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Effect of ankle versus thigh tourniquets on post-operative pain in foot and ankle surgery 被引量:2
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作者 Ashish Mishra Ahmed Barakat +5 位作者 Jitendra Mangwani Jakub Kazda Sagar Tiwatane Sana Mohammed Aamir Shaikh Linzy Houchen-Wolloff Vipul Kaushik 《World Journal of Orthopedics》 2024年第2期163-169,共7页
BACKGROUND Tourniquets are commonly used in elective extremity orthopaedic surgery to reduce blood loss,improve visualization in the surgical field,and to potentially reduce surgical time.There is a lack of consensus ... BACKGROUND Tourniquets are commonly used in elective extremity orthopaedic surgery to reduce blood loss,improve visualization in the surgical field,and to potentially reduce surgical time.There is a lack of consensus in existing guidelines regarding the optimal tourniquet pressure,placement site,and duration of use.There is a paucity of data on the relationship between the site of a tourniquet and postoperative pain in foot and ankle surgery.AIM To explore the relationship between tourniquet site and intensity of post-operative pain scores in patients undergoing elective foot and ankle surgery.METHODS Retrospective analysis of prospectively collected data on 201 patients who underwent foot and ankle surgery in a single institution was undertaken.Intraoperative tourniquet duration,tourniquet pressure and site,and postoperative pain scores using Visual Analogue Score were collected in immediate recovery,at six hours and at 24 h post-op.Scatter plots were used to analyse the data and to assess for the statistical correlation between tourniquet pressure,duration,site,and pain scores using Pearson correlation coefficient.RESULTS All patients who underwent foot and ankle surgery had tourniquet pressure of 250 mmHg for ankle tourniquet and 300 mmHg for thigh.There was no correlation between the site of the tourniquet and pain scores in recovery,at six hours and after 24 h.There was a weak correlation between tourniquet time and Visual Analogue Score immediately post-op(r=0.14,P=0.04)but not at six or 24 h post-operatively.CONCLUSION This study shows that there was no statistically significant correlation between tourniquet pressure,site and postop pain in patients undergoing foot and ankle surgery.The choice of using a tourniquet is based on the surgeon's preference,with the goal of minimizing the duration of its application at the operative site. 展开更多
关键词 Lower limb surgery Tourniquet time Tourniquet pressure Tourniquet site Post-operative pain Pain scores
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Risk factors for hepatocellular carcinoma associated with hepatitis C genotype 3 infection:A systematic review
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作者 Hamzah Z Farooq Michael James +4 位作者 Jane Abbott Patrick Oyibo Pip Divall Naheed Choudhry Graham R Foster 《World Journal of Gastrointestinal Oncology》 SCIE 2024年第4期1596-1612,共17页
BACKGROUND Hepatitis C virus(HCV)is a blood-borne virus which globally affects around 79 million people and is associated with high morbidity and mortality.Chronic infection leads to cirrhosis in a large proportion of... BACKGROUND Hepatitis C virus(HCV)is a blood-borne virus which globally affects around 79 million people and is associated with high morbidity and mortality.Chronic infection leads to cirrhosis in a large proportion of patients and often causes hepatocellular carcinoma(HCC)in people with cirrhosis.Of the 6 HCV genotypes(G1-G6),genotype-3 accounts for 17.9%of infections.HCV genotype-3 responds least well to directly-acting antivirals and patients with genotype-3 infection are at increased risk of HCC even if they do not have cirrhosis.AIM To systematically review and critically appraise all risk factors for HCC secondary to HCV-G3 in all settings.Consequently,we studied possible risk factors for HCC due to HCV-G3 in the literature from 1946 to 2023.METHODS This systematic review aimed to synthesise existing and published studies of risk factors for HCC secondary to HCV genotype-3 and evaluate their strengths and limitations.We searched Web of Science,Medline,EMBASE,and CENTRAL for publications reporting risk factors for HCC due to HCV genotype-3 in all settings,1946-2023.RESULTS Four thousand one hundred and forty-four records were identified from the four databases with 260 records removed as duplicates.Three thousand eight hundred and eighty-four records were screened with 3514 excluded.Three hundred and seventy-one full-texts were assessed for eligibility with seven studies included for analysis.Of the seven studies,three studies were retrospective case-control trials,two retrospective cohort studies,one a prospective cohort study and one a cross-sectional study design.All were based in hospital settings with four in Pakistan,two in South Korea and one in the United States.The total number of participants were 9621 of which 167 developed HCC(1.7%).All seven studies found cirrhosis to be a risk factor for HCC secondary to HCV genotype-3 followed by higher age(five-studies),with two studies each showing male sex,high alpha feto-protein,directly-acting antivirals treatment and achievement of sustained virologic response as risk factors for developing HCC.CONCLUSION Although,studies have shown that HCV genotype-3 infection is an independent risk factor for end-stage liver disease,HCC,and liver-related death,there is a lack of evidence for specific risk factors for HCC secondary to HCV genotype-3.Only cirrhosis and age have demonstrated an association;however,the number of studies is very small,and more research is required to investigate risk factors for HCC secondary to HCV genotype-3. 展开更多
关键词 Hepatocellular carcinoma Hepatitis C Genotype 3 Systematic review Blood-borne viruses Liver cancer
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Management of a patient with an unusual trajectory of a temporary trans-venous pacing lead
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作者 Metesh Acharya Ethan Kavanagh +2 位作者 Sheena Garg Davorin Sef Fabio De Robertis 《World Journal of Cardiology》 2024年第6期314-317,共4页
Perforation of the right ventricle during placement of pacing wires is a welldocumented complication and can be potentially fatal.Use of temporary pacemaker,helical screw leads and steroids use prior to implant are re... Perforation of the right ventricle during placement of pacing wires is a welldocumented complication and can be potentially fatal.Use of temporary pacemaker,helical screw leads and steroids use prior to implant are recognised as risk factors for development of post-permanent pacemaker effusion.We reported an unusual case of pacing wire perforating interventricular septum into the left ventricle that occurred during the implant procedure performed in another institution.After the preoperative work-up and transfer to our tertiary cardiothoracic centre,the patient underwent successful surgical management.In conclusion,early recognition and timely diagnosis using advanced multimodality imaging can guide surgical intervention and prevent unfavourable consequences of device-related complications. 展开更多
关键词 Ventricular perforation Lead perforation PACING
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Confocal laser endomicroscopy for gastric neoplasm
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作者 Arkadeep Dhali Rick Maity +1 位作者 Roger B Rathna Jyotirmoy Biswas 《World Journal of Gastrointestinal Endoscopy》 2024年第9期540-544,共5页
Confocal laser endomicroscopy(CLE)is a novel endoscopic modality that provides real-time histological information via high-resolution magnified view of the mucosa.CLE has a higher sensitivity,specificity,and diagnosti... Confocal laser endomicroscopy(CLE)is a novel endoscopic modality that provides real-time histological information via high-resolution magnified view of the mucosa.CLE has a higher sensitivity,specificity,and diagnostic accuracy in detecting atrophic gastritis as compared to chromoendoscopy and narrow-band imaging.It can even predict low-grade and high-grade intraepithelial neoplasia by analyzing gastric pit patterns.CLE may have some advantages over the standard biopsy protocol,such as higher diagnostic yield and fewer biopsy requirements.Its diagnostic accuracy in detecting superficial gastric cancer is higher than that of white-light endoscopy.Inherent limitations,such as a narrow field of vision,can be surpassed by technological advancements and integration with other detection methods.Artificial intelligence holds promise in automated analysis of histopathological images.Thus,CLE can be helpful in screening for early gastric cancer and may help reduce the risk of complications from repeated biopsies,such as mucosal damage,bleeding,and infection. 展开更多
关键词 Confocal laser endomicroscopy Gastric cancer Narrow band imaging Diagnostic yield
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Combined aqueous misdirection and persistent choroidal effusions following implantation of a Preserflo Micro Shunt
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作者 Huzaifa Malick Craig Wilde Richard E Stead 《International Journal of Ophthalmology(English edition)》 SCIE CAS 2023年第4期652-655,共4页
AIM:To describe a case of aqueous misdirection complicated by subsequent persistent choroidal effusions following implantation of a Preserflo Micro Shunt(PMS)device to treat advanced closed angle glaucoma.METHODS:A 67... AIM:To describe a case of aqueous misdirection complicated by subsequent persistent choroidal effusions following implantation of a Preserflo Micro Shunt(PMS)device to treat advanced closed angle glaucoma.METHODS:A 67-year-old caucasian female with advanced primar y angle-closure glaucoma on four medications with an intraocular pressure(IOP)of 26 mm Hg was listed for a PMS insertion with mitomycin C(MMC).RESULTS:Past ocular history was significant for pseudophakia and previous yttrium aluminum garnet(YAG)peripheral iridotomy.Surgery was uneventful but on the first postoperative day,she developed aqueous misdirection complicated by subsequent development of persistent uveal effusions.Conventional treatment strategies including atropine drops,YAG hyaloidotomy and choroidal effusion drainage proved ineffective.A combination of oral steroids and pars plana vitrectomy(PPV)along with an irido-zonulohyloidectomy(IZH)proved efficacious.CONCLUSION:To the best of the author’s knowledge,this is the first published case of aqueous misdirection complicated with the presence of significant,unresolving choroidal effusions,highlighting the possibility and sequelae of comorbid pathology in nanophthalmic eyes. 展开更多
关键词 COMBINED AQUEOUS misdirections PERSISTENT choroidal EFFUSIONS
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Perceived barriers and facilitators of day-case surgery for major foot and ankle procedures?A cross-sectional survey of United Kingdom surgeons
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作者 Amber Berry Linzy Houchen-Wolloff +3 位作者 Natalie Crane David Townshend Robert Clayton Jitendra Mangwani 《World Journal of Orthopedics》 2023年第4期248-259,共12页
BACKGROUND Advances in minimally invasive surgery and improved post-operative pain management make it possible to consider performing even major foot/ankle operations as day-case.This could have significant benefits f... BACKGROUND Advances in minimally invasive surgery and improved post-operative pain management make it possible to consider performing even major foot/ankle operations as day-case.This could have significant benefits for patients and the health service.However there are theoretical concerns about post-operative complications and patient satisfaction due to pain.AIM To scope the current practice of foot and ankle surgeons on day-case surgery for major foot and ankle procedures in the United Kingdom(UK).METHODS An online survey(19 questions)was sent to UK foot and ankle surgeons via the British Orthopaedic Foot&Ankle Society membership list in August 2021.Major foot and ankle procedures were defined as surgery that is usually performed as an inpatient in majority of centres and day-case as same day discharge,with day surgery as the intended treatment pathway.RESULTS 132 people responded to the survey invitation with 80%working in Acute NHS Trusts.Currently 45%of respondents perform less than 100 day-case surgeries per year for these procedures.78%felt that there was scope to perform more procedures as day-case at their centre.Post-operative pain(34%)and patient satisfaction(10%)was not highly measured within their centres.Lack of adequate physiotherapy input pre/post-operatively(23%)and lack of out of hours support(21%)were the top perceived barriers to performing more major foot and ankle procedures as day-case.CONCLUSION There is consensus among UK surgeons to do more major foot/ankle procedures as day-case.Out of hours support and physiotherapy input pre/post-op were perceived as the main barriers.Despite theoretical concerns about post-operative pain and satisfaction this was only measured by a third of those surveyed.There is a need for nationally agreed protocols to optimise the delivery of and measurement of outcomes in this type of surgery.At a local level,the provision of physiotherapy and out of hours support should be explored at sites where this is a perceived barrier. 展开更多
关键词 Day-case FOOT ANKLE PHYSIOTHERAPY Survey
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Improving polyp detection at colonoscopy: Non-technological techniques
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作者 Ragul Rajivan Sreedhari Thayalasekaran 《World Journal of Gastrointestinal Endoscopy》 2023年第5期354-367,共14页
Colonoscopy and polypectomy remain the gold standard investigation for the detection and prevention of colorectal cancer.Halting the progression of colonic adenoma through adequate detection of pre-cancerous lesions i... Colonoscopy and polypectomy remain the gold standard investigation for the detection and prevention of colorectal cancer.Halting the progression of colonic adenoma through adequate detection of pre-cancerous lesions interrupts the progression to carcinoma.The adenoma detection rate is a key performance indicator.Increasing adenoma detection rates are associated with reducing rates of interval colorectal cancer.Endoscopists with high baseline adenoma detection rate have a meticulous technique during colonoscopy withdrawal that improves their adenoma detection.This minireview article summarizes the evidence on the following simple operator techniques and their effects on the adenoma detection rate;minimum withdrawal times,dynamic patient position change and proximal colon retroflexion. 展开更多
关键词 COLONOSCOPY Minimum withdrawal times Dynamic position change Proximal colon retroflexion
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药物洗脱支架在冠状动脉介入治疗中的应用
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作者 肖文良 Jan Kovac 《临床荟萃》 CAS 北大核心 2005年第8期472-473,共2页
关键词 冠状动脉疾病 介入治疗 支架
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Cardiovascular magnetic resonance imaging assessment of outcomes in acute myocardial infarction 被引量:17
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作者 Jamal N Khan Gerry P McCann 《World Journal of Cardiology》 CAS 2017年第2期109-133,共25页
Cardiovascular magnetic resonance(CMR) imaging uniquely characterizes myocardial and microvascular injury in acute myocardial infarction(AMI), providing powerful surrogate markers of outcomes. The last 10 years have s... Cardiovascular magnetic resonance(CMR) imaging uniquely characterizes myocardial and microvascular injury in acute myocardial infarction(AMI), providing powerful surrogate markers of outcomes. The last 10 years have seen an exponential increase in AMI studies utilizing CMR based endpoints. This article provides a contemporary, comprehensive review of the powerful role of CMR imaging in the assessment of outcomes in AMI. The theory, assessment techniques, chronology, importance in predicting left ventricular function and remodelling, and prognostic value of each CMR surrogate marker is described in detail. Major studies illustrating the importance of the markers are summarized, providing an up to date review of the literature base in CMR imaging in AMI. 展开更多
关键词 Myocardial infarction INFARCT Cardiovascular magnetic resonance Left ventricular remodelling PROGNOSIS
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Management of acute spinal cord injury:A summary of the evidence pertaining to the acute management,operative and non-operative management 被引量:5
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作者 Darren Sandean 《World Journal of Orthopedics》 2020年第12期573-583,共11页
Acute traumatic spinal cord injury is often a lifechanging and devastating event with considerable mortality and morbidity.Over half a million people suffer from traumatic spinal cord injury annually with the majority... Acute traumatic spinal cord injury is often a lifechanging and devastating event with considerable mortality and morbidity.Over half a million people suffer from traumatic spinal cord injury annually with the majority resulting from road traffic accidents or falls.The Individual,societal and economic costs are enormous.Initial recognition and treatment of acute traumatic spinal cord injury are crucial to limit secondary injury to the spinal cord and to provide patients with the best chance of some functional recovery.This article is an overview of the management of the acute traumatic spinal cord injury patient presenting to the emergency department.We review the initial assessment,criteria for imaging and clearing the spine,and evaluate the literature to determine the optimum timing of surgery and the role of non-surgical treatment in patients presenting with acute spinal cord injury. 展开更多
关键词 Traumatic spinal cord injury Acute management Spinal fracture Vertebral fracture Spinal cord transection Traumatic myelopathy
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Prognostic value of baseline FDG uptake on PET-CT in esophageal carcinoma 被引量:2
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作者 Omar S Al-Taan Amar Eltweri +3 位作者 David Sharpe Peter M Rodgers Sukhbir S Ubhi David J Bowrey 《World Journal of Gastrointestinal Oncology》 SCIE CAS 2014年第5期139-144,共6页
AIM: To evaluate the influence of baseline maximum standardized uptake value(SUVmax) on survival in a cohort of patients, undergoing positron emission tomography-computed tomography(PET-CT) scan for esophageal carcino... AIM: To evaluate the influence of baseline maximum standardized uptake value(SUVmax) on survival in a cohort of patients, undergoing positron emission tomography-computed tomography(PET-CT) scan for esophageal carcinoma. METHODS: The pre-treatment SUVmax numeric reading was determined in patients with confirmed esophageal or junctional cancer having PET-CT scan during the time period 1st January 2007 until 31 st July 2012. A minimum follow up of 12 mo was required. Patients were subdivided into quartiles according to SUVmax value and the influence of SUVmax on survival was assessed using univariate and multivariate analysis. The following pre-treatment factors were investigated: patient characteristics, tumor characteristics and planned treatment. RESULTS: The study population was 271 patients(191male) with esophageal or junctional carcinoma. The median age was 65 years(range 40-85) and histologic subtype was adenocarcinoma in 197 patients and squamous carcinoma in 74 patients. The treatment intent was radical in 182 and palliative in 89 patients. SUVmax was linked to histologic subtype(P = 0.008), tumor site(P = 0.01) and Union for International Cancer Control(UICC) stage(P < 0.001). On univariate analysis, prognosis was significantly associated with SUVmax(P = 0.001), T-stage(P < 0.001) and UICC stage(P < 0.001). On multivariate analysis, only T-stage and UICC stage remained significant. CONCLUSION: Pretreatment SUVmax was not a useful marker in isolation for determining prognosis of patients with esophageal carcinoma. 展开更多
关键词 Esophageal neoplasms Fluorodeoxyglucose F18 Positron emission tomography Positron emission tomography-computed tomography PROGNOSIS
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Delayed presentation of a loose body in undisplaced paediatric talar neck fracture 被引量:2
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作者 Vishal Patel Benjamin Bloch +1 位作者 Nicholas Johnson Jitendra Mangwani 《World Journal of Orthopedics》 2014年第3期398-401,共4页
Fractures of the talus are rare in children.A high index of suspicion is needed to avoid missing such an injury,which is not an uncommon occurrence especially with undisplaced fractures.We present an unusual case of a... Fractures of the talus are rare in children.A high index of suspicion is needed to avoid missing such an injury,which is not an uncommon occurrence especially with undisplaced fractures.We present an unusual case of an undisplaced talar neck fracture in a five-year-old child leading to a delayed presentation of a symptomatic osteochondral loose body in the ankle joint.To our knowledge there are no reports in the literature of osteochondral loose bodies occurring in conjunction with an associated undisplaced talar neck fracture in either children or adults.The loose body was removed using anterior ankle arthroscopy.The child had an uneventful post operative recovery and regained full range of movement and function of his ankle joint and was discharged at one year follow-up.We aim to highlight the need to have a low threshold to further evaluate symptomatic children after fracture healing of an undisplaced talar neck fracture for a possible associated loose bodyin the ankle joint. 展开更多
关键词 TALUS Fracture LOOSE BODY ANKLE ARTHROSCOPY Children
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Short-term outcomes in heart failure patients with chronic obstructive pulmonary disease in the community 被引量:1
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作者 Noel O'Kelly William Robertson +3 位作者 Jude Smith Jonathan Dexter Collette Carroll-Hawkins Sudip Ghosh 《World Journal of Cardiology》 CAS 2012年第3期66-71,共6页
AIM:To establish the short term outcomes of heart failure(HF)patients in the community who have concurrent chronic obstructive pulmonary disease(COPD).METHODS:We evaluated 783 patients(27.2%)with left ventricular syst... AIM:To establish the short term outcomes of heart failure(HF)patients in the community who have concurrent chronic obstructive pulmonary disease(COPD).METHODS:We evaluated 783 patients(27.2%)with left ventricular systolic dysfunction under the care of a regional nurse-led community HF team between June 2007 and June 2010 through a database analysis.RESULTS:One hundred and one patients(12.9%)also had a diagnosis of COPD;94% of patients were treated with loop diuretics,83% with angiotensin converting enzyme inhibitors,74% with β-blockers;10.6% with bronchodilators;and 42% with aldosterone an-tagonists.The mean age of the patients was 77.9 ± 5.7 years;43% were female and mean New York Heart Association class was 2.3 ± 0.6.The mean follow-up was 28.2 ± 2.9 mo.β-blocker utilization was markedly lower in patients receiving bronchodilators compared with those not taking bronchodilators(overall 21.7% vs 81%,P < 0.001).The 24-mo survival was 93% in patients with HF alone and 89% in those with both comorbidities(P = not significant).The presence of COPD was associated with increased risk of HF hospitalization [hazard ratio(HR):1.56;95% CI:1.4-2.1;P < 0.001] and major adverse cardiovascular events(HR:1.23;95% CI:1.03-1.75;P < 0.001).CONCLUSION:COPD is a common comorbidity in ambulatory HF patients in the community and is a powerful predictor of worsening HF.It does not however appear to affect short-term mortality in ambulatory HF patients. 展开更多
关键词 Heart failure Chronic OBSTRUCTIVE PULMONARY disease SHORT-TERM MORTALITY
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Ischaemic/reperfusion injury:Role of infliximab 被引量:2
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作者 Atul Bagul 《World Journal of Transplantation》 2012年第3期35-40,共6页
Ischaemia/reperfusion(I/R) injury is an underlying complex interrelated patho-physiological process which effects the outcome of many clinical situations, in particular transplantation. Tumor necrosis factor(TNF)-α i... Ischaemia/reperfusion(I/R) injury is an underlying complex interrelated patho-physiological process which effects the outcome of many clinical situations, in particular transplantation. Tumor necrosis factor(TNF)-α is a pleiotropic inflammatory cytokine; a trimeric protein encoded within the major histocompatibility complex which plays a pivotal role in this disease process. This review is based at looking into an update, particularly the new insights in the mechanisms of action of TNF antagonist such as infliximab. Infliximab may thus play a dual role in the field of transplantation where it might not only down regulate the I/R injury, it may also have a beneficial role in the reduction of acute rejection. 展开更多
关键词 INFLIXIMAB Ischaemia/reperfusion INJURY Tumor NECROSIS factor-α
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Duration of treatment with 5-aminosalicylic acid compounds 被引量:1
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作者 T Moshkovska JF Mayberry 《World Journal of Gastroenterology》 SCIE CAS CSCD 2007年第32期4310-4315,共6页
The development of 5-aminosalicylic acid (5-ASA) therapy as a life long treatment for ulcerative colitis is reviewed from its origins in the 1940s to the present day. The drug was designed to treat rheumatoid arthriti... The development of 5-aminosalicylic acid (5-ASA) therapy as a life long treatment for ulcerative colitis is reviewed from its origins in the 1940s to the present day. The drug was designed to treat rheumatoid arthritis,but was found helpful in the management of nine patients with ulcerative colitis. This discovery preceded the emergence of the clinical trial as a tool for assessing a new drug's efficacy; as a result it lacked scientific rigour and was selective in its presentation of results. Nevertheless it identified the future cornerstone of therapy in ulcerative colitis. In 1962,the first double blind controlled trial of sulphasalazine was conducted on 40 patients. Outcome measures were subjective and included symptoms and an assessment of the rectal mucosa. In 1973,the first two papers on the role of sulphasalazine in maintenance of remission were published. Both used placebo controls and had a stratified design. Outcomes were measured using "an intention to treat" approach. The British study of 64 patients used both subjective and objective criteria to assess outcomes. Patients on placebo had a relapse rate four times patients on active treatment and this founded the basis for a life long approach to therapy with 5-ASA compounds in ulcerative colitis. However,in 1985,a small "on demand" study of 32 patients suggested this approach might be as effective as continuous treatment. Some support for this view came from an Italian study which showed no benefit to continued treatment for those in remission for two years or more. The central problem these studies identify is that of adherence to treatment in the long-term. Few studies have considered patients' attitudes to continuous therapy and it is an area that needs further investigation. 展开更多
关键词 Ulcerative colitis 5-aminosalicylic acid compounds Sulphasalazine mesalazine adherance trials
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1400W reduces ischemia reperfusion injury in an ex-vivo porcine model of the donation after circulatory death kidney donor 被引量:2
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作者 Sarah A Hosgood Phillip J Yates Michael L Nicholson 《World Journal of Transplantation》 2014年第4期299-305,共7页
AIM: To investigate the effects of 1400W-a selective inducible nitric oxide synthase(iN OS) inhibitor in a model of donation after circulatory death(DCD) kidneys. METHODS: Porcine kidneys were retrieved after 25 min w... AIM: To investigate the effects of 1400W-a selective inducible nitric oxide synthase(iN OS) inhibitor in a model of donation after circulatory death(DCD) kidneys. METHODS: Porcine kidneys were retrieved after 25 min warm ischemia. They were then stored on ice for 18 h before being reperfused ex vivo with oxygenated autologous blood on an isolated organ perfusion system. The selective i NOS inhibitor 1400W(10 mg/kg) was administered before reperfusion(n = 6) vs control group(n = 7). Creatinine(1000 μmol/L) was added to the system, renal and tubular cell function and the level of ischemia reperfusion injury were assessed over 3 h of reperfusion using plasma, urine and tissue samples. RESULTS: Kidneys treated with 1400 W had a higher level of creatinine clearance(CrC l) [area under the curve(AUC) CrC l: 2.37 ± 0.97 mL /min per 100 g vs 0.96 ± 0.32 mL /min per 100 g, P = 0.004] and urine output [Total: 320 ± 96 mL vs 156 ± 82 mL, P = 0.008]. There was no significant difference in levels of fractional excretion of sodium(AUC, Fr ex Na+: Control, 186.3% ± 81.7%.h vs 1400 W, 153.4% ± 12.1%.h, P = 0.429). Levels of total protein creatinine ratio were significantly lower in the 1400 W group after 1 h of reperfusion(1h Pr/Cr: 1400 W 9068 ± 6910 mg/L/mmol/L vs Control 21586 ± 5464 mg/L/mmol/L, P = 0.026). Levels of 8-isoprostane were significantly lower in the 1400 W group [8-iso/creatinine ratio: Control 239 ± 136 pg/L/mmol/L vs 1400 W 139 ± 47 pg/L/mmol/L, P = 0.041].CONCLUSION: This study demonstrated that 1400 W reduced ischaemia reperfusion injury in this porcine kidney model of DCD donor. Kidneys had improved renal function and reduced oxidative stress. 展开更多
关键词 Kidney Transplantation Ischemia DONATION AFTER circulatory DEATH INDUCIBLE NITRIC oxide
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Carcinoembryonic Antigen as a Prognostic Factor in Colorectal Cancer with Liver Metastases 被引量:2
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作者 George E. McNally David M. Lloyd Jorge P. Grondona 《Journal of Cancer Therapy》 2015年第12期1035-1044,共10页
Aim: The objective of this study was to investigate the prognostic value of serum carcinoembryonic antigen (CEA) level in colorectal cancer patients with liver metastases. The serum CEA level was recorded at the point... Aim: The objective of this study was to investigate the prognostic value of serum carcinoembryonic antigen (CEA) level in colorectal cancer patients with liver metastases. The serum CEA level was recorded at the point of metastasis diagnosis, differing from the majority of literature looking at preoperative metastasectomy CEA level. Methods: From January 2010 to December 2014, 138 patients with a diagnosis of colorectal cancer and liver metastases were included in the study—population from Buenos Aires, Argentina. Patients with both resectable and unresectable liver metastases were followed up over a 4-year period. Kaplan Meier survival analysis was used to produce survival curves that were compared by log-rank test. Results: The overall survival for all patients studied with a CEA < 100 ng/ml was significantly longer compared to patients with CEA ≥ 100 ng/mL (p < 0.001). The 1-, 2-, and 3-year overall survival rates for the whole cohort were 73.6, 56.6 and 53.8% respectively. For patients with unresectable metastases, a low CEA level (<100 ng/mL) was also associated with the increased overall survival (p = 0.036). Conclusions: In our patient cohort, this study indicated that a low CEA level (<100 ng/mL) measured at metastasis diagnosis was a good prognostic indicator for improving survival in patients with colorectal liver metastases. These findings highlight the importance of measuring serum CEA levels in this group of patients at the time of liver metastasis diagnosis. 展开更多
关键词 Carcinoembryonic ANTIGEN (CEA) COLORECTAL Cancer SURVIVAL Liver METASTASIS POSTOPERATIVE MORTALITY
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Age at diagnosis of type 2 diabetes and cardiovascular risk factor profile:A pooled analysis 被引量:2
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作者 Mary M Barker Francesco Zaccardi +13 位作者 Emer M Brady Gaurav S Gulsin Andrew P Hall Joseph Henson Zin ZinHtike Kamlesh Khunti Gerald P McCann Emma L Redman David R Webb Emma G Wilmot Tom Yates Jian Yeo Melanie J Davies Jack A Sargeant 《World Journal of Diabetes》 SCIE 2022年第3期260-271,共12页
BACKGROUND The diagnosis of type 2 diabetes(T2D)in younger adults,an increasingly common public health issue,is associated with a higher risk of cardiovascular complications and mortality,which may be due to a more ad... BACKGROUND The diagnosis of type 2 diabetes(T2D)in younger adults,an increasingly common public health issue,is associated with a higher risk of cardiovascular complications and mortality,which may be due to a more adverse cardiovascular risk profile in individuals diagnosed at a younger age.AIM To investigate the association between age at diagnosis and the cardiovascular risk profile in adults with T2D.METHODS A pooled dataset was used,comprised of data from five previous studies of adults with T2D,including 1409 participants of whom 196 were diagnosed with T2D under the age of 40 years.Anthropometric and blood biomarker measurements included body weight,body mass index(BMI),waist circumference,body fat percentage,glycaemic control(HbA1c),lipid profile and blood pressure.Univariable and multivariable linear regression models,adjusted for diabetes duration,sex,ethnicity and smoking status,were used to investigate the association between age at diagnosis and each cardiovascular risk factor.RESULTS A higher proportion of participants diagnosed with T2D under the age of 40 were female,current smokers and treated with glucose-lowering medications,compared to participants diagnosed later in life.Participants diagnosed with T2D under the age of 40 also had higher body weight,BMI,waist circumference and body fat percentage,in addition to a more adverse lipid profile,compared to participants diagnosed at an older age.Modelling results showed that each one year reduction in age at diagnosis was significantly associated with 0.67 kg higher body weight[95%confidence interval(CI):0.52-0.82 kg],0.18 kg/m^(2) higher BMI(95%CI:0.10-0.25)and 0.32 cm higher waist circumference(95%CI:0.14-0.49),after adjustment for duration of diabetes and other confounders.Younger age at diagnosis was also significantly associated with higher HbA1c,total cholesterol,low-density lipoprotein cholesterol and triglycerides.CONCLUSION The diagnosis of T2D earlier in life is associated with a worse cardiovascular risk factor profile,compared to those diagnosed later in life. 展开更多
关键词 Type 2 diabetes mellitus Early-onset adult type 2 diabetes Age of onset Cardiovascular risk Young adults Glycaemic control OBESITY
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Acute kidney injury in China:A neglected truth and perspective 被引量:1
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作者 Cheng Yang Bin Yang 《Asian Journal of Urology》 2016年第1期4-5,共2页
Acute kidney injury(AKI)affects approximately 13.3 million individuals and contributes to about 1.7 million deaths globally per year.As estimated 85% of those affected live in the developing world[1].Although there ar... Acute kidney injury(AKI)affects approximately 13.3 million individuals and contributes to about 1.7 million deaths globally per year.As estimated 85% of those affected live in the developing world[1].Although there are various measures to prevent or treat AKI,including renal protective drugs and continuous renal replacement therapy,most of them have limited success or are still in their infancy[2,3]. 展开更多
关键词 ACUTE protective KIDNEY
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Migraine in physicians and final year medical students:A crosssectional insight into prevalence,self-awareness,and knowledge from Pakistan 被引量:1
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作者 Hassan Choudry Fateen Ata +5 位作者 Muhammad Naveed Naveed Alam Ruqaiya Ruqaiya Mahammed Khan Suheb Muhammad Qaiser Ikram Muhammad Muzammil Chouhdry Muaz Muaz 《World Journal of Methodology》 2022年第5期414-427,共14页
BACKGROUND Despite its high prevalence,migraine remains underdiagnosed worldwide.A significant reason is the knowledge gap in physicians regarding diagnostic criteria,clinical features,and other clinical aspects of mi... BACKGROUND Despite its high prevalence,migraine remains underdiagnosed worldwide.A significant reason is the knowledge gap in physicians regarding diagnostic criteria,clinical features,and other clinical aspects of migraine.AIM To measure the knowledge deficit in physicians and medical students and to assess the prevalence of migraine in the same population.METHODS An online questionnaire was developed and distributed among physicians and final year medical students on duty in various medical and surgical specialties of Allied and DHQ Hospitals,Faisalabad,between October 2018 and October 2019.Inclusion criteria were public practicing physicians who experience headaches,while those who never experienced headaches were excluded.Different questions assessed respondents on their knowledge of triggers,diagnosis,management,and prophylaxis of the migraine headache.They were asked to diagnose themselves using embedded ICHD-3 diagnostic criteria for different types of migraine.Graphs,tables,and figures were made using Microsoft Office 2016 and Microsoft Visio,and data analysis was done in R Studio 1.4.RESULTS We had 213 respondents and 175 fulfilled inclusion criteria,with 99(52%),58(30%)and 12(6.3%)belonging to specialties of medicine,surgery,and others,respectively.Both genders were symmetrically represented(88 male and 87 female).Fifty-two(24.4%)of our 213 respondents were diagnosed with migraine,with 26(50%)being aware of it.Females had higher prevalence among study participants(n=28,32.2%)compared to males(n=20,22.7%,P=0.19).A majority(62%)of subjects never consulted any doctor for their headache.Similarly,a majority(62%)either never heard or did not remember the diagnostic criteria of migraine.Around 38%falsely believed that having any type of aura is essential for diagnosing migraine.The consultation rate was 37%(n=65),and migraineurs were significantly more likely to have consulted a doctor,and a neurologist in particular(P<0.001).Consulters and migraineurs fared better in the knowledge of diagnostic aspects of the disease than their counterparts.There was no significant difference in other knowledge aspects between consulters versus non-consulters and migraineurs versus nonmigraineurs.CONCLUSION Critical knowledge gaps exist between physicians and medical students,potentially contributing to misdiagnosis and mismanagement of migraine. 展开更多
关键词 MIGRAINE Headache disorders Knowledge study PREVALENCE KNOWLEDGE Epidemiology Public health
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