs) is a long-term undertaking, which requires available, motivated and well-managed human resources (HR). The administrative management of skills on both qualitative and quantitative levels is one of the essential functions of a health system. To better implement policies of fight against High Blood Pressure (HBP) and other chronic diseases, it is important to establish strategies to retain health personnel. This loyalty requires favorable working conditions and consideration of the contribution-reward couple. Good working conditions are likely to reduce the phenomenon of medical nomadism;conversely, poor HR management can contribute to their exodus towards exotic “green pastures”, thus leading to an additional crisis in the Cameroonian health system. The fight against HBP is a complex, multifaceted and multifactorial reality that requires appropriate management model for all types of resources mainly HR. The main objective of this research is to show the impact of poor management of human resources in Cameroon health system on medical nomadism and the ineffectiveness of the fight against High Blood Pressure. Method: A cross-sectional descriptive survey among five hundred (500) health facilities in the center region of Cameroon has been conducted. A stratified probabilistic technique has been used, and the number of health facilities to be surveyed has been determined using the “sample size estimation table” of Depelteau. The physical questionnaires have been printed and then distributed to data collectors. After data collection, the latter were grouped during processing in Excel sheets. The Chi-square test was used for data with a qualitative value and that of Kolmogorov-Sminorf for data with a quantitative value to assess the normality and reliability of data. The Crochach’s Alpha reliability test allowed us to have a summary of the means and variances and then to search for intragroup correlations between variables. Descriptive analysis was possible with the XLSTAT 2016 software. Results: 43.60% of Health Facilities (HF) managers were unqualified. 82.20% of HF managers have staff in a situation of professional insecurity. They are mainly contractual (49.00), decision-making agents (24.40%), casual agents (08.80). The proportion of unstable personnel is average of 22.00% and very unstable, 12.00%. 展开更多
关键词 ETHICS Human Resources management Cameroonian Health System Medical Nomadism Ineffectiveness High Blood Pressure
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The Role of Impulsivity and Addiction in Gambling Behaviors: How Applied Neuroscience Research Can Help in the Monitoring and Management of Mental Health Issues
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作者 Yingzhen Jia Kimberly Rose Clark 《Open Journal of Medical Psychology》 2024年第1期11-24,共14页
One in five Americans experience symptoms associated with at least one mental health disorder every year. These include behavioral addictions, which have long been overlooked despite their similar neural bases with su... One in five Americans experience symptoms associated with at least one mental health disorder every year. These include behavioral addictions, which have long been overlooked despite their similar neural bases with substance addictions. Gambling addiction, a type of behavioral addiction, deserves particular attention given the significant negative effects, this addiction has on financial and interpersonal health. The purpose of this paper is to review the available literature concerning the behavioral and neural processes involved in gambling addiction, including: the anticipation of reward, the role of dopamine, and the neural substrates of the decision-making processes involved in gambling addiction. Market research has also identified solutions that integrate applied neuroscience and self-tracking systems to monitor and manage mental health issues associated with gambling addiction. The authors then propose a gambling treatment-focused mobile app solution that addresses outstanding issues with a special design aimed at reversing plasticity in order to relieve the effects of gambling addiction. . 展开更多
关键词 Applied Neuroscience GAMBLING ADDICTION Mental Health management
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Non-operative management of rectal cancer: Highlighting the controversies
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作者 Sameh Hany Emile Anjelli Wignakumar 《World Journal of Gastrointestinal Surgery》 SCIE 2024年第6期1501-1506,共6页
There remains much ambiguity on what non-operative management(NOM)of rectal cancer truly entails in terms of the methods to be adopted and the best algorithm to follow.This is clearly shown by the discordance between ... There remains much ambiguity on what non-operative management(NOM)of rectal cancer truly entails in terms of the methods to be adopted and the best algorithm to follow.This is clearly shown by the discordance between various national and international guidelines on NOM of rectal cancer.The main aim of the NOM strategy is organ preservation and avoiding unnecessary surgical in-tervention,which carries its own risk of morbidity.A highly specific and sensitive surveillance program must be devised to avoid patients undergoing unnecessary surgical interventions.In many studies,NOM,often interchangeably called the Watch and Wait strategy,has been shown as a promising treatment option when undertaken in the appropriate patient population,where a clinical complete res-ponse is achieved.However,there are no clear guidelines on patient selection for NOM along with the optimal method of surveillance. 展开更多
关键词 NON-OPERATIVE management Rectal cancer Highlighting CONTROVERSIES
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Sustainable Management of Biodegradable Waste in Guinea: Effect of Compost on Eggplant and Chilli Crop Yields Pepper
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作者 Mamadou Yaya Baldé Mamadou Aliou Diallo +3 位作者 Mariama Barry Dian Foula Diallo Mamadouba Bangaly Camara Nyankoï Soropogui 《Agricultural Sciences》 2024年第9期1009-1017,共9页
The fight against insalubrity in large urban and peri-urban agglomerations is a major challenge in developing countries. This problem is compounded by that of sustainable waste management mechanisms. Indeed, the curre... The fight against insalubrity in large urban and peri-urban agglomerations is a major challenge in developing countries. This problem is compounded by that of sustainable waste management mechanisms. Indeed, the current waste collection system in Guinea has proved inadequate, as moving garbage from point “A” to point “B” is tantamount to “moving the problem”. The aim of this experimental work is to demonstrate the cost-effectiveness and benefits of sustainable waste management. As part of this drive to valorize biodegradable waste, the Waste Management Research Center has undertaken a series of activities ranging from composting organic waste to testing compost on certain crop varieties. An experimental field of 8024 m2 was laid out and treated with 1500 Kg of fine compost in doses ranging from 2.5 to 5 T/ha. Two crop varieties, eggplant and chili, were tested. Compost application increased production yields: 15 to 21 tonnes of eggplant and 10.4 to 11.1 tonnes of chili per hectare. Growth rates compared with usual yields varied from 50% to 64% and from 11% to 17% for eggplant and chili, respectively. This study resulted in an optimum compost dose of 2.5 T/ha for this phase. 展开更多
关键词 Sustainable Waste management COMPOST EGGPLANT CHILLI YIELD IREG CREGED
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Knowledge,management,and complications of sepsis and septic shock:A significant therapeutic challenge in the intensive care unit
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作者 Jakub Mizera Adrian Bystroń +2 位作者 Karolina Matuszewska Justyna Pilch Ugo Giordano 《Journal of Acute Disease》 2024年第2期53-59,共7页
Sepsis and septic shock are life-threatening conditions that are globally responsible for almost 20%of mortality,especially in low and middle-income countries.This review was conducted on PubMed and Google Scholar dat... Sepsis and septic shock are life-threatening conditions that are globally responsible for almost 20%of mortality,especially in low and middle-income countries.This review was conducted on PubMed and Google Scholar databases with keywords sepsis,septic shock,sepsis management,and sepsis complications.Articles published up to July 2023 in English were included.Diagnosis and management should be carried out without unnecessary delay.Cooperation between various medical specialties including intensive care doctors,neurologists,hepatologists,cardiologists,and pediatric doctors is needed if a child is affected.New strategies have to be implemented in low and middle-income countries to decrease the sepsis incidence and reduce mortality in the population. 展开更多
关键词 SEPSIS Septic shock management COMPLICATIONS Diagnosis Review
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