AIM： TO describe the socio-demographic features, etiology, and risk factors for Budd-Chiari syndrome （BCS） in Egyptian patients. METHODS： Ninety-four Egyptian patients with confirmed primary Budd-Chiari syndrome w...AIM： TO describe the socio-demographic features, etiology, and risk factors for Budd-Chiari syndrome （BCS） in Egyptian patients. METHODS： Ninety-four Egyptian patients with confirmed primary Budd-Chiari syndrome were presented to the Budd-Chiari Study Group （BCSG） and admitted to the Tropical Medicine Department of Ain Shams University Hospital （Cairo, Egypt）. Complete clinical evaluation and laboratory investigations, including a thrombophilia workup and full radiological assessment, were performed to determine underlying disease etiologies.RESULTS： BCS was chronic in 79.8% of patients, acute or subacute in 19.1%, and fulminant in 1.1%. Factor V Leiden mutation （FVLM） was the most common etiological cause of disease （53.1%）, followed by mutation of the gene encoding methylene tetrahydrofolate reductase （MTHFR） （51.6%）. Current or recent hormonal treatment was documented in 15.5% of females, and BCS associated with pregnancy was present in 17.2% of females. Etiology could not be determined in 8.5% of patients. Males had significantly higher rates of MTHFR gene mutation and Behcet＇ s disease, and females had significantly higher rates of secondary antiphospholipid antibody syndrome. A highly significant positive relationship was evident between the presence of Behcet＇s disease and inferior vena caval occlusion, either alone or combined with occlusion of the hepatic veins （,0 〈 0.0001）. CONCLUSION： FVLM is the most common disease etiology and MTHFR the second most common in Egyptian BCS patients. BCS etiology tends to vary with geographic region.展开更多
The objective of our study was to study the epidemiological, etiological and contributory factors of maternal deaths in the obstetrics and gynecology department of the regional hospital center (RHC) of Ouahigouya from...The objective of our study was to study the epidemiological, etiological and contributory factors of maternal deaths in the obstetrics and gynecology department of the regional hospital center (RHC) of Ouahigouya from 2013 to 2015. We carried out a descriptive and analytical study on maternal deaths in maternity of the RHC of Ouahigouya, including all patients who died in the obstetrics and gynecology department of the RHC of Ouahigouya from 1 January 2013 to 31 December 2015, which meets WHO’s definition of maternal death. We recorded 151 maternal deaths and 5481 live births, a maternal mortality ratio of 2755 per 100,000 live births. The most affected women were women aged 20 - 24 years (27.8%), multiparous (25.5%), married women (88.7%) and those without income-generating activities (85.4%). The main causes of death from direct obstetrical complications were hemorrhage (38.3%), infections (21.5%), abortions (16.8%) and complications of hypertension disorders (15.8%) and for indirect obstetrical complications, malaria (36.6%), anemia (29.5%), and HIV/AIDS (9.1%). Contributing factors to maternal deaths prior to admission were delay in referral (33.3%) and delay in transfer (31.5%) and delay in admission (32.8%) and delay in diagnosis (23.4). From our study, it appears elsewhere as well as that most maternal deaths are preventable, hence the need for coordinated actions to effectively fight against maternal mortality.展开更多
This study aims to determine the environmental aspects and impacts of the phase relating to the operation of Manantali’s hydroelectric structures and facilities according to the requirements of the ISO 14001 version ...This study aims to determine the environmental aspects and impacts of the phase relating to the operation of Manantali’s hydroelectric structures and facilities according to the requirements of the ISO 14001 version 2015 standard. To do this, the mapping of the different work areas made it possible to identify all the activities within the framework of the farm. Based on the mapping, environmental measurements made including noise level, brightness, electric and magnetic fields, total particles, PM10, PM2.5, PM1 showed the work areas with the exposure limit values exceeded. The inventories of the waste produced show eighteen (18) types of waste, 67% of which are special industrial waste (SIW), 28% are ordinary industrial waste (OIW) and 5% are inert industrial waste (IIW). The identification and assessment of environmental aspects and impacts made it possible to determine sixteen (16) positive and negative significant environmental aspects (ESAs). The positive AES must be maintained, and for the negative ones, mitigation and mitigation measures must be put in place in order to manage them effectively. This will ultimately improve environmental management in the operation of hydroelectric structures and facilities.展开更多
Objective: Describe the psychosocial aspects of male infertility at the hospital of the Sino-Guinean Friendship. Patients and method: It is a prospective study of a descriptive type covering a period of 6 months. The ...Objective: Describe the psychosocial aspects of male infertility at the hospital of the Sino-Guinean Friendship. Patients and method: It is a prospective study of a descriptive type covering a period of 6 months. The study covered 17 patients, all received for a desire to conceive after at least one year of regular sexual intercourse without contraception. The data were collected from patient interviews using a pre-established questionnaire. Results: The average age of the patients was 32.07 years with extremes of 23 years and 42 years. During this study, 64.70% of patients were no longer participating in community ceremonies. The patients’ relationships with their spouse and family deteriorated in 52.94% and 47.06%, respectively. Conversely, relations with the family of origin remained unchanged in 70.59 percent of cases. The reduction in economic activity was by 13 patients (76.48%). Conclusion: Male infertility causes a real psychic earthquake in men with its corollaries of negative feelings. The rather complex moral repercussions of male infertility affect not only the individual, his/her partner, and family, but also economic activity.展开更多
Development of the telencephalon relies upon several signaling centers-localized cellular populations that supply secreted factors to pattern the cortical neuroepithelium.One such signaling center is the cortical hem,...Development of the telencephalon relies upon several signaling centers-localized cellular populations that supply secreted factors to pattern the cortical neuroepithelium.One such signaling center is the cortical hem,which arises during embryonic development at the telencephalic dorsal midline,adjacent to the choroid plexus and hippocampal primordium(Figure 1A).While the cortical hem has also been described in reptiles and birds,most of our knowledge about the developmental roles of the cortical hem is derived from the analysis in mice.The cortical hem produces several types of secreted molecules,including wingless-related integration site(Wnt)and bone morphogenetic(Bmp)proteins.The cortical hem is particularly important for the development of the hippocampus,which is involved in learning and memory,and the neocortex,which is the most complex brain region that mediates multiple types of behavior and higher cognitive functions(Mangale et al.,2008;Dal-Valle-Anton and Borrell,2022).展开更多
Objective: To describe and analyze the epidemiological aspects as well as the observance of post-exposure prophylaxis (PEP) of people bitten by a dog and received at the Buanionzi State Health Center from 2014 to 2017...Objective: To describe and analyze the epidemiological aspects as well as the observance of post-exposure prophylaxis (PEP) of people bitten by a dog and received at the Buanionzi State Health Center from 2014 to 2017. Methods: Descriptive cross-sectional study which took place in two stages. The first interview was an interrogation carried out at the health Center until surgical trimming (100% of cases) followed by PEP (70.3% of cases) according to the Essen protocol. The second time was a 24 h telephone interview after a missed appointment for a dose of PEP. Results: The prevalence was 5.6 bites/10.000 people. The average age was 26.4 ± 18.3 years. Age ≤ 26 years was more concerned with 59.3% of cases (p = 0.006) in which children Conclusion: The rabies risk is potential in Boma. Efforts in terms of public health strategies must be made to reduce it.展开更多
Introduction: Globally, tuberculosis is the leading cause of death from a single infectious agent ahead of HIV/AIDS. Approximately 10 million people contracted TB in 2017, 10% of whom were children aged 0 - 15 years, ...Introduction: Globally, tuberculosis is the leading cause of death from a single infectious agent ahead of HIV/AIDS. Approximately 10 million people contracted TB in 2017, 10% of whom were children aged 0 - 15 years, or about 1 million with 250,000 deaths in 2016 (including children with HIV-associated TB). The signs of TB in children are not always specific and diagnosis remains difficult unlike in adults. According to a study conducted in 2011 in the paediatric department of the CHU-Gabriel Touré, only seventeen cases of all forms of tuberculosis were found, or approximately 0.2% of hospitalised children. The objective of our study was to investigate the epidemiological and clinical aspects of tuberculosis in children. Materials and Method: This was a prospective, cross-sectional and descriptive study that took place from 24 October 2017 to 23 October 2018, or 12 months in children aged 0-15 years. Data were collected from an individual medical record opened for each patient and an individual survey form established for each child. Results: During the study period, 40,434 children were consulted. Tuberculosis was suspected in 91 children, with a frequency of 0.22%. The age range of 1 to 4 years was 36.3% with a median age of 72 months. The sex ratio was 1.8. Chronic cough with 84.6% and malnutrition with 24.17% were the most frequent symptoms. Chest X-ray revealed bilateral pulmonary lesions in 52.7% and mediastinal adenopathy in 12.1%. TST was positive in 10.9% of patients, microscopy in 26.4%, Gene Xpert in 18.7%, and culture in 16.5%. The biological diagnosis of tuberculosis was retained in 48.4% of the patients, the pulmonary form represented 93.2%. The therapeutic regime (2RHZE/4RH) was used in 81.6% of cases and the evolution was favourable in 65.9% of patients. Conclusion: The diagnosis of tuberculosis in children remains difficult in our context. The clinical signs are not always specific, and further studies are needed to further elucidate this disease.展开更多
Purpose: The authors analyzed the epidemiological and clinical aspects of diabetic retinopathy at the Center for the Application of the Specialized Studies Diploma in Ophthalmology, Gamal Abdel Nasser University (CHU/...Purpose: The authors analyzed the epidemiological and clinical aspects of diabetic retinopathy at the Center for the Application of the Specialized Studies Diploma in Ophthalmology, Gamal Abdel Nasser University (CHU/ Donka) Conakry. Diabetic retinopathy (eye damage: eye and retina) is a serious complication of diabetes that affects 50% of type 2 diabetic patients. The eyes are particularly sensitive to damage to a small vessel. Diabetic retinopathy (DR) is the retinal localization of diabetic micro angiopathy resulting in impaired blood flow in the affected territories, the consequences of which will determine the clinical manifestations of the disease. DR is the leading cause of vision loss in adults of working age. Patients and Methods: This is a longitudinal prospective study carried out at CADES/O concerning 198 diabetic patients. The selection criteria were that the media be transparent and the fundus accessible over a period of six months from February to July 2018. Results: A total of 73 patients (37%) presented with diabetic retinopathy with an average age of 49.5 +/−9 years. The sex ratio (M/F) was 0.6 with a female predominance of 59%. Liberal profession patients were the most numerous 47.5%. Type 2 diabetes was the most common (85.86%). Diabetes fundus assessment was the most common reason for consultation (52%). Arterial hypertension was the most incriminated risk factor (45.45%) followed by the poor balance of diabetes (40.90%), and the age of diabetes (28.28%). 9.5% had diabetic retinopathy complicated by rubella iris, neovascular glaucoma and retinal detachment. Conclusion: Diabetic retinopathy is a common condition for which early detection and regular monitoring must be the rule to prevent, slow down or avoids irreversible blindness if possible, induced by this pathology by a good balance of diabetes and good control of associated risk factors.展开更多
目的 探究NIHSS/DWI-ASPECTS不匹配对大脑中动脉供血区脑梗死早期神经功能恶化的预测价值。方法 回顾性收集2017年3月~2018年5月因大脑中动脉供血区脑梗死在安徽医科大学第二附属医院神经内科住院的患者。收集其临床资料,根据入院时和住...目的 探究NIHSS/DWI-ASPECTS不匹配对大脑中动脉供血区脑梗死早期神经功能恶化的预测价值。方法 回顾性收集2017年3月~2018年5月因大脑中动脉供血区脑梗死在安徽医科大学第二附属医院神经内科住院的患者。收集其临床资料,根据入院时和住院72 h NIHSS评分,评估早期神经功能恶化(early neurological deterioration,END),将患者分为END组和非END组。所有患者在入院48 h内完成头部MRI检查,并行DWI-Alberta 卒中项目早期CT评分(DWI-ASPECTS),NIHSS/DWI-ASPECTS不匹配(NIHSS/DWI-ASPECTS Mismatch,NDM)定义为 NIHSS评分≥8且DWI-ASPECTS≥8,应用多变量Logistic回归分析NDM与大脑中动脉供血区脑梗死END的相关性。结果 共收集94例大脑中动脉供血区脑梗死患者,男性52例(55.3%),年龄(65.4±11.0)岁。符合END患者31例(33%)。NIHSS/DWI-ASPECTS不匹配(NDM)病例18例(19.1%),其中END组14例(45%),非END组4例(6.5%)。END组年龄大、NIHSS高、DWI-ASPECTS低、NDM患者比例显著高于非END组( P ≤0.05或 P ≤0.01)。多变量Logistic回归分析显示,在校正混杂因素后,DWI-ASPECTS(优势比0.637,95%置信区间0.409~0.994, P =0.047)和NDM(优势比13.175,95%置信区间1.539~112.824, P =0.019)是大脑中动脉供血区脑梗死END的预测因素。结论 NIHSS/DWI-ASPECTS不匹配对大脑中动脉供血区脑梗死早期神经功能恶化具有一定的预测价值。展开更多
Principles which teachers should adhere to in second language class are based on the synthesis of linguistic,cultural and competent aspects.This paper first puts forward linguistic,cultural and competent aspects of se...Principles which teachers should adhere to in second language class are based on the synthesis of linguistic,cultural and competent aspects.This paper first puts forward linguistic,cultural and competent aspects of second language teaching.Then,the principles which teachers should adhere to in second language class are introduced.Finally,the synthesis implication for second language teaching is presented.展开更多
目的探讨ASPECTs评分联合ASITN/SIR侧支循环评分模式评估前循环急性大动脉脑梗死患者超时间窗血管内治疗的临床效果。方法收集52例超时间窗急性大动脉闭塞脑梗死患者为研究组,以本中心63例标准治疗窗内患者为对照组,在三系统同轴下使用...目的探讨ASPECTs评分联合ASITN/SIR侧支循环评分模式评估前循环急性大动脉脑梗死患者超时间窗血管内治疗的临床效果。方法收集52例超时间窗急性大动脉闭塞脑梗死患者为研究组,以本中心63例标准治疗窗内患者为对照组,在三系统同轴下使用颅内血栓抽吸系统、支架取栓装置进行机械取栓治疗,纵向对比2组术后90 d良好恢复率(mRS≤2分)、安全性(症状性颅内出血转化、病死率),研究组间横向对比有效性,主要对比手术前后NIHSS评分。结果研究组与对照组患者术前NIHSS评分差异无统计学意义(P>0.05)。研究组与对照组术中mTICI分级血管再通率分别为90.4%(47/52)、92.1%(58/63),2组比较差异无统计学意义(P>0.05);2组术后良好恢复率(90 d mRS≤2分)[分别为42.3%(22/52)、40%(25/63)]、安全性[研究组症状性颅内出血转化、病死率分别为13.5%(7/52)、15.4%(8/52),对照组分别为11.1%(6/63)、12.7%(8/63)],2组比较差异均无统计学意义(P>0.05)。结论在ASPECTs评分联合ASITN/SIR侧支循环评估模式下急性缺血性脑卒中超时间窗血管内治疗临床疗效具有可行性。展开更多
Research concerning the psychosocial aspects of infertility and infertility treatment focuses more often on women than men. The aim of this review was to synthesize the English-language evidence related to the psychol...Research concerning the psychosocial aspects of infertility and infertility treatment focuses more often on women than men. The aim of this review was to synthesize the English-language evidence related to the psychological and social aspects of infertility in men and discuss the implications of these reports for clinical care and future research. A structured search identified 73 studies that reported data concerning the desire for fatherhood and the psychological and social aspects of diagnosis, assisted reproductive technology （ART） treatment and unsuccessful treatment among men with fertility difficulties. The studies are diverse in conceptualisation, design, setting and data collection, but the findings were reasonably consistent. These studies indicated that fertile and infertile childless men of reproductive age have desires to experience parenthood that are similar to those of their female counterparts; in addition, diagnosis and initiation of treatment are associated with elevated infertility-specific anxiety, and unsuccessful treatment can lead to a state of lasting sadness. However, rates of clinically significant mental health problems among this patient population are no higher than in the general population. Infertile men who are socially isolated, have an avoidant coping style and appraise stressful events as overwhelming, are more vulnerable to severe anxiety than men without these characteristics. Men prefer oral to written treatment information and prefer to receive emotional support from infertility clinicians rather than from mental health professionals, self-help support groups or friends. Nevertheless, structured, facilitated psycho-educational groups that are didactic but permit informal sharing of experiences might be beneficial. There are gaps in knowledge about factors governing seeking, persisting with and deciding to cease treatment; experiences of invasive procedures; parenting after assisted conception; adoption and infertility-related grief and shame among men. Few resource-constrained countries have any data concerning male experiences of infertility.展开更多
Schizophrenia is a severe mental illness which is associated with significant consequences for both the patients and their relatives. Due to chronicity of the illness, the relatives of patients of schizophrenia have t...Schizophrenia is a severe mental illness which is associated with significant consequences for both the patients and their relatives. Due to chronicity of the illness, the relatives of patients of schizophrenia have to bear the main brunt of the illness. Studies across the world have evaluated various aspects of caregiving and caregivers such as burden, coping, quality of life, social support, expressed emotions, and psychological morbidity. In general the research has looked at caregiving as a negative phenomenon, however, now it is increasingly recognised that caregiving is not only associated with negative consequences only, also experience subjective gains and satisfaction. This review focus on the conceptual issues, instruments available to assess the positive aspects of caregiving and the various correlates of positive aspects of caregiving reported in relation to schizophrenia. The positive aspect of caregiving has been variously measured as positive caregiving experience, caregiving satisfaction, caregiving gains and finding meaning through caregiving scale and positive aspects of caregiving experience. Studies suggests that caregivers of patients with schizophrenia and psychotic disorders experience caregiving gains(in the form of becoming more sensitive to persons with disabilities, clarity about their priorities in life and a greater sense of inner strength), experience good aspects of relationship with the patient, do have personal positive experiences. Some of the studies suggest that those who experience greater negative caregiving experience also do experience positive caregiving experience.展开更多
文摘AIM： TO describe the socio-demographic features, etiology, and risk factors for Budd-Chiari syndrome （BCS） in Egyptian patients. METHODS： Ninety-four Egyptian patients with confirmed primary Budd-Chiari syndrome were presented to the Budd-Chiari Study Group （BCSG） and admitted to the Tropical Medicine Department of Ain Shams University Hospital （Cairo, Egypt）. Complete clinical evaluation and laboratory investigations, including a thrombophilia workup and full radiological assessment, were performed to determine underlying disease etiologies.RESULTS： BCS was chronic in 79.8% of patients, acute or subacute in 19.1%, and fulminant in 1.1%. Factor V Leiden mutation （FVLM） was the most common etiological cause of disease （53.1%）, followed by mutation of the gene encoding methylene tetrahydrofolate reductase （MTHFR） （51.6%）. Current or recent hormonal treatment was documented in 15.5% of females, and BCS associated with pregnancy was present in 17.2% of females. Etiology could not be determined in 8.5% of patients. Males had significantly higher rates of MTHFR gene mutation and Behcet＇ s disease, and females had significantly higher rates of secondary antiphospholipid antibody syndrome. A highly significant positive relationship was evident between the presence of Behcet＇s disease and inferior vena caval occlusion, either alone or combined with occlusion of the hepatic veins （,0 〈 0.0001）. CONCLUSION： FVLM is the most common disease etiology and MTHFR the second most common in Egyptian BCS patients. BCS etiology tends to vary with geographic region.
文摘The objective of our study was to study the epidemiological, etiological and contributory factors of maternal deaths in the obstetrics and gynecology department of the regional hospital center (RHC) of Ouahigouya from 2013 to 2015. We carried out a descriptive and analytical study on maternal deaths in maternity of the RHC of Ouahigouya, including all patients who died in the obstetrics and gynecology department of the RHC of Ouahigouya from 1 January 2013 to 31 December 2015, which meets WHO’s definition of maternal death. We recorded 151 maternal deaths and 5481 live births, a maternal mortality ratio of 2755 per 100,000 live births. The most affected women were women aged 20 - 24 years (27.8%), multiparous (25.5%), married women (88.7%) and those without income-generating activities (85.4%). The main causes of death from direct obstetrical complications were hemorrhage (38.3%), infections (21.5%), abortions (16.8%) and complications of hypertension disorders (15.8%) and for indirect obstetrical complications, malaria (36.6%), anemia (29.5%), and HIV/AIDS (9.1%). Contributing factors to maternal deaths prior to admission were delay in referral (33.3%) and delay in transfer (31.5%) and delay in admission (32.8%) and delay in diagnosis (23.4). From our study, it appears elsewhere as well as that most maternal deaths are preventable, hence the need for coordinated actions to effectively fight against maternal mortality.
文摘This study aims to determine the environmental aspects and impacts of the phase relating to the operation of Manantali’s hydroelectric structures and facilities according to the requirements of the ISO 14001 version 2015 standard. To do this, the mapping of the different work areas made it possible to identify all the activities within the framework of the farm. Based on the mapping, environmental measurements made including noise level, brightness, electric and magnetic fields, total particles, PM10, PM2.5, PM1 showed the work areas with the exposure limit values exceeded. The inventories of the waste produced show eighteen (18) types of waste, 67% of which are special industrial waste (SIW), 28% are ordinary industrial waste (OIW) and 5% are inert industrial waste (IIW). The identification and assessment of environmental aspects and impacts made it possible to determine sixteen (16) positive and negative significant environmental aspects (ESAs). The positive AES must be maintained, and for the negative ones, mitigation and mitigation measures must be put in place in order to manage them effectively. This will ultimately improve environmental management in the operation of hydroelectric structures and facilities.
文摘Objective: Describe the psychosocial aspects of male infertility at the hospital of the Sino-Guinean Friendship. Patients and method: It is a prospective study of a descriptive type covering a period of 6 months. The study covered 17 patients, all received for a desire to conceive after at least one year of regular sexual intercourse without contraception. The data were collected from patient interviews using a pre-established questionnaire. Results: The average age of the patients was 32.07 years with extremes of 23 years and 42 years. During this study, 64.70% of patients were no longer participating in community ceremonies. The patients’ relationships with their spouse and family deteriorated in 52.94% and 47.06%, respectively. Conversely, relations with the family of origin remained unchanged in 70.59 percent of cases. The reduction in economic activity was by 13 patients (76.48%). Conclusion: Male infertility causes a real psychic earthquake in men with its corollaries of negative feelings. The rather complex moral repercussions of male infertility affect not only the individual, his/her partner, and family, but also economic activity.
基金supported by R01 NS093009 grant from NIH(to VVC).
文摘Development of the telencephalon relies upon several signaling centers-localized cellular populations that supply secreted factors to pattern the cortical neuroepithelium.One such signaling center is the cortical hem,which arises during embryonic development at the telencephalic dorsal midline,adjacent to the choroid plexus and hippocampal primordium(Figure 1A).While the cortical hem has also been described in reptiles and birds,most of our knowledge about the developmental roles of the cortical hem is derived from the analysis in mice.The cortical hem produces several types of secreted molecules,including wingless-related integration site(Wnt)and bone morphogenetic(Bmp)proteins.The cortical hem is particularly important for the development of the hippocampus,which is involved in learning and memory,and the neocortex,which is the most complex brain region that mediates multiple types of behavior and higher cognitive functions(Mangale et al.,2008;Dal-Valle-Anton and Borrell,2022).
文摘Objective: To describe and analyze the epidemiological aspects as well as the observance of post-exposure prophylaxis (PEP) of people bitten by a dog and received at the Buanionzi State Health Center from 2014 to 2017. Methods: Descriptive cross-sectional study which took place in two stages. The first interview was an interrogation carried out at the health Center until surgical trimming (100% of cases) followed by PEP (70.3% of cases) according to the Essen protocol. The second time was a 24 h telephone interview after a missed appointment for a dose of PEP. Results: The prevalence was 5.6 bites/10.000 people. The average age was 26.4 ± 18.3 years. Age ≤ 26 years was more concerned with 59.3% of cases (p = 0.006) in which children Conclusion: The rabies risk is potential in Boma. Efforts in terms of public health strategies must be made to reduce it.
文摘Introduction: Globally, tuberculosis is the leading cause of death from a single infectious agent ahead of HIV/AIDS. Approximately 10 million people contracted TB in 2017, 10% of whom were children aged 0 - 15 years, or about 1 million with 250,000 deaths in 2016 (including children with HIV-associated TB). The signs of TB in children are not always specific and diagnosis remains difficult unlike in adults. According to a study conducted in 2011 in the paediatric department of the CHU-Gabriel Touré, only seventeen cases of all forms of tuberculosis were found, or approximately 0.2% of hospitalised children. The objective of our study was to investigate the epidemiological and clinical aspects of tuberculosis in children. Materials and Method: This was a prospective, cross-sectional and descriptive study that took place from 24 October 2017 to 23 October 2018, or 12 months in children aged 0-15 years. Data were collected from an individual medical record opened for each patient and an individual survey form established for each child. Results: During the study period, 40,434 children were consulted. Tuberculosis was suspected in 91 children, with a frequency of 0.22%. The age range of 1 to 4 years was 36.3% with a median age of 72 months. The sex ratio was 1.8. Chronic cough with 84.6% and malnutrition with 24.17% were the most frequent symptoms. Chest X-ray revealed bilateral pulmonary lesions in 52.7% and mediastinal adenopathy in 12.1%. TST was positive in 10.9% of patients, microscopy in 26.4%, Gene Xpert in 18.7%, and culture in 16.5%. The biological diagnosis of tuberculosis was retained in 48.4% of the patients, the pulmonary form represented 93.2%. The therapeutic regime (2RHZE/4RH) was used in 81.6% of cases and the evolution was favourable in 65.9% of patients. Conclusion: The diagnosis of tuberculosis in children remains difficult in our context. The clinical signs are not always specific, and further studies are needed to further elucidate this disease.
文摘Purpose: The authors analyzed the epidemiological and clinical aspects of diabetic retinopathy at the Center for the Application of the Specialized Studies Diploma in Ophthalmology, Gamal Abdel Nasser University (CHU/ Donka) Conakry. Diabetic retinopathy (eye damage: eye and retina) is a serious complication of diabetes that affects 50% of type 2 diabetic patients. The eyes are particularly sensitive to damage to a small vessel. Diabetic retinopathy (DR) is the retinal localization of diabetic micro angiopathy resulting in impaired blood flow in the affected territories, the consequences of which will determine the clinical manifestations of the disease. DR is the leading cause of vision loss in adults of working age. Patients and Methods: This is a longitudinal prospective study carried out at CADES/O concerning 198 diabetic patients. The selection criteria were that the media be transparent and the fundus accessible over a period of six months from February to July 2018. Results: A total of 73 patients (37%) presented with diabetic retinopathy with an average age of 49.5 +/−9 years. The sex ratio (M/F) was 0.6 with a female predominance of 59%. Liberal profession patients were the most numerous 47.5%. Type 2 diabetes was the most common (85.86%). Diabetes fundus assessment was the most common reason for consultation (52%). Arterial hypertension was the most incriminated risk factor (45.45%) followed by the poor balance of diabetes (40.90%), and the age of diabetes (28.28%). 9.5% had diabetic retinopathy complicated by rubella iris, neovascular glaucoma and retinal detachment. Conclusion: Diabetic retinopathy is a common condition for which early detection and regular monitoring must be the rule to prevent, slow down or avoids irreversible blindness if possible, induced by this pathology by a good balance of diabetes and good control of associated risk factors.
文摘目的 探究NIHSS/DWI-ASPECTS不匹配对大脑中动脉供血区脑梗死早期神经功能恶化的预测价值。方法 回顾性收集2017年3月~2018年5月因大脑中动脉供血区脑梗死在安徽医科大学第二附属医院神经内科住院的患者。收集其临床资料,根据入院时和住院72 h NIHSS评分,评估早期神经功能恶化(early neurological deterioration,END),将患者分为END组和非END组。所有患者在入院48 h内完成头部MRI检查,并行DWI-Alberta 卒中项目早期CT评分(DWI-ASPECTS),NIHSS/DWI-ASPECTS不匹配(NIHSS/DWI-ASPECTS Mismatch,NDM)定义为 NIHSS评分≥8且DWI-ASPECTS≥8,应用多变量Logistic回归分析NDM与大脑中动脉供血区脑梗死END的相关性。结果 共收集94例大脑中动脉供血区脑梗死患者,男性52例(55.3%),年龄(65.4±11.0)岁。符合END患者31例(33%)。NIHSS/DWI-ASPECTS不匹配(NDM)病例18例(19.1%),其中END组14例(45%),非END组4例(6.5%)。END组年龄大、NIHSS高、DWI-ASPECTS低、NDM患者比例显著高于非END组( P ≤0.05或 P ≤0.01)。多变量Logistic回归分析显示,在校正混杂因素后,DWI-ASPECTS(优势比0.637,95%置信区间0.409~0.994, P =0.047)和NDM(优势比13.175,95%置信区间1.539~112.824, P =0.019)是大脑中动脉供血区脑梗死END的预测因素。结论 NIHSS/DWI-ASPECTS不匹配对大脑中动脉供血区脑梗死早期神经功能恶化具有一定的预测价值。
文摘Principles which teachers should adhere to in second language class are based on the synthesis of linguistic,cultural and competent aspects.This paper first puts forward linguistic,cultural and competent aspects of second language teaching.Then,the principles which teachers should adhere to in second language class are introduced.Finally,the synthesis implication for second language teaching is presented.
文摘目的探讨ASPECTs评分联合ASITN/SIR侧支循环评分模式评估前循环急性大动脉脑梗死患者超时间窗血管内治疗的临床效果。方法收集52例超时间窗急性大动脉闭塞脑梗死患者为研究组,以本中心63例标准治疗窗内患者为对照组,在三系统同轴下使用颅内血栓抽吸系统、支架取栓装置进行机械取栓治疗,纵向对比2组术后90 d良好恢复率(mRS≤2分)、安全性(症状性颅内出血转化、病死率),研究组间横向对比有效性,主要对比手术前后NIHSS评分。结果研究组与对照组患者术前NIHSS评分差异无统计学意义(P>0.05)。研究组与对照组术中mTICI分级血管再通率分别为90.4%(47/52)、92.1%(58/63),2组比较差异无统计学意义(P>0.05);2组术后良好恢复率(90 d mRS≤2分)[分别为42.3%(22/52)、40%(25/63)]、安全性[研究组症状性颅内出血转化、病死率分别为13.5%(7/52)、15.4%(8/52),对照组分别为11.1%(6/63)、12.7%(8/63)],2组比较差异均无统计学意义(P>0.05)。结论在ASPECTs评分联合ASITN/SIR侧支循环评估模式下急性缺血性脑卒中超时间窗血管内治疗临床疗效具有可行性。
文摘Research concerning the psychosocial aspects of infertility and infertility treatment focuses more often on women than men. The aim of this review was to synthesize the English-language evidence related to the psychological and social aspects of infertility in men and discuss the implications of these reports for clinical care and future research. A structured search identified 73 studies that reported data concerning the desire for fatherhood and the psychological and social aspects of diagnosis, assisted reproductive technology （ART） treatment and unsuccessful treatment among men with fertility difficulties. The studies are diverse in conceptualisation, design, setting and data collection, but the findings were reasonably consistent. These studies indicated that fertile and infertile childless men of reproductive age have desires to experience parenthood that are similar to those of their female counterparts; in addition, diagnosis and initiation of treatment are associated with elevated infertility-specific anxiety, and unsuccessful treatment can lead to a state of lasting sadness. However, rates of clinically significant mental health problems among this patient population are no higher than in the general population. Infertile men who are socially isolated, have an avoidant coping style and appraise stressful events as overwhelming, are more vulnerable to severe anxiety than men without these characteristics. Men prefer oral to written treatment information and prefer to receive emotional support from infertility clinicians rather than from mental health professionals, self-help support groups or friends. Nevertheless, structured, facilitated psycho-educational groups that are didactic but permit informal sharing of experiences might be beneficial. There are gaps in knowledge about factors governing seeking, persisting with and deciding to cease treatment; experiences of invasive procedures; parenting after assisted conception; adoption and infertility-related grief and shame among men. Few resource-constrained countries have any data concerning male experiences of infertility.
文摘Schizophrenia is a severe mental illness which is associated with significant consequences for both the patients and their relatives. Due to chronicity of the illness, the relatives of patients of schizophrenia have to bear the main brunt of the illness. Studies across the world have evaluated various aspects of caregiving and caregivers such as burden, coping, quality of life, social support, expressed emotions, and psychological morbidity. In general the research has looked at caregiving as a negative phenomenon, however, now it is increasingly recognised that caregiving is not only associated with negative consequences only, also experience subjective gains and satisfaction. This review focus on the conceptual issues, instruments available to assess the positive aspects of caregiving and the various correlates of positive aspects of caregiving reported in relation to schizophrenia. The positive aspect of caregiving has been variously measured as positive caregiving experience, caregiving satisfaction, caregiving gains and finding meaning through caregiving scale and positive aspects of caregiving experience. Studies suggests that caregivers of patients with schizophrenia and psychotic disorders experience caregiving gains(in the form of becoming more sensitive to persons with disabilities, clarity about their priorities in life and a greater sense of inner strength), experience good aspects of relationship with the patient, do have personal positive experiences. Some of the studies suggest that those who experience greater negative caregiving experience also do experience positive caregiving experience.
