Pericarditis in Cardiology at a Regional Hospital

Introduction: Pericarditis is an inflammation of the pericardium with or without pericardial fluid effusion. Its prevalence is difficult to determine given the many forms that are not symptomatic. In Africa, its prevalence was 6.3% in Gabon in 2020 and 7.2% in Mali in 2022. In Europe, an Italian study estimates the incidence of acute pericarditis at 27.7 cases per 100,000 people per year. In another study conducted in Finland over a period of 9 years, the incidence of pericarditis requiring hospitalisation was 3.32 cases per 100,000 people per year. The aim of our study was to describe the clinical and paraclinical characteristics of pericarditis observed in the cardiology department of the regional hospital in Mali. Methodology: This was a single centre cross-sectional study from 30 January 2018 to 30 June 2020 in the cardiology department of the Ségou regional hospital. All consenting patients, regardless of age or sex hospitalised in the department for pericarditis confirmed on cardiac ultrasound were included. Data were collected using an individual patient follow-up form recording sociodemographic, clinical, biological, electrocardiographic and echocardiographic data, as well as the course of the disease. Results: Out of 879 patients hospitalized, the hospital frequency was 7.28%. Females predominated, with a sex ratio of 0.42. More than half the patients were aged 45 or younger (59.4%). The mean age of patients was 41.8 ± 18.1 years. Cardiovascular risk factors were dominated by hypertension and smoking (46.9% and 12.5% respectively). The reasons for consultation were dyspnoea (84.3%), chest pain (54.7%), cough (71.9%) and fever (34.4%). Physical signs included muffled heart sounds (76.6%), tachycardia (70.3%), pericardial friction (17.2%) and signs of peripheral stasis in 53.1% of cases. We observed elevated C-reactive protein (CRP) in 57.8% of cases, hypercreatininaemia in 37.5% and positive HIV serology in 3.1%. The major radiographic signs were cardiomegaly in 82.8% and pleural effusion in 37.5%. On electrocardiogram (ECG), 51.6% of patients had a repolarisation disorder and sinus tachycardia;34.4% had QRS microvoltage. Echocardiography revealed tamponade in 1.6% and pericardial effusion in 100%. The effusion was very large in 17.3% of cases. The pericardial fluid was citrine yellow in 18.8%, serosanguineous in 9.4% and haemorrhagic in 7.8%. The aetiology of the pericarditis was idiopathic in 42.1% and secondary to HIV in 3.1%. Transudative fluid was observed in 16.5% of cases. The outcome was generally favourable, with 92.2% of cases cured, but 1.6% with persistent effusion, 3.1% with recurrence, and 3.1% with mortality.

Primary Non-Hodgkin’s Malignant Lymphoma of the Uterus at the Reference Hospital of Maradi/Niger: A Case Report

Malignant non-Hodgkins lymphoma (MHNL) of the uterus is uncommon. We report a case diagnosed on the basis of histologic and immunohistochemical studies of a hysterectomy specimen induced by a very painful pelvic mass in a 50-year-old patient with no previous history of the disease. It was classified as Ann Arbor IV Bb after imaging, given the medullary infiltration and signs of clinical and biological evolutivity: the patient had received two courses of chemotherapy, CHOP protocol. She died 23 days after the second treatment due to a hypertensive crisis.

Four Dimensions of Integrating Chinese Culture Into College English Teaching From the Perspective of Tyler’s Basic Principles

Integrating Chinese culture into college English can not only enhance students’humanities literacy and cultivate their cultural confidence,but also facilitate the inheritance and international dissemination of Chinese culture.Taking Tyler’s curriculum framework as the starting point,this paper analyzes some factors that affect the integration of Chinese culture into the college English teaching and proposes some strategies for the integration of Chinese culture into college English teaching by innovating teaching objectives,enriching teaching contents,transforming modes of course delivery,and reconstructing the assessment system.

A Comparative Assessment of Patient Safety Culture between Iranian Selected Hospitals and Agency for Healthcare Research and Quality (AHRQ) Report

Establishing a culture of patient safety can be effective in reducing the incidence of medical errors and solving concerns of safety inadequacy in health systems. The purpose of this study was to assess the culture of patient safety in the selected hospitals, and compare the results with published reports of AHRQ. This study was approved by the Ethical Committee of BPUMS. The subjects signed the informed consent form to participle in the study. Confidentiality was maintained throughout the study reports. Cross-sectional study was conducted in 2012;the study sample was composed of 364 staffs working at two selected hospitals affiliated to Bushehr University of Medical Sciences. Hospital Survey on Patient Safety Culture was used to collect data. Descriptive statistical analysis was used to analyze the data. No reports of events in both studied hospitals and benchmark were accounted for the most of the reported errors, although this indicator in studied hospitals was nearly 23% higher than that of the benchmark report. The highest patient safety grade in studied hospitals and benchmark was “acceptable” and “very good”, respectively. The highest percentage of positive response to patient safety dimension was organization learning and then teamwork within units in studied hospitals. Teamwork within units also was the highest average percent in benchmark report. Non-punitive response to errors had the lowest positive percentage of participant responses in both studies. To achieve the patient safety culture, we do not need to blame individual and apply punitive approach when errors occur. This makes person accept responsibility for their actions honestly and report errors in a timely manner to prevent reoccurrence of similar errors.

Health care staffs’ perception of patient safety culture in hospital settings and factors of importance for this

Many hospital patients are affected by adverse events. Managers are important when improving safety. The perception of patient safety culture varies among health care staff. Health care staff (n = 1023) working in medical, surgical or mixed medical-surgical health care divisions answered the 51 items (14 dimensions) Swedish Hospital Survey on Patient Safety Culture (S-HSOPSC). Respondents with a managerial function scored higher than non-managers for 11 of 14 dimensions, indicating patient safety culture strengths for a majority of dimensions. Enrolled nurses and staff with experience > 10 years also scored high for several dimensions. The 12 dimensions and sample characteristics explained 49% and 26% of the variance for the outcome dimensions Overall Perceptions of Safety and Frequency of Incident Reporting, respectively. RNs, ENs and physicians have different views on patient safety culture. Hospital Management Support and Organisational Learning is some important factors influencing patient safety culture. Bridging the gap in health care staff’s perceptions of safety in order to improve patient safety is of utmost importance. Managers have the responsibility to foster patient safety culture at their workplace and can thus benefit from results when improving safety for patients.

Cross-Cultural Adjustment and Coping:U.S.Students in Taiwan Residents Higher Education

The aim of this study was to investigate the adjustment problems of students from the United States enrolled in universities in the East,specifically in Taiwan,their problems related to cultural adaptation,and the process of adjustment to student life in Taiwan.Under investigation were cultural adjustment and coping skills as these students transitioned from West to East.Qualitative data were collected from interviews with participants and faculty members as well as participant observations.Results indicated that U.S.students found their own ways to acclimate to their new academic setting as well as to social relations,cross-cultural issues,and the linguistic environment in Taiwan to achieve effective adaptation.They made changes in themselves to cope with all situations they encountered.This study provides suggestions for international students abroad in Taiwan,for the Taiwan Residents government,and for universities or colleges in terms of what they should offer to current and future international students.

Evaluation of patient safety culture as perceived by nurses during the COVID-19 pandemic

Objectives:A good patient safety culture(PSC)is linked to a reduced risk of patient problems and minimal undesirable occurrences.This study investigated the PSC levels from nurses'perspectives during the COVID-19 pandemic.Methods:A descriptive cross-sectional design was applied.The Hospital Survey on Patient Safety Culture(HSOPSC)questionnaire was administered to 315 nurses working at 2 major hospitals in Jeddah,Saudi Arabia.The data were analyzed using descriptive statistics,a t-test,and a one-way ANOVA test.The statistical significance of the correlation was determined at the 0.05 level.Results:PSC was rated as medium overall according to the nurses,with a weighted mean of 2.88–0.76 and a relative weight of 57.57%.In addition,all PSC composites were rated from medium to high,except organizational learning,which was rated low.The correlation between sociodemographic variables as well as PSC levels was investigated using the t-test and one-way ANOVA test.The association is statistically significant when P≤0.05.The findings revealed a statistically significant correlation between nurse nationality(t=-4.399,P=0.000),age(F=7.917,P=0.000),experience in years(F=3.760,P=0.024),and hospital(t=-0.401,P=0.689).Conclusions:The nurses in this study had a medium overall PSC level,and all PSC composites ranged from a medium to a high level,except organizational learning,which had a low level.In addition,the findings showed that there is a significant relationship between PSC levels,nurses'nationalities,experience in years,and the hospital itself.

Venous Thromboembolic Disease in a Regional Hospital in Mali

Introduction: Venous thromboembolism (VTE) is a nosological group which mainly includes deep vein thrombosis (DVT) and pulmonary embolism (PE), it is frequently associated with high morbidity and mortality. We initiated this study with the aim of studying VTE in a cardiological hospital environment in a regional hospital in Mali. Methodology: This was a descriptive study with prospective recruitment over 1 year from June 20, 2019 to June 20, 2020, covering patients hospitalized and followed in consultation in the cardiology department of the Ségou regional hospital in Mali. Results: We collected 31 cases of VTE out of 366 patients, representing a frequency of 8.47%. The sex ratio was 0.88. VTE risk factors were dominated by immobilization (29.03%), pregnancy and postpartum (16.12%), heart failure (16.12%). The reason for consultation was dyspnea (93.54%) followed by chest pain (83.87%). On admission the clinical manifestations were tachycardia (74.19%), tachypnea (90.32%), muffled heart sounds (70.96%), global heart failure syndrome (51.6%). According to VTE probability scores;51.61% of patients had an intermediate clinical probability according to the simplified Wells score for PE and 54.84% had an intermediate clinical probability for the simplified Geneva score for DVT. D-Dimers were only performed in 12 patients (38.70%) and were elevated in all. A chest CT angiogram showed PE in 90% of patients (n = 28/31). Venous Doppler ultrasound of the lower limbs showed venous thrombosis in 3 patients. Conclusion: Venous thromboembolism, although underdiagnosed, is common in our health structures. Prevention, particularly heparinoprophylaxis and early recovery in a hospital environment, remains the effective means of combating this condition.

The English Translation of Lunyu and the Dissemination of the Confucian Culture

As one of the carriers of Confucian culture,and from ancient times to the present,Lunyu or The Analects or The Analects of Confucius,has been well received by readers at home and abroad,and there are more and more English translations of Lunyu.This article will select some of the vocabulary translations with ancient Chinese characteristics in Lunyu as the object,employ the method of a comparative analysis to explore the cultural connotation behind the text and the dissemination of the translation,and discuss the translator’s translation strategies.Judging from the research on The Analects by scholars from home and abroad and the opening and development of overseas Confucius Institutes,Lunyu has exerted an enlightenment effect in different times.

基于S-O-R模型的视觉营销对消费者购买意愿的影响研究——以红色文创网店为例

为提高红色文创网店的点击转化率,文章从消费者视角出发,研究影响消费者购买意愿的视觉因素。基于S-O-R模型理论,构建红色文创网店视觉营销对消费者购买意愿因素的理论模型。利用S-O-R模型分析了红色文创网店视觉营销中的商品形象、界面形象以及品牌视觉形象对顾客感知价值及顾客购买意向的影响。通过设计量表和调查问卷进行实证研究,并结合结构方程模型加以论证,得出品牌视觉形象和界面形象是影响消费者购买意愿的关键因素,为设计师和红色文创品牌进行网店设计提供了一定的理论参考和建议。

L'Hospital法则的新证明

法则是求不定式极限的常用、有效的方法。文章利用Stolz定理和Heine归结原则,上、下极限,Newton-Leibniz公式三种方法证明了L'Hospital法则。启发人们在改造《高等数学》和《数学分析》教材体系上产生新的思路,同时作为以上几个定理的直接应用,解决了一类比原来更为广泛的利用导数求极限的问题.

Cultures and Subcultures

A cross-cultural analysis of an extract of the book Lost in Translation is provided in the essay. Definitions of culture and subculture are discussed and different theories from Hofstede and Schwartz are referred to in order to validate the analysis.

Simplified three-dimensional culture system for long-term expansion of embryonic stem cells

AIM: To devise a simplified and efficient method for long-term culture and maintenance of embryonic stem cells requiring less frequent passaging. METHODS: Mouse embryonic stem cells(ESCs) labeled with enhanced yellow fluorescent protein were cultured in three-dimensional(3-D) self-assembling scaffolds and compared with traditional two-dimentional(2-D) culture techniques requiring mouse embryonic fibroblast feeder layers or leukemia inhibitory factor. 3-D scaffolds encapsulating ESCs were prepared by mixing ESCs with polyethylene glycol tetra-acrylate(PEG-4-Acr) and thiolfunctionalized dextran(Dex-SH). Distribution of ESCs in 3-D was monitored by confocal microscopy. Viability and proliferation of encapsulated cells during long-term culture were determined by propidium iodide as well as direct cell counts and PrestoB lue(PB) assays. Genetic expression of pluripotency markers(Oct4, Nanog, Klf4, and Sox2) in ESCs grown under 2-D and 3-D cultureconditions was examined by quantitative real-time polymerase chain reaction. Protein expression of selected stemness markers was determined by two different methods, immunofluorescence staining(Oct4 and Nanog) and western blot analysis(Oct4, Nanog, and Klf4). Pluripotency of 3-D scaffold grown ESCs was analyzed by in vivo teratoma assay and in vitro differentiation via embryoid bodies into cells of all three germ layers. RESULTS: Self-assembling scaffolds encapsulating ESCs for 3-D culture without the loss of cell viability were prepared by mixing PEG-4-Acr and Dex-SH(1:1 v/v) to a final concentration of 5%(w/v). Scaffold integrity was dependent on the degree of thiol substitution of Dex-SH and cell concentration. Scaffolds prepared using Dex-SH with 7.5% and 33% thiol substitution and incubated in culture medium maintained their integrity for 11 and 13 d without cells and 22 ± 5 d and 37 ± 5 d with cells, respectively. ESCs formed compact colonies, which progressively increased in size over time due to cell proliferation as determined by confocal microscopy and PB staining. 3-D scaffold cultured ESCs expressed significantly higher levels(P < 0.01) of Oct4, Nanog, and Kl4, showing a 2.8, 3.0 and 1.8 fold increase, respectively, in comparison to 2-D grown cells. A similar increase in the protein expression levels of Oct4, Nanog, and Klf4 was observed in 3-D grown ESCs. However, when 3-D cultured ESCs were subsequently passaged in 2-D culture conditions, the level of these pluripotent markers was reduced to normal levels. 3-D grown ESCs produced teratomas and yielded cells of all three germ layers, expressing brachyury(mesoderm), NCAM(ectoderm), and GATA4(endoderm) markers. Furthermore, these cells differentiated into osteogenic, chondrogenic, myogenic, and neural lineages expressing Col1, Col2, Myog, and Nestin, respectively. CONCLUSION: This novel 3-D culture system demonstrated long-term maintenance of mouse ESCs without the routine passaging and manipulation necessary for traditional 2-D cell propagation.

Intensify standardized therapy for esophageal and stomach cancer in tumor hospitals

INTRODUCTIONCancer treatment situation in tumor hospitals inChina has its own unique characteristics which arenot found in other parts of the world. Because ofthe huge population and high incidence rates ofesophageal and stomach cancer[1-5], the number ofcancer patients waiting for admission isinconceivably large.

Establishment of the Culture Technique o f Pulmonary Vascular Pericytes and Its Identification in Rats

Summary: In order to study the cellular origin of muscularization in non muscular arterioles of the lung, the pulmonary vascular pericytes culture was established. The terminal lung tissue of the rat was taken out and minced. Then 0.5 % of type Ⅳ collagenase solution was added for digestion and the microvascular segments were obtained by screening. The targeted cells were cultured by “selective conditioned media”. Under phase contrast microscope, the cultured cells were large in size with ragged margin and numerous pseudopodia, which imparted tubule like structure. There was no contact inhibition in growing cells, so multiple layers developed. When they were confluent, there were morphologically no “hillock and dale” growth pattern as in smooth muscle cells or “weave like” pattern as in fibroblasts. The ultrastructure of cultured cells showed numerous digital processes, moderate amount of rough and smooth endoplasmic reticulum, rich Golgi's apparatus, microfilaments, few lysosomes without myofilaments and dense bodies. Immunohistochemical staining revealed that the cultured pericytes had same kind of cellular skeletal protein, α SM actin, like smooth muscle cells. The cultured cells also exhibited positive reaction to CD 34 antigen and S 100 antigen, which were negative in smooth muscle cells and fibroblasts. The cell growth pattern, ultrastructure and immunological phenotype suggested that the cultured cells had characteristics of vascular pericytes. Pericytes are one of the components of microvascular cells, and the establishment of in vitro culture technique of pericytes is of significance for further exploration of the muscularization of non muscular arterioles in lung and the mechanism of structural remodeling of pulmonary vessels.

Clinical presentation and endoscopic management of Dieulafoy's lesions in an urban community hospital

AIM:To identify rates of occurrence,common clinical and endoscopic features,and to review the outcome of endoscopic management of Dieulafoy's lesions in the upper gastrointestinal (GI) tract in an urban community hospital setting. METHODS:Endoscopic data from esophagogastroduo denoscopies (EGDs),done at Wyckoff Heights Medical Center,Brooklyn,NY between 2000 and 2006 were reviewed to identify patients with Dieulafoy's lesions. Demographic data,medical history,examination findings,lab data,endoscopic findings and details of therapy for patients treated for Dieulafoy's lesions were reviewed retrospectively. RESULTS:Dieulafoy's lesions were documented to be the cause of bleeding in approximately 1% of patients presenting with upper gastrointestinal bleeding,while they were detected in only 2 patients when the indications for EGDs were different from active GI bleeding. When we analyzed EGDs performed in patients above age 65 years presenting with gastrointestinal bleeding,prevalence of Dieulafoy's lesions approached 10 percent. The most common location of the lesion was the body of stomach (7),followed by the cardia (4) and the esophagus (2). One patient had this lesion in the fundus and one patient in the duodenal apex. All patients were initially treated endoscopically with epinephrine injection,in eight cases heater probe was applied following epinephrine and endoscopic clips were applied in two cases. All but one of the patients did well in near and intermediate term follow-up (average follow-up period of 18 mo). One patient died of multi-organ failure during the same hospital stay. Average length hospital stay was 7 d.CONCLUSION:Community hospital gastroenterologists and endoscopists should be aware that Dieulafoy's lesions are an uncommon cause of upper GI bleeding among elderly patients. Early accurate diagnosis through emergent endoscopy and endoscopic therapy,especially in patients with multiple co-morbid conditions,can be very effective and life saving.

Influence of cultural factors on choice of childbirth place among women in Oyigbo Local Government Area,Rivers State,Nigeria

Objectives:This study aims to ascertain if cultural factors influence the childbirth place choice of women in Oyigbo.Materials and Methods:The study used a cross‑sectional study design using a self‑structured questionnaire as the instrument to collect data from 384 volunteers through simple random sampling,and these data were analyzed using frequency and percentage for descriptive statistics while Chi‑square was used for inferential statistics at 0.05 level of significance.Results:The influence of cultural factors such as family traditions(χ^(2)=12.56,P=0.006),beliefs(χ^(2)=70.66,P=0.000),lack of confidence in health facilities(χ^(2)=367.83,P=0.000),and the presence of male skilled birth attendants(χ^(2)=50.85,P=0.000)were statistically significant to the choice of childbirth place,while patriarchal system(χ^(2)=2.99,P=0.393)was not statistically significant to the choices of childbirth places of women in Oyigbo.Religion had a statistically significant influence on childbirth place(χ^(2)=125.46,P=0.000).Conclusion:This study shows that religious and cultural factors have a significant influence on the childbirth place choices of women in Oyigbo Local Government Area of Rivers State.

Quality of care delivered to hospitalized inflammatory bowel disease patients

Hospitalized patients with inflammatory bowel disease(IBD)are at high risk for morbidity,mortality,and health care utilization costs.While the literature on trends in hospitalization rates for this disease is conflicting,there does appear to be significant variation in the delivery of care to this complex group,which may be a marker of suboptimal quality of care.There is a need for improvement in identifying patients at risk for hospitalization in an effort to reduce admissions.Moreover,appropriate screening for a number of hospital acquired complications such as venous thromboembolism and Clostridium difficile infection is suboptimal.This review discusses areas of inpatient care for IBD patients that are in need of improvement and outlines a number of potential quality improvement initiatives such as payfor-performance models,quality improvement frameworks,and healthcare information technology.

Impact of vitamin D on the hospitalization rate of Crohn's disease patients seen at a tertiary care center

AIM To study the association between vitamin D level and hospitalization rate in Crohn's disease(CD) patients.METHODS We designed a retrospective cohort study using adult patients(> 19 years) with CD followed for at least one year at our inflammatory bowel disease center. Vitamin D levels were divided into: low mean vitamin D level(< 30 ng/m L) vs appropriate mean vitamin D level(30-100 ng/m L). Generalized Poisson Regression Models(GPR) for Rate Data were used to estimate partially adjusted and fully adjusted incidence rate ratios(IRR) of hospitalization among CD patients. We also examined IRRs for vitamin D level as a continuous variable.RESULTS Of the 880 CD patients, 196 patients with vitamin D level during the observation period were included. Partially adjusted model demonstrated that CD patients with a low mean vitamin D level were almost twice more likely to be admitted(IRR = 1.76, 95%CI: 1.38-2.24) compared to those with an appropriate vitamin D level. The fully adjusted model confirmed this association(IRR = 1.44, 95%CI: 1.11-1.87). Partially adjusted model with vitamin D level as a continuous variable demonstrated,higher mean vitamin D level was associated with a 3% lower likelihood of admission with every unit(ng/m L) rise in mean vitamin D level(IRR = 0.97, 95%CI: 0.96-0.98). The fully adjusted model confirmed this association(IRR = 0.98, 95%CI: 0.97-0.99). CONCLUSION Normal or adequate vitamin D stores may be protective in the clinical course of CD. However, this role needs to be further characterized and understood.

Feminism, Patriarchy and Culture Dominance ——A review to "The Woman Warrior

The Woman Warrior" is an influential book in the 20th century making a thunder of voice in the world to accuse the stereotype of patriarchy and racism, which also shows the Chinese Americans’ difficulty of being edged to the cultural cliff. This article analyses the content and the style of the novel to see inside what the writer wants to express and to figure out the real reason of the inequality between sexes and reveal the truth of the western culture dominance. Feminism, Patriarchy and culture are the main factors considered in the article.