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 preva...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.展开更多
Background: There are multiple questionnaires to measure academic stress in university students, which have been used in nursing students. In Puerto Rico, a questionnaire valid in content and reliability was required ...Background: There are multiple questionnaires to measure academic stress in university students, which have been used in nursing students. In Puerto Rico, a questionnaire valid in content and reliability was required to measure the variable of academic stress in nursing students. Purpose: The aim of this study was to adapt transculturally and validate the Academic Stress Questionnaire (CEA) for its use in Puerto Rico. Materials and Methods: Used for the first phase of this study consisted in the evaluation of the validity of content and appearance, whereas the second phase was the actual administering of the questionnaire to 20 (twenty) nursing students, to pilot test its internal consistency using the Cronbach’s α test. Results: Validity of content and appearance allowed for the modification of the questionnaire into one, consisting of 42 items, thus eliminating 34 premises from the original 76 items the questionnaire was composed of. Furthermore, the appearance of the questionnaire was modified by placing the measuring scales in columns, adapting social, demographic, and academic data to the required Puerto Rican reality. The sections meant to measure the academic stress variables were left intact, except for the linguistics adaptation, which was accomplished by a team of experts in the Spanish language. With an α global of 0.80 and coefficients larger than 0.7 in the multi-item sub scales, which oscillated between 0.750 and 0.860, the questionnaire provides a high reliability. Conclusion: Although the values reported in this study are somewhat lower than previous research, they were comparable the Cronbach’s Alpha coefficients reported by Cabanach, in which the numbers reported are considered high (α > 0.70) which show acceptable confiability of the subscales included in the study and a high degree of consistency and thus can be relied upon in future research. In synthesis, the Academic Stress Questionnaire (CEA) modified and adapted, thoroughly fulfills the established criteria of confiability and validity to evaluate academic stress of Puertorrican nursing students.展开更多
The temperature is one of the principal controlling parameters of oncological hyperthermia. However, local heating forms a complicated thermal distribution in space and has developed over time, too. The decisional fac...The temperature is one of the principal controlling parameters of oncological hyperthermia. However, local heating forms a complicated thermal distribution in space and has developed over time, too. The decisional factors are the heterogeneity of the targeted volume, the electrolyte perfusions controlled by thermal homeostasis, and the spreading of the heat energy with time. A further complication is that the energy absorption sharply changes by depth, so the spatiotemporal development of the temperature distribution requires specialized methods to control. Most of the temperature imaging facilities (thermography, radiometry, electric impedance tomography, etc.) are less precise than the medical practice needs. In contrast, precise point sensing (like thermocouples, thermistors, and fluoroptical methods) is invasive and measures only a discrete point in the robustly changing thermal map. The two most precise thermal imaging methods, computer tomography, and magnetic resonance are expensive and have numerous technical complications. Our objective is to show the complexity of the temperature distribution inside the human body, and offer a relatively simple and cheap method to visualize its spatiotemporal development. A novel emerging technology, the application of ultrasound microbubble contrast agents is a promising method for solving complicated tasks of thermal distribution deep inside the living body. Noteworthy, the temperature distribution does not determine the full hyperthermia process, nonthermal effects make considerable impact, too. Additionally to the difficulties to measure the thermal heterogeneity during hyperthermia in oncology, numerous nonthermal processes, molecular and structural changes are triggered by the incoming electromagnetic energy, which presently has no spatiotemporal visualization technique. Microbubble imaging has a suitable spatiotemporal thermal resolution, and also it is sensitive to nonthermal effects. Its application for characterization of the modulated electrohyperthermia (mEHT) may open a new theranostic facility, using the synergy of the thermal and nonthermal effects of the radiofrequency delivered energy. This complex approach gives facility to follow the mEHT processes, and the proposed microbubble ultrasound imaging has a particularly promising advantage sensing and acting also nonthermally, having potential to characterize the thermally conditioned nonthermal electromagnetic effects in oncologic hyperthermia. The mEHT combined with microbubble ultrasound images could be a robust theranostic method against cancer.展开更多
Summary: Hepatomegaly is one of the clinical signs commonly encountered in chronic liver disease. The aim of our study was to study the epidemiological, clinical and etiological aspects of hepatomegaly in the hepato-g...Summary: Hepatomegaly is one of the clinical signs commonly encountered in chronic liver disease. The aim of our study was to study the epidemiological, clinical and etiological aspects of hepatomegaly in the hepato-gastroenterology department (HGE) of the Gabriel Touré university hospital. This was a cross-sectional study that took place from September 2021 to October 2022 in the department. All patients aged 18 years and older with hepatomegaly, hospitalized or examined by physicians were included. We collected 100 cases of hepatomegaly, representing 3.7% of 2661 patients examined or hospitalized in the HGE department during the study period. These patients had a mean age was 46.7 ± 16.10 years with extremes of 18 and 76 years. The sex ratio was 2.7. Jaundice was the most commonly reported history with a frequency of 26%. Pertaining to patients’ lifestyle, alcohol consumption was the most common feature with 6%. The most common associated clinical signs were jaundice, ascites, and edema of the lower limbs. Painful hepatomegaly (86%), with a sharp lower edge (74%), a firm consistency (69%), and an irregular surface (52%) was frequently observed. Cytolysis (75.5%), increased alphafetoprotein levels (70%), microcytic anemia (37%), hyperleukocytosis (54.3%), and biological hepatocellular insufficiency syndrome (low albumin with 30.4%, high bilirubinemia with 61.2% and low platelets with 33.9%) were the most common observed laboratory abnormalities. Hepatitis B virus markers (61%) were the most frequently found in the study patients. At ultrasound examination, heterogeneous hepatomegaly was observed in 87.3% of the patients. Esophageal varices (43.1%) were more commonly seen than other varices during upper gastrointestinal endoscopy. The dominant etiology was hepatocellular carcinoma on cirrhosis with 66% followed by cirrhosis. Conclusion: Painful hepatomegaly was quite frequently in our urban setting hospital with several etiologies. HCC was the most common etiology, therefore measures to prevent it in the community need to be established by the concerned stakeholders to improve adult population health in Bamako.展开更多
文摘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.
文摘Background: There are multiple questionnaires to measure academic stress in university students, which have been used in nursing students. In Puerto Rico, a questionnaire valid in content and reliability was required to measure the variable of academic stress in nursing students. Purpose: The aim of this study was to adapt transculturally and validate the Academic Stress Questionnaire (CEA) for its use in Puerto Rico. Materials and Methods: Used for the first phase of this study consisted in the evaluation of the validity of content and appearance, whereas the second phase was the actual administering of the questionnaire to 20 (twenty) nursing students, to pilot test its internal consistency using the Cronbach’s α test. Results: Validity of content and appearance allowed for the modification of the questionnaire into one, consisting of 42 items, thus eliminating 34 premises from the original 76 items the questionnaire was composed of. Furthermore, the appearance of the questionnaire was modified by placing the measuring scales in columns, adapting social, demographic, and academic data to the required Puerto Rican reality. The sections meant to measure the academic stress variables were left intact, except for the linguistics adaptation, which was accomplished by a team of experts in the Spanish language. With an α global of 0.80 and coefficients larger than 0.7 in the multi-item sub scales, which oscillated between 0.750 and 0.860, the questionnaire provides a high reliability. Conclusion: Although the values reported in this study are somewhat lower than previous research, they were comparable the Cronbach’s Alpha coefficients reported by Cabanach, in which the numbers reported are considered high (α > 0.70) which show acceptable confiability of the subscales included in the study and a high degree of consistency and thus can be relied upon in future research. In synthesis, the Academic Stress Questionnaire (CEA) modified and adapted, thoroughly fulfills the established criteria of confiability and validity to evaluate academic stress of Puertorrican nursing students.
文摘The temperature is one of the principal controlling parameters of oncological hyperthermia. However, local heating forms a complicated thermal distribution in space and has developed over time, too. The decisional factors are the heterogeneity of the targeted volume, the electrolyte perfusions controlled by thermal homeostasis, and the spreading of the heat energy with time. A further complication is that the energy absorption sharply changes by depth, so the spatiotemporal development of the temperature distribution requires specialized methods to control. Most of the temperature imaging facilities (thermography, radiometry, electric impedance tomography, etc.) are less precise than the medical practice needs. In contrast, precise point sensing (like thermocouples, thermistors, and fluoroptical methods) is invasive and measures only a discrete point in the robustly changing thermal map. The two most precise thermal imaging methods, computer tomography, and magnetic resonance are expensive and have numerous technical complications. Our objective is to show the complexity of the temperature distribution inside the human body, and offer a relatively simple and cheap method to visualize its spatiotemporal development. A novel emerging technology, the application of ultrasound microbubble contrast agents is a promising method for solving complicated tasks of thermal distribution deep inside the living body. Noteworthy, the temperature distribution does not determine the full hyperthermia process, nonthermal effects make considerable impact, too. Additionally to the difficulties to measure the thermal heterogeneity during hyperthermia in oncology, numerous nonthermal processes, molecular and structural changes are triggered by the incoming electromagnetic energy, which presently has no spatiotemporal visualization technique. Microbubble imaging has a suitable spatiotemporal thermal resolution, and also it is sensitive to nonthermal effects. Its application for characterization of the modulated electrohyperthermia (mEHT) may open a new theranostic facility, using the synergy of the thermal and nonthermal effects of the radiofrequency delivered energy. This complex approach gives facility to follow the mEHT processes, and the proposed microbubble ultrasound imaging has a particularly promising advantage sensing and acting also nonthermally, having potential to characterize the thermally conditioned nonthermal electromagnetic effects in oncologic hyperthermia. The mEHT combined with microbubble ultrasound images could be a robust theranostic method against cancer.
文摘Summary: Hepatomegaly is one of the clinical signs commonly encountered in chronic liver disease. The aim of our study was to study the epidemiological, clinical and etiological aspects of hepatomegaly in the hepato-gastroenterology department (HGE) of the Gabriel Touré university hospital. This was a cross-sectional study that took place from September 2021 to October 2022 in the department. All patients aged 18 years and older with hepatomegaly, hospitalized or examined by physicians were included. We collected 100 cases of hepatomegaly, representing 3.7% of 2661 patients examined or hospitalized in the HGE department during the study period. These patients had a mean age was 46.7 ± 16.10 years with extremes of 18 and 76 years. The sex ratio was 2.7. Jaundice was the most commonly reported history with a frequency of 26%. Pertaining to patients’ lifestyle, alcohol consumption was the most common feature with 6%. The most common associated clinical signs were jaundice, ascites, and edema of the lower limbs. Painful hepatomegaly (86%), with a sharp lower edge (74%), a firm consistency (69%), and an irregular surface (52%) was frequently observed. Cytolysis (75.5%), increased alphafetoprotein levels (70%), microcytic anemia (37%), hyperleukocytosis (54.3%), and biological hepatocellular insufficiency syndrome (low albumin with 30.4%, high bilirubinemia with 61.2% and low platelets with 33.9%) were the most common observed laboratory abnormalities. Hepatitis B virus markers (61%) were the most frequently found in the study patients. At ultrasound examination, heterogeneous hepatomegaly was observed in 87.3% of the patients. Esophageal varices (43.1%) were more commonly seen than other varices during upper gastrointestinal endoscopy. The dominant etiology was hepatocellular carcinoma on cirrhosis with 66% followed by cirrhosis. Conclusion: Painful hepatomegaly was quite frequently in our urban setting hospital with several etiologies. HCC was the most common etiology, therefore measures to prevent it in the community need to be established by the concerned stakeholders to improve adult population health in Bamako.